scholarly journals Molecular Sovereignty: Building a Blood Screening Test for the Brazilian Nation

2021 ◽  
Vol 8 (2) ◽  
pp. 1-25
Author(s):  
Koichi Kameda
Keyword(s):  
Healthcare System ◽  
Transition To Democracy ◽  
Universal Healthcare ◽  
National Imaginary ◽  
Constitutional Right ◽  
National Boundaries ◽  
Acid Test ◽  
Diagnostic Technologies ◽  
Universal Healthcare System ◽  
Blood Screening

This article interrogates the relationship between the development of national diagnostic technologies and the exercise of sovereignty, by analysing a Brazilian project to produce a nucleic acid test (NAT) for the country’s blood screening programme. The concept of ‘molecular sovereignty’ is proposed to demonstrate that exercising sovereignty demands not only technological resources but also a sufficiently powerful and national imaginary to support local knowledge production as a means of advancing national healthcare priorities. First, this research article contextualises the political importance of blood safety for Brazil during its transition to democracy in the 1980s and the creation of its universal healthcare system. Then, it investigates how adopting the NAT led the state to invest in the production of a national technology. Third, the article unpacks the diagnostic test to consider how certain aspects of the project might ultimately strengthen the ability of global capital to cross national boundaries and create new markets. Lastly, it discusses how the project ended up creating a centralised and ‘closed’ system to avoid leaving the country vulnerable to the entry of global diagnostic companies. This case demonstrates how the molecularisation of blood, through the construction of a unified healthcare system driven by the constitutional right to health, can be deployed to construct imagined communities on the scale of a nation.

Evaluation of disparity in care for perforated appendicitis in a universal healthcare system

2019 ◽  
Vol 36 (2) ◽  
pp. 219-225 ◽  
Author(s):  
Laura M. Fluke ◽  
Christian S. McEvoy ◽  
Anne H. Peruski ◽  
Christina A. Shibley ◽  
Brian T. Adams ◽  
...  
Keyword(s):  
Healthcare System ◽  
Perforated Appendicitis ◽  
Universal Healthcare ◽  
Universal Healthcare System

scholarly journals Inequalities in heart failure care in a tax‐financed universal healthcare system: a nationwide population‐based cohort study

2020 ◽  
Vol 7 (5) ◽  
pp. 3095-3108
Author(s):  
Inge Schjødt ◽  
Søren P. Johnsen ◽  
Anna Strömberg ◽  
Jan B. Valentin ◽  
Brian B. Løgstrup
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Healthcare System ◽  
Population Based ◽  
Heart Failure Care ◽  
Universal Healthcare ◽  
System A ◽  
Universal Healthcare System

scholarly journals Obstetrical brachial plexus injury: burden in a publicly funded, universal healthcare system

2016 ◽  
Vol 17 (2) ◽  
pp. 222-229 ◽  
Author(s):  
Christopher J. Coroneos ◽  
Sophocles H. Voineskos ◽  
Marie K. Coroneos ◽  
Noor Alolabi ◽  
Serge R. Goekjian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Brachial Plexus ◽  
Healthcare System ◽  
Quality Indicators ◽  
Brachial Plexus Injury ◽  
Shoulder Dystocia ◽  
Publicly Funded ◽  
Universal Healthcare ◽  
Universal Healthcare System

OBJECT The aim of this study was to determine the volume and timing of referrals for obstetrical brachial plexus injury (OBPI) to multidisciplinary centers in a national demographic sample. Secondarily, we aimed to measure the incidence and risk factors for OBPI in the sample. The burden of OBPI has not been investigated in a publicly funded system, and the timing and volume of referrals to multidisciplinary centers are unknown. The incidence and risk factors for OBPI have not been established in Canada. METHODS This is a retrospective cohort study. The authors used a demographic sample of all infants born in Canada, capturing all children born in a publicly funded, universal healthcare system. OBPI diagnoses and corresponding risk factors from 2004 to 2012 were identified and correlated with referrals to Canada’s 10 multidisciplinary OBPI centers. Quality indicators were approved by the Canadian OBPI Working Group’s guideline consensus group. The primary outcome was the timing of initial assessment at a multidisciplinary center, “good” if assessed by the time the patient was 1 month of age, “satisfactory” if by 3 months of age, and “poor” if thereafter. Joinpoint regression analysis was used to determine the OBPI incidence over the study period. Odds ratios were calculated to determine the strength of association for risk factors. RESULTS OBPI incidence was 1.24 per 1000 live births, and was consistent from 2004 to 2012. Potential biases underestimate the level of injury identification. The factors associated with a very strong risk for OBPI were humerus fracture, shoulder dystocia, and clavicle fracture. The majority (55%–60%) of OBPI patients identified at birth were not referred. Among those who were referred, the timing of assessment was “good” in 28%, “satisfactory” in 66%, and “poor” in 34%. CONCLUSIONS Shoulder dystocia was the strongest modifiable risk factor for OBPI. Most children with OBPI were not referred to multidisciplinary care. Of those who were referred, 72% were assessed later than the target quality indicator of 1 month that was established by the national guideline consensus group. A referral gap has been identified using quality indicators at clinically relevant time points; this gap should be addressed with the use of knowledge tools (e.g., a clinical practice guideline) to target variations in referral rates and clinical practice. Interventions should guide the referral process.

scholarly journals Blockchain Technology: Investing in a National EMR Strategy

2019 ◽  
Vol 87 (2) ◽  
pp. 12-14
Author(s):  
Josiah Marquis ◽  
Erik Elliott ◽  
Martyn Dahal ◽  
Dor Abelman
Keyword(s):  
Healthcare System ◽  
Information Transfer ◽  
Stakeholder Collaboration ◽  
Health Technologies ◽  
Universal Healthcare ◽  
Blockchain Technology ◽  
Quality Of Medical Care ◽  
Unique Framework ◽  
Universal Healthcare System

Improving the efficiency and sustainability of Canada’s healthcare system is currently being prioritized by the federal government. In order to achieve this, government and non-government stakeholder collaboration will be required to improve integration, universality, and equity for all populations throughout the country. Although technological innovations pose certain risks, investing in health technologies plays a major role in improving service delivery and cost-saving within healthcare. Canada has historically had a relatively low use of electronic medical records (EMR’s) in comparison to other high-income countries - which appears to be partially due to inefficiencies within the fragmented systems throughout Canada. Improving the current EMR infrastructure has the potential to save our country substantial amounts of money, improve information transfer for patients and practitioners, and enhance the overall quality of medical care Canadian citizens receive. There has been mention of developing a national EMR strategy by various organizations, including the Canadian Medical Association. Blockchain technology appears to have many desired characteristics for developing a comprehensive national EMR strategy to support the needs of our universal healthcare system. This is due to the fact that it is a secure platform to store huge amounts of information and make data transfers between a diverse group of stakeholders. It is believed that blockchain can provide a unique framework upon which a national data system can be built.

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