Compreendendo o termo gordofobia médica a partir da perspectiva de pessoas gordas / Understanding the term medical fatphobia from the perspective of fat people

Resumo O ativismo gordo tem como objetivo unir e mobilizar pessoas gordas, a fim de romper com a inviabilização de seus corpos e denunciar a gordofobia. Há algum tempo, o ativismo vem impulsionando a expressão "gordofobia médica" para denunciar a opressão vivenciada dentro dos serviços de saúde. Este artigo tem como objetivo compreender o termo, a partir da percepção de pessoas gordas. É uma pesquisa qualitativa, com dados coletados por meio de um questionário virtual direcionado a pessoas gordas ou ex-gordas, que alcançou 515 respondentes de todas as regiões do Brasil. Os dados foram analisados utilizando a análise temática, com a criação de seis categorias. Entre os principais resultados, pode-se compreender que a gordofobia médica envolve: despreparo, desrespeito e autoritarismo; reprodução de estereótipos, repulsa e preconceito, desumanização da pessoa gorda, diagnóstico superficial e generalizante, desprezo da queixa, foco no peso e negligência, e precarização do acesso e dos cuidados em saúde. Conclui-se que o estudo auxilia na compreensão do termo gordofobia médica, o que facilita o seu reconhecimento e prevenção na área da saúde.

Abstract Fat activism aims to unite and mobilize fat people to break with the impracticability of these bodies and denounce fatphobia. For some time now, activism has been pushing the expression "medical fatphobia" to denounce the oppression experienced by fat people within health services. This article aims to understand the term, from the perspective of fat people. This is a qualitative research, with data were collected via a virtual questionnaire aimed at fat or formerly fat people, which reached 515 respondents from all regions of Brazil. Data were analyzed using thematic analysis, with the creation of six categories. Among the main results, it can be understood that medical fatphobia involves: unpreparedness, disrespect and authoritarianism; reproduction of stereotypes, disgust and prejudice; dehumanization of the fat person; superficial and generalizing diagnosis; dismissal of the complaint, focus on weight and negligence; and precarious access to the health care. In conclusion, the work helps in understanding the term medical fatphobia, which facilitates its recognition and prevention in the health field.

Enfrentamento do estigma relacionado ao peso corporal no cuidado em saúde: impactos de um curso educativo em profissionais de saúde / Tackling weight stigma in healthcare: impacts of an educational course on health care professionals

Introdução:O estigma relacionado ao peso corporal, presente entre profissionais e estudantes da área da saúde, prejudica a saúde e o cuidado de pessoas com sobrepeso e obesidade, e deve ser combatido. Objetivo:Este artigo visa relatar os resultados obtidos por meio da aplicação de um curso educativo sobre estigma relacionado ao peso corporal e o cuidado em saúde. Métodos:A aplicação ocorreu com 11 profissionais de saúde e teve desenho misto. No componente quantitativo, foi realizada análise estatística dos resultados iniciais e finais obtidos por meio da Escala de Atitudes Antiobesidade (AFAT), com realização de teste t pareado (nível de significância de p ≤ 0,05). No componente qualitativo, foi realizada análise de conteúdo temática de uma atividade final dissertativa sobre ideias que ficaram marcadas a partir do curso. Feedbacksestruturados a respeito da qualidade do material foram preenchidos. Resultados:As análises estatísticas não identificaram alterações entre os valores iniciais e finais da AFAT (p >0,05), com escore geral médio inicial de 0,418 e final de 0,419. Cinco temas emergiram da análise de conteúdo, os quais demonstram aprendizagem quanto à multifatorialidade da obesidade; reconhecimento de implicações interseccionais; compreensão dos impactos do estigma no cuidado em saúde; estímulo ao pensamento crítico; e considerações sobre o curso, no geral, bem avaliado de forma consistente. Conclusão:O instrumento quantitativo não indicou mudança; contudo, as análises qualitativas demonstram que o curso promoveu compreensão ampliada sobre os temas discutidos, bem como a reflexão e a autocrítica das/os profissionais.

Introduction:Weight stigma, present among health professionals and students, harms the health and healthcare of people with overweight and obesity and must be combated. Objective:This article aims to report the results obtained through a test application of an educational course on weight stigma and healthcare. Methods:The test was carried out with 11 healthcare professionals and had a mixed design. In the quantitative component, statistical analysis was carried out on the initial and final results obtained using theAntifat Attitudes Scale (AFAT), with a paired t test (significance level of p ≤ 0.05). In the qualitative component, a thematic content analysis was carried out with data produced in a final dissertation activity about ideas that were highlighted from thecourse. Structured feedback regarding the quality of the material was completed. Results:Statistical analyzes did not identify changes between initial and final AFAT values (p >0.05), with an initial overall average score of 0.418 and final of 0.419. Five themes emerged from the content analysis, which demonstrate learning regarding the multifactorial nature of obesity; recognition of intersectional implications; understanding of impacts of stigma on health care; stimulation of critical thinking; and considerations about the course, overall, consistently well evaluated. Conclusion: The quantitative instrument did not indicate change, however, qualitative analysis indicated that the course promoted expanded understanding of the topics discussed, as well as reflection and self-criticism by professionals.

Acesso e qualidade da alimentação: percepção da população em situação de rua / Acceso y calidad de la alimentación: percepción de personas en situación de calle / Access to food and food quality: perception of the homeless population

Resumo Objetivo Compreender a percepção do acesso e da qualidade da alimentação para a população em situação de rua. Métodos Estudo descritivo qualitativo, realizado em um Centro de Referência da População de Rua na região centro-sul de Belo Horizonte (MG). Utilizou-se roteiro semiestruturado para a realização das entrevistas de 18 participantes. A coleta de dados ocorreu entre dezembro de 2020 e janeiro de 2021. A análise temática do material, proposta por Bardin, possibilitou a elaboração de três categorias empíricas. Resultados O público entrevistado era masculino, com idade média de 43 anos e tempo médio de situação de rua de 44,6 meses. O acesso à alimentação foi proveniente das doações de alimentos, refeições em instituições governamentais e aquisições ao dispor de renda. Foram relatadas dificuldades quanto à quantidade e qualidade dos alimentos, à aquisição das refeições nos fins de semana, aos sentimentos de medo e angústia perante a fome, à falta do alimento e pelo estigma social, agravados pela COVID-19. Conclusão Diante do cenário de iniquidades sociais, o direito ao acesso à alimentação não é garantido, sendo necessária a implementação de políticas públicas de proteção social que garantam os direitos básicos.

Resumen Objetivo Comprender la percepción del acceso y de la calidad de la alimentación según personas en situación de calle. Métodos Estudio descriptivo cualitativo, realizado en un Centro de Referencia de Personas de la Calle en la región centro-sur de Belo Horizonte (Minas Gerais). Se utilizó un guion semiestructurado para realizar entrevistas a 18 participantes. La recopilación de datos se realizó entre diciembre de 2020 y enero de 2021. El análisis temático del material, propuesto por Bardin, permitió la elaboración de tres categorías empíricas. Resultados El público entrevistado era masculino, de 43 años de edad promedio y tiempo promedio de situación de calle de 44,6 meses. El acceso a la alimentación fue proveniente de donaciones de alimentos, comidas en instituciones gubernamentales y adquisiciones al disponer de ingresos. Las personas relataron dificultades con relación a la cantidad y calidad de los alimentos, a la adquisición de comida los fines de semana, a los sentimientos de miedo y angustia ante el hambre, a la falta de alimentos y al estigma social, agravados por el COVID-19. Conclusión Ante el escenario de iniquidades sociales, el derecho al acceso a la alimentación no está garantizado, por lo cual es necesario implementar políticas públicas de protección social que garanticen los derechos básicos.

Abstract Objective To understand the perception of access to food and food quality for the street population. Methods This qualitative descriptive study was performed in a Reference Center for the Homeless Population in the south-central region of Belo Horizonte (MG). A semi-structured script was used to conduct interviews with 18 participants. Data collection occurred between December 2020 and January 2021. The thematic analysis of the material, as proposed by Bardin, made it possible to elaborate three empirical categories. Results The public interviewed was male, with a mean age of 43 years, and a mean time on the streets of 44.6 months. Access to food came from donations, meals at government institutions, and acquisition when income was available. Difficulties were reported regarding the quantity and quality of food, acquisition of meals on weekends, feelings of fear and anguish in the face of hunger, lack of food, and social stigma, which were aggravated by COVID-19. Conclusion As in this scenario of social inequalities the access to food is not guaranteed, implementing public policies of social protection is necessary to guarantee basic rights.

Depression and associated psychosocial factors following a legal abortion in Mexico

Introduction: Scientific evidence from the United States and European countries shows that women who have had an induced abortion are not more likely to become depressed and several factors may confound this outcome. In contrast, in the case of Latin America, there are practically no studies in this regard due to restrictive legislation prevailing in the region. This paper aims to determine the prevalence of a probable major depressive episode (PMDE) in women who have legally terminated a pregnancy by way of public service in Mexico City and whether there are any psychosocial factors reported by the international literature associated with this outcome. Method: In a cross-sectional study, 274 women aged 15 years or older were interviewed two weeks after undergoing a medical abortion between November 2018 and November 2019. The Center for Epidemiological Studies Depression Scale 35-item version (CES-D-R35) was used to measure the PMDE in a structured interview. Results: The prevalence of a PMDE was 15.8%. Multivariate logistic regression was used for adjusted analysis. Perceived abortion stigma ( OR = 6.74, 95% CI = 3.29-13.82), child sexual abuse (OR = 2.23, 95% CI = 1.01-4.93), and previous childless pregnancies (OR = 6.07, 95% CI = 1.52-24.21) were associated with PMDE. Conclusions: The prevalence of PMDE is similar to or lower than that reported in studies with women who continued a pregnancy; post-abortion counseling and clinical considerations should include the impact that stigma and gender-based violence have on women's mental health.

Introducción: Evidencia científica proveniente de los Estados Unidos y los países europeos indica que las mujeres que han tenido un aborto inducido no tienen más probabilidades de deprimirse y que hay varios factores que pueden intervenir para confundir este resultado. En el caso de América Latina, prácticamente no existen estudios al respecto debido a las legislaciones restrictivas imperantes. El objetivo de este artículo es determinar la prevalencia de un probable episodio depresivo mayor (PEDM) en mujeres que interrumpieron legalmente un embarazo en un servicio público en la Ciudad de México, y si hay algunos factores psicosociales reportados por la literatura internacional asociados con el resultado. Método: En un estudio transversal, se entrevistó a 274 mujeres de 15 años o más dos semanas después de someterse a un aborto médico entre noviembre del 2018 y noviembre del 2019. Se utilizó la versión de 35 reactivos de la Escala de Depresión del Centro para Estudios Epidemiológicos (CES-D-R35) para medir el PEDM en una entrevista estructurada. Resultados: La prevalencia de PEDM fue de 15,8 %. Se utilizó una regresión logística multivariada para el análisis ajustado. El estigma percibido por el aborto (OR = 6.74, IC 95 % = 3.29-13.82), el abuso sexual infantil (OR = 2.23, IC 95 % = 1.01-4.93) y los embarazos previos sin hijos (OR = 6.07, IC 95 % = 1.52-24.21) se asociaron con un PMDE. Conclusiones: La prevalencia de PEDM es similar o menor que la reportada en estudios con mujeres que continuaron un embarazo; el asesoramiento posaborto y las consideraciones clínicas deben incluir el impacto que el estigma y la violencia de género tienen en la salud mental de las mujeres.

Estigma en mujeres de peso alto a través de un análisis fenomenológico interpretativo

Tener peso alto es una característica que ha sido devaluada y denigrada socialmente, convirtiendo a las personas de cuerpos grandes en víctimas de estereotipos, prejuicios y discriminación, lo que se ha denominado estigmatización por el peso, fenómeno que ocurre especialmente en mujeres. El objetivo de este estudio fue describir las experiencias de estigma de peso de mujeres con obesidad que viven en el sur de Chile. Participaron seis mujeres entre 20 y 57 años a través de entrevistas semi-estructuradas realizadas de manera remota. Mediante Análisis Fenomenológico Interpretativo se identificaron cuatro supratemas y diversos subtemas, los supratemas son: 1. La obesidad como parte de la persona. 2. Las experiencias de sentirse discriminada. 3. Todo gira en función del peso. 4. Lo que la sociedad piensa de la obesidad, los que en su conjunto permiten caracterizar la experiencia de vivir con obesidad y sufrir el estigma asociado al peso en distintos ámbitos de sus vidas, incluso en contextos sanitarios. Las consecuencias de esta experiencia son diversas y negativas, destacando el impacto que tiene en su autoestima y las constantes emociones negativas que derivan de las situaciones de discriminación. Estos resultados ponen de manifiesto la importancia de avanzar hacia la diversidad y aceptación corporal, lo que supone un desafío a la sociedad en general y en particular a los proveedores de salud, ya que se requiere de intervenciones libres de prejuicios y orientadas a la salud y el bienestar de las personas.

Carrying a high weight is a characteristic that has been devalued and socially denigrated, turning people with large bodies into victims of stereotypes, prejudice, or discrimination, which has been called weight stigmatisation, a phenomenon that occurs especially in women. The aim of this study was to describe the weight stigma experiences of women with obesity who live in southern Chile. Six women between 20 and 57 years of age participated in semi-structured interviews conducted remotely. Through Interpretative Phenomenological Analysis four supra-themes and several sub-themes were identified, the supra-themes are: 1. Obesity as part of the person. 2. Experiences of feeling discriminated. 3. Everything is about weight. 4. what society thinks of obesity, which together allow characterising the experience of living with obesity and suffering the weight stigma in different areas of their lives, including in health contexts. The consequences of this experience are diverse and negative, highlighting the impact it has on their self-esteem and the constant negative emotions that derive from discrimination situations. These results highlight the importance of moving toward body diversity and acceptance, which is a challenge for society in general and health care providers in particular, as it requires interventions free from prejudice and orientated to the health and well-being of individuals.

Construction and validation of a scale of stigma against individuals diagnosed with schizophrenia

Antecedents: Individuals diagnosed with schizophrenia are not just dealing with their diagnoses. They are facing stigma due to their pathology. International research has proposed that individuals diagnosed with schizophrenia suffer more stigma than other types of mental issues. However, in Chile, a valid scale is not available to measure stigma against individuals diagnosed with schizophrenia. Objectives: To fill this gap, this research is aimed to develop and validate a scale to measure stigma against individuals diagnosed with schizophrenia. Methods: Two stages were completed to achieve the research objective. First, a pool of items was developed based on the three critical components of stigma, cognitive, affective and behavioral. Three independent judges were asked to assess the content aspects of the content validity of the items. Second, following an instrumental and longitudinal design with non-probabilistic with a quota sampling by gender (N = 607) the validity and reliability of the final scale was assessed. Results: A one-dimensional scale composed of 22 items showed good statistical boundaries. The observed factor loadings suggest that the items adequately represent the dimension (λ>, 6), and the reliability estimates are optimal (α>, 8; ω>, 8). Results suggest that the scale can be used the respondents' gender irrespectively.

Antecedentes: Las personas diagnosticadas con esquizofrenia no solo enfrentan su diagnóstico. Ellos también tienen que enfrentar el estigma producto de su patología. Investigaciones internacionales han propuesto que las personas diagnosticas con esquizofrenia sufren más de estigma que otras patologías mentales. Sin embargo, en Chile no existe una escala validada para medir el estigma hacia personas diagnosticadas con esquizofrenia. Objetivos: Para cubrir esta necesidad en la literatura, esta investigación tiene como objetivo desarrollar y validar un instrumento para medir el estigma hacia personas diagnosticadas con esquizofrenia. Métodos: Dos etapas fueron completadas para lograr el objetivo de investigación. En primer lugar, se desarrolló un set de ítems basados en los "tres componentes centrales del estigma: creencia, emoción y conducta". Se les solicitó a tres jueces independientes evaluar estas preguntas de acuerdo con su contenido y validez. En segundo lugar, siguiendo un diseño instrumental y longitudinal con muestreo no probabilístico por cuotas por género (N = 607) se evaluó la validez y confiabilidad de la escala final. Resultados: Una escala unidimensional compuesta por 22 ítems mostró buenos límites estadísticos. Las saturaciones de factores observadas sugieren que los ítems representan adecuadamente la dimensión (λ>, 6), y las estimaciones de confiabilidad son óptimas (α>, 8; ω>, 8). Los resultados sugieren que la escala se puede utilizar independientemente del género de los encuestados

Normality and mental health: The ethical dimension / Normalidad y salud mental: La dimensión ética

Abstract This article applies the concept of normality, in both its descriptive and normative connotations, to the field of mental health, emphasizing its ethical undertones in different cultural and situational contexts. Ethics is defined as the linguistic justification of morals, and bioethics is characterized by arguments based on dialogical, discursive, and deliberative processes. Bioethical decision-making influences human relationships and has implications for diagnosis, prognosis, interventions, and evaluation of therapeutic results and outcomes. Normality in mental health should be reformulated on bioethical principles to avoid being a source of stigma and discrimination, at a time when human diversity and cultural change impose a redefinition of conceptual boundaries and depathologization of different forms of behavior and experience.

Resumen Se aplica el concepto de normalidad en sus connotaciones descriptiva y normativa al campo de la salud mental, destacando su tonalidad ética en diferentes contextos culturales y situacionales. Se define la ética como la justificación lingüística de la moral y se caracteriza a la bioética como fuente de argumentos basados en procesos dialógicos, discursivos y deliberativos. La toma de decisiones en clave bioética influencia las relaciones humanas y posee implicaciones para el diagnóstico, el pronóstico, las intervenciones y la evaluación de resultados y consecuencias. La normalidad en salud mental debiera ser reformulada sobre la base de principios bioéticos a fin de impedir ser fuente de estigma y discriminación en una época en que la diversidad y el cambio cultural imponen una redefinición de límites conceptuales y la despatologización de diferentes formas de conducta y vivencia.

In the shoes of a person with Gynaecomastia

In this narrative, I step into the shoes of someone who has lived with gynaecomastia — male breasts. Using the imaginary character of Aarav, I reflect on the themes of the stigma associated with body image, the courage to face it, and the role human relationships can play in fostering self-acceptance.

Socio-psychological Issues of Adolescents Affected with Leprosy: A Scoping Review

Skin sores, ulcers, nerve weakness, and disfigurement are a few most common leprosy complications when the diagnosis is delayed and not treated timely. The chronic nature of leprosy and the associated risks of deformities make it the most horrifying illness in human history. Although leprosy affects every segment of the population, adolescents and their highly sophisticated social life put them at additional risk and prone to severe socio-psychological problems. This study has systematically collected and reviewed published literature and arranged findings in a single report to provide a comprehensive understanding of adolescents affected by leprosy. Findings indicate that early adolescents are affected mainly compared to children (0-10 years). Household contact is the primary source of infection among adolescents, and changes in daily life, poor wellbeing, the experience of stigma, self-isolation, and reduced social mobility are prominent issues among affected adolescents. Adolescents with one or both parents affected with leprosy showed signs of anxiety, depression, poor academic performance, or dropout. Leprosy among adolescents demands extra attention due to their precarious and unsafe behavioural traits and their comparably extensive peer and social engagements. This review shows that systematic and well planned studies are required on directly or indirectly leprosy affected adolescents to further research relevant issues for defining the problems and finding solutions to various challenges so as to frame effective interventions and policies

Prevalence of Stigma Among TB Patients and Its Associated Factors - A Community Based Cross-Sectional Study in Puducherry, India

Background: Tuberculosis (TB) is a disease that has both medical as well as social dimensions. Stigma and associated discrimination experienced by persons affected by TB is a barrier to the interventions towards TB elimination. A better understanding of stigma will improve the effectiveness of the interventions aimed to al-leviate the effects of TB stigma. The objectives were to measure the prevalence of self, anticipated, experi-enced stigma and its associated factors and to explore the impact of tuberculosis related stigma among TB pa-tients. Methodology: A cross-sectional study was conducted in Puducherry district, Southern India among 420 adult drug sensitive non-HIV TB patients registered under NTEP. Data was collected by face-to-face interview using standardised questionnaire. Results: The mean(±SD) age of the study participants was 44.5 (±15.03) years. Majority were males (267, 63.6%) and were married (330, 78.6%). The prevalence of stigma among TB patients was found to be 69.3%. Perceived stigma was noted in 47.1%, 33.6% had self- stigma and 26.0% had experienced stigma. On measur-ing the impact of stigma, 52.6% reported participation restriction. Illiteracy and lower-socio economic status were found to be significantly associated with TB stigma. Conclusions: Stigma among TB patients was high. Tailored patient-centric interventions to address stigma and discrimination using culturally appropriate and locally available resources are necessary

Transtornos do espectro autista: visão de discentes dos cursos de medicina e enfermagem de uma universidade pública / Autism spectrum disorders: students' view of medicine and nursing courses at a public university

Resumo O termo estigma é oriundo do grego, relacionado a identificação de pessoas através de marcação física. A literatura aponta quatro tipos de estigmas: púbico, institucional, autoestima e de cortesia. Pessoas com Transtornos do Espectro Autista são estigmatizadas em diversas culturas e sociedades. Este estudo descreve a visão sobre estigma em relação ao Transtorno do Espectro Autista entre estudantes dos cursos medicina e enfermagem. Estudo transversal, qualitativo, dados coletados por meio de dois grupos focais, um com estudantes de medicina, outro com enfermagem, de uma universidade pública, em Alagoas. Foi utilizado um roteiro com oito perguntas para discussão nos grupos focais. As falas foram gravadas, transcritas e analisadas no software IRAMUTEQ, embasada na análise de conteúdo. A Classificação Hierárquica Descendente apresentou cinco categorias relacionadas ao Transtorno, que foram: 1 - Abordagem da pessoa com o Transtorno; 2 - Vivência de Estigma; 3 - Segregação de Pessoas com Transtorno; 4 - Cuidado com a Pessoa com o Transtorno; e a Classe 5 - Desafios enfrentados pelas pessoas acometidas

Abstract The term stigma comes from Greek, being related to the identification of people through a physical mark, which can generate marginalization. The literature points out four types of stigmas: public, institutional, self-esteem, and courtesy. People with Autistic Spectrum Disorders are stigmatized in various cultures and societies. This study describes the view on stigma regarding Autistic Spectrum Disorder among undergraduate medical and nursing students. This is a cross-sectional study of a qualitative approach, whose data were collected through two focus groups, one with medical and another with nursing students, from a public university in Alagoas, Brazil. A script with eight questions for discussion in the focus groups was used. The speeches were recorded, transcribed, and analyzed with the IRAMUTEQ software, based on content analysis. The Descending Hierarchical Classification showed five categories related to the disorder, which were: 1 - Approach to the person with the disorder; 2 - Experience of Stigma; 3 - Segregation of People with Disorders; 4 - Care of the Person with the Disorder and Class; 5 - Challenges faced by the people affected.

Discriminación racial y Determinantes Sociales de la salud en niños y niñas migrantes: revisión narrativa

Objetivo: Analizar la relación entre Determinantes Sociales de la Salud (DSS) y discriminación en niños, niñas y adolescentes migrantes a partir de la información disponible en la literatura científica. Método: Revisión narrativa de estudios primarios publicados entre 2008 y 2021 en las bases de datos PubMed y Web of Science. Se utilizaron los descriptores "Psychological/Social Discrimination", "Racism", "Social Stigma", "Social Determinants of Health", "Public Health", "Health Equity", "Transients and Migrants", "Refugees", "Emigrants and Immigrants", "Undocumented Immigrants", "Child", "Adolescent", "Child, "Preschool". Los operadores booleanos utilizados fueron AND y OR. Se incluyeron artículos observacionales (analíticos o descriptivos) que evaluaran la relación entre discriminación racial y DSS, publicados en inglés o español. La población de estudio fueron niños, niñas y adolescentes. La selección de artículos se realizó siguiendo las recomendaciones PRISMA. La calidad de la evidencia fue evaluada mediante la herramienta MMAT. Resultados: De un total de 1249 artículos identificados, se incluyeron 55. La mayor cantidad de artículos identificó el efecto de la relación entre discriminación racial y migración en ámbitos de salud mental negativa. Fue escasa la evidencia respecto de determinantes estructurales, sin embargo, destaca la relación entre discriminación racial y el efecto moderador de la familia y la escuela. Conclusiones: Analizar la discriminación racial que perciben niños y niñas migrantes mediante un enfoque de DSS permite identificar áreas sensibles al desarrollo estrategias de reducción de inequidades en este grupo.

Objective: To analyze the relationship between Social Determinants of Health (SDH) and racial discrimination in migrant children and adolescents, based on the information available in the scientific literature. Method: Narrative review of primary studies published between 2008 and 2021 in PubMed and Web of Science databases. The descriptors "Psychological/Social Discrimination", "Racism", "Social Stigma", "Social Determinants of Health", "Public Health", "Health Equity", "Transients and Migrants", "Refugees", "Emigrants and Immigrants", "Undocumented Immigrants", "Child", "Adolescent", "Child", "Preschool" were using. The Boolean operators used were AND OR. We included observational articles (analytical or descriptive) that evaluated the relationship between racial discrimination and SDH, published in English or Spanish. The study population was children and adolescents. We select articles following the PRISMA recommendations. The evaluation of the quality of the evidence was made using MMAT. Results: Of a total of 1249 articles identified, 55 articles were included. The most significant number of articles identified the relationship between racial discrimination and migration on adverse mental health outcomes. Evidence regarding structural determinants was scarce; however, the relationship between racial discrimination and the moderating effect of family and school stands out. Conclusions: Analyzing racial discrimination as perceived by migrant children through a DSS approach allows us to identify sensitive areas to develop strategies to reduce inequities in this group.

Representaciones sociales de estudiantes de posgrado en psicología respecto a personas trans / Social Representations of Graduate Students in Psychology regarding trans people

Resumen Los derechos humanos de la población trans son vulnerados como consecuencia del heterocispatriarcado y las representaciones sociales generadas, promovidas y reforzadas por este sistema hegemónico. El objetivo de este artículo es describir las representaciones sociales que tienen los estudiantes de un posgrado en psicología de una universidad privada de Cali sobre las personas trans, así como las necesidades y retos que perciben en su quehacer profesional con esta población. Este es un estudio cualitativo, fenomenológico-interpretativo, en el que participaron voluntariamente 45 estudiantes de la asignatura de Salud Sexual y Salud Reproductiva. Los datos se recogieron por redes semánticas naturales y grupos de discusión y fueron procesados desde la teoría de análisis temático. La investigación se ajusta a principios de beneficencia, no maleficencia y autonomía. De igual forma, se fundamenta en conocimiento acumulado bajo estricto rigor metodológico. Se clasificó como una investigación con riesgo mínimo. Las representaciones sociales de algunos participantes sobre las personas trans están asociadas a aspectos estigmatizantes y excluyentes, que pueden transformarse positivamente en la interacción con la comunidad en cuestión. Se concluye que las representaciones sociales tienen un rol fundamental en la calidad de la atención en salud. Es importante capacitar a los estudiantes de la salud y las ciencias sociales en temas de sexualidad, interacciones humanas, autocuidado, respeto por el otro y por sí mismo, además de habilidades para la toma de decisiones, comunicación asertiva, pensamiento crítico y resolución de conflictos desde un enfoque transafirmativo, de género y de derechos.

Abstract The human rights of the trans population are violated because of heterocispatriarchy and the social representations generated, promoted, and reinforced by this hegemonic system. The objective of this article is to describe the social representations that students of a graduate program in psychology at a private university in Cali have about trans persons, as well as the needs and challenges they perceive in their professional work with this population. This is a qualitative, phenomenological-interpretative study, in which 45 students of the Sexual Health and Reproductive Health course voluntarily participated. The data were collected by natural semantic networks and discussion groups and were processed from the thematic analysis theory. The research conforms to the principles of beneficence, non-maleficence, and autonomy. Likewise, it is based on accumulated knowledge under strict methodological rigor. It was classified as research with minimal risk. The social representations of some participants about trans persons are associated with stigmatizing and excluding aspects, which can be positively transformed in the interaction with the community in question. It is concluded that social representations play a fundamental role in the quality of health care. It is important to train health and social science students in sexuality, human interactions, self-care, respect for others and for oneself, as well as decision-making skills, assertive communication, critical thinking, and conflict resolution from a transaffirmative, gender and rights-based approach.

Mental illness attitudes in medical education: Assessing the stigma in medical students / Actitudes hacia los trastornos mentales en la educación médica: evaluando el estigma en estudiantes médicos

Abstract Introduction Factors affecting the quality of physician care include a shortage of trained staff, stigma, and discrimination. Objective The objective was to compare the intensity of stigmatization before and after a Psychiatry course, as measured by the scale of clinicians' attitudes towards mental illness, a version for medical students (MICA-2) designed to identify stigmatic attitudes towards mental disorders. Method The fifth-year Medicine students enrolled in the Psychiatry course answered anonymously using the MICA-2 test at the start and the end of their course. Additionally, we asked the students to answer a question about their interest in learning more about mental illness. Results Three hundred and thirty students were invited; 300 agreed to participate in the first application of the scales, and 291 in the follow-up. The average age was 22 ± 2 years, with a range of 20-30 years, and there was a similar gender distribution in both applications. In the initial application, the average score of the MICA-2 was 41.34 (SD = 7.86, 95% CI = [40.43, 42.25]). The follow-up application's mean was 37.10 (SD = 8.15, 95% CI = [36.30, 38.15]). Also, there was a decrease in interest in learning more about mental illness. Discussion and conclusion A reduction in the average scores of the MICA-2 was observed after a Psychiatry course, suggesting that attitudes toward mental disorders improved. A Psychiatry clerkship with close supervision modified the attitudes of medical students toward mental disorders. However, it did not increase their interest in learning more about mental illness.

Resumen Introducción Los factores que afectan la calidad de la atención médica incluyen: la escasez de personal capacitado, el estigma y la discriminación. Objetivo El objetivo fue comparar la intensidad de la estigmatización antes y después del curso de Psiquiatría, se utilizó la escala de las actitudes de los clínicos hacia la enfermedad mental, versión para estudiantes médicos (MICA-2), diseñada para identificar actitudes estigmatizantes hacia los trastornos mentales. Método Los estudiantes médicos de quinto año que tomaban el curso de Psiquiatría respondieron de forma anónima la escala MICA-2 al inicio y al final del curso. Además, se les preguntó sobre su interés en aprender más sobre los trastornos mentales. Resultados Se invitaron a 330 estudiantes; 300 aceptaron participar en la primera aplicación de las escalas y 291 en el seguimiento. La edad promedio fue de 22 ± 2 años, con un rango de 20-30 años; con una distribución de género similar en ambas aplicaciones. En la aplicación inicial, la puntuación media del MICA-2 fue de 41.34 (DE = 7.86, IC 95% = [40.43, 42.25]). En la de seguimiento, la media fue de 37.10 (DE = 8.15, IC 95% = [36.30, 38.15]). El interés en aprender más sobre los trastornos mentales disminuyó. Discusión y conclusión Observamos una reducción en los puntajes promedio después de tomar el curso de Psiquiatría, lo que sugiere que las actitudes hacia los trastornos mentales mejoraron. Un curso de Psiquiatría con mayor disposición y supervisión estrecha modificó las actitudes hacia los trastornos mentales de los estudiantes médicos, pero su interés en aprender más sobre los trastornos mentales disminuyó.

Prevalence, Characteristics and Socio-Demographic Correlates of Self-Stigma among Leprosy Affected Persons - A Case Study

This study has determined the prevalence of self-stigma, its characteristics in terms of alienation, stereotype endorsement, perceived discrimination and social withdrawal and stigma resistance among leprosy-affected persons and its relationship and extent of this relationship with various socio-demographic features. This has been done by carrying out a cross-sectional survey of 120 active people affected by leprosy during 2020-21. An internationally validated and standardised instrument (ISMI) was used to measure self-stigma. Statistical techniques such as independent t-test, Pearson’s and point biserial correlation and regression analysis were used for data analysis. The study found significant correlations between ISMI self-stigma scores and socio- demographic variables with moderate to minor deviation across the four components of the ISMI scale. The high to low correlation of various components of the ISMI scale found is discrimination experience, followed by stigma resistance, stereotype endorsement and alienation. Overall, the highest self-stigma was found in disabled people affected by leprosy, followed by those whose age was less than 40 years, followed by unemployed and male people affected by leprosy. It was concluded that alienation was maximum among people affected by leprosy who were either disabled, aged less than 40 years or were males. Discrimination experience was reported mainly by unemployed, disabled, males and younger people affected by leprosy. The findings indicate that proper methodology and components of Cognitive Behavioural Therapy may help reduce self-stigma among leprosy-affected persons

Hanseníase e vulnerabilidade: uma revisão de escopo / Leprosy and vulnerability: a scoping review

Resumo O estudo teve como objetivo a revisão de trabalhos científicos publicados sobre a hanseníase como problema de saúde pública no Brasil e o marcador de vulnerabilidade para os portadores da enfermidade. Foi realizada uma scoping review com o descritor "hanseníase AND vulnerabilidade" na base de dados da Biblioteca Virtual em Saúde (BVS). Foram selecionados 29 artigos publicados entre janeiro de 2016 e dezembro de 2020 que atenderam aos critérios de inclusão. Os resultados apontaram para trabalhos científicos publicados em revistas indexadas e com diferentes fatores de impacto, com destaque para a maioria das publicações selecionadas constarem em periódicos com métricas de impacto pouco significativas aos olhos da comunidade internacional, ainda que elas tenham impacto nacional. A maioria dos estudos teve abrangência municipal, com destaque para cidades do Norte e do Nordeste brasileiro. Os trabalhos trataram a vulnerabilidade na hanseníase utilizando distintas tipologias.

Abstract The objective of this work was to review published scientific works on leprosy as a public health problem in Brazil, and the marker of vulnerability for people with the disease. A scoping review was carried out with the descriptor 'leprosy AND vulnerability', on the Virtual Health Library (BVS) database. A total of 29 articles published between January 2016 and December 2020 that met the inclusion criteria were selected. The results pointed to scientific papers published in indexed journals and with different impact factors, with emphasis on the fact that most of the selected publications appear in journals with impact metrics that are not very significant in the eyes of the international community, even though they have national impact. The majority of the studies had municipal coverage, with emphasis on cities in the North and Northeast of Brazil. The works addressed vulnerability in leprosy using different typologies.

Study on the status quo of spiritual nursing needs and its correlation with disability acceptance and stigma of patients with permanent enterostomy / 中国实用护理杂志

Objective:To investigate the status quo of spiritual nursing needs and its influencing factors of patients with permanent enterostomy, and analyze its correlation with disability acceptance and stigma, so as to provide a reference for the construction of targeted spiritual nursing intervention programs.Methods:A total of 351 patients with permanent enterostomy in Xiangya Hospital Central South University and Hunan Cancer Hospital were selected by convenience sampling from January 2021 to March 2022. A cross-section by using the self-made general information questionnaire, Nurse Spiritual Therapeutics Scale (NSTS), Acceptance of Disability Scale (ADS), and Stigma Scale for Chronic Illness (SSCI). And multiple linear regression was used to analyze the influencing factors of spiritual nursing needs of patients with permanent enterostomy.Results:The total score of spiritual nursing needs of patients with permanent enterostomy was 30.15 ± 6.46, and the average score of items was 2.51 ± 0.78. Among the five dimensions, the highest average score was creating a good atmosphere 3.10 ± 0.98, and and the lowest was helping religious practice 1.65 ± 0.70. The total score of disability acceptance was 81.94 ± 13.86; the total score of stigma was 64.03 ± 14.28. The total scores of spiritual nursing needs were positively correlated with the total scores of disability acceptance ( r=0.703, P<0.01), and negatively correlated with the total scores of stigma ( r=-0.516, P<0.01). Multivariate linear regression analysis showed that religious beliefs, educational level, residence, course of disease, disability acceptance, and stigma were the main influencing factors for the spiritual nursing needs of patients with permanent enterostomy ( t values were -13.26-13.56, all P<0.01), accounting for 52.5% of the total variation. Conclusions:The spiritual nursing needs of patients with permanent enterostomy were moderate. It is suggested that nurses can develop targeted spiritual nursing measures according to the individualized characteristics of patients, improve their disability acceptance and reduce their stigma level, so as to meet their spiritual nursing needs and realize their spiritual safety.

Study on the status quo and correlation between body image and stigma of drug-resistant tuberculosis patients treated with Clofazimine / 中国实用护理杂志

Objective:To investigate the current situation of body image and stigma of drug-resistant tuberculosis patients treated with Clofazimine, and analyze the correlation between them.Methods:A cross-sectional study was conducted using convenience sampling method to investigate 150 patients with drug-resistant tuberculosis treated with Clofazimine in tuberculosis ward of Chengdu Public Health Clinical Medical Center from October 2020 to October 2021. The general questionnaire, Body Image Scale (BIS) and Tuberculosis Related Stigma Scale were used to conduct a questionnaire survey.Results:A total of 130 questionnaires were effectively collected. The body image score of 130 patients with drug-resistant tuberculosis treated with Clofazimine was (20.51 ± 6.80) points; the score of stigma was (17.78 ± 6.92) points. There was a positive correlation between the total score of disease shame and the total score of body image ( r=0.544, P<0.05). Conclusions:Patients with drug-resistant tuberculosis treated with Clofazimine have body image disorder and stigma, and the two are positively correlated. Caregivers should carry out psychological assessment and intervention at an early stage to improve the patient′s mental health level.

Analysis of the correlation between stigma and coping styles and social support among parents of children with autism spectrum disorders / 四川精神卫生

BackgroundThe incidence of autism spectrum disorders （ASD） is showing an upward trend， and the treatment and training process for children with ASD is lengthy， placing a heavy burden on their families. Such fact results in parents being prone to feelings of stigma. However， there exists a lack of research studying on the stigma among parents of children with ASD. ObjectiveTo explore the relationship between stigma and coping styles and social support of parents with ASD， and to provide references for practices of reducing stigma level and taking targeted interventions in this group. MethodsThis study involved parents of children diagnosed with ASD and admitted to the children's health clinic of a tertiary hospital in Urumqi between January 2021 and May 2022. General information questionnaire， Affiliate Stigma Scale （ASS）， Simplified Coping Style Questionnaire （SCSQ） and Social Support Rating Scale （SSRS） were employed to conduct investigation. Pearson correlation analysis was used analyze the correlation between stigma， coping styles and social support. ResultsThe ASS total score of parents of children with ASD was （52.40±11.22）. Correlation analysis results showed that the ASS total score of parents was positively correlated with the score of negative coping dimension in SCSQ （r=0.787， P<0.01）， and negatively correlated with the score of positive coping dimension in SCSQ and SSRS total score （r=-0.565， -0.795， P<0.01）. The result of regression analysis suggested that stigma among parents of children with ASD was affected by coping style and social support （∆R2=0.768， F=114.931， P<0.01）. These two factors could explain 76.80% of the total variance. ConclusionParents of children with ASD have stigma of moderate to high level， and coping styles and social support are two important factors influencing the stigma. ［Funded by Xinjiang Uygur Autonomous Region Science and Technology Program Resource Sharing Platform Construction Project （number， PT2215）］

CiteSpace knowledge map of research status and trends of Croci Stigma / 中国中药杂志

This study retrieved Croci Stigma related literature from CNKI, Wanfang, VIP, and Web of Science database, and used bibliometrics and CiteSpace 6.1.R2 software to analyze the published Croci Stigma related articles in Chinese and English from 2000 to 2022. The authors, research institutions, and keywords were visualized and analyzed, and the current status and development trend of Croci Stigma research was summarized by combining the information extraction methods. A total of 1 846 Chinese articles and 2 703 English articles were screened out and included. The results showed a generally steady increase in the number of Croci Stigma related articles. The results of the visualization analysis showed that there were more collaborations between researcher teams and major research institutions in English articles than Chinese articles. The Chinese articles was mainly published by China Pharmaceutical University, and most of the inter-institutional collaborations occurred in neighboring regions. The English articles was mainly published by Iranian institutions, and most of the cooperation occurred within the country, with less transnational cooperation. Keywords analysis showed that the research on Croci Stigma was mainly focused on chemical compositions, pharmacological effects, mechanisms, quality control, etc. It was predicted that the future research hotspots of Croci Stigma would mainly focus on pharmacological mechanism and clinical efficacy. The current research related to Croci Stigma still needs to be developed, cooperation should be strengthened, and more in-depth research should be conducted.