Direito à saúde nas populações de refugiados: uma revisão sistemática com meta-análise / Right to health in refugee populations: a systematic review with meta-analysis

Objetivo: avaliar evidências acerca da garantia dos direitos à saúde das populações de refugiados no mundo. Fontes de dados: foram utilizados os seguintes bancos de dados: MEDLINE, acessado via Biblioteca Virtual em Saúde (BVS), e SCOPUS. Com a finalidade de realizar uma pesquisa mais segura e direcionada, os autores optaram pelo uso reunir todos os descritores (MeSH) usando o operador AND da seguinte forma: (Refugees AND Right to health AND human rights). Seleção de estudo: A seleção primária ocorreu pela análise dos títulos e abstracts/resumos seguida da elegibilidade baseada nos critérios de inclusão previamente estabelecidos. Extração de dados: algumas informações foram extraídas dos estudos como autor / ano, tipo de participantes e seus respectivos números, tipos de intervenções, número de sessões ou tempo de acompanhamento e resultados. Resultados: As estratégias de pesquisa resultaram em 241 artigos. Com o uso subsequente dos critérios de inclusão e exclusão, 10 estudos foram inseridos na amostra (n) e incluídos por razões qualitativas e quantitativas. Para análise estatística foi utilizado o programa Stata 14.0 em que foi calculado a meta-análise pelo método de efeitos aleatórios, metarregressão para analisar associação entre as variáveis analisadas e metabias para análise de viés dos resultados apresentados.Os gráficos gerados foram respectivamente Forest Plot, Bublle Plot. Conclusão: A falta de acesso à informação, a língua, a cultura e o estranhamento do país são fatores que contribuem para a precarização da saúde do refugiado e dificulta o seu acesso a ela.

Produtos biofarmacêuticos no tratamento de doenças mentais: revisão sistemática com meta-análise / Biopharmaceutical products in the treatment of mental diseases: systematic review with meta-analysis

INTRODUÇÃO: A Medicina popular vem sendo utilizada no tratamento de diversas doenças, incluindo as mentais há bastante tempo. O desenvolvimento dessa poderosa ferramenta pode trazer inúmeros benefícios ao mundo, melhorando a forma de tratar pessoas acometidas de doenças mentais. OBJETIVO: Averiguar por meio de pesquisas de banco de dados sistemáticas, transparentes e reprodutíveis, evidências relevantes sobre produtos biofarmacêuticos avaliando sua equivalência para identificar sua eficácia e segurança quando comparados a drogas químicas no tratamento de doenças mentais. METODOLOGIA: Uma revisão sistemática com meta-análise foi realizada nos bancos de dados PubMed, Scopus e ScienceDirect. A busca foi elaborada com o descritor "doenças mentais" e com as palavras-chave "produtos biofarmacêuticos" e "biomoléculas". RESULTADOS: O gráfico da meta-análise mostra o efeito positivo no uso das substâncias mencionadas em doenças mentais com um efeito final de 5.12 (3.46 - 6.78), sendo este um resultado significante para os dados analisados com = 0.049. CONCLUSÃO: No presente estudo, os compostos naturais relatados vem sendo utilizados, há muitos anos, no tratamento de doenças mentais, o que confirma sua potencial atividade como produto biofarmacêutico

Association between the pandemic and its impact on the mental health of immigrants: systematic review and meta-analysis / Associação entre a pandemia e o seu impacto sobre a saúde mental dos imigrantes: revisão sistemática e meta-análise

Some populations are more susceptible to developing mental health disorders. One of these populations is immigrants. The study aimed to establish an association between the pandemic and the impact on the mental health of immigrants. This is a systematic review with meta-analysis carried out using Web of Science, Scopus, and EMBASE sources. The results showed that the immigrant population is more susceptible to the development of mental changes in the pandemic period when compared to other groups. There is a moderate association (0.80) with a confidence interval of 0.70 to 0.90. Some risk factors can be identified, but there is still a significant lack of primary data, which encourages further observational studies

Hope And Pediatric Cancer

Pediatric cancer is rare when compared to the incidence of cases in adults. In Brazil it is the second largest cause of death by disease in children and adolescents. Cancer is a life-altering disease that brings with it fear, disbelief, anger, uncertainty, devastation, at the time it is diagnosed. In childhood cancer, diagnosis extends to the whole family. The diagnosis brings psychological and social changes in family dynamics and needs emotional support, discussion of possible therapies and possible death. Hope comes, bringing with it a meaning in illness, contributing positively to a better adaptation and adherence to treatment and consequently the quality and the prospect of life. Hope has been shown as a positive factor when facing this new reality. However there are few studies dealing with this issue

Comparing Intramedullary Nailing, External Fixation, and External Fixation followed by Intramedullary Nailing as management for open fractures of the tibial shaft: a Systematic Review

Background: The treatment of open fractures of the tibial shaft is often a dilemma since it requires particular caution and individual assistance for each case. Methods and Findings: Systematic review of the literature was conducted on the following databases: PubMed and VHL from 2000 to 2013 aiming to compare Intramedullary Nailing (IM Nailing), External Fixation (EF), and EF followed by IM Nailing in the treatment of open fractures of the tibial shaft. After analysis by inclusion criteria 24 articles met the eligibility criteria. The healing time was under 32 weeks, and the nonunion and defective healing rates were under 13.35% and 16.6%, respectively. The infection rate ranged from 3% to 53% for patients treated with EF as definitive management; from 0% to 22% for those treated with IM Nailing as definitive management; and from 0% to 16.7% for those who underwent EF followed by IM Nailing. Conclusion: The cases treated with EF as definitive management presented shorter healing time as for the analyzed samples. The nonunion cases with greater percentages were those of EF followed by IM Nailing. The studies using IM Nailing as definitive management presented more healing cases defective. Even though few studies analyze hospital stay, it was found to be shorter in the sample treated with EF as definitive management.Â

Negative impacts of the adaptation process linked to local cultural stress levels in immigrants and development of psychiatric disorders: a systematic review and meta-analysis

Background Current studies underline and enable the international scientific community to reflect on migrant needs to restart, mostly without fluency in the language from the country of destination, without a way of proving his/her knowledges and abilities, with an incomplete family core, without cultural references that until that moment defined him/her as belonging to a specific group, with defined and meaningful habits, full of symbolic representations. Iams Conduct an analysis on the implications of migration in refugees’ mental health, and the link between these implications and Post-traumatic Stress Disorder (PTSD). Method Indexed journals in MEDLINE and LILACS databases hosted in Biblioteca Virtual em Saúde (BVS), as well as papers hosted in Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Periodicals Portal. Searches were carried using the following DeCS descriptors: “Stress Disorders, Post-Traumatic”, "Refugees” e “Mental Health”. Results The 10 studies included in the present review were carried in Australia, Denmark, Ethiopia, Turkey, Uganda, Israel, South Korea and Papua New Guinea, and were published in 2014 (2), 2015 (6), and 2017 (2). Regarding the subject, 50% of the articles concentrate information regarding PTSD and mental health problems, while the remaining half deals with psychosocial effects of mass conflict on refugees. Meta-analysis concludes that a considerable percentage of refugees suffer from psychiatric disorder, I-squared (variation in ES attributable to heterogeneity) = 96,46%; Estimate of between-study variance Tau^2= 0.02. Test of ES=0 : z= 17.75 p= 0.00. Conclusion Exposure to traumatic events such as public executions and other extreme acts of violence, murder of family members, family and friends’ death due to starvation, homelessness, are closely related to PTSD prevalence in refugees. Acculturation and family’s prolonged estrangement are predictors of depressive symptoms in refugees and both exposure to a new culture and adaptation to new laws and norms of welcoming countries act as stressors and aggravators of depressive symptoms. &nbsp

Consequences of the SARS-CoV-2 Pandemic on Mental Health: Integrative Review

The lack of specific treatment and knowledge about the exact pathophysiology of the 2019 Coronavirus disease (COVID-19) and its vaccines makes the organic aspects of the pandemic a concern and puts the psychiatric consequences and psychological effects of SARS-CoV-2, COVID-19, in second place. Hence, the psychiatric impacts of the COVID-19 pandemic have not been well established yet. We have performed an integrative literature review in three electronic databases: Medline, PsycINFO, and Published International Literature on Traumatic Stress (PILOTS). The findings were then divided into five subcategories: impacts of COVID-19 on the mental health of psychiatric patients; use of technology as an ally in combating impacts on mental health in the context of the COVID-19 pandemic; mental health promotion measures in the context of the COVID-19 pandemic for the population; mental health promotion measures in the context of the COVID-19 pandemic for health professionals; and mental health in specific groups in the context of the COVID-19 pandemic. This study has showed that the situation and measures proposed to fight the COVID-19 pandemic cause stress, anxiety, fear, and uncertainty in the population. Psychiatric patients, the elderly, refugees, and migrant workers are more vulnerable due to the stigmatization and lack of specialized support in health services and reduced access to medications. Therefore, they require care from governments and health authorities. In addition, measures to promote hospital health for health professionals seem to be essential to improve care and reduce the psychologic/psychiatric impacts on professionals. Thus, technology is a valuable ally in this process

Entrevistas narrativas: um importante recurso em pesquisa qualitativa

Objetivo Este estudio es un aporte metodológico en que se explica y destaca el alcance y la fertilidad de la entrevista narrativa en la investigación cualitativa. Método Describir el método de la narrativa en la investigación cualitativa. Resultados El método de investigación cualitativa se caracteriza por abordar las cuestiones relacionadas con las singularidades del campo y de las personas encuestadas, siendo las entrevistas narrativas un método potente para uso de los investigadores que toman posesión de ella. Permiten que la profundización de la investigación, la combinación de historias de vida con los contextos socio-históricos e la comprensión de los sentidos que producen cambios en las creencias y valores que motivan y justifican las acciones de los posibles informantes. Conclusion El uso de la narrativa se presenta un recurso de investigación ventajosa en la investigación cualitativa, la narrativa es una forma tradicional de comunicación cuyo objetivo es servir contenido a partir de la que se pueden transmitir las experiencias subjetivas.Objetives This methodological study explain and emphasize the extent and fertility of the narrative interview in qualitative research. Methods To describe the narrative method within the qualitative research. Results The qualitative research method is characterized by addressing issues related to the singularities of the field and individuals investigated, being the narrative interviews a powerful method for use by researchers who aggregate it. They allow the deepening of research, the combination of life stories with socio-historical contexts, making the understanding of the senses that produce changes in the beliefs and values that motivate and justify the actions of possible informants. Conclusion The use of narrative is an advantageous investigative resource in qualitative research, in which the narrative is a traditional form of communication whose purpose is to serve content from which the subjective experiences can be transmitted.Objetivo Este trabalho consiste numa contribuição metodológica em que se explicitam e se enfatizam o alcance e a fecundidade da entrevista narrativa no âmbito da investigação de natureza qualitativa. Método Descrever o método da narrativa no âmbito da investigação qualitativa. Resultados O método qualitativo de pesquisa caracteriza-se por abordar questões relacionadas às singularidades do campo e dos indivíduos pesquisados, sendo as entrevistas narrativas um método potente para uso dos investigadores que dele se apropriam. Elas permitem o aprofundamento das investigações, a combinação de histórias de vida com contextos sócio–históricos, tornando possível a compreensão dos sentidos que produzem mudanças nas crenças e valores que motivam e justificam as ações dos informantes. Conclusão As narrativas mostram-se muito úteis em estudos de abordagem qualitativa, uma vez que a narratividade é uma forma artesanal de comunicação cujo objetivo é veicular conteúdos a partir dos quais as experiências subjetivas podem ser transmitidas

Exposição de crianças e adolescentes afrodescendentes à violência e seus impactos na saúde: uma revisão sistemática com meta-análise / Exposure of children and adolescents african to violence and its impacts on health: a systematic review with meta-analysis

Objetivo: Caracterizar as evidências relevantes no determinar os efeitos da exposição de crianças e adolescentes afrodescentes à violência e seus impactos na saúde, utilizando o protocolo internacional PRISMA (Preferred Reporting Items for Systematic review and Meta-Analyses).Método: Foi realizada uma revisão sistemática da literatura com meta-análise com buscas por artigos originais nas bases de dados eletrônicas Scopus e Biblioteca Virtual em Saúde (BVS), que hospeda bases como MEDLINE e LILACS, através dos descritores (MeSH) “african continental ancestry group” (1), african americans” (2), “violence” (3), “adolescent” (4) e “child” (5). Na Scopus, a busca deu-se por “2 AND 3 AND 4 AND 5” com limitação a tipo de documento (artigo) e área de estudo (Medicina. Já na BVS, a pesquisa por “1 AND 3 AND 4 OR 5” foi realizada sem filtros ou restrições de data.Resultados: Foi verificado que para o objeto de análise, obteve-se um efeito geral significativo (p= 0,00) no contexto da violência dirigida a negros. Além disso, o peso atribuído para cada estudo foi homogêneo demonstrando que o efeito esperado no que tange a violência na população estudada ocorre em diferentes contextos diminuindo a chance do acaso. As evidências da metabias mostra que mesmo em pequenos estudos é significativo o efeito da violência na saúde de populações afrodescendentesConclusão: Os desfechos negativos possíveis para a saúde de crianças e adolescentes negros vítimas de situações de violência ou expostos a contextos de violência em suas comunidades são diversos. No entanto, vale lembrar que a existência de políticas de saúde integral e a previsão de direitos não garantem necessariamente seu exercício pleno

Cardiovascular System and SARS-CoV-2: Etiology, Physiopathology and Clinical Presentation: A Systematic Review

During SARS-CoV-1 and Middle East Respiratory Distress Syndrome (MERS) outbreaks it was observed a particularly elevated incidence of cardiovascular disease among patients. With COVID-19, this correlation becomes evident again. However, the cardiovascular impacts by COVID-19 pandemic are not yet well established although publications about its potential deleterious effects are constant. Thus, aimed to carry a systematic review of the literature with meta-analysis, the following question was used as a guide: what practical contributions does the scientific literature produced in the period of 2019-2020 has to offer about the impact of the COVID-19 on cardiovascular system? A systematic review of the literature using the Virtual Health Library (VHL) and PubMed with the following descriptors: #1 “cardiovascular disease” [MeSH] AND #2 “COVID-19” [keyword], as well as their equivalents in the Portuguese and Spanish language, during the period from December 2019 to March 2020 was performed. One hundred articles were found in Pubmed and twenty-seven were selected. In VHL there are 59 articles and four were selected totaling thirty-one papers. The findings were then divided into three subcategories: Etiology, Physiopathology and Risk factors of SARS-CoV-2 in Cardiovascular System; Clinical presentation, laboratory markers and imagenological aspects of SARS-CoV-2 in cardiovascular system; and Anti-Hypertensive Drugs, Cardiovascular System and SARS-CoV-2. When it comes to the cardiovascular system, these issues are aggravated and urge as a joint commitment from researchers, medical and governmental organizations to carry out more robust studies with bold methodologies aimed at mapping prognostic factors and assertive therapeutic approaches in the management of cardiovascular complications of COVID- 19