El hombre en la atención primaria a la salud: discutiendo (in)visibilidad a partir de la perspectiva de género

This paper presents an ethnographic study on the relationship between men and primary healthcare in eight clinics in four Brazilian states. The objective was to comprehend the (in)visibility of men within the daily routine of care, based on gender perspectives, with discussion of the mechanisms that favor inequalities in healthcare work. Different dimensions of male (in)visibility were identified within this context: targeting of men in interventions within the field of public healthcare policies; male users who face difficulties in seeking attendance; difficulty in stimulating effective participation among men; and male subjects of care (for themselves and for others). The paper emphasizes the importance of gender studies and their relationship with health, while discussing the production of social inequalities that are (re)produced by the gender inequalities that are present in the social imaginary and in healthcare services.Este trabajo presenta un estudio de caracter etnográfico acerca de la relación entre hombres y la asistencia a la salud en la Atención Primaria, realizado en ocho servicios de cuatro estados brasileños . Se objetivo es el de comprender la (in)visibilidad de los hombres en lo cotidiano de la asistencia, a partir de la perspectiva de género, que discute los mecanismos promotores de desigualdades presentes en el trabajo de salud. Se identificaron en tal contexto diferentes dimensiones de esta (in) visibilidad: los hombres como objeto de intervenciones en el campo de las políticas públicas de salud; como usuarios que afrontan dificultades en la busca por atención y en el estímulo a su participación efectiva; como sujetos del cuidado (de sí mesmos y de terceros). El trabajo refuerza la importancia de los estudios de género y su relación con la salud, en la medida en que discute la producción de las iniquidades sociales, (re)producidas por las desigualdades de género presentes en el imaginario social y en los servicios de salud.Este trabalho apresenta estudo de caráter etnográfico acerca da relação entre homens e a assistência à saúde na Atenção Primária, realizado em oito serviços de quatro estados brasileiros. Seu objetivo é compreender a (in)visibilidade dos homens no cotidiano da assistência a partir da perspectiva de gênero, que discute os mecanismos promotores de desigualdades presentes no trabalho em saúde. Foram identificadas, nesse contexto, diferentes dimensões desta (in) visibilidade: os homens como alvo de intervenções no campo das políticas públicas de saúde; como usuários que enfrentam dificuldades na busca por atendimento e no estímulo à sua participação efetiva; como sujeitos do cuidado (de si e de terceiros). O trabalho reforça a importância dos estudos de gênero e sua relação com a saúde, na medida em que discute a produção das iniquidades sociais (re) produzidas pelas desigualdades de gênero presentes no imaginário social e nos serviços de saúde.Universidade de São Paulo Faculdade de Medicina Departamento de Medicina PreventivaFMUSPConselho Regional de Medicina de PernambucoUniversidade Federal de São Paulo (UNIFESP) campus Santos Departamento Saúde, Educação, SociedadeUniversidade Federal do Rio Grande do Norte Departamento de PsicologiaFundação Oswaldo Cruz Instituto Fernandes FigueiraFMUSP Departamento de Medicina PreventivaUNIFESP, campus Santos Depto. Saúde, Educação, SociedadeSciEL

Concepts of gender, masculinity and healthcare: a study of primary healthcare professionals

This paper analyzes concepts of gender and masculinity among Primary Healthcare professionals in four Brazilian States (Pernambuco, Rio de Janeiro, Rio Grande do Norte, São Paulo). It is based on two perspectives: the meanings associated with being a man and the relations between masculinity and healthcare. This qualitative study is part of a multicentric investigation, which used triangulation methods as a benchmark. Sixty-nine in-depth interviews carried out among health professionals with higher education were analyzed. The discourses (re)produce the notion that health facilities are feminized spaces. Within the daily routine, this notion is translated as reinforcing the idea that the male body is not a locus of this care, as opposed to the female body which is considered a locus of care. The presence of a hegemonic pattern of masculinity is prominent among professionals' representations of men and seems to influence the latter, in their lack of commitment with healthcare. The existence of a stereotyped gender model (re)produces disparities between men and women in healthcare and compromises the visibility of other meanings and expressions of gender identities.O trabalho analisa as concepções de gênero e masculinidades de profissionais de saúde da Atenção Primária à Saúde em quatro estados do país (PE, RJ, RN, SP) a partir de duas perspectivas: os significados associados a ser homem e a relação masculinidade e cuidados em saúde. O estudo de natureza qualitativa é parte de pesquisa multicêntrica tendo por referência a triangulação de métodos. Foram analisadas 69 entrevistas em profundidade de profissionais de saúde com formação de nível superior. Os relatos dos profissionais (re)produzem a noção de que os serviços são espaços feminilizados, o que se traduz no seu cotidiano por um reforço à ideia do corpo masculino como lócus do não cuidado em oposição ao corpo feminino visto como lócus desse cuidado. Sobressai a representação dos profissionais sobre os homens centrados na forte presença de um padrão hegemônico de masculinidade, que influencia o pouco envolvimento destes com os cuidados em saúde. A existência de um modelo estereotipado de gênero acarreta a (re)produção de desigualdades entre homens e mulheres na assistência a saúde e compromete a visibilidade de outros significados e expressões de identidades de gênero.Universidade Federal de São Paulo (UNIFESP) Departamento Saúde, Educação, SociedadeUniversidade de São Paulo Faculdade de Medicina Departamento de Medicina PreventivaUNIFESP, Depto. Saúde, Educação, SociedadeSciEL

Health needs and masculinities: primary health care services for men

Estudam-se relações entre masculinidades e cuidado em saúde, abordando o reconhecimento de necessidades por homens usuários de atenção primária e respostas dos serviços. É parte de pesquisa realizada em quatro estados brasileiros, com oito serviços amostrados por conveniência. Triangulou-se observação etnográfica com entrevistas semi-estruturadas com 182 usuários de 15 a 65 anos e com 72 profissionais. A análise temática dos registros etnográficos e das entrevistas foi baseada nos referenciais de gênero e em estudos do trabalho em saúde. Os resultados apontam como a medicalização das necessidades de saúde marca usuários, profissionais e serviços, ocultando questões vinculadas à masculinidade. Permitem caracterizar a atenção primária como voltada para as mulheres, reproduzindo no funcionamento dos serviços e nos desempenhos profissionais as desigualdades de gênero, em que para as mulheres há a disciplina do cuidado e para os homens, impropriedades para assistir e cuidar.This study deals with the relations between masculinities and health care, approaching the recognition of health needs among male users of primary health care and the responses by the services. The study is part of a larger research project in four Brazilian States, with a convenience sample of eight health services. Ethnographic observation was compared with semi-structured interviews with 182 health care users from 15 to 65 years of age and 72 health professionals. Thematic analysis of the ethnographic records and interviews was based on gender references and studies on health work. The findings show how medicalization of health needs affects users, professionals, and services, disguising issues related to masculinity. Primary care focuses mainly on women, thereby reproducing gender inequalities in health services operations and professional performance, with women receiving disciplined care and men receiving insufficient attention and care

Anatomopathological Evaluation of Fecal Peritonitis Complications in Horses Treated with Peritoneal Lavage

Background: Reproductive management in horses when performed with malpractice or by an unqualified person can cause many lesions of various degrees. When the rectum is affected it can compromise the mucous layer of the rectal ampulla and may even cause total perforation of this intestinal segment. Once the rectum ruptured, its contents gets into the abdominal cavity and generates severe abdominal infection, which may cause intense adhesions between organs and even to the abdominal wall and requires a particular intensive intervention. This work reports the use of peritoneal lavage protocol in three horses with septic peritonitis caused by rectal laceration, correlating with post-mortem findings.Cases: Three horses were referred to the Veterinary Hospital Rancho Belo Vista, in the city of Serra - ES, with an accident report during reproductive management in different properties. In all cases, blood loss and loss of continuity of the rectal mucosa were reported by the technicians. Patients were referred at different post-accident times. When they arrived at the hospital, they were examined and a sample of blood and peritoneal fluid were collected and sent to the laboratory. They presented intense apathy, mucosa coloration ranging from hyperemic to pale with halo toxemia, high cardiac and respiratory rate, reduction of globular volume and prolonged time of capillary refill. Patients were given fluid therapy support with lactated Ringer’s solution and systemic therapy protocols such as antibiotic therapy, peritoneal lavage with antibiotic containing solution and anticoagulant, and other supportive treatments were instituted. Peritoneal lavages were instituted every eight hours, in the first 48 hours and every twelve hours, until five days were completed. All patients had to be sacrificed. Euthanasia occurred at different times according to response to treatment and onset of clinical signs of shock. Significant variations were observed among patients at necropsy. The patient submitted to fewer wash cycles had severe adhesions. The other two patients who underwent more wash cycles presented less severe adhesion and less fibrin deposition in the abdominal viscera.Discussion: The use of peritoneal lavage associated with systemic treatment has been shown to be beneficial for the treatment of peritonitis since the initial condition and alteration in the results of laboratory tests. However, the time elapsed between rectal laceration and referral to a specialized technical unit was a decisive factor, together with the severity of the lesion, that were determinant for the increased response and consequent chance of treatment success and chances of survival. Although they received a combination of systemic therapy with broad-spectrum antibiotics and peritoneal lavage associated with daily washing cycles, the patients were euthanized, reiterating the lethality of the disease. At necropsy it was possible to evaluate the extent of contamination and adhesions, as well as to find the lacerated segment, the main source of contamination of the peritoneum. The difference between the degrees of adhesion is evident when compared to the patients who went through more cycles of peritoneal lavage with the ones that went through fewer cycles. Thus, it is possible to estimate that the patients who received a greater number of peritoneal lavage cycles with the drugs used in the same route presented a reduced number of adhesions between similar structures (same organs) and between the organs and the abdominal wall. There is a need for more controlled studies to evaluate the effectiveness of serial peritoneal lavage treatments in horses, as well as the application of drugs that seek to reduce abdominal inflammation, fibrin production and adhesions

SARS-CoV-2 in Brazil and Psychosocial Repercussions on Men’s Health: Health Literacy Is Important

This study aimed at analyzing the psychosocial repercussions of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic on the health of men living in Brazil. For this, we carried out a socio-historical and qualitative study, with the participation of 200 men who answered an online questionnaire. The data collected were processed in the NVIVO12® software, structured by the Collective Subject Discourse method, and analyzed from the epidemic disease theoretical framework proposed by Charles Rosenberg. Our results showed that the SARS-CoV-2 pandemic brought about repercussions of different dimensions that compromised the health of men living in Brazil. The repercussions evidenced were behavioral changes and emergence of new habits due to the pandemic; uncomfortable family situations; impaired affective and sexual relationships; harms in marital relationships; and insecurity and psychological distress. It is important to implement strategies that maximize men’s health literacy, promoting better communication in terms of health, and search for help and suitable information about health/mental health.info:eu-repo/semantics/publishedVersio

Impacts on Men’s Health/Mental Health

Publisher Copyright: Copyright © 2022 de Sousa, Moreira, da Silva Santana, Araújo, Borges, Almeida, das Mercês, da Silva, Teixeira, Lourenção, Gomes, de Santana Carvalho, de Sousa, de Almeida, Viana and Pereira.Objective: This study aims to analyze sociohistorically how the normative patterns of hegemonic masculinity produced impacts on men’s health/mental health in the context of the COVID-19 pandemic. Methods: A qualitative study from a socio-historical perspective was conducted with 50 men based on an online survey. A semistructured form was applied. The data were analyzed by the Collective Subject Discourse method, interpreted in the light of the context of epidemic disease and hegemonic masculinity. Results: The experience of the pandemic exposed the normative patterns of masculinities from the consummation of acts representative of the pandemic context, which incited men to deny the existence of COVID-19 disease and to delay the understanding and adoption of measures to protect and control COVID-19. As a repercussion, men presented conflicts in the regulation of emotions; presented emotional suppression; were more reactive; felt threatened regarding the loss of the role of family provider, virility; and revealed a sense of invulnerability, added to the weakening of self-care. Conclusion: The discourse revealed that the men’s behaviors are consistent with the characteristics of hegemonic masculinity, but express signs of recognition that this behavior causes harm to themselves and their health.publishersversionpublishe

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Consistent patterns of common species across tropical tree communities

Trees structure the Earth’s most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations1,2,3,4,5,6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth’s 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories7, we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world’s most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees.Publisher PDFPeer reviewe