scholarly journals Cadaveric Donation and Post-mortem Reuse of Pacemakers and Defibrillators in Nepal: Medical, Legal and Ethical Challenges

2017 ◽  
Vol 6 (1) ◽  
pp. 14-20 ◽  
Author(s):  
Yub Raj Sedhai ◽  
Aloysius Ochasi ◽  
Soney Basnyat ◽  
Deepak Acharya ◽  
Peter Clark
Keyword(s):  
Common Good ◽  
Retrospective Studies ◽  
Post Mortem ◽  
Respect For Persons ◽  
Ethical Challenges ◽  
Middle Income ◽  
Middle Income Countries ◽  
Life Saving ◽  
The Common ◽  
Deceased Donors

Cardiovascular diseases (CVDs) are the number one cause of death globally. An estimated 17.5 million people died from CVDs in 2012, representing 31% of all global deaths. Over three quarters of all deaths related CVDs take place in low- and middle-income countries (LMICs). Studies have estimated that 1 to 2 million people worldwide die each year due to lack of access to cardiac rhythm management devices (CRMDs) i.e. implantable cardiac defibrillator (ICD) or a pacemaker. The principal challenge is the high cost of these devices and the resource constraint in LMICs. A growing body of literature, mostly single center, uncontrolled and retrospective studies has suggested reuse of CRMDs from deceased donors as a safe and effective alternative. This paper seeks to propose the concept of post-mortem CRMD donation and reutilization program within Nepal as a life-saving initiative. Though the spirit of the program is in line with the ethical principles of respect for persons, beneficence, justice, and the common good, it is challenged with several logistical barriers and legal concerns. In this paper we have discussed the clinical, legal and ethical perspectives with a literature review on similar programs.

An Overview of the Ethics of Injury in Public Health

2019 ◽  
pp. 597-603
Author(s):  
Adnan A. Hyder
Keyword(s):  
Public Health ◽  
Injury Prevention ◽  
Prevention And Control ◽  
Public Health Ethics ◽  
Ethical Challenges ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Ethics ◽  
Prompt Attention ◽  
And Control

This chapter briefly introduces ethics issues in injury prevention and control in low- and middle-income countries (LMICs), using a series of examples that prompt attention to the ethical principles of autonomy and justice. The chapter also introduces the section of The Oxford Handbook of Public Health Ethics dedicated to an examination of injury and public health ethics, with attention given to the complex ethical challenges arising in injury prevention and control in LMICs. The section’s two chapters discuss public health ethics issues arising in the prevention and control of unintentional injuries and intentional injuries, respectively. Those chapters define a set of ethics issues within international injury work and provide an initial analysis of the nature of those ethics issues, their specificity, and potential pathways for addressing them.

scholarly journals Immunisation financing and programme performance in the Middle East and North Africa, 2010 to 2017

2019 ◽  
Vol 4 (2) ◽  
pp. e001248
Author(s):  
Helen Saxenian ◽  
Nahad Sadr-Azodi ◽  
Miloud Kaddar ◽  
Kamel Senouci
Keyword(s):  
Economic Growth ◽  
Middle East ◽  
North Africa ◽  
Low Income ◽  
Health Sector ◽  
Cost Effective ◽  
Middle Income ◽  
Middle Income Countries ◽  
Life Saving ◽  
Fiscal Space

Immunisation is a cornerstone to primary health care and is an exceptionally good value. The 14 low-income and middle-income countries in the Middle East and North Africa region make up 88% of the region’s population and 92% of its births. Many of these countries have maintained high immunisation coverage even during periods of low or negative economic growth. However, coverage has sharply deteriorated in countries directly impacted by conflict and political unrest. Approximately 1.3 million children were not completely vaccinated in 2017, as measured by third dose of diphtheria–pertussis–tetanus vaccine. Most of the countries have been slow to adopt the newer, more expensive life-saving vaccines mainly because of financial constraints and the socioeconomic context. Apart from the three countries that have had long-standing assistance from Gavi, the Vaccine Alliance, most countries have not benefited appreciably from donor and partner activities in supporting their health sector and in achieving their national and subnational immunisation targets. Looking forward, development partners will have an important role in helping reconstruct health systems in conflict-affected countries. They can also help with generating evidence and strategic advocacy for high-priority and cost-effective services, including immunisation. Governments and ministries of health would ensure important benefits to their populations by investing further in their immunisation programmes. Where possible, the health system can create and expand fiscal space from efficiency gains in harmonising vaccine procurement mechanisms and service integration; broader revenue generation from economic growth; and reallocation of government budgets to health, and from within health, to immunization.

scholarly journals Suicide on Facebook-the tales of unnoticed departure in Bangladesh

2020 ◽  
Vol 7 ◽  
Author(s):  
Tanjir Rashid Soron ◽  
Sheikh Mohammed Shariful Islam
Keyword(s):  
Live Streaming ◽  
Relationship Problems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Online Newspaper ◽  
Patterns Of Communication ◽  
Media Platform ◽  
The Common ◽  
Research Assistants ◽  
Potential Area

Abstract Facebook has transformed social communication and offers the opportunity to share personal thoughts to people including suicide ideas, plans and attempts. Suicide after Facebook posts has been reported in different parts of the world and it has become a potential area of research for suicide prevention. The analysis of Facebook posts prior to suicide or Facebook live streaming may help in understanding the etiological factors, patterns of communication and possible prevention approaches for a particular community. However, there is a dearth of evidence about suicide incidents after Facebook posts and Facebook live streaming in low and middle-income countries. This study aims to explore the trends and phenomena of suicide after Facebook posts and live streaming in Bangladesh. We conducted an online search using the Google, Facebook and five daily online newspaper archives from 15th August to 15th September 2019. Two research assistants independently conducted the initial searching to find out people who committed suicide after Facebook posts or live streamed suicide in Bangladesh and documented 21 cases. After further evaluation of each of the 21 cases we confirmed 19 cases that met the selection criteria. All of them were under 35-years of age. We observed sucide after Facebook posts were more common in male(78%) e and students. Hanging was the most frequently used method of suicide followed by poisoning. Their Facebook posts and livestream videos indicated relationship problems, academic stress and mental disorders were the common stressors for their suicide. This study lays the foundation for the future researchers to work on suicidal posts on Facebook in Bangladesh and develop culture-specific, real-time suicide preventive systems using a social media platform.

scholarly journals Compulsory Licenses for Cancer Drugs: Does Circumventing Patent Rights Improve Access to Oncology Medications?

2016 ◽  
Vol 2 (5) ◽  
pp. 292-301 ◽  
Author(s):  
Cinthia Leite Frizzera Borges Bognar ◽  
Brittany L. Bychkovsky ◽  
Gilberto de Lima Lopes
Keyword(s):  
Cancer Control ◽  
Compulsory License ◽  
Legal Framework ◽  
Essential Medicines ◽  
Cancer Drugs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Life Saving ◽  
Poor Outcomes ◽  
Improve Access

Worldwide, there are enormous inequities in cancer control that cause poor outcomes among patients with cancer who live in low- and middle-income countries (LMICs). One of the biggest challenges that oncology faces today is how to increase patient access to expensive, but life-saving, therapies in LMICs. Access to cancer medications in LMICs is a major problem, especially in recent years, as the costs of these therapies continue to rise exponentially. One mechanism available to LMICs to improve access to cancer medications allows a country to pursue a compulsory license for a given drug. Here, we will review how the legal framework in the World Trade Organization's Trade-Related Aspects of Intellectual Property Rights Agreement and the Doha Declaration supports countries to circumvent patent laws and acquire compulsory licenses for essential medicines. We will also discuss the current and future role of compulsory licenses in oncology and how compulsory licenses may improve access to cancer drugs in LMICs.

Civic Disengagement in Contemporary America

2001 ◽  
Vol 36 (2) ◽  
pp. 135-156 ◽  
Author(s):  
Robert D. Putnam
Keyword(s):  
United States ◽  
Information Technology ◽  
Common Good ◽  
The United States ◽  
Equal Rights ◽  
The Common Good ◽  
The Past ◽  
Life Saving ◽  
Two Generations ◽  
The Common

Over The Past Two Generations The United States Has Undergone a series of remarkable transformations. It has helped to defeat global communism, led a revolution in information technology that is fuelling unprecedented prosperity, invented life-saving treatments for diseases from AIDS to cancer, and made great strides in reversing discriminatory practices and promoting equal rights for all citizens. But during these same decades the United States also has undergone a less sanguine transformation: its citizens have become remarkably less civic, less politically engaged, less socially connected, less trusting, and less committed to the common good. At the dawn of the millennium Americans are fast becoming a loose aggregation of disengaged observers, rather than a community of connected participants.

scholarly journals Impact of traditional bonesetters on contemporary fracture care in Low and Middle Income Countries (LMICs): a systematic review

2019 ◽  
Author(s):  
Ndubuisi Onyemaechi ◽  
William N.A. Menson ◽  
Xan Goodman ◽  
Samantha Slinkard ◽  
Obinna E Onwujekwe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Retrospective Studies ◽  
Web Of Science ◽  
Clinical Effects ◽  
Middle Income ◽  
Fracture Care ◽  
Middle Income Countries ◽  
Meta Analyses ◽  
The Impact ◽  
Low And Middle Income

Abstract Background: The review aimed at systematically examining the evidence in articles that assess the clinical effects and impact of traditional bonesetters on contemporary fracture care in Low and Middle Income Countries (LMICs).Methods: A systematic review was conducted. Articles were identified by database searching ((PubMed, Embase, ScienceDirect, SCOPUS, and Web of Science). Searching, selecting and reporting were conducted according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) Statement. The key words that were used in search for literature were: “Bonesetter”, “fracture healer” and “traditional bone setting”. Publications included for review were original articles, set in an LMIC and directly talked about the role and/or impact of traditional bonesetters in providing fracture care. Papers that focused on Low and Middle Income (LMIC) settings were reviewed.Results: A total of 176 papers were screened for eligibility and 15 studies were finally included. Nine were prospective studies, while 6 were retrospective studies. Most of the studies focused on clinical impacts of bone setter intervention. The evidence from the publications show that the main clinical effects of traditional bonesetters had been deleterious, but they had the potential to contribute positively when trained.Conclusion: Few well designed studies are available that assessed the impact of traditional bonesetters. Reported cases and reviews indicate their impact to be deleterious. However, the potential exist that when trained, these deleterious impact can be reduced through training for traditional bonesetters who contribute to fracture care in many LMICs.

scholarly journals Midwives’ Knowledge of Non-Pneumatic Anti-Shock Garment and Associated Factors among Midwives Working in Public Hospitals of Jimma Zone, South-West Ethiopia.

2020 ◽  
Author(s):  
Gemechu Sori Terefe ◽  
Gadisa Bedada Bekele
Keyword(s):  
Associated Factors ◽  
Positive Attitude ◽  
Design Method ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Middle Income ◽  
Pregnancy And Childbirth ◽  
Middle Income Countries ◽  
Life Saving ◽  
Jimma Zone

Abstract Background: The non-pneumatic anti-shock garment is a unique, simple, life-saving first-aid device made of neoprene and velcro. Neoprene is a stretchy material, and Velcro is a “hook and loop” material that closes things tightly . I n 2017 e very day, approximately 810 women died from preventable causes related to pregnancy and childbirth . From this death about 94% of all maternal deaths occur in low and lower middle-income countries.Objective: The objective of this study was designed to assess Midwives knowledge of non-pneumatic anti-shock garment and associated factors among Midwives. Methods: Facility based a quantitative cross-sectional studies design method was employed among 150 Midwives. Data was collected by pretested semi-structured self-administered questionnaire . The collected data were checked, coded and entered into Epi-data version 3.1 by double data enter and exported to SPSS version 23 for analysis. Bivariable and multivariable logistic regression were done to identify factors associated with Midwives’ Knowledge of non-pneumatic anti-shock garment. Results: Eighty one (54%) of Midwives have good knowledge of non-pneumatic anti-shock garment. Having positive attitude [ (AOR= 4.9 , 95% CI :( 2.06, 11.65 )], attending training [AOR= 3.91 , 95% CI :( 1.48, 10.32 ], presence guideline of non-pneumatic anti-shock garment at their hospitals [AOR= 2.57 , 95% CI :( 1.13, 5.82 )] were significantly associated with Midwives’ knowledge of non-pneumatic anti-shock garment. Conclusion and Recommendation: The knowledge Midwives’ on non-pneumatic anti-shock garment was low. The identified factors that significantly associated with Midwives’ knowledge of non-pneumatic anti-shock garment were positive attitude; attend training and presence of guideline of non-pneumatic anti-shock garments. The Midwives that involved in the maternity service should be improving their knowledge on non-pneumatic anti-shock garment.

scholarly journals Socioeconomic inequities in the health and nutrition of children in low/middle income countries

2010 ◽  
Vol 44 (1) ◽  
pp. 1-16 ◽  
Author(s):  
Fernando C Barros ◽  
Cesar G Victora ◽  
Robert Scherpbier ◽  
Davidson Gwatkin
Keyword(s):  
Access To Health Services ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health And Nutrition ◽  
Life Saving ◽  
Low Middle Income Countries ◽  
Pubmed Database ◽  
Use Of Services ◽  
Multiple Indicator ◽  
Pathogenic Agents

OBJECTIVE: To describe the effects of social inequities on the health and nutrition of children in low and middle income countries. METHODS: We reviewed existing data on socioeconomic disparities within-countries relative to the use of services, nutritional status, morbidity, and mortality. A conceptual framework including five major hierarchical categories affecting inequities was adopted: socioeconomic context and position, differential exposure, differential vulnerability, differential health outcomes, and differential consequences. The search of the PubMed database since 1990 identified 244 articles related to the theme. Results were also analyzed from almost 100 recent national surveys, including Demographic Health Surveys and the UNICEF Multiple Indicator Cluster Surveys. RESULTS: Children from poor families are more likely, relative to those from better-off families, to be exposed to pathogenic agents; once they are exposed, they are more likely to become ill because of their lower resistance and lower coverage with preventive interventions. Once they become ill, they are less likely to have access to health services and the quality of these services is likely to be lower, with less access to life-saving treatments. As a consequence, children from poor family have higher mortality rates and are more likely to be undernourished. CONCLUSIONS: Except for child obesity and inadequate breastfeeding practices, all the other adverse conditions analyzed were more prevalent in children from less well-off families. Careful documentation of the multiple levels of determination of socioeconomic inequities in child health is essential for understanding the nature of this problem and for establishing interventions that can reduce these differences.

scholarly journals The Importance of Conscious Sedation for Life-Saving Valve Procedures in Patients With Rheumatic Heart Disease From Low- to Middle-Income Countries

Global Heart ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. 311 ◽  
Author(s):  
Marta Eugenia Alcici ◽  
Lucas Lodi-Junqueira ◽  
Guilherme Rafael Sant’Anna ◽  
Juliana Rodrigues Soares ◽  
Diogo Antônio Gomes Tiago ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Conscious Sedation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Life Saving ◽  
Rheumatic Heart
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