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This study aimed to analyze the implementation of Street Clinic teams, co-financed by the Ministry of Health, in the national territory from 2018 to 2023, focusing on the perspective of equity and the scope of healthcare provided to Brazilian people living on the streets. This quantitative, exploratory study employed spatial distribution techniques based on secondary data from implemented Street Clinic teams. The data analysis on the implementation of eCR showed significant developments toward democratizing access to health services. An increase of 21,73% in the number of teams co-financed by the Ministry of Health was observed from 2018 to 2023. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Member countries of the United Nations have pledged to ensure access to affordable, reliable, and sustainable energy for all by 2030 (Sustainable Development Goal 7). However, energy poverty continues to be a significant challenge for billions of people. Empirical research established a connection between energy poverty and traditional public health indicators such as overall mortality rate, but relatively little is known about its holistic impact on public health and in particular on health vulnerability. This research establishes a holistic measure of public health using panel data from 143 countries between 2000 and 2016 to analyze the impact of energy poverty on health vulnerability. Using Ordinary Least‐Squares (OLS), fixed effects, system Generalized Method of Moments (GMM), and quantile regression approaches, our results show that reducing energy poverty mitigates health vulnerability. Energy poverty amplifies the susceptibility to negative health outcomes (sensitivity) and diminishes a population's capacity to respond to public health crises (resilience). The analysis also reveals a heterogeneous impact of energy poverty on health vulnerability associated with the socio‐economic development level of the region, with the largest increase being in more developed and high‐income regions. [ABSTRACT FROM AUTHOR]

Free, post-study and indefinite access to the best prophylactic, diagnostic and therapeutic method that has been demonstrated to be effective during the study is a fundamental condition for protecting research participants. Since its inception in ethical regulations for research with human beings, Brazil has made this condition a cornerstone of protection for study participants. Through a qualitative analysis of Chapter VI of Law 14874, a new Law that regulates research with human beings in Brazil it was possible to perceive that there was a regression in the protection and recognition of the fundamental rights and dignity of the human beings participating in the research.

The aim of the present study was to describe the conceptual and operational definitions of the frailty syndrome recommended by the Brazilian Consensus on Frailty in Older People. In 2015, a task force consisting of Brazilian specialists on human aging conducted a bibliographical review on frailty among older people in Brazil and established a consensus on the main findings through periodic meetings. A total of 72 articles were included in the analysis, comprising one systematic review, two conceptual discussions, two methodological descriptions, four longitudinal studies focusing on mortality and worsening of the frailty profile, eight cross-cultural adaptation studies, and 55 cross-sectional or prevalence studies. Forty-five studies (62.5%) used the Cardiovascular Health Study (CHS) frailty scale, of which seven (15.2%) used unadjusted cut-off points for their samples and 17 (36.9%) modified at least one of the five items of the instrument. The prevalence of frailty varied between 6.7 and 74.1%. When the CHS frailty scale was used, the wide range of prevalence — from 8 to 49.3% — depended on the cut-off points used to classify changes in gait speed and handgrip strength, as well as the research setting. The studies were based on four major conceptual models of frailty. Frailty in older people represents a state of physiological vulnerability and should not be confused with disabilities or multi-morbidities. In the Brazilian population, the prevalence of frailty has not yet been adequately estimated, and the cut-off points of the items of the frailty scales should be adapted to the parameters of this population.

BACKGROUND: Existing instruments for the diagnosis of frailty are limited by their focus on mobility evaluation, failure to incorporate comorbidities, and dichotomous classification of patients as frail or non-frail, which hinders adequate identification of frail older adults. OBJECTIVE: To evaluate the frailty profile of outpatients seen at a secondary geriatric care service in Belo Horizonte, Brazil, as measured by the Visual Scale of Frailty, and describe the five levels of health status proposed by this instrument in terms of function, disabilities, and comorbidities. METHODS: The medical records of patients who attended the clinic between February 2011 and February 2014 were evaluated, and the patients classified in accordance with the Visual Scale of Frailty. Continuous variables were analyzed by ANOVA or the Kruskal-Wallis test, and categorical variables, by the χ2 test. Analyses were performed in SPSS Version 19.0. RESULTS: A total of 813 medical records were evaluated. Among these patients, 5.2% were considered robust, 31% at risk of frailty, 24.6% as frail, 34.8% as highly complex frail, and 4.4% as frail individuals in the final stage of life. Analysis of the health status categories demonstrated an association between these categories, greater functional impairment, and greater presence of disabilities and comorbidities. CONCLUSION: The Visual Scale of Frailty is a useful tool in assessing the health status of older adults and indicated a high prevalence of frailty in the studied population.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: People with disabilities face many challenges on a daily basis. Despite legislative advances and inclusion policies, discrimination against people with disabilities persists in various areas of life, including access to health services. Aim: This study aims to conduct an integrative literature review to investigate the factors associated with discrimination faced by people with disabilities in health services. Materials and Methods: The search was conducted in February 2024 in the IBECS, Lilacs, BDEnf, Medline (PubMed), Scopus, and Web of Science databases. The health descriptors (DeCS) “people with disabilities,” “social discrimination,” and “health services” were used. Original articles available in full, from the last five years, and in any language were included. The exclusion criteria were duplicate articles and those that did not answer the guiding question. Results: A total of 162 records were identified, from which 17 studies were selected, resulting in a final sample of 10 articles. The main factors associated with the discriminatory experiences faced by people with disabilities when accessing and using the health system were “stigmatization,” “negligence,” “prejudice,” and “access difficulties.” Conclusions: Significant drivers of discrimination were identified, including financial barriers, lack of training for health professionals, and other gaps that generate prejudice, stigmatization, and neglect. It is essential to implement public policies to ensure service accessibility, provide financial assistance for people with disabilities, establish training programs for health professionals, and conduct more research on this subject. [ABSTRACT FROM AUTHOR]

Objective. To identify differences in the barriers to access health services between the population with and without vulnerable conditions based on the results of the Encuesta Nacional de Salud y Nutrición Continua 2023 (Ensanut Continua 2023). Material and methods. Four categories of vulnerability were defined between the population with health needs that did not seek care and users of health services who went to institutions that did not correspond to them. The reasons for not requesting care and for requesting care in an institution that did not correspond to them were grouped by type of access barrier. The differences between the barriers reported according to the vulnerability category were analyzed, as well as the expenditure to address health needs. Results. Regardless of their vulnerable situation, an important part of the population must overcome barriers to seek or obtain the care they require. The most frequent barriers were personal and organizational. The population with more vulnerable conditions reported more personal and economic barriers. Conclusions. To advance in the satisfaction of the right to health, it is necessary to strengthen the organizational capacity of health services to improve their availability, accessibility, acceptability and quality, and reduce the vulnerability conditions of the population. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background The COVID‐19 pandemic has created additional challenges for family health. Worry, fear, and anxiety associated with this disease can affect the perception of family health. The study's objective was to analyze the factors associated with health vulnerability of family members in the Peruvian population after pandemic. Methods Observational, cross‐sectional, and analytical study. Sampling was nonprobabilistic. The sample consisted of 519 residents who met the following inclusion criteria: Peruvian resident, of both genders, over 18 years of age, who lives with their family, and who agrees to participate in the study. For data collection, the “SALUFAM” and “PRE‐COVID‐19” scales were used, which measure the health vulnerability of family members and concern about the contagion of COVID‐19, respectively. Data collection was done between January and March, 2023. Results Living in the Coast region increases by 3.299 times (95% CI = 1.55–9.28; p = 0.003) the probability of lower family health vulnerability compared to residents from the Jungle region. In the same way, having a low concern about the contagion of COVID‐19 increases 2.77 times (95% CI = 1.02–7.53; p = 0.044) the probability of less vulnerability to family health, unlike participants who are highly concerned about the contagion of COVID‐19. Conclusions It should be necessary to design prevention and family health promotion strategies according to the geographical region; it is also essential to provide education on the risks and the importance of prevention measures for COVID‐19, regardless of their initial level of concern.

Background: The COVID‐19 pandemic has created additional challenges for family health. Worry, fear, and anxiety associated with this disease can affect the perception of family health. The study's objective was to analyze the factors associated with health vulnerability of family members in the Peruvian population after pandemic. Methods: Observational, cross‐sectional, and analytical study. Sampling was nonprobabilistic. The sample consisted of 519 residents who met the following inclusion criteria: Peruvian resident, of both genders, over 18 years of age, who lives with their family, and who agrees to participate in the study. For data collection, the "SALUFAM" and "PRE‐COVID‐19" scales were used, which measure the health vulnerability of family members and concern about the contagion of COVID‐19, respectively. Data collection was done between January and March, 2023. Results: Living in the Coast region increases by 3.299 times (95% CI = 1.55–9.28; p = 0.003) the probability of lower family health vulnerability compared to residents from the Jungle region. In the same way, having a low concern about the contagion of COVID‐19 increases 2.77 times (95% CI = 1.02–7.53; p = 0.044) the probability of less vulnerability to family health, unlike participants who are highly concerned about the contagion of COVID‐19. Conclusions: It should be necessary to design prevention and family health promotion strategies according to the geographical region; it is also essential to provide education on the risks and the importance of prevention measures for COVID‐19, regardless of their initial level of concern. [ABSTRACT FROM AUTHOR]

Copyright of Saúde e Sociedade is the property of Universidade de Sao Paulo, Faculdade de Saude Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT Objective: To describe the possibility of applying Fuzzy Logic in analyzing the vulnerability of Women Who Have Sex with Women to Sexually Transmitted Infections/HIV/AIDS. Methods: We developed a Fuzzy Logic system with 17 input variables and one output variable, using data related to vulnerability in a municipality located in the Midwest region of the State of São Paulo, Brazil. Results: The factor with the greatest positive impact was the confirmation that a low understanding of Sexually Transmitted Infections/HIV/AIDS is associated with higher vulnerability. Conversely, the statement “Not disclosing sexual activity to healthcare professionals,” where individuals do not admit to having sex with women, had the least impact. Conclusions: Fuzzy Logic facilitates the identification of vulnerability, expressed through the analysis of interaction between variables in each dimension. This makes it a promising method to assist in analyzing the vulnerability of specific populations.

ABSTRACT Objective: To identify the manifestations presented by parents of children and adolescents who require special health attention that can impact their mental health. Methods: exploratory, qualitative research, based on the concept of vulnerability, with data collection carried out through interviews with 18 parents of children and adolescents with special health care needs, hospitalized in the pediatric ward of a hospital in Paraná, between May/2017 and May/ 2018. Data analyzed by inductive thematic analysis. Results: parents experienced situations of vulnerability when providing care at home, with repercussions on their mental health, expressed by manifestations of lack of protection, anxiety and depression. Final considerations: It is important that health professionals seek to expand actions to promote care and reduce situations that generate threats, insecurities, concerns and damage to the health of parents, which can impact and further weaken care for children and adolescents who need attention especially health.

Background: Personal emotions and affects have been identified and studied in the context of pandemics, as well as coping strategies centered on emotional regulation or the balance between positive and negative emotions. Objectives: The objectives of this paper are to identify an emotion and affect structure in our sample and analyze the relationship of these dimensions with resilient coping in the context of the COVID-19 pandemic. Method: This study employed a cross-sectional design that involved a non-probabilistic sample with 598 participants over the age of 18, with 51.1% being female, and an average age of 40.73 years. First, the emotional structure was identified through principal component analysis (PCA). Secondly, a linear regression analysis was performed to investigate emotional dimensions as predictors of coping. Results: A valid and reliable emotional structure with four dimensions was identified. The regression model revealed that coping is positively associated with the active and positive dimension and negatively correlated with the negative and moral dimensions. Conclusions: Emotional dimensions are predictors of coping, with moral and negative dimensions having a negative effect, while active and positive dimensions have a positive effect. When designing interventions for coping strategies, multiple dimensions of emotions and affective states in people who are in vulnerable situations must be considered.

Background: Personal emotions and affects have been identified and studied in the context of pandemics, as well as coping strategies centered on emotional regulation or the balance between positive and negative emotions. Objectives: The objectives of this paper are to identify an emotion and affect structure in our sample and analyze the relationship of these dimensions with resilient coping in the context of the COVID-19 pandemic. Method: This study employed a cross-sectional design that involved a non-probabilistic sample with 598 participants over the age of 18, with 51.1% being female, and an average age of 40.73 years. First, the emotional structure was identified through principal component analysis (PCA). Secondly, a linear regression analysis was performed to investigate emotional dimensions as predictors of coping. Results: A valid and reliable emotional structure with four dimensions was identified. The regression model revealed that coping is positively associated with the active and positive dimension and negatively correlated with the negative and moral dimensions. Conclusions: Emotional dimensions are predictors of coping, with moral and negative dimensions having a negative effect, while active and positive dimensions have a positive effect. When designing interventions for coping strategies, multiple dimensions of emotions and affective states in people who are in vulnerable situations must be considered. [ABSTRACT FROM AUTHOR]

Based on the fundamental reality of China’s aging population and the increasingly severe health problems among older adults, this study focuses on the health vulnerability of older adults to construct a structural equation model to investigate the impact of leisure and recreational participation on the health vulnerability of the older adults based on the data from 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The results show that participation in leisure and recreational activities can directly alleviate the health vulnerability of the older adults and reduce their health vulnerability by improving the self ⁃ assessed health level. There are multiple intermediary pathways such as“leisure and recreational activity → health level →physical health vulnerability → mental health vulnerability”. At the same time, participation in leisure and recreation activities plays a more prominent role in alleviating the physical health vulnerability of urban older adults. It is more effective in alleviating the mental health vulnerability of the older adults in townships and rural areas. On this basis, the article proposes to focus on improving the aging construction of urban regional public leisure places, establishing psychological intervention systems for older adults in townships and rural areas, and improving the inclusive pension service system, therefore narrowing the gap between urban and rural areas. [ABSTRACT FROM AUTHOR]

Background: Being introduced in the interpretations on the perspectives of the expansion of the HIV/ AIDS epidemic in the 1990s, the concept of vulnerability seeks to articulate the individual dimension of vulnerability to HIV to social and programmatic contexts, often marked by inequality and social injustice. Objective: The aim of this study was to analyze the uses of the multifactorial conception (individual, social, programmatic) of vulnerability in studies on women and HIV/AIDS, from 1990 to 2018, published in SciELO. Methods: From the scoping review of the national literature, 39 selected studies were classified as to the use of the concept of vulnerability in consistent, partial, or inconsistent use. Results: The main aspects associated with women’s vulnerability to AIDS were difficulty in negotiating condom use, social and symbolic dimension of marriage and motherhood, differentiated meanings of sexuality between genders, and fragility of sexual and reproductive rights. We observed gaps regarding the articulation of the three components of the concept and a scarcity of evaluations of interventions guided by the referential of vulnerability. Conclusion: The findings indicate the potential contribution of the concept in the analysis of the syndemic between HIV, social, racial, gender inequalities, and other health problems such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Copyright of Saúde e Sociedade is the property of Universidade de Sao Paulo, Faculdade de Saude Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saúde e Sociedade is the property of Universidade de Sao Paulo, Faculdade de Saude Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Understanding the repercussions of the COVID-19 pandemic on the care of children with special health needs. Methods: Exploratory, qualitative research, anchored in the conceptual framework of health vulnerability in the individual, social and institutional dimensions. Interviews were carried out from October 2020 to February 2021 (pre-vaccination against COVID-19) with 19 family caregivers, 11 professionals from education, social protection and health institutions and 15 primary health care nurses in a Brazilian city on the Brazil-Argentina-Paraguay border. Reflective thematic analysis was applied. Results: Discontinuity in care, low scope of social protection and unstable institutional context marked the attention of children with special health needs. Individual vulnerabilities were highlighted as a result of vaccination delays, fear of contagion and changes in development; institutional vulnerability due to restrictions on home visits, waiting lists, lack of professionals and absence of group activities; and social vulnerability related to difficulties in social assistance and the closure of land borders. Elements related to the telehealth strategy and mechanisms that assume professional responsibility expressed strengths for the care of children with special health needs. Conclusion: The restrictive measures adopted at the beginning of the COVID-19 pandemic had a negative impact on the care of children with special health needs, intensifying their individual and social vulnerabilities. Strengthening family and community contexts and expanding dialogue between sectors of primary health care indicate avoiding a mismatch between professional support and the pressing needs of these children, ensuring continuity of care. [ABSTRACT FROM AUTHOR]

Objective: To analyze the evidence of content validity and response process of a health vulnerability item bank. Methods: Psychometric study with support of Pasquali's theoretical pole in which 62 specialists with different sociodemographic and academic characteristics were selected and 15 of them responded to the content validity questionnaire. After adjustments, the bank moved to the response process validity phase and was evaluated by 12 health service users. A content validity coefficient was used to evaluate the items and the bank, which had the reliability assessed by the binomial test, considering a percentage of 80% and p-value >0.05. Results: The bank presented good evidence of content validity by experts. The coefficients were 0.87 for the subject element, 0.86 for the social element and 0.865 for the general element. The target audience made suggestions in the response process validity phase to better understand the items (total coefficient: 0.89), which were considered clear, accurate and understandable. Conclusion: The final version of the item bank has 535 items, 238 for the subject and 297 for the social element. It presents evidence of validity of content and response process and is suitable for testing the validity of internal structure. [ABSTRACT FROM AUTHOR]

ABSTRACT OBJECTIVE Investigate evidence of validity of the Family Vulnerability Scale (EVFAM-BR) as an instrument to support population-based management in primary health care (PHC), in the scope of Health Care Planning (PAS). METHODS This is a psychometric study to assess any additional evidence of the internal structure of EVFAM-BR using confirmatory factor analysis (CFA) and network analysis (NA). A preliminary version of the scale with 38 items was submitted to patients of PHC facilities that use the PAS methodology, distributed across the five regions of Brazil. For the primary CFA data, factor loadings and predictive power (R2) of the item were used. Seven model adjustment indices were adopted and reliability was measured by three indicators, using Bayesian estimation. RESULTS The preliminary version of the scale was applied to 1,255 patients. Using the AFC, factor loadings ranged from 0.66 to 0.90 and R2 from 0.44 to 0.81. Both the primary indicators and the model adequacy indices presented satisfactory and consistent levels. According to the NA, the items were appropriately associated with their peers, respecting the established dimensions, thus demonstrating sustainability and stability of the proposed model. CONCLUSIONS The evidence of validity presented by EVFAM-BR indicates, for the first time in Brazil, a concise instrument that is able to assertively measure family vulnerability, potentially supporting population-based management.

The objective of this study was to systematically investigate and review studies on the concept of vulnerability associated with the health of the older population. Articles were selected, filtered, and analyzed following the steps recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Screening and data extraction were performed independently by 2 reviewers using templates developed by the authors. Data extracted included specific details about population, interest, and context. Studies were eligible for inclusion if they: 1) were cross-sectional or prospective, 2) involved community-dwellers aged ≥60 years, 3) were published in the last 10 years, and 4) had as a concept vulnerability associated with the health of the older population. A total of 833 studies were identified and screened, 26 of which were included. Most included studies addressed vulnerability in older adults as an individual aspect, whether biological or psychological. The remaining studies reported vulnerability as affecting socio-environmental, health care system, and multifactorial aspects. Therefore, the concept of “vulnerability in older people” was not properly defined in the biomedical scientific community. When we return to the guiding question of this review, we can conclude that the conditions of vulnerability of older people are being treated broadly and diversely, producing different methodological strategies. The systematic review was conducted in the United States National Library of Medicine (PubMed), Latin American and Caribbean Health Sciences Literature (LILACS), and Scientific Electronic Library Online (SciELO) databases between August and December 2020 and updated in September 2022, with registration number CRD42022361649.

Abstract Background Leptospirosis, caused by the Leptospira bacteria, is an acute infectious disease that is mainly transmitted by exposure to contaminated soil or water, thereby presenting a wide range of subsequent clinical conditions. This study aimed to assess the distribution of cases and deaths from leptospirosis and its association with social vulnerability in the state of Rio Grande do Sul, Brazil, between 2010 and 2019. Methods The lethality rates and incidence of leptospirosis and their association with gender, age, education, and skin color were analyzed using chi-square tests. The spatial relationship between the environmental determinants, social vulnerability, and the incidence rate of leptospirosis in the different municipalities of Rio Grande do Sul was analyzed through spatial regression analysis. Results During the study period, a total of 4,760 cases of leptospirosis, along with 238 deaths, were confirmed. The mean incidence rate was 4.06 cases/100,000 inhabitants, while the mean fatality rate was 5%. Although the entire population was susceptible, white-colored individuals, males, people of the working-age group, along with less-educated individuals, were more affected by the disease. Lethality was higher in people with dark skin, and the prime risk factor associated with death was the direct contact of the patients with rodents, sewage, and garbage. The social vulnerability was positively associated with the incidence of leptospirosis in the Rio Grande do Sul, especially in municipalities located in the center of the state. Conclusions It is evident that the incidence of the disease is significantly related to the vulnerability of the population. The use of the health vulnerability index showed great relevance in the evaluation of leptospirosis cases and can be used further as a tool to help municipalities identify disease-prone areas for intervention and resource allocation.

This study aimed to further explore the concept of health vulnerability in Argentina, including environmental pollution in 2010. To this end, we developed a geo-referenced database of PM2.5 concentrations and emissions data from the national emissions inventory to analyze possible correlations with the demographic, activity, education, and health data from the 2010 national census. In addition, to provide a more complete picture of health vulnerability in Argentina, an extended index (SVI + PM2.5) was constructed and mapped, including PM concentration. We obtained data for annual PM2.5 values emissions and air concentrations in Argentina from public sources (GEEA-AEIv3.0M for emissions and the Atmospheric Composition Analysis Group V5.GL.03 dataset for surface PM2.5). We evaluated health vulnerability using the "Sanitary Vulnerability Index" (SVI). PM2.5 emissions are concentrated in urban and intensive agricultural areas of Argentina. PM2.5 air concentrations were acceptable (≤10 µg/m3) in only 15% of the Argentinean territory. The newly developed SVI + PM2.5 index showed that exposure to particulate material significantly increases the vulnerability shown by SVI in almost all census blocks. These results indicate that the new SVI + PM2.5 index might help identify populations that are at risk because of social issues or air pollution. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Enfermagem e Atenção à Saúde (REAS) is the property of Revista de Enfermagem e Atencao a Saude - Reas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Vulnerability is a concept widely used in the social sciences literature, and incorporated into the health field with the development of bioethics, and the model of social determinants of health. It has been described by experts as a complex concept, and very useful for addressing populations susceptible to illness. This ethically obliges nursing to identify these groups and respond to their care needs. Goal. To review the literature to analyze the intersections in the conceptual relationship between vulnerability and care, from a nursing perspective. Methodology. An integrative review of the literature was carried out based on the systematization proposed by Whittemore and Knafl. Literature from the last five years available in the Wos®, Scopus® and PubMed® databases was considered. The keywords “vulnerability” and “care” were used in the search strategy. Results. 18 articles were selected, coinciding with countries with health models with a social focus, such as Canada and Brazil. In the analysis, five themes were identified and described in which vulnerability and care intersect; ontological, epidemiological, social and bioethical paradigm, and the association between vulnerability and care needs. conclusions. The literature reports the close relationship between vulnerability and care, given that the nature of professional nursing care is the socially organized response to human vulnerability. [ABSTRACT FROM AUTHOR]

The study aimed to analyze the perception of risk for infection by Treponema pallidum in female public security workers, in the capital of the State of Goiás, Goiânia. This is a qualitative, descriptive research with 47 women through the application of a semi-structured instrument. To analyze the collections of narratives, the content analysis method was used. There was the emergence of 03 (three) thematic categories: (Mis) General knowledge about syphilis; Taboos regarding the use of condoms in a monogamous relationship; and New tools and health education. The main findings reveal the low perception of knowledge about syphilis, the feeling of invulnerability and the low adherence to the use of condoms among women in the police force. These results reinforce the need for effective intervention programs to prevent this infection, which has epidemic proportions and is projected to increase, among public security workers. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: to analyze the repercussions of transphobia on trans men’s and transmasculine people’s health. Method: a qualitative study carried out with 38 participants, 35 trans men and three trans men, who attended specialized transgender health services in Bahia, Brazil. In-depth interviews were carried out between June 2019 and February 2020. The Discourse of Collective Subject technique was used and interpretation based on the theoretical concept of transphobia. Results: transphobia has intra and interpersonal repercussions on the life and health of trans men and transmasculine people who attend health services. There were experiences of violence in the private space, fraying of family ties; discrimination in the school space; limitation in professional/work opportunities; barriers to self-care and access to health services; elaboration of trans identity protection strategies; consequences of transphobia on psycho-emotional health. Conclusion: transphobia is a social disease that affects different life and health dimensions. It causes damage to the socialization of trans men and transmasculine people, in addition to health service spaces as well as in family environments, schools, universities and at work, which result in non-adherence to self-care, distancing from health services and psycho-emotional distress.

ABSTRACT Objective: To analyze content validity evidence and response processes of a bank of items for measuring vulnerability to physical inactivity in adults. Method: Methodological study, with 13 specialists and 46 representatives of the target population. The Content Validity Index (CVI) and binomial test were calculated; data obtained through validity based on response processes were collected through interviews. Results: Of the 105 constructed items, 16 were excluded (CVI0.78), 34 were changed and 4 were deleted after evaluating the evidence of response processes. In the end, 97 items remained, with a global CVI of 0.92, organized into two dimensions: Subject (CVI=0.91) and Social (CVI=0.94). Conclusion: The items presented adequate parameters and evidence of validity; and can subsidize the construction of instruments that consider the subject’s and social vulnerability in understanding physical inactivity.

We investigated people's preferences in COVID-19 vaccine allocation priority, comparing different social categories based on age and occupation. Vaccine allocation preferences were related to perceived health vulnerability and economic backlash (economic negative consequences) endured by the different social groups during the pandemic. In-group favoritism in vaccine allocation preferences was analyzed. Data were collected through an online survey in Italy (n = 506) before the start of the vaccination campaign. Vaccine allocation preferences, health vulnerability, and economic backlash due to COVID-19, measured through ranking tasks. The healthcare workers category was placed at the top of the ranking in vaccine allocation priority by 65% of the respondents. Vaccine allocation priority was related to perceived health vulnerability and not economic difficulties. Limited self-preference effects emerged. People who did not consider healthcare workers a priority (1/5 of the sample) had a lower education level, were more worried about COVID-19 infection risk, and did not trust vaccines. A consensus emerged on who should be vaccinated first. Governments and policymakers should be aware of these preferences when designing and communicating vaccine allocation plans to predict and foster the public's acceptance of the COVID-19 vaccination programs created by experts. [ABSTRACT FROM AUTHOR]

Human activities have compelled massive environmental degradation, which causes climate vulnerability and that has emerged as a significant health issue. The present study assesses the role of social progress with greenhouse gases to determine the health vulnerability in 77 developing countries from 2011 to 2020. The empirical results are estimated by using the panel ARDL econometric approach. The study found that greenhouse gas emission proposes a U-shaped relationship to determine health vulnerability. In this study, social progress is used as the moderator variable, which shifts the turning point of the U-shaped curve. For this purpose, the interaction term of social progress with greenhouse gases shifts the turning point to the left side of the U-shaped curve and further flattens it. Furthermore, this study explores that urbanization, export openness, and government education expenditure negatively impact health vulnerability while industrialization increases health vulnerability. The study recommends that government should pay special attention to declining greenhouse gases and rising social progress to improve health vulnerability. Graphical abstact. [ABSTRACT FROM AUTHOR]

Background: Leptospirosis, caused by the Leptospira bacteria, is an acute infectious disease that is mainly transmitted by exposure to contaminated soil or water, thereby presenting a wide range of subsequent clinical conditions. This study aimed to assess the distribution of cases and deaths from leptospirosis and its association with social vulnerability in the state of Rio Grande do Sul, Brazil, between 2010 and 2019. Methods: The lethality rates and incidence of leptospirosis and their association with gender, age, education, and skin color were analyzed using chi-square tests. The spatial relationship between the environmental determinants, social vulnerability, and the incidence rate of leptospirosis in the different municipalities of Rio Grande do Sul was analyzed through spatial regression analysis. Results: During the study period, a total of 4,760 cases of leptospirosis, along with 238 deaths, were confirmed. The mean incidence rate was 4.06 cases/100,000 inhabitants, while the mean fatality rate was 5%. Although the entire population was susceptible, white-colored individuals, males, people of the working-age group, along with less-educated individuals, were more affected by the disease. Lethality was higher in people with dark skin, and the prime risk factor associated with death was the direct contact of the patients with rodents, sewage, and garbage. The social vulnerability was positively associated with the incidence of leptospirosis in the Rio Grande do Sul, especially in municipalities located in the center of the state. Conclusions: It is evident that the incidence of the disease is significantly related to the vulnerability of the population. The use of the health vulnerability index showed great relevance in the evaluation of leptospirosis cases and can be used further as a tool to help municipalities identify disease-prone areas for intervention and resource allocation. [ABSTRACT FROM AUTHOR]

Introduction: After an acquired neurological lesion, some people are in situations of greater vulnerability to complications and comorbidities, which can exert impacts on their life and health, compromise their quality of life, and lead to hospitalizations and premature death. Identifying the vulnerability situation can guide nurses in the development of actions to prevent complications, comorbidities, and other conditions after the neurological lesion. Objective: To validate a scale to identify the vulnerability situation of people with motor disabilities after an acquired neurological lesion (Escala de Vulnerabilidade de Pessoas com Deficiência, EVU-PcD). Materials and method: The article presents a methodological development and psychometric study with a quantitative approach. The construct validity stages were as follows: application of the Vulnerability Scale for people with motor disabilities after an acquired neurological lesion (EVU-PcD) and reliability and confirmatory factor analysis. EVU-PcD, initially with 38 items, was applied to 102 individuals with acquired motor disabilities. Reliability was assessed using Cronbach’s alpha from 0.7 to 0.9. In the confirmatory factor analysis, the structural equations model for latent variables a path diagram was used. Results: The overall Cronbach’s alpha coefficient was 0.86, which was considered excellent. The fit indices, chi-square ratio (1.63), root mean square of approximation errors (0.08) and parsimonious fit quality index (0.61) presented acceptable indicators of adequacy to the final model with three domains and 28 items. Conclusions: The final factor structure of the EVU-PcD scale with 28 items showed satisfactory reliability and validity results to identify the vulnerability of people with motor disabilities after an acquired neurological lesion. [ABSTRACT FROM AUTHOR]

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: In adolescents, the vulnerabilities resulting from HIV infection are linked to the biopsychosocial singularities of the phase, making them a priority group for health strategies. Objective: To analyze the state of the art regarding situations of vulnerability of adolescents who (co)live with HIV. Method: Integrative literature review conducted in eight libraries/databases to answer the guiding question. The standardized recommendations for review were followed, the findings were categorized and discussed according to the vulnerability framework. Result: 7,517 publications were identified, of which 11 were included. Different situations of individual, social and programmatic vulnerability experienced by young people with HIV were evidenced, namely: omission of diagnosis, stigma, discrimination, low adherence to antiretroviral therapy, emotional distress, among others. Discussion: Adolescents living with HIV are susceptible to situations that expose them to real and/or potential risks. In this sense, it is imperative to qualify health services and actions, in a logic of universal and integral offer, free of judgments based on personal beliefs. Conclusion: Adolescents who (co)live with HIV are inserted in dynamic, subjective, and complex contexts of vulnerability, constrained by individual, social and programmatic aspects that negatively influence their adolescence, their health, and their relationships. [ABSTRACT FROM AUTHOR]

Introduction: The concepts of risk and vulnerability have been discussed in the healthcare field and represent different approaches in the process of care, with an important amount of interventions that included drug prescriptions and treatments. Objectives: To analyze the healthcare professionals’ perceptions of the concepts of risk and vulnerability and their influence on Medication Use Process. Methods: Data were collected in an academic tertiary hospital, from a focus group conducted with healthcare professionals who are active in diverse settings of care. The meeting was recorded, audio statements were transcribed and coded, and the content was organized and analyzed using content analysis. Results: Three physicians, 2 nurses and 2 pharmacists participated in the study. The findings suggest that there is a continuum between both concepts, with vulnerability preceding risk: each individual has its own range of vulnerability prior to the drug administration, being risk inherent to the drug utilization process. Conclusions: According to the research subjects, reducing vulnerability can potentially prevent additional drug therapy problems development: the patient has to be the focus of the medication use process, not only the drug and its risk.

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Landslides being a widespread disaster are associated with susceptibility, vulnerability and risk. The physical factors inducing landslides are relatively well-known. However, how landslide susceptibility will be exacerbated by climate change, impede the attainment of the sustainable development goals and increase health vulnerability is relatively less explored. We present an integrated assessment of landslide susceptibility, health vulnerability and overall risk to understand these interconnected dimensions using Arunachal Pradesh, India, as a case study, which is susceptible to landslides due to its topography and climate conditions. Landslide susceptibility was examined using twenty landslide conditioning parameters through the fuzzy analytical hierarchy process (FAHP). The susceptibility map was validated using the area under the ROC curve (AUC). National Family Health Survey (NFHS 4) data were used to analyze the health vulnerability, while the overall risk was computed through the integration of susceptibility and vulnerability. Landslide susceptibility analysis indicated that nearly 22% area of the state is characterized by moderate susceptibility followed by high (17%) and very high susceptibility (13%). High elevation, slope, rainfall, SPI, drainage density and complex geology were identified as the causative factors of landslides. In the case of health vulnerability, East Kameng and Lohit districts were found to be very highly vulnerable, while Papum Pare, Changlang and Tirap districts experience high health vulnerability due to high degree of exposure and sensitivity. Overall risk analysis revealed over 16.8% area of the state is under moderate risk followed by high (9.8%) and very high (4.2%) risk. Linking this analysis with the climate change projections and SDG goals attainment revealed that Papum Pare, Upper Subansiri, Tirap and West Kameng require priority for lessening susceptibility, vulnerability and risk for achieving sustainable development. A strong correlation (99%) between HVI and risk further demonstrates the need for lessening health vulnerability and risk in the study area. Furthermore, our study contributes additional insights into landslide susceptibility by considering heal vulnerability and risk which may help in planning sustainable development strategies in a changing climate. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Investigate evidence of validity of the Family Vulnerability Scale (EVFAM-BR) as an instrument to support population-based management in primary health care (PHC), in the scope of Health Care Planning (PAS). METHODS: This is a psychometric study to assess any additional evidence of the internal structure of EVFAM-BR using confirmatory factor analysis (CFA) and network analysis (NA). A preliminary version of the scale with 38 items was submitted to patients of PHC facilities that use the PAS methodology, distributed across the five regions of Brazil. For the primary CFA data, factor loadings and predictive power (R2) of the item were used. Seven model adjustment indices were adopted and reliability was measured by three indicators, using Bayesian estimation. RESULTS: The preliminary version of the scale was applied to 1,255 patients. Using the AFC, factor loadings ranged from 0.66 to 0.90 and R2 from 0.44 to 0.81. Both the primary indicators and the model adequacy indices presented satisfactory and consistent levels. According to the NA, the items were appropriately associated with their peers, respecting the established dimensions, thus demonstrating sustainability and stability of the proposed model. CONCLUSIONS: The evidence of validity presented by EVFAM-BR indicates, for the first time in Brazil, a concise instrument that is able to assertively measure family vulnerability, potentially supporting population-based management. [ABSTRACT FROM AUTHOR]