Challenges faced by migrant seasonal agricultural farmworkers for food accessibility in Spain: A qualitative study.

ABSTRACTMigrants who work seasonally in agriculture face living and working conditions that significantly impact their health. Some of these conditions are related to inadequate food access or food preservation and preparation hygiene. This study aimed to explore how migrant and seasonal agricultural farmworkers access food in Spain from the perspective of professionals supporting this population. We conducted a qualitative study in 2021 based on semistructured interviews with 92 social and health service professionals involved in the care of seasonal migrant workers in 4 Spanish provinces. We identified three themes through reflective thematic analysis: (1) Access to food depends on NGOs and institutions, especially after the COVID-19 pandemic; (2) Relevant cultural differences in diet depending on North African or sub-Saharan origin; (3) Seasonal migrant workers frequently suffer from nutritional and other health problems related to food security. The professionals interviewed described the diet of seasonal migrant workers as based on food with little variety, insufficient protein content, and obesogenic products. They also reported a generalized lack of hygiene in food storage and preparation. This study calls for encouraging dietary support strategies to reduce challenges in food accessibility, which would prevent health problems in this population and bring them social justice.

Water insecurity among seasonal agriculture workers: perspectives from Spanish professionals.

BACKGROUND: Migrant seasonal agricultural workers face conditions of material vulnerability such as inadequate housing difficulties prevent access to running water supplies. The purpose of this study is to explore the perceptions of professionals involved in the care and support of seasonal migrant agricultural workers, as it relates to water access and water consumption and their impact on these workers' health, in a context of COVID-19 pandemic. METHODS: A qualitative exploratory and descriptive study was conducted in 2021 as part of a larger research project, based on 63 personal semi-structured interviews with professionals who provided support to seasonal migrant agricultural workers in three Spanish autonomous regions. COREQ checklist was used for reporting. The interviews were recorded, transcribed, and imported into ATLAS.ti-9 for an inductive thematic analysis. RESULTS: The results have been structured into two main themes: (1) Accessing and obtaining water; and (2) Health problems related to water consumption. Seasonal migrant agricultural workers experience barriers to obtaining safe water for hygiene, cleaning, food preparation and drinking. The implementation of regulations to reduce COVID-19 transmission resulted in improved hygiene levels in the migrants' quarters, including access to safe drinking water. CONCLUSION: This study suggests that water insecurity experienced by migrant seasonal agricultural workers in Spain results from their poor living conditions and causes health problems related to a lack of hygiene and the use of unsafe water. Sustainable solutions are needed beyond the pandemic in order to provide migrant workers with adequate living conditions and ensure their water needs are fulfilled.

Austerity Measures and Underfunding of the Spanish Health System during the COVID-19 Pandemic-Perception of Healthcare Staff in Spain.

Insufficient pandemic preparedness and underfunding of human and economic resources have conditioned the response to COVID-19 in Spain. This underfunding has continued since the austerity measures introduced during the 2008 financial crisis. This study aims to understand the perceptions of healthcare staff in Spain on the relationship between the funding of the health system and its capacity to respond to the COVID-19 pandemic. To this end, we carried out a thematic content analysis, based on 79 online semi-structured interviews with healthcare staff across the regions most affected by the COVID-19 first wave. Participants reported a lack of material resources, which had compromised the capacity of the health system before the pandemic. The lack of human resources was to be addressed by staff reorganisation, such as reinforcing hospital units to the detriment of primary health care. Staff shortages continued straining the COVID-19 response, even after material scarcities were later partially alleviated. Personnel shortages need to be adequately addressed in order to adequately respond to future health crises.

Cultural competency among Lithuanian nurses and preparedness to work with intercultural immigrants: A quantitative study protocol.

Introduction: Health care providers are increasingly required to provide care to patients from diverse cultural backgrounds. A culturally competent approach could be used to address gaps in the health care of migrants, whether they are refugees, asylum seekers, or undocumented migrants. From June 2021 onward, there are estimated to be 4,300 asylum seekers in Lithuania who crossed the Belarusian border. Furthermore, ~65 thousand Ukrainians registered within 6 months of the beginning of the war on 24 February 2022. Aim: To determine the cultural competence of Lithuanian nurses using the Nurse Cultural Competence Scale (NCCS) questionnaire. Methods: A quantitative study evaluating the cultural competency of nursing professionals will be conducted using the Lithuanian version of the Nurse Cultural Competence Scale (NCCS). The study will be conducted in Lithuanian municipalities and will involve primary, secondary, and tertiary health care providers. Discussion: This study will provide data that can guide the development and evaluation of interventions designed to reduce health disparities among migrants, including the need to identify the appropriate type of cultural competency training for nurses. In addition to the results of this study, it may provide an indication of other cultural competency required for nurses. This includes consideration of religion, sexual orientation, gender identity, household classifications on the basis of urban vs. rural areas, language spoken, and country of origin.

The role of nurses in euthanasia: A scoping review.

OBJECTIVE: To define the role and scope of nursing practice within the global context of the euthanasia process by reviewing international legislation and scientific literature. BACKGROUND: Euthanasia is a controversial ethical topic that has been widely discussed. The provision of euthanasia involves a multidisciplinary health care team, in which nurses often have secondary roles. However, nurses play key roles in all major healthcare processes. As increasing numbers of countries are currently regulating or considering the inclusion of euthanasia as a healthcare service, there is an urgent need to define nurses' roles and participation in this process. DESIGN: A scoping review of research published in English, Spanish, French, Dutch, or Portuguese between 1992 and April 2021 was undertaken. Medline (PubMed), CinahlPlus, EMBASE, WoS, PsycInfo, and Scopus were searched for eligible articles. METHODS: Data were analysed using an adapted version of Arksey and O'Malley's framework methodology. A total of 31 scientific papers, and 11 legislation documents were included. RESULTS: Analyses of current laws showed that few territories have legislation with well-defined nurses' roles. Based on the scientific research, we identified 15 roles and 80 tasks nurses assume during the euthanasia process. We divided our results into five categories: initial care and accompaniment, evaluation of patient's condition, euthanasia procedure, debriefing and notification, and overall role. CONCLUSIONS: Nurses perform tasks throughout the euthanasia process. The review of the current legislation and the existing body of scientific literature showed a lack of legislation of the roles nurses assume, thus leading them to participate in practices outside of the legal framework. Policymakers should take into consideration the wide range of roles and tasks nurses assume in the provision of euthanasia to meet their educational and support needs and ensure they are effectively included in this complex process.

Who's in the House? Staffing in Long-Term Care Homes Before and During COVID-19 Pandemic.

Critical gaps exist in our knowledge on how best to provide quality person-centered care to long-term care (LTC) home residents which is closely tied to not knowing what the ideal staff is complement in the home. A survey was created on staffing in LTC homes before and during the COVID-19 pandemic to determine how the staff complement changed. Perspectives were garnered from researchers, clinicians, and policy experts in eight countries and the data provides a first approximation of staffing before and during the pandemic. Five broad categories of staff working in LTC homes were as follows: (1) those responsible for personal and support care, (2) nursing care, (3) medical care, (4) rehabilitation and recreational care, and (5) others. There is limited availability of data related to measuring staff complement in the home and those with similar roles had different titles making it difficult to compare between countries. Nevertheless, the survey results highlight that some categories of staff were either absent or deemed non-essential during the pandemic. We require standardized high-quality workforce data to design better decision-making tools for staffing and planning, which are in line with the complex care needs of the residents and prevent precarious work conditions for staff.

Trabajo agrícola y migración en España: precariedad sociolaboral y salud (Proyecto AGROMISALUD) / Agricultural work and migration in Spain: socio-labour precariousness and health (AGROMISALUD project)

Objetivo: Valorar la influencia de la precariedad laboral y la exclusión social en la salud de hombres y mujeres migrantes que trabajan en el sector agrícola en España. Método: Se recogerán datos cualitativos y cuantitativos en cuatro comunidades autónomas (Cataluña, La Rioja, Murcia y Andalucía) entre 2021 y 2022. En una primera fase se realizarán entrevistas personales semiestructuradas, con un mínimo de 40 informantes clave profesionales o expertos (de ONG, asociaciones, sanidad, servicios sociales, sindicatos, cooperativas agrícolas, política y mediadores culturales). En una segunda fase se combinarán entrevistas personales con técnicas cualitativas participativas (body mapping y photovoice), con 40 hombres y mujeres migrantes jornaleros/as. En una tercera fase se realizará un estudio transversal con una muestra estimada de 400-500 migrantes jornaleros/as basada en la Encuesta Nacional de Salud y la Encuesta de Condiciones de Vida. (AU)

Objective: To assess the influence of job insecurity and social exclusion on the health of migrant men and women working in the agricultural sector in Spain. Method: Qualitative and quantitative data will be collected in four Spanish autonomous regions (Catalonia, La Rioja, Murcia, and Andalusia) between 2021 and 2022. First, semi-structured personal interviews with at least 40 professional key informants or experts (from NGOs, associations, health, social services, trade unions, agricultural cooperatives, politics, and cultural mediators). Second, semi-structured personal interviews combined with participatory techniques (body mapping and photovoice) will be conducted with 40 migrant men and women working in agriculture. Thirdly, a cross-sectional study with an estimated sample of 400-500 migrants working in agriculture, based on the National Health Survey and the Living Conditions Survey.

Gender Equality and the Global Gender Gap in Life Expectancy: An Exploratory Analysis of 152 Countries.

When looking at life expectancy (LE) by sex, women live longer than men in all countries. Biological factors alone do not explain gender differences in LE, and examining structural differences may help illuminate other explanatory factors. The aim of this research is to analyse the influence of gender inequality on the gender gap in LE globally. We have carried out a regression analysis between the gender gap in relativised LE and the UN Gender Inequality Index (GII), with a sensitivity analysis conducted for its three dimensions, stratified by the six World Health Organization (WHO) regions. We adjusted the model by taking into consideration gross national income (GNI), democratic status and rural population. The results indicated a positive association for the European region (ß=0.184) and the Americas (ß=0.136) in our adjusted model. Conversely, for the African region, the relations between gender equality and the LE gender gap were found to be negative (ß=-0.125). The findings suggest that in the WHO European region and the Americas, greater gender equality leads to a narrowing of the gender LE gap, while it has a contrary relationship in Africa. We suggest that this could be because only higher scores in the GII between men and women show health benefits.

Health and social needs of asylum seekers and Ukrainian refugees in Lithuania: A mixed-method protocol.

Refugees, asylum seekers, and migrants often do not end up in the places they expected. Because of the pandemic impacts, their exposure to COVID-19 may be increased as a result of crowded camps and detention centers. A total of 4,537 undocumented migrants entered Lithuania via Belarus from June 2021 to November 30, 2022. In the period 24 February 2022 to 30 November 2022, Lithuania's Immigration Department registered 71,386 Ukrainian refugees. This study investigates the healthcare and social needs of recent asylum seekers who have crossed the Belarusian border and Ukrainian refugees in Lithuania. This is a study protocol for a mixed-methods study which will involve qualitative interviews with asylum seekers who crossed from Belarus in June 2021 and Ukrainian refugees. During a quantitative phase, refugees and asylum seekers will be asked to complete questionnaires. In this study, validated questionnaires will be used, including the Hopkins Symptom Checklist (HSCL-25), the Harvard Trauma Questionnaire (HTQ), and the Short Form 36 (SF-36). Participants will also be asked to self-report sociodemographic information. As a result of the findings of this study, it is possible to provide guidelines for improving access to health care services, including prevention (i.e., vaccination programs) and treatment of chronic and acute illnesses, through primary and secondary healthcare delivery, thereby reducing negative health outcomes. This study may shed light on the social needs of asylum seekers and refugees in Lithuania. In addition, this may provide insight into how they are integrating into the community, such as what their employment and educational prospects are.

Advancing gender equ(al)ity, lifting men's health: dealing with the spirit of our time.

In this paper, we jointly address two connected issues that should be addressed together more purposefully within both public health policies and programmes: the health and well-being of men and boys, and the focus on equity versus equality from a gender perspective. Awareness of these issues has boosted the debate on the impacts of gender inequality on health and men's role within it. Although this essay is not intended as an in-depth review on the subject, we provide a brief approach to some critical factors interwoven in the process of achieving greater gender equality. We identify some of the challenges that may arise for both policy and new research that seek to assume a relational gender approach that also pays greater attention to men's health.

COVID-19 en clave de género / COVID-19 in gender key

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[The study of health in men from a gender perspective: where we come from, where are we going]. / El estudio de la salud de los hombres desde una perspectiva de género: de dónde venimos, hacia dónde vamos.

Comprehensive and in-depth analyses of differences and inequalities in health require a broad-based approach to the study of masculinities and men's health. Interest in this issue has grown in parallel to increased concern over specific risks and vulnerabilities faced by men, but also due to the need to involve them in programs capable of promoting progress towards gender-based health equity. This article attempts to reframe these issues from the perspective of public health, providing a wider viewpoint on men's health situated within debates on the social determinants of health and the analysis of health inequalities. Based on a relational gender approach, we formulate some recommendations regarding policy and research agendas, which we argue can contribute to advancing the study and development of programs from a gender-based perspective in health.

Llevar a cabo un análisis más integral y profundo de las diferencias y desigualdades en salud requiere de una aproximación más amplia al estudio de las masculinidades y la salud de los hombres en el momento actual. Estamos ante un tema cuyo interés ha ido a la par de la creciente preocupación por los riesgos y vulnerabilidades específicas de los hombres, pero también de la necesidad de involucrarlos en programas con capacidad de promover cambios positivos en el orden de género hacia la equidad en salud. Este artículo resitúa este campo dentro de la salud pública, proporcionando una visión amplificada sobre la salud de los hombres dentro del debate de los determinantes sociales de la salud y el análisis de las desigualdades. Sobre la base de un enfoque relacional de género, se formulan una serie de recomendaciones orientadas a las políticas y la investigación, que consideramos pueden contribuir a avanzar en el estudio y el desarrollo de programas desde una perspectiva de género en salud.

El estudio de la salud de los hombres desde una perspectiva de género: de dónde venimos, hacia dónde vamos / The study of men's health from a gender-based perspective: where we come from, where we are going

RESUMEN Llevar a cabo un análisis más integral y profundo de las diferencias y desigualdades en salud requiere de una aproximación más amplia al estudio de las masculinidades y la salud de los hombres en el momento actual. Estamos ante un tema cuyo interés ha ido a la par de la creciente preocupación por los riesgos y vulnerabilidades específicas de los hombres, pero también de la necesidad de involucrarlos en programas con capacidad de promover cambios positivos en el orden de género hacia la equidad en salud. Este artículo resitúa este campo dentro de la salud pública, proporcionando una visión amplificada sobre la salud de los hombres dentro del debate de los determinantes sociales de la salud y el análisis de las desigualdades. Sobre la base de un enfoque relacional de género, se formulan una serie de recomendaciones orientadas a las políticas y la investigación, que consideramos pueden contribuir a avanzar en el estudio y el desarrollo de programas desde una perspectiva de género en salud.

ABSTRACT Comprehensive and in-depth analyses of differences and inequalities in health require a broad-based approach to the study of masculinities and men's health. Interest in this issue has grown in parallel to increased concern over specific risks and vulnerabilities faced by men, but also due to the need to involve them in programs capable of promoting progress towards gender-based health equity. This article attempts to reframe these issues from the perspective of public health, providing a wider viewpoint on men's health situated within debates on the social determinants of health and the analysis of health inequalities. Based on a relational gender approach, we formulate some recommendations regarding policy and research agendas, which we argue can contribute to advancing the study and development of programs from a gender-based perspective in health.

Occupational Precariousness of Nursing Staff in Catalonia's Public and Private Nursing Homes.

Nursing staff who provide care in the nursing homes of Catalonia have more precarious work conditions, including more demanding schedules and work overload, than those in other areas of care. This situation entails two major problems: Detrimental health results for nurses who face psychosocial and physical risks and a negative impact on the care provided to patients, with a decrease in the quality of care. This study aimed to describe the precarious employment situation of nursing staff in nursing homes. We carried out a descriptive study based on the employment precariousness scale (EPRES), which was administered to a sample of 239 nurses and nursing assistants working in public and private nursing homes in Catalonia. The highest level of job insecurity occurred among nursing assistants and in privately managed nursing homes. The precariousness of the working conditions of nursing staff poses a risk both to the workers themselves and to the people they tend to. For this reason, there is a need for greater knowledge on the scale of the problem and the implementation of appropriate legislative measures to alleviate it.

Inclusión de la orientación afectivo-sexual y de las identidades de género como determinantes sociales de la salud / Inclusion of affective-sexual orientation and gender identities as social determinants of health

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