scholarly journals Transsexuality in the streets of Campinas: borderline resistance movements towards a humanistic care

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D S Komoda ◽  
J Justino ◽  
B Danny ◽  
S Suzy ◽  
S R Carvalho ◽  
...  
Keyword(s):  
Health System ◽  
Narrative Analysis ◽  
Life Experience ◽  
Case Reports ◽  
National Policy ◽  
Transgender People ◽  
Resistance Movements ◽  
Access To Health ◽  
Actual Care ◽  
Global And Local

Abstract According to WHO, transgender people are more likely to suffer from a broad range of health Issues high HIV prevalence, low access to health, discrimination, violence, rejection, unemployement, poverty, housing insecurity, and marginalisation. Structural macho-sexism is one of the main causes not only of violence, but also of lack of protective legislation and policy to this population. Developing research regarding transgender people's life experience in the streets and their pathways to healthcare is of major importance to achieve a more equitable society and public health system. This qualitative research is a chapter of the book “Experiências do Cuidado na Rua” (”Living Care in the Streets”). From the experience of offering care in downtown Campinas to people living in the streets, 2 case reports were selected. The narratives were collected in a field journal. Both participants were female transgenders living in the context of Brazil's Universal Health System. National policy and legislation were confronted with narrative analysis of the participants, to show the barriers to receiving proper and humanistic care. Some narratives show the clear violence suffered from law enforcement personnel: “We used to be beaten by the Police because we were prostituting ourselves”. Others show a transphobic moralistic context: “Last week a transexual had her heart torn here in Campinas, and a Saint image was put in her chest! I'm afraid to walk alone in the streets at night. “Yet others show a clear transphobic and problematic position from the now president Bolsonaro which reflects in transphobic sympathizers in hate speeches: “Nowadays [after presidential election] we hear in the streets 'let's send them to Bolsonaro!'”, as sending someone to the guillotine. The narratives show a clear need of global and local actions towards a more accepting society, and actions must be taken in a broad range of fields, such as human rights legislation, policy and surveillance. Key messages This research show the neglect for the transgender population and the lack of protective measures, which reflects in access to the health care system and actual care. A growth of discrimination and hate speeches directly related to the election of an extremist-right national administration has been observed.

Novel Therapeutic Approaches and Targets for Treatment of Chronic Urticaria: New Insights and Promising Targets for a Challenging Disease

2020 ◽  
Vol 22 (1) ◽  
pp. 32-45
Author(s):  
Emanuela Martina ◽  
Federico Diotallevi ◽  
Tommaso Bianchelli ◽  
Matteo Paolinelli ◽  
Annamaria Offidani
Keyword(s):  
English Language ◽  
Life Experience ◽  
Case Reports ◽  
Immunosuppressive Agents ◽  
Real Life ◽  
Chronic Spontaneous Urticaria ◽  
New Targets ◽  
Current State ◽  
Pubmed Database ◽  
Novel Drugs

Background: Chronic Spontaneous Urticaria (CSU) is a disease characterized by the onset of wheals and/or angioedema over 6 weeks. The pathophysiology for CSU is very complex, involving mast cells and basophils with a multitude of inflammatory mediators. For many years the treatment of CSU has been based on the use of antihistamines, steroids and immunosuppressive agents with inconstant and frustrating results. The introduction of omalizumab, the only licensed biologic for antihistamine- refractory CSU, has changed the management of the disease. Objective: The aim of this article is to review the current state of the art of CSU, the real-life experience with omalizumab and the promising drugs that are under development. Methods:: An electronic search was performed to identify studies, case reports, guidelines and reviews focused on the new targets for the treatment of chronic spontaneous urticaria, both approved or under investigation. The search was limited to articles published in peer-reviewed journals in the English Language in the PubMed database and trials registered in Clinicaltrials.gov. Results:: Since the advent of omalizumab, the search for new therapies for chronic spontaneous urticaria has had a new impulse. Anti-IgE drugs will probably still be the cornerstone of therapy, but new targets may prove effective in syndromic urticaria or refractory cases. Conclusion:: Although omalizumab has been a breakthrough in the treatment of CSU, many patients do not completely get benefit and even require more effective treatments. Novel drugs are under investigation with promising results.

Access to health care and Informal Patient Payments for health care in Serbia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Buch Mejsner ◽  
S Lavasani Kjær ◽  
L Eklund Karlsson
Keyword(s):  
Health Care ◽  
Health System ◽  
Access To Health Care ◽  
Health Care Services ◽  
Local Population ◽  
Civil Servants ◽  
Care Providers ◽  
Care Services ◽  
Access To Health

Abstract Background Evidence often shows that migrants in the European region have poor access to quality health care. Having a large number of migrants seeking towards Europe, crossing through i.e. Serbia, it is crucial to improve migrants' access to health care and ensure equality in service provision Aim To investigate what are the barriers and facilitators of access to health care in Serbia, perceived by migrants, policy makers, health care providers, civil servants and experts working with migrants. Methods six migrants in an asylum center and eight civil servants in the field of migration were conducted. A complementary questionnaire to key civil servants working with migrants (N = 19) is being distributed to complement the data. The qualitative and quantitative data will be analysed through Grounded Theory and Logistic Regression respectively. Results According to preliminary findings, migrants reported that they were able to access the health care services quite easily. Migrants were mostly fully aware of their rights to access these health care services. However, the interviewed civil servants experienced that, despite the majority of migrants in camps were treated fairly, some migrants were treated inappropriately by health care professionals (being addressed inappropriately, poor or lacking treatment). The civil servants believed that local Serbs, from their own experiences, were treated poorer than migrants (I.e. paying Informal Patient Payments, poor quality of and access to health care services). The interviewed migrants were trusting towards the health system, because they felt protected by the official system that guaranteed them services. The final results will be presented at the conference. Conclusions There was a difference in quality of and access to health care services of local Serbs and migrants in the region. Migrants may be protected by the official health care system and thus have access to and do not pay additional fees for health care services. Key messages Despite comprehensive evidence on Informal Patient Payments (IPP) in Serbia, further research is needed to highlight how health system governance and prevailing policies affect IPP in migrants. There may be clear differences in quality of and access to health care services between the local population and migrants in Serbia.

scholarly journals Equitable access to health services for children aged 5 to 9 in a medium city of northeasth of Brazil: a result of Family Health Strategy

2014 ◽  
Vol 17 (suppl 2) ◽  
pp. 39-52 ◽  
Author(s):  
Adriana Xavier de Santiago ◽  
Ivana Cristina de Holanda Cunha Barreto ◽  
Ana Cecília Silveira Lins Sucupira ◽  
José Wellington de Oliveira Lima ◽  
Luiz Odorico Monteiro de Andrade
Keyword(s):  
Health Services ◽  
Health System ◽  
Family Health ◽  
Northeastern Brazil ◽  
Local Health ◽  
Access To Health Services ◽  
Care Services ◽  
Health Strategy ◽  
Access To Health ◽  
Family Health Strategy

INTRODUCTION: The Brazilian National Health System may reduce inequalities in access to health services through strategies that can reach those most in need with no access to care services. OBJECTIVE: To identify factors associated with the use of health service by children aged 5 to 9 years in the city of Sobral, Ceará, northeastern Brazil. RESULTS: Only 558 (17.0%) children used health care services in the 30 days preceding this survey. Children with any health condition (OR = 3.90) who were frequent attenders of primary care strategy of organization (the Family Health Strategy, FHS) (OR = 1.81) and living in the city's urban area (OR = 1.51) were more likely to use health services. Almost 80% of children used FHS as their referral care service. Children from poorer families and with easier access to services were more likely to be FHS users. CONCLUSION: The study showed that access to health services has been relatively equitable through the FHS, a point of entry to the local health system.

scholarly journals Health mediator model as a way to access to care and health information for Syrian refugees in Turkey

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
I Kayi ◽  
Z Şimşek2 ◽  
G Yıldırımkaya
Keyword(s):  
Health Care ◽  
Health System ◽  
Access To Health Care ◽  
Health Care Services ◽  
Legal Status ◽  
Healthcare Access ◽  
Syrian Refugees ◽  
Care Services ◽  
Access To Health ◽  
The City

Abstract The number of Syrian refugees residing in Turkey has increased over 200 times since 2012 reaching to 3,621,330 (April 2019). Turkey has granted temporary protection status, including access healthcare in the city of registration. Ministry of Health provides on-site health service in temporary shelters, however more than 90% of the Syrian refugees choose to stay in community settings, which along with language barriers limits their ability to access health care and information. With UNFPA we have designed a health mediator model to improve access to health care and awareness on priority concerns such as mental health, reproductive health, child health, health system in Turkey and legal status provided to Syrian refugees. This study is a participatory operational research to test the health mediator model. Operationalization took place in 3 phases: (1) selection and training of Syrian health mediators and provincial coordinators; (2) household visits and data collection; (3) evaluation and supervision. So far, we have trained 174 health mediators from 24 different Turkish cities. Training took 5 days with up to 30 participants each. UNFPA collaborated with NGOs that work with Syrian refugees for coordination purposes. Health mediators made household visits to reach out to Syrian families, gave health education and where necessary support for access to health care services, and conducted a needs assessment. Data collected has been the subject to weekly supervision meetings by local NGOs, health mediators and coordinators to set priorities for the upcoming week. Health mediator model was effective in reaching out to hard-to-reach groups among Syrian refugees, increased health system and legal awareness, contribute to improved healthcare access and prevention of negative health outcomes such as teenage marriages and pregnancies. Inclusion of refugees in decision-making and guidance during the implementation of the project was key for project success.

scholarly journals Medical Vulnerability in America: How Does the Health System Respond?

2003 ◽  
Vol 40 (2) ◽  
pp. 198-209
Author(s):  
James R. Knickman ◽  
Kelly A. Hunt
Keyword(s):  
Health System ◽  
Access To Care ◽  
Chronically Ill ◽  
Market Change ◽  
Measuring Change ◽  
Actual Care ◽  
Market Changes

This study explores the hypothesis that market change affects the medically vulnerable more than the non-medically vulnerable. Analysis of data measuring change between 1997 and 1999 indicates that access to care eroded for both groups, but no evidence emerges to suggest that the changes were systematically worse for the medically vulnerable. Paradoxically, some measures of satisfaction with actual care received improved between 1997 and 1999 for both groups of people. Recent market changes do not seem to pose extra special threats to the medically vulnerable. However, our findings reinforce the need to better coordinate and integrate services for the medically vulnerable and chronically ill.

scholarly journals Does the ehealth card facilitate access to healthcare from the point of view of refugees in Germany?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
K Rolke ◽  
J Wenner ◽  
O Razum
Keyword(s):  
Health Care ◽  
Health System ◽  
Access To Health Care ◽  
Chronic Illnesses ◽  
Point Of View ◽  
Informal Support ◽  
Federal State ◽  
Health Card ◽  
Delayed Treatment ◽  
Access To Health

Abstract Background The municipalities in the federal state of North Rhine-Westphalia (NRW) decide autonomously how to organize access to health care for refugees: either with electronic health card (eHC model) or with health care voucher (HcV model). The eHC model is often expected to facilitate access to health care and to reduce bureaucratic barriers. However, there are only few analyses of how refugees perceive the two models and their corresponding access to health care. Methods A total of 28 problem-centered interviews with refugees were conducted in three municipalities in NRW (two with HcV and one with eHC model). Sampling was purposive, aiming to achieve a maximum variation of interview partners with regard to age, gender, chronic illnesses, pregnancy and parenthood. The interviews were conducted with the support of translators in the language of the respondents’ choice. Interviews transcripts were evaluated by content analysis using the software atlas.ti. Results Refugees using both the eHC and HcV models report mostly positive experiences when seeking care - both in terms of treatment and interaction with physicians or non-medical staff. The first contact with the health care system was rarely organized by refugees themselves in both models, but mostly with the support of social workers, friends, or family members. The main perceived difference between the models was that in the HcV model, urgent treatment required additional waiting time. Conclusions Access to care is assessed similarly well by refugees in all municipalities. The additional approval process for treatment by the social welfare office in HcV municipalities may lead to a delayed treatment. Formal and informal support is particularly important for newly arriving refugees to help them navigate the complex German health system. Key messages The implementation of one access model alone does not facilitate access to health care for refugees. Formal and informal support is necessary for refugees to gain access to the health system.

PP155 The Impact Of Lawsuits In The Brazilian Public Health System

2017 ◽  
Vol 33 (S1) ◽  
pp. 141-141
Author(s):  
Carla Biella ◽  
Viviane Pereira ◽  
Fabiana Raynal ◽  
Jorge Barreto ◽  
Vania Canuto ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Public Health System ◽  
Scientific Evidence ◽  
Health Technology ◽  
Health Technologies ◽  
Access To Health ◽  
The Right ◽  
The Impact

INTRODUCTION:The increase of litigation in Brazil on the right to health, and the Brazilian Public Health System (SUS) targets of litigation, are phenomena that generate discussions both in the judiciary, and among researchers and managers of health. The lawsuits are based on the integrality that includes the right to any health technology. Our aim was to gather information on the use of scientific evidence by judges and other law professionals to support their decisions in lawsuits involving health care in Brazil.METHODS:A narrative review by literature search using key terms of legalization in specific databases was conducted.RESULTS:Twenty-five studies showed litigation matters relating to health care which were focused on legal claims about drugs. In general, law operators used the scientific evidences in a limited way when making decisions, by considering the medical report and medication label indications and disregarding therapeutic alternatives contemplated in the SUS list. The access to health technologies, by litigation, reveals that the gap between scientific knowledge and legal practice are similar to those found between science and decision-making in the formulation and implementation of health policies. The Health Technology Assessment studies have high potential for use by the judiciary as a reference source to support technical and scientific decisions in lawsuits on health care.CONCLUSIONS:For the judiciary to ensure not only access to health technologies, but also the efficacy and safety of technologies to system users, their decisions must be substantiated by scientific evidence. The National Committee for Health Technology Incorporation (CONITEC) in SUS has established actions in conjunction with law operators and society, such as a communication using e-mail, aiding the decision for the injunction and elaboration of technical reports and a policy brief, with the intention that the decisions are taken with the greatest possible knowledge about technologies provided by SUS, and based on scientific evidence.

Critical Perspectives on the National Policy on Education 2016

2017 ◽  
Vol 4 (2) ◽  
pp. 129-146
Author(s):  
Somdatta Bhattacharya ◽  
Swarupa Deb ◽  
Hari Nair ◽  
Tanu Shukla ◽  
Anupam Yadav
Keyword(s):  
Higher Education ◽  
National Policy ◽  
Complex Task ◽  
Policy Document ◽  
Transgender People ◽  
National Policy On Education ◽  
Critical Perspectives

This article brings together critical perspectives on a broad range of issues that emerge from a reading of the National Policy on Education 2016. The issues vary from accountability to transdisciplinarity and from the marginalization of transgender people to value education. Such a complex task of critiquing this policy document cannot be accomplished by an individual alone. This task must be borne by a team of scholars with training in diverse fields. Working in a team however generates divergences as well as convergences. Yet no attempt has been made to iron out the creases emanating from differences in opinions, nor persist with the search for an underlying singularity, nor enforce a consensus. Such is the uncertain nature of the task of reforming higher education.

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