scholarly journals Whose life to save? Scarce resources allocation in the COVID-19 outbreak

2020 ◽  
Vol 46 (6) ◽  
pp. 364-366 ◽  
Author(s):  
Chiara Mannelli
Keyword(s):  
Northern Region ◽  
World Health ◽  
Resources Allocation ◽  
Ethical Perspective ◽  
Scarce Resources ◽  
Health Organization ◽  
The Right ◽  
Scarcity Of Resources ◽  
National Emergency ◽  
Intense Debate

After initially emerging in China, the coronavirus (COVID-19) outbreak has advanced rapidly. The World Health Organization (WHO) has recently declared it a pandemic, with Europe becoming its new epicentre. Italy has so far been the most severely hit European country and demand for critical care in the northern region currently exceeds its supply. This raises significant ethical concerns, among which is the allocation of scarce resources. Professionals are considering the prioritisation of patients most likely to survive over those with remote chances, and this news has triggered an intense debate about the right of every individual to access healthcare. The proposed analysis suggests that the national emergency framework in which prioritisation criteria are currently enforced should not lead us to perceive scarce resources allocation as something new. From an ethical perspective, the novelty of the current emergency is not grounded in the devastating effects of scarce resources allocation, which is rife in recent and present clinical practice. Rather, it has to do with the extraordinarily high number of people who find themselves personally affected by the implications of scarce resources allocation and who suddenly realise that the principle of ‘equals should be treated equally’ may no longer be applicable. Along with the need to allocate appropriate additional financial resources to support the healthcare system, and thus to mitigate the scarcity of resources, the analysis insists on the relevance of a medical ethics perspective that does not place the burden of care and choice solely on physicians.

scholarly journals Judicialization of health during the COVID-19 pandemic in Pará state, Northern region of Brazil

2020 ◽  
Vol 9 (9) ◽  
pp. e338997127
Author(s):  
Kellice Feitosa de Araújo ◽  
Emanuele Rocha da Silva ◽  
Rodolfo Gomes do Nascimento ◽  
Erica Silva de Souza Matsumura ◽  
Katiane da Costa Cunha
Keyword(s):  
Intensive Care ◽  
Health Resources ◽  
Northern Region ◽  
World Health ◽  
Health Database ◽  
Health Organization ◽  
The Right ◽  
Specific Health ◽  
Judicialization Of Health ◽  
The Ideal

In Brazil, the right to health has constitutional universal provision. However, its incompleteness and the scarcity of structural and human resources leads people who would benefit from access to specific health services, mainly the ones in intensive care need - as currently intensified by the COVID-19 pandemic -, to appeal to judicial way to obtain access to them. The aim of this study was to problematize the relation between the insufficient number of ICU (Intensive Care Unit) beds at the current demands for them due to the COVID-19 pandemic through judicialization. The data from the Ministry of Health database were confronted with the literature on the judicialization of health within the national scope, with attention to the statistical data of Pará state’s Court of Justice. There were 14 actions aimed at guaranteeing access to the ICU beds in the period from 03/20/2020 to 05/25/2020 in Pará state. The availability of these in the state (1,718) represents 9% of the total number of beds, below the national average, both beneath the ideal determined by the World Health Organization (ideal rate of 3 to 5 ICU beds for every thousand inhabitants). In conclusion, the judicialization of health can be a sign of dysfunctions and failures in the management of the health systems, evidenced by the COVID-19 pandemic, which could lead to the possibility of scarcity of health resources in the country.

Implementing the Sphere Project’s standards for patient’s healthcare rights in the disaster zone: The experience of the Israeli field hospital in post-quake Nepal

2021 ◽  
Vol 16 (1) ◽  
pp. 59-66
Author(s):  
Deganit Kobliner-Friedman, RN, MPH ◽  
Ofer Merin, MD ◽  
Eran Mashiach, MD ◽  
Reuven Kedar, MD ◽  
Shai Schul, MHA ◽  
...  
Keyword(s):  
Disaster Response ◽  
Sexual Exploitation ◽  
World Health ◽  
Field Hospital ◽  
Medical Teams ◽  
Health Organization ◽  
The Individual ◽  
The Right ◽  
Israel Defense Forces ◽  
Privacy And Confidentiality

Emergency medical teams (EMTs) encounter chaos upon arriving at the scene of a disaster. Rescue efforts are utilitarian and focus on providing the technical aspects of medical care in order to save the most lives at the expense of the individual. This often neglects the basic healthcare rights of the patient. The Sphere Project was initiated to develop universal humanitarian standards for disaster response.The increase in the number of EMTs led the World Health Organization (WHO) to organize standards for disaster response. In 2016, the WHO certified the Israel Defense Forces Field Hospital (IDF-FH) as the first to be awarded the highest level of accreditation (EMT-3). This paper presents the IDF-FH’s efforts to protect the patient’s healthcare rights in a disaster zone based on the Sphere Principles.These core Sphere Principles include the right to professional medical treatment; the right to dignity, privacy, and confidentiality; the right for information in an understandable language; the right to informed consent; the obligation to maintain private medical records; the obligation to adhere to universal ethical standards, to respect culture and custom and to care for vulnerable populations; the right to protection from sexual exploitation and violence; and the right to continued treatment.

scholarly journals Barriers and Solutions to Developing Future Therapies for Pulmonary Hypertension

2018 ◽  
Vol 17 (4) ◽  
pp. 159-165
Author(s):  
Brian Graham ◽  
Peter Fernandes ◽  
Sue Gu
Keyword(s):  
Clinical Trials ◽  
Pulmonary Hypertension ◽  
Phase 1 ◽  
Unmet Need ◽  
Orphan Drugs ◽  
World Health ◽  
Vasodilator Therapy ◽  
Scarce Resources ◽  
Pulmonary Arterial ◽  
Health Organization

Pulmonary hypertension (PH) and its subset, pulmonary arterial hypertension (PAH), are rare diseases with a significant unmet need. Between the 1980s and 2010s, the 5-year survival rate for PAH after diagnosis improved from 34% to 65%,12 but remains unacceptably low. Since the introduction of vasodilator therapy, 34 important advances have been made in the understanding of the disease pathophysiology and development of targeted therapies. There are now 14 US Food and Drug Administration (FDA)-approved therapies that target 3 distinct pathways that contribute to PAH, and additional therapeutic targets are currently under investigation in phase 1, 2, and 3 clinical trials.5 However, there have been major challenges in PH medication development to date, including: 1) only one medication approved for pediatric PAH; 2) focusing on vasodilator therapy rather than targeting the underlying pathogenesis of the disease; 3) no medications approved for PH World Health Organization (WHO) Groups 2, 3, and 5; and 4) several recent high-profile clinical failures after promising preclinical studies.The focus and goal of the PH research community should be directed at identifying new options and solutions for patients. The field must ensure that the approaches used for clinical trials to develop orphan drugs maximize the scarce resources available for recruiting subjects, and are directed toward making safe and effective therapies available in a timely manner. Therefore, there is a critical need to coordinate and harmonize innovative approaches within the field, including strengthening translational research to deliver promising candidates and optimize the designs, endpoints, and biomarkers to conduct safe and efficient clinical trials.

scholarly journals Lebanon Cities’ Public Spaces

2018 ◽  
Vol 3 (1) ◽  
pp. 119-152 ◽  
Author(s):  
Maryam Nazzal ◽  
Samer Chinder
Keyword(s):  
Green Space ◽  
Public Spaces ◽  
World Health ◽  
Right To The City ◽  
Social Connections ◽  
Land Prices ◽  
The Social ◽  
Health Organization ◽  
The Right ◽  
The City

In Lebanon, the social connections are undeniable and crucial. However, meeting places remain private such as houses, restaurants, malls, and beach resorts. This is mainly due to the shortage of public spaces in Lebanon resulting from lack of planning, regulations and awareness around the right to the city and the importance of public spaces. In main cities where land prices are so expensive, common practice has prioritized the use of land in real estate development, thus trumping other uses such as public and communal spaces.In the late 1990s, Lebanon saw the emergence of malls, which have arguably acted as alternatives to public spaces. Malls, with their wealth of food courts, restaurants, cinemas, and play areas, have become the new downtown for a portion of the Lebanese population. They are also considered safe, which is another important factor.In 2015, the percentage of green spaces in Lebanon has decreased to less than 13%. While the World Health Organization (WHO) recommends a minimum of 9m2 of green space per capita (UN-HABITAT, 2016), Beirut has only 0.8m2.

scholarly journals THE HUMAN RIGHT TO HEALTH: A RETROSPECTIVE ANALYSIS AFTER 70 YEARS OF INTERNATIONAL RECOGNITION

2018 ◽  
pp. 24-42
Author(s):  
MARÍA DALLI
Keyword(s):  
Human Rights ◽  
Right To Health ◽  
World Health ◽  
Health Coverage ◽  
Human Right ◽  
The Sustainable Development ◽  
Cultural Rights ◽  
Health Organization ◽  
The Individual ◽  
The Right

In 1948, the General Assembly of the United Nations adopted the first international text recognising universal human rights for all; the Universal Declaration of Human Rights. Article 25 recognises the right to an adequate standard of living, which includes the right to health and medical care. On the occasion of the 70th anniversary of the Declaration, this article presents an overview of the main developments that have been made towards understanding the content and implications of the right to health, as well as an analysis of some specific advancements that aim to facilitate the enforcement thereof. These include: a) the implication of private entities as responsible for right to health obligations; b) the Universal Health Coverage goal, proposed by the World Health Organization and included as one of the Sustainable Development Goals; and c) the individual complaints mechanism introduced by the Optional Protocol to the International Covenant on Economic, Social and Cultural Rights (adopted on the 10th December 2008, 60 years after the UDHR).

Right diagnosis, right treatment: SAFER PRACTICES

2019 ◽  
Vol 1 (7) ◽  
pp. 356-360 ◽  
Author(s):  
Paul Silverston
Keyword(s):  
Clinical Practice ◽  
Health Professionals ◽  
Diagnostic Errors ◽  
Integrated Approach ◽  
Diagnostic Error ◽  
World Health ◽  
Formal Training ◽  
The World ◽  
Health Organization ◽  
The Right

Choosing the right treatment for the patient requires that the right diagnosis is made first. In primary and ambulatory care, however, diagnostic errors are both common and commonly preventable. The World Health Organization has recommended that all health professionals should receive formal training in the principles of diagnostic reasoning and the causes of diagnostic error, and that strategies and interventions to reduce the risk of diagnostic error should be used in clinical practice. This article describes a mnemonic checklist, SAFER PRACTICES, which can be used in an integrated approach to the prevention and detection of diagnostic errors that starts in the classroom and continues through to the consulting room.

scholarly journals Everything counts in sending the right message: science-based messaging implications from the 2020 WHO guidelines on physical activity and sedentary behaviour

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Michelle L. Segar ◽  
Marta M. Marques ◽  
Antonio L. Palmeira ◽  
Anthony D. Okely
Keyword(s):  
Physical Activity ◽  
Sedentary Behaviour ◽  
Psychological Needs ◽  
World Health ◽  
Behavioural Science ◽  
Aerobic Activity ◽  
New Guidelines ◽  
Health Organization ◽  
The Right ◽  
Country Specific

Abstract The World Health Organization (WHO) released the 2020 global guidelines on physical activity and sedentary behaviour. The new guidelines contain a significant change from the 2010 guidelines on physical activity for adults and older adults that has important implications for next-generation physical activity messaging: The removal of the need for aerobic activity to occur in bouts of at least 10 min duration. This change in the guidelines provides an opportunity to communicate in new ways that align with behavioural science, permitting physical activity communicators and promoters to better support people’s psychological needs, motivation, and ability to fit healthy levels of physical activity into their lives. The frames and messages we use to communicate about the guidelines matter because they influence whether activity is perceived as relevant, meaningful, and feasible – or not. When developing new physical activity communications there are some overarching principles, based on behavioural science, to keep in mind. Using established theory, this commentary aims to support the creation of more strategic frames and messages for increasing the value and integration of physical activity into daily living. Country-specific physical activity campaigns using these ideas will be discussed.

scholarly journals Lipomatous tumours in adrenal gland: WHO updates and clinical implications

2017 ◽  
Vol 24 (3) ◽  
pp. R65-R79 ◽  
Author(s):  
Alfred King-yin Lam
Keyword(s):  
Adrenal Gland ◽  
Age Distribution ◽  
World Health ◽  
Adrenal Myelolipoma ◽  
Adrenal Tumours ◽  
Endocrine Organs ◽  
Lipomatous Tumour ◽  
Health Organization ◽  
The Right

Adrenal lipomatous tumour is a group of adrenal tumours with a significant component of adipose tissue. According to the current World Health Organization (WHO) classification of tumours of endocrine organs, adrenal myelolipoma is the only entity amongst the group of tumours being described. In the literature, other more recently documented adrenal lipomatous tumours included 24 lipomas, 32 teratomas and 16 angiomyolipomas. Rare fatty tumours of the adrenal gland comprised liposarcoma, hibernoma, adrenocortical tumours with fat component and rare adrenal tumours with fat component. Myelolipoma comprises approximately 3% of primary adrenal tumour. It is noted more commonly in females and in the right adrenal gland. Approximately 40 bilateral myelolipomas were reported. The tumour is most frequently recorded in patients between fifth and seventh decades of life. Adrenal lipomas are often seen in males and in the right adrenal gland. They were commonly noted in patients in the sixth decade of life. The diagnosis could only be possible on examination of the surgically removed specimen. Adrenal teratomas were more common in females and with a bimodal age distribution. Slightly over 60% of the patients with adrenal teratoma are symptomatic. Adrenal angiomyolipomas were often symptomatic, more common in females and in the fifth decades of life. To conclude, adrenal lipomatous tumour is uncommon. They are often benign and non-functional. It is important to recognize the features of this group of lipomatous tumours in the adrenal gland as they are being detected on increasing incidence as a result of the wide-spread use of modern imaging modalities.

scholarly journals Neglected tropical diseases in Brazil

2009 ◽  
Vol 51 (5) ◽  
pp. 247-253 ◽  
Author(s):  
José Angelo L. Lindoso ◽  
Ana Angélica B.P. Lindoso
Keyword(s):  
Neglected Tropical Diseases ◽  
Clinical Manifestations ◽  
Northern Region ◽  
New Drugs ◽  
World Health ◽  
Tropical Diseases ◽  
The North ◽  
The World ◽  
The Status ◽  
Health Organization

Poverty is intrinsically related to the incidence of Neglected Tropical Diseases (NTDs). The main countries that have the lowest human development indices (HDI) and the highest burdens of NTDs are located in tropical and subtropical regions of the world. Among these countries is Brazil, which is ranked 70th in HDI. Nine out of the ten NTDs established by the World Health Organization (WHO) are present in Brazil. Leishmaniasis, tuberculosis, dengue fever and leprosy are present over almost the entire Brazilian territory. More than 90% of malaria cases occur in the Northern region of the country, and lymphatic filariasis and onchocerciasis occur in outbreaks in a particular region. The North and Northeast regions of Brazil have the lowest HDIs and the highest rates of NTDs. These diseases are considered neglected because there is not important investment in projects for the development of new drugs and vaccines and existing programs to control these diseases are not sufficient. Another problem related to NTDs is co-infection with HIV, which favors the occurrence of severe clinical manifestations and therapeutic failure. In this article, we describe the status of the main NTDs currently occurring in Brazil and relate them to the HDI and poverty.

scholarly journals COVID-19 Knowledge Resource Categorization and Tracking: A Conceptual Framework (Preprint)

2021 ◽  
Author(s):  
Muhammad Afzal ◽  
Maqbool Hussain ◽  
Jamil Hussain ◽  
Sungyoung Lee
Keyword(s):  
Conceptual Framework ◽  
Level Structure ◽  
Global Scale ◽  
Information Resources ◽  
World Health ◽  
Infrastructure Development ◽  
Knowledge Resources ◽  
Health Organization ◽  
The Right ◽  
Resource Categorization

BACKGROUND Declaring the COVID-19 disease a global pandemic by the World Health Organization (WHO), it gained momentum as every day passed, and private and government sectors of different countries pushed funding towards research in various capacities. A great portion of efforts is devoted to information technology and service infrastructure development, including research to develop intelligent models and techniques for alerts, monitoring, early diagnosis, prevention, and other relevant services. As a result, tons of information resource have been created in the global space and are available for use. However, there is lack of a defined structure to organize these resources into categories or classes based on the nature as well the origin of data. OBJECTIVE This study aims to organize COVID-19 information resources into a well-defined structure to facilitate easy identification of a resource, tracing information workflows, and a guide for contextual dashboards design and development. METHODS A sequence of action research was performed that involve a review of COVID-19 efforts and initiatives on a global scale during the year 2020. Data is collected according to a defined structure of primary, secondary, and tertiary categories. Various descriptive statistical analysis techniques were employed to get insights of the data to help in developing a conceptual framework underlining the organization of resources and interactions among different resources. RESULTS In this paper, we present a three-level structure of resource categorization that provides a gateway to access the global initiatives with enriched metadata, assists users in tracing the workflow of tertiary, secondary, and primary resources with relationships among various fragments of information. The results comprise mapping initiatives at the tertiary level to secondary and then to the primary level to reach the firsthand resource of data, research, and trials. CONCLUSIONS Adopting the proposed three-level structure enables a consistent organization and management of existing COVID-19 knowledge resources and provides a roadmap for classifying the futuristic resources. This study is one of the earliest studies to introduce an organized structure and demonstrate the placement of COVID-19 resources at the right place. By implementing the proposed framework according to the stated guidelines, this study facilitates the development of applications such as interactive dashboards to facilitate the contextual identification and tracking of interdependent COVID-19 information resources.

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