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"Martin, Denise"
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Migration and refuge: necessary topics for Nursing teaching in COVID-19 times
2022
ABSTRACT Objectives: to present an overview of migratory processes and access to health care for immigrants in Brazil and reflect on the importance of training in Nursing from an interdisciplinary perspective, focused on the care of this population in the context of a pandemic. Methods: this is a theoretical-reflective study based on the authors’ experiences and anchored in the literature. Results: some particularities in the access to health services by migrants and refugees show how the pandemic’s advancement and continuity impacted them in different ways. Interdisciplinary research and teaching are essential to study and better understand the health needs of the migrant population in Brazil, especially in the context of a pandemic. Final Considerations: the training of health professionals, especially in Nursing, must include these people’s specificities so that future interventions are more sensitive and closer to their reality. RESUMO Objetivos: apresentar o panorama dos processos migratórios e de acesso à saúde de imigrante no Brasil e refletir sobre a importância da formação em Enfermagem, numa perspectiva interdisciplinar, voltada ao cuidado dessa população, no contexto de pandemia. Métodos: trata-se de um estudo teórico-reflexivo, pautado nas experiências dos autores e ancorado na literatura. Resultados: algumas particularidades no acesso a serviços de saúde de migrantes e pessoas refugiadas evidenciam como elas têm sido impactadas de diferentes maneiras com o avanço e continuidade da pandemia. A pesquisa e ensino de abordagem interdisciplinar são importantes para estudar e melhor compreender as necessidades de saúde da população migrante no país, especialmente no contexto de pandemia. Considerações Finais: a formação de profissionais de saúde, especialmente em Enfermagem, deve compreender as especificidades destas pessoas para que futuras intervenções sejam mais sensíveis e próximas da realidade que vivem. RESUMEN Objetivos: presentar el panorama de los procesos migratorios junto al acceso a los cuidados de salud de los inmigrantes en Brasil y reflexionar sobre la importancia de la formación en Enfermería dirigida a la atención de esta población desde una perspectiva interdisciplinaria en el contexto de la pandemia. Métodos: se trata de un estudio teórico-reflexivo, pautado en las experiencias de los autores y también basado en la literatura. Resultados: algunas particularidades en el acceso a los servicios de salud de los migrantes y las personas refugiadas evidencian que éstas han sido impactadas de diferentes maneras con el avance y la continuidad de la pandemia. La investigación y la enseñanza con un enfoque interdisciplinario son importantes para estudiar y comprender mejor las necesidades sanitarias de la población migrante en el país, especialmente en el contexto de la pandemia. Consideraciones Finales: la formación de los profesionales sanitarios, especialmente en Enfermería, debe comprender las especificidades de estas personas para que las futuras intervenciones sean más sensibles y cercanas a la realidad que viven.
Journal Article
Career Impacts and Referral Patterns: Army Mental Health Treatment in the Combat Theater
by
Clayton, Spencer P.
,
Martin Zona, Denise M.
,
Rowan, Anderson B.
in
Adolescent
,
Adult
,
Afghan Campaign 2001
2014
This study examined the relationships between referral source, career impacts, and diagnostic severity among service members seeking mental health intervention in a deployed setting. Data were drawn from the mental health records of 1,640 Army service members presenting for outpatient mental health services while deployed in Afghanistan. Results suggested that self-referrals were significantly less likely to have contact made with their command or to experience potentially career impacting recommendations. Overall, greater than 80% of military personnel were returned to duty with no limits and 60% were assigned either no diagnosis or a mild/moderate diagnosis. These findings indicate that seeking psychological services is much less likely to impact a service member's career when self-initiated. Given the significant concerns about career impacts among many service members in need of psychological services, these findings should be incorporated in information campaigns to promote early help seeking.
Journal Article
Percepção de risco de moradoras em áreas sujeitas a escorregamentos de encostas
2022
Resumo A exposição a riscos naturais pode provocar impactos sobre a saúde. A precariedade das moradias, das condições de vida e a ausência de proteção social tornam a sobrevivência em áreas de risco um problema de saúde pública. Esta pesquisa buscou compreender o lugar que o risco natural ocupa na vida de moradoras de dois bairros mapeados como zonas de alto risco para escorregamentos em São José dos Campos (SP). Foi realizada uma pesquisa qualitativa na qual a pesquisadora, acompanhada por agentes comunitários de saúde, entrevistou 12 moradoras e realizou observações etnográficas de campo. O risco percebido pelas entrevistadas, em seu contexto sociocultural, era de serem removidas de suas casas pelo poder público. Concluiu-se que estudos socioculturais na interface entre saúde coletiva e meio ambiente são fundamentais para redução da exposição de alguns grupos sociais ao risco natural e para a criação de políticas públicas que visem à diminuição das iniquidades. Abstract Exposure to natural hazards can have an impact on health. The precariousness of housing, living conditions and the lack of social protection, make surviving in risk areas a public health issue. This research sought to understand the place that natural hazards occupy in the lives of female residents of two neighborhoods mapped as areas of very high risk for landslides in São José dos Campos (state of São Paulo). Qualitative research was carried out in which the researcher, accompanied by community health agents, interviewed 12 female residents and made field ethnographic observations. The risk perceived by the interviewees, in their sociocultural context, was of being removed from their homes by the government. In conclusion, sociocultural studies at the interface between collective health and the environment are essential to reduce the exposure of some social groups to natural hazards and to create public policies that seek to reduce inequities.
Journal Article
Epidemic West Nile encephalitis, New York, 1999: results of a household-based seroepidemiological survey
2001
In the summer of 1999, West Nile virus was recognised in the western hemisphere for the first time when it caused an epidemic of encephalitis and meningitis in the metropolitan area of New York City, NY, USA. Intensive hospital-based surveillance identified 59 cases, including seven deaths in the region. We did a household-based seroepidemiological survey to assess more clearly the publichealth impact of the epidemic, its range of illness, and risk factors associated with infection.
We used cluster sampling to select a representative sample of households in an area of about 7·3 km2 at the outbreak epicentre. All individuals aged 5 years or older were eligible for interviews and phlebotomy. Serum samples were tested for IgM and IgG antibodies specific for West Nile virus.
677 individuals from 459 households participated. 19 were seropositive (weighted seroprevalence 2·6% [95% CI 1·2–4·1). Six (32%) of the seropositive individuals reported a recent febrile illness compared with 70 of 648 (11%) seronegative participants (difference 21% [0–47]). A febrile syndrome with fatigue, headache, myalgia, and arthralgia was highly associated with seropositivity (prevalence ratio 7·4 [1·5–36·6]). By extrapolation from the 59 diagnosed meningoencephalitis cases, we conservatively estimated that the New York outbreak consisted of 8200 (range 3500–13 000) West Nile viral infections, including about 1700 febrile infections.
During the 1999 West Nile virus outbreak, thousands of symptomless and symptomatic West Nile viral infections probably occurred, with fewer than 1% resulting in severe neurological disease.
Journal Article
O linchamento em Morrinhos (boato, estigma e violência)
2019
Resumo Em 2014, na Baixada Santista, ocorreu o linchamento de uma jovem de 33 anos, episódio deflagrado por meio do compartilhamento em redes sociais do boato da existência no bairro de Morrinhos, em Guarujá (SP), de uma suposta bruxa sequestradora de crianças que realizava “rituais de magia negra”. Esse episódio ganhou importante atenção da imprensa nacional, sendo destacado - em parte relevante das reportagens - que a jovem espancada e morta era bastante conhecida na comunidade e fazia tratamento para uma doença psiquiátrica que desencadeava crises nas quais ela “perdia a noção de realidade”. Este artigo tem como objetivo apresentar uma análise do contexto sociocultural relacionado a esse acontecimento: o linchamento de uma mulher com transtorno mental. Foram utilizados os métodos e as técnicas de pesquisa tradicionais da antropologia; entre eles, observação etnográfica densa e entrevistas em profundidade com moradores de Morrinhos. A análise do material permitiu apontar que a violência é vivamente presente no local e está diretamente relacionada aos conflitos cotidianos e às disputas sociais existentes no bairro, destacando-se a violência contra o doente mental. A propagação de boatos é frequente nesse local e possui importante papel em manter certo equilíbrio nas relações sociais. Nesse contexto, pode-se considerar que a ocorrência do linchamento se configurou como um fato que, em grande medida, foi capaz de representar uma condensação desses elementos - os boatos, a estigmatização e a violência - e, assim, os expôs despidos em sua forma mais bruta. Abstract In 2014, in Baixada Santista, a coast city of the state of São Paulo, Brazil, a young woman, aged 33, was lynched. The event received much attention due to the sharing on social networks of a rumor regarding a witch living in Morrinhos neighborhood, in the city of Guarujá, São Paulo, who kidnapped children and performed “black magic rituals”. This episode has gathered important attention of the national press, and a substantial amount of the related news reports announced that the victim, who was spanked and killed, was notorious among the neighborhood’s inhabitants and underwent treatment for a psychiatric illness that provoked crises in which she “lost control of reality”. This study aims to analyze the sociocultural context related to this event: the lynching of a mentally ill woman. Traditional anthropology research methods were utilized, among them ethnographic observation and in-depth interviews with Morrinhos’ inhabitants. The data analysis allowed us to point out that violence is vividly present there and is directly related to everyday conflicts and social disputes of all possible contexts in the neighborhood - especially those manifested through violence against the mentally ill. The spreading of those rumors is frequent in Morrinhos and has an important role in maintaining a certain balance in social relations. In this context, this lynching can be understood as a fact that, to a major extent, was able to represent a condensation of these elements - rumors, stigmatization and violence - and thus uncovered them in their rawest form.
Journal Article
79 International immigrant health access and social protection in the context of COVID-19 in Brazil
2025
Abstract
OP 9: Health Services 1, B210 (FCSH), September 3, 2025, 15:45 - 16:45
Aims
This research aims to identify the problems related to the health access and social protection of international migrants and refugees regarding their needs during the pandemic COVID19 in Brazil. Considering the social and territorial inequalities in Brazil, the consequences of the pandemic were more severe due to critical situations of social vulnerability.
Methods
The qualitative research followed the interdisciplinary theoretical axis of transnational migrations and anthropology. Between the years 2022 and 2023, we conducted in-depth interviews and participant observation with migrants and refugees living in six Brazilian states: in the metropolitan region of São Paulo (SP), in the cities of Florianópolis and Chapecó (SC), Uberlândia (MG), Londrina (PR), Cuiabá and Várzea Grande (MT) and Manaus (AM). In the field research, in each state, in-depth interviews were conducted with 14 migrants (men and women), totaling 84 international migrants (with and without refugee status) from Venezuela, Haiti, Syria, Colombia, Bolivia, and Angola.
Results
The results provided a detailed and complex panorama of the situation of immigrants during the pandemic, highlighting the role of the Unified Health System and the increased vulnerability of these populations due to factors already widely discussed in the literature on health and migration. Gender, skin color, and social status also affected their living conditions, access to health, and social protection. Despite the difficulties and disinformation, the Brazilian Unified Health System (SUS), the social protection system, the role of civil society organizations, and migrants were essential for access to services and benefits. It also highlights, as a result, the formation of solidarity networks promoted by NGOs and by the people themselves.
Conclusions
The research highlights the need for policies and actions related to work, housing, strengthening social and community networks, and strengthening socio-political spaces that value the protagonism of international migrants and human rights.
Journal Article
Imigração, refúgio e saúde: perspectivas de análise sociocultural
2018
Os recentes processos migratórios internacionais ocorridos no Brasil se apresentam como um campo de estudo para as ciências sociais e humanas em saúde. Este artigo tem como objetivo refletir sobre os processos de inclusão de imigrantes e refugiados pelas instituições de saúde, considerando o campo de debates das ciências sociais e humanas em Saúde e o comprometimento dessa área com os direitos humanos. Inicialmente, são apresentadas características contemporâneas das migrações internacionais, incluindo a situação brasileira. Em seguida, são descritas algumas pesquisas e práticas sobre concepções de saúde, doenças e cuidados com imigrantes e, por fim, propomos um debate acerca de alguns conceitos antropológicos que podem contribuir para uma abordagem menos estereotipada dos processos de inclusão nas instituições de saúde nacionais. Pretendemos apresentar uma perspectiva das ciências sociais e humanas em saúde em um horizonte teórico articulado com práticas em saúde que, de certa forma, podem contribuir para a formulação de conceitos, explicações e orientações no plano das políticas públicas com essas populações.
Journal Article