Access to antivenoms is not guarranteed for vulnerable populations that inhabit remote areas in the Amazon. The study of therapeutic itineraries (TI) for treatment of snakebites would support strategies to provide timely access to users. A TI is the set of processes by which individuals adhere to certain forms of treatment, and includes the path traveled in the search for healthcare, and practices to solve their health problems. This study aims to describe TIs of snakebite patients in the Brazilian Amazon. This study was carried out at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, in Manaus, state of Amazonas, Brazil. The itinerary from the moment of the bite to the patient’s admission to the reference unit was analyzed. Sample size was defined by saturation. After an exploratory survey to collect epidemiological variables, in-depth interviews were conducted following a semi-structured guide. Patients originated from rural areas of 11 different municipalities, including ones located >500 kilometers from Manaus. A great fragmentation was observed in the itineraries, marked by several changes of means of transport along the route. Four themes emerged from the analysis: exposure to snakebite during day-to-day activities, use of traditional therapeutic practices, and personal perception of the severity, as well as the route taken and its contingencies. Access to healthcare requires considerable effort on the part of snakebite patients. Major barriers were identified, such as the low number of hospitals that offer antivenom treatment, poor access to healthcare due to long distances and geographic barriers, low acceptability of healthcare offered in countryside, lack of use of personal protective equipment, common use of ineffective or deleterious self-care practices, late recognition of serious clinical signs and resistance to seeking medical assistance. Health education, promotion of immediate transport to health centers and decentralization of antivenom from reference hospitals to community healthcare centers in the Brazilian Amazon are more effective strategies that would to maximize access to antivenom treatment.
This work presents a compilation of data obtained by clinical psychologists during the Covid-19 pandemic in Brazil. Through searches on social media with #Covid19 and #MentalHealth and the exchange of information on networks of professionals, it was possible to compile and group the main psychological symptoms presented during isolation. Information was clustered according to the period it appeared, in order to guide future situations. Moreover, to prepare a group of clinical psychologists to provide online assistance.
Dealing with the Covid-19 pandemic is playing a significant role in public health policies around the world. Mental health is one. Either in supporting the maintenance of isolation or dealing with demands, which may come from the general population and health professionals. This work presents a compilation of data obtained by clinical psychologists during the Covid-19 pandemic in Brazil. Through searches on social media with #Covid19 and #MentalHealth and the exchange of information on networks of professionals, it was possible to compile and group the main psychological symptoms presented during isolation. Information was clustered according to the period it appeared, in order to guide future situations. Moreover, to prepare a group of clinical psychologists to provide online assistance. Prevention must be the key to deal with the mental health catastrophe that there is to come.
Objetivo: Compreender os sentidos produzidos por enfermeiros (as) sobre o acolhimento de pessoas travestis e transexuais na atenção básica. Método: Estudo qualitativo, realizado com quatro enfermeiros (as) que atuam em uma Unidade Básica de Saúde na Zona Sul Oeste de Manaus. Os dados foram coletados de maio a junho de 2016. Utilizou-se estudos socioantropológicos para a análise e discussão dos dados e teve como referencial metodológico a pesquisa de campo. Os dados foram analisados por meio da técnica de análise Construtivo-interpretativa. Resultados: Os sentidos produzidos por enfermeiros (as) sobre o acolhimento às pessoas travestis e transexuais na atenção básica se alicerçam em questões como constrangimento, neutralidade e desconhecimento frente às questões de gênero para além do binarismo de gênero. Conclusão:Existe uma formação dominante de base biomédica, e o cuidado de enfermagem não dá conta de aspectos socioculturais e políticos das pessoas, dos seus corpos e da sua saúde.
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