PP109 Horizon Scanning For Information Providing In Brazil

2017 ◽  
Vol 33 (S1) ◽  
pp. 123-124
Author(s):  
Pollyanna Gomes ◽  
Avila Vidal ◽  
Andrea Brígida de Souza ◽  
Vania Canuto ◽  
Clarice Petramale
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Latin American ◽  
National Committee ◽  
Scanning System ◽  
Specific Information ◽  
Ministry Of Health ◽  
Horizon Scanning ◽  
Definition Of ◽  
The Right

INTRODUCTION:The last five years represented an advanced season for the establishment and reinforcement of the Brazilian Ministry of Health's Horizon Scanning System. The recognition of Horizon Scanning (HS) as a tool for evidence- based decision making has been reflected in the requests for information directed to the Horizon Scanning's team. These requests for information about new and emerging technologies come from cabinets offices and thematic departments of the Ministry of Health. The methodology of Horizon Scanning assessments described in EuroScan's toolkit1 has been applied to guarantee that the information reach stakeholders at the right time. The National Committee for Health Technology Incorporation (CONITEC) was accepted as a member of EuroScan (1) in 2016, and this represented another important step of Brazil's HS System.METHODS:In order to provide the specific information requested, the assessments of the technologies are done. So, databases on ongoing clinical trials, commercial pharmaceutical database, registration and licensing sites, proceedings and abstracts of scientific conferences and scientific databases are checked to collect the information. The extent and depth of the assessments depends on the stakeholders needs and time available to complete them. However, information as how the technology works, the clinical burden of disease, if there are available technologies in the Brazilian Public Health System to treat the disease, safety and effectiveness data, the regulatory status in the world as well costs, social, ethical and legal concerns are commonly given.RESULTS:The information provided using the HS methodology is used by stakeholders for several purposes as to defend the Ministry of Health in the Courts in the typical Latin American phenomena called “judicialization of health;” in assistance of the decision making of incorporation of technologies by the Brazilian Public Health and to support the definition of which medicines would be more strategic for establishment of Public-private partnerships for development of medicines, the named “Productive Development Partnerships (PDPs)”.CONCLUSIONS:The assessment of the technologies and the prediction of its potential for impact has helped the health policy making process in Brazil.

Making Decisions as A Student: Decision-Making Opportunities

2013 ◽  
Author(s):  
Deborah Roberts
Keyword(s):  
Decision Making ◽  
Nursing Education ◽  
Clinical Reasoning ◽  
Opportunity To Learn ◽  
Leadership Management ◽  
Professional Body ◽  
Right Reason ◽  
Definition Of ◽  
The Right

This chapter introduces the underlying principles of decision making. You will be encouraged to consider decision making as a student in university together with decision making as a student nurse (see Chapter 1 ). In 2010, following a review of pre-registration nursing education, the professional body for nursing in the United Kingdom, the Nursing and Midwifery Council (NMC), published new Standards for Pre-Registration Nursing Education , including competencies that all students must achieve to qualify as a registered nurse. These competencies have to be met in four broad areas known as ‘domains’. 1. Professional values 2. Communication and interpersonal skills 3. Nursing practice and decision making 4. Leadership, management, and team working You will find reference to these domains throughout the book, and there will be an opportunity to learn how the competencies in each of these that relate to decision making can be linked to your clinical and university-based learning. There are a number of terms that can be found in the literature that are often used interchangeably; you may see terms such as ‘decision making’, ‘problem solving’, ‘clinical reasoning’ or ‘clinical judgement’, and others used when writers are discussing how and why nurses respond to clinical situations in a particular way (see Chapter 1 for more detail). For example, Levett-Jones et al. (2010: 515) provide a helpful definition of clinical reasoning as ‘the process by which nurses collect cues, process the information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes, and reflect on and learn from the process’. They also emphasize that a nurse’s ability to develop these clinical reasoning skills depends on what they term as ‘five rights’—that is, the nurse’s ability ‘to collect the right cues and to take the right action for the right patient at the right time and for the right reason’. In the context of ensuring that any patient receives the best possible care, these ‘five rights’ are very appropriate, and indeed if one were to fail to pick up on the right cues and to take the appropriate actions in many clinical situations, the outcome may have serious repercussions for the nurse and the patient.

What is aortic overriding?

2014 ◽  
Vol 25 (4) ◽  
pp. 612-625 ◽  
Author(s):  
Robert H. Anderson ◽  
Diane E. Spicer ◽  
G. William Henry ◽  
Cynthia Rigsby ◽  
Anthony M. Hlavacek ◽  
...  
Keyword(s):  
Decision Making ◽  
Aortic Valve ◽  
Clinical Data ◽  
Aortic Root ◽  
Diagnostic Techniques ◽  
Optimal Decision ◽  
Normal Heart ◽  
Optimal Decision Making ◽  
Definition Of ◽  
The Right

AbstractBackground: Disagreement currently exists regarding the definition of aortic dextroposition. It is suggested that the term be used interchangeably with aortic overriding, along with suggestions that the aortic valve overrides in the normal heart. The dextroposed aorta, however, does not always override the crest of the muscular ventricular septum. It is incorrect to argue that the normal aortic valve overrides. It is the cavity of the right aortic valvar sinus, rather than the valvar orifice, that sits above the muscular septum when the septum itself is intact. Therefore, to circumvent these difficulties, those using the term “dextroposition” find it necessary to distinguish “true” as opposed to “false” categories. The problems arise because “dextroposition” is remarkably ill-suited as an alternative term for aortic valvar overriding.Methods and Results:In this review, combining developmental, morphologic, and clinical data, we show how aortic overriding is best considered on the basis of biventricular connection of the aortic root in the setting of deficient ventricular septation. When analysed in this manner, it becomes an easy matter to distinguish between one-to-one and double outlet ventriculo-arterial connections. Appreciation of these features emphasises the different spatial alignments of interventricular communications as opposed to the plane of deficient ventricular septation. The concept of overriding is applicable not only to biventricular connection of the aortic root, but also the pulmonary and common arterial roots.Conclusions:The diagnostic techniques now available to the paediatric cardiologist illustrate the features of arterial valvar overriding with exquisite accuracy, informing the discussions now required for optimal decision making.

Less is more when reducing antimicrobial prescribing

2019 ◽  
Vol 30 (9) ◽  
pp. 452-455
Author(s):  
Gail Haddock
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Decision Making ◽  
General Practice ◽  
Modern Medicine ◽  
Practice Nurses ◽  
Less Is More ◽  
Antimicrobial Prescribing ◽  
The Past ◽  
The Right

As primary care is the main provider of antimicrobial prescriptions, knowing when and what to prescribe, and for how long, is hugely important to public health. Gail Haddock shares useful resources and toolkits to help practice nurses in their decision making Clinicians have reduced their antimicrobial prescribing by 6% in the past 5 years, but this is not enough to overcome the ever-increasing antimicrobial resistance that is a threat to modern medicine. The UK's new target is to reduce prescribing by a further 15% by 2020. This can only be achieved by the commitment of the full general practice team to only prescribe at the right time (ie only if necessary), and the right dose of the right antibiotic for the right length of time. There are numerous excellent resources for patients and clinicians alike on the TARGET website.

Pornography and Human Trafficking

2021 ◽  
pp. 179-186
Author(s):  
Emily F. Rothman
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Human Trafficking ◽  
Health Problem ◽  
Health Professionals ◽  
Sex Workers ◽  
Public Health Problem ◽  
Informed Decision Making ◽  
Public Health Professionals ◽  
Definition Of

Human trafficking is an insidious public health problem that may be worsened by the constant demand for new pornography, but sex workers’ rights—including the rights of pornography performers—are not always served by anti-trafficking efforts. This chapter provides a definition of human trafficking, reviews three main arguments about how pornography may influence human trafficking, and encourages public health professionals to value anecdotal information from both sex workers’ rights advocates and human trafficking survivors to move toward better science and evidence-informed decision-making.

The right to legal agency: domination, disability and the protections of Article 12 of the Convention on the Rights of Persons with Disabilities

2017 ◽  
Vol 13 (1) ◽  
pp. 22-38 ◽  
Author(s):  
Anna Arstein-Kerslake ◽  
Eilionóir Flynn
Keyword(s):  
Decision Making ◽  
Lived Experience ◽  
Law Reform ◽  
Cognitive Disability ◽  
Legal Capacity ◽  
Persons With Disabilities ◽  
Definition Of ◽  
The Right ◽  
High Level ◽  
Republican Theory

AbstractArticle 12 of the Convention on the Rights of Persons with Disabilities has created a revolution in legal-capacity law reform. It protects the right to exercise legal agency for people with disabilities with more clarity than any prior human rights instrument. This paper explores what constitutes an exercise of legal agency and what exactly Article 12 protects. It proposes a definition of legal agency and applies it to the lived experience of cognitive disability. It also uses a republican theory of domination to argue that people with cognitive disabilities who are experiencing domination are forced to assert legal agency in even daily decision-making because of the high level of external regulation of their lives and the ever-present threat of others substituting their decision-making. It identifies Article 12 as a tool for protecting such exertions of legal agency and curtailing relationships of domination.

Ainu Landowners’ Struggle for Justice and the Illegitimacy of the Nibutani Dam Project in Hokkaido Japan

2012 ◽  
Vol 14 (1) ◽  
pp. 63-80 ◽  
Author(s):  
Hiroshi Maruyama
Keyword(s):  
Decision Making ◽  
Indigenous People ◽  
Legal System ◽  
Public Works ◽  
Decision Making Process ◽  
Japanese History ◽  
Fait Accompli ◽  
Definition Of ◽  
The Right ◽  
First Time

Abstract In 2008 the Ainu were officially recognized as an indigenous people by the Japanese Government. The recognition arose from the 1997 court’s decision on the Nibutani Dam case which concluded, for the first time in Japanese history, that the Ainu people have the right to enjoy their own culture and that they fit the definition of indigenous people. The plaintiffs were Ainu landowners from the Nibutani Community who claimed the revocation of the expropriation decision. However, the Nibutani Dam was completed before the court’s decision, with the court acknowledging the completion as fait accompli on the grounds that the revocation of the expropriation decision would not be in the public’s interest. This article reveals the flawed legal system in the decision making process for public works as well as a brief history and some cultural background of the Ainu through those plaintiffs’ struggle for justice. Further, the illegitimacy of the Nibutani Dam project is discussed in light of publicness based on the complaint of those plaintiffs, and lastly, publicness of public works is explored in the context of studies on publicness in Japan.

scholarly journals Determining the Ideal Strategy and Modeling in Integrating Spending Reviews in Budget Decision Making at the Ministry of Health of the Republic of Indonesia

2020 ◽  
Vol 2 (4) ◽  
pp. 84-94
Author(s):  
Beni Ruslandi ◽  
Bahrullah Akbar ◽  
Aries Djaenuri ◽  
Deti Mulyati
Keyword(s):  
Decision Making ◽  
Evaluation Model ◽  
Monitoring And Evaluation ◽  
Three Dimensions ◽  
Organizational Size ◽  
Time Dimension ◽  
Ministry Of Health ◽  
Budget Decision ◽  
The Republic ◽  
The Right

This study aims to find the right strategy and modelling in integrating Spending Review in budget decision making at the Ministry of Health of the Republic of Indonesia. This study uses a qualitative approach with an exploratory method, in which the researcher seeks to explore and build the phenomena being studied to answer the previously formulated problems. The results showed that the spending review integration strategy was divided into three dimensions, namely the organizational size, the process dimension and the time dimension. Meanwhile, the modelling used in integrating spending review in budget decision making in the Indonesian Ministry is known as the Comprehensive Monitoring and Evaluation Model for Budget Management Ministries / Institutions.

scholarly journals Participation in the decision making-making cities proces of regularization policies in Buenos Aires. The case of Villa 20 in Buenos Aires autonomous city

2020 ◽  
Author(s):  
Francesca Ferlicca ◽  
Keyword(s):  
Decision Making ◽  
Latin American ◽  
Land Tenure ◽  
Buenos Aires ◽  
Informal Settlement ◽  
Informal Settlements ◽  
Vulnerable Groups ◽  
Regulatory Policies ◽  
The Right ◽  
The City

In Latin American cities informal settlements and insecure land tenure are the result of an exclusionary planning and urban management system which fails to provide legal and secure housing for lower-income groups. Against this backdrop, the State implemented land-title and urban regulatory policies, in order to improve the housing conditions of these neighbourhoods and integrate their residents into the legal regime. This paper proposes to address the conflicts implied in the processes of urbanization and regularization of the villas of the city of Buenos Aires during the first government of Rodríguez Larreta (2015-2019). In the official political discourse, the urbanization of informal settlements is considered one of the main axes of local management. Within this framework, institutional changes are being carried out, such as the creation of the Ministry of Social and Urban Integration. This report proposes to address the participation implied in the process of urbanization and regularization of Villa 20 in the Autonomous City of Buenos Aires. This process have raised many challenges in the interaction between government decision-making and the needs of inhabitants of informal settlement. These challenges are linked to a) the democratic participation of the inhabitants in the decision-making process at all stages, b) land management policies and domain regularization; c) the modalities and logic of relocation of inhabitants; d) the provision and access to infrastructure services and public spaces; e) the treatment of tenants and other more vulnerable groups. Based on the analysis of the case study, we propose to account for the limits and scope of the implemented urbanization policy as well as for the opportunities to expand the horizon of tools and intervention modalities promote the right to the city and reduce territorial inequalities

PP105 Applying Horizon Scanning To Decision Making: The Case of Tafamidis

2018 ◽  
Vol 34 (S1) ◽  
pp. 105-106
Author(s):  
Pollyanna Teresa Cirilo Gomes ◽  
Andrea Brígida de Souza ◽  
Artur Felipe de Brito
Keyword(s):  
Clinical Trial ◽  
Decision Making ◽  
Health System ◽  
Policy Formulation ◽  
National Committee ◽  
Horizon Scanning ◽  
Potential Competitor ◽  
Amyloid Polyneuropathy ◽  
Transthyretin Familial Amyloid Polyneuropathy ◽  
Brazilian Health System

Introduction:Horizon scanning (HS) is an important tool for guiding health policy formulation and the decision-making process in Brazil. In 2016, the Ministry of Health started to draft Brazilian clinical practice guidelines for transthyretin familial amyloid polyneuropathy (TTR-FAP), which is a rare disease caused by a mutation of the transthyretin gene. An initial HS report was conducted that provided information about new and emerging technologies for TTR-FAP. The HS identified five drugs that were based on two mechanisms of action: transthyretin stabilization (diflunisal, tafamidis, and tolcapone) and gene silencing (ALN-TTR02 and ISIS-TTR-Rx). At that time in Brazil there were no drugs registered for the treatment of TTR-FAP. However, a few months later tafamidis was licensed in Brazil. In early 2017 the manufacturer submitted an application to the National Committee for Health Technology Incorporation (CONITEC), with the aim of incorporating tafamidis into the Brazilian health system. As a result the HS report was updated to support the assessment by CONITEC. This study aims to show how HS is being used to support CONITEC in this issue.Methods:As per the EuroScan toolkit, we performed a reassessment of the technologies included in the initial HS report. We searched clinical trial registers, the websites of pharmaceutical companies, conference proceedings, scientific journals, HS databases, and regulatory websites for further information. The data were synthesized and a reformulated landscape of the technological environment for TTR-FAP therapy was presented to the CONITEC Plenary.Results:The main difference between the initial and final HS output was that tafamidis was approved for use in Brazil, making it the only registered drug for TTR-FAP. Another difference was related to the start of a new clinical trial with diflunisal for TTR-FAP, indicating that this drug could be a potential competitor for tafamidis. It was also possible to add published positive results from a clinical trial with ISIS-TTR-Rx, which were unavailable when the first report was written. Beyond that, it appears that there are two promising gene silencers on the horizon that could represent potential competitors for tafamidis.Conclusions:The analysis of tafamidis for incorporation into the Brazilian health system is ongoing, but HS was able to deliver strategic information that could affect the final recommendation of CONITEC.

scholarly journals Early Phase Management of the SARS-CoV-2 Pandemic in the Geographic Area of the Veneto Region, in One of the World’s Oldest Populations

2020 ◽  
Vol 17 (23) ◽  
pp. 9045
Author(s):  
Alessandro Camerotto ◽  
Andrea Sartorio ◽  
Anna Mazzetto ◽  
Milena Gusella ◽  
Ornella Luppi ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Molecular Diagnostic ◽  
Diagnostic Tools ◽  
Local Health ◽  
Veneto Region ◽  
Local Health Unit ◽  
Infected People ◽  
Italian Regions ◽  
The Right

The first cases of Coronavirus disease-2019 (COVID-19) were reported on 21 February in the small town of Vo’ near Padua in the Veneto region of Italy. This event led to 19,286 infected people in the region by 30 June 2020 (39.30 cases/10,000 inhabitants). Meanwhile, Rovigo Local Health Unit n. 5 (ULSS 5), bordering areas with high epidemic rates and having one of the world’s oldest populations, registered the lowest infection rates in the region (19.03 cases/10,000 inhabitants). The aim of this study was to describe timing and event management by ULSS 5 in preventing the propagation of infection within the timeframe spanning from 21 February to 30 June. Our analysis considered age, genetic clusters, sex, orography, the population density, pollution, and economic activities linked to the pandemic, according to the literature. The ULSS 5 Health Director General’s quick decision-making in the realm of public health, territorial assistance, and retirement homes were key to taking the right actions at the right time. Indeed, the number of isolated cases in the Veneto region was the highest among all the Italian regions at the beginning of the epidemic. Moreover, the implementation of molecular diagnostic tools, which were initially absent, enabled health care experts to make quick diagnoses. Quick decision-making, timely actions, and encouraging results were achieved thanks to a solid chain of command, despite a somewhat unclear legislative environment. In conclusion, we believe that the containment of the epidemic depends on the time factor, coupled with a strong sense of awareness and discretion in the Health Director General’s decision-making. Moreover, real-time communication with operating units and institutions goes hand in hand with the common goal of protecting public health.

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