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.

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 The challenge of tackling the obesity economic burden: The case of Uruguay

2019 ◽  
Vol 1 ◽  
pp. 11 ◽  
Author(s):  
Ricardo Kaufmann ◽  
Norma Pontet-Ubal
Keyword(s):  
Economic Burden ◽  
Overweight And Obesity ◽  
Medical Expenditure ◽  
World Health ◽  
Health Prevention ◽  
The World ◽  
Health Organization ◽  
The Right ◽  
The Cost ◽  
Specific Health

The estimation of the burden of a disease is one of the tasks with the longest tradition in Health Economics, which allows us to know the volume of resources that a country allocates to a specific health problem, and to compare countries and diseases. Although the fundamental objective of Health Systems is not to reduce the cost of the disease, but to improve the health of the population, the studies of burden of disease establish the economic seriousness of the problem, orienting the priorities of action. Government-funded medical expenditure in Uruguay for the last ten years has tripled in US dollars. The increase in the prevalence of overweight and obesity has contributed to this growth. According to the World Health Organization, Uruguay has the highest growing trend in the prevalence of both overweight and obesity in South America. We have previously estimated that economic burden linked to obesity will be more than US$500 million by 2020, a figure close to 1% of the country’s GDP. In this study, we tried to generate a measure of value to ascertain the cost of inaction in the fight against obesity and its consequences linked to several non-communicable diseases. The cost of inaction is not defined as the cost of not doing, but as the cost of not implementing the right policies (in this case health prevention policies) at the right time.

The Coronavirus Disease 2019 Pandemic in Taiwan: An Facebook Online study on Concern/Fear Regarding the Disease and General Anxiety and Relevant Factors (Preprint)

2020 ◽  
Author(s):  
Peng-Wei Wang ◽  
Wei-Hsin Lu ◽  
Yi-Lung Chen ◽  
Dian-Jeng Li ◽  
Yu-Ping Chang ◽  
...  
Keyword(s):  
Mental Health ◽  
Environmental Factors ◽  
Online Survey ◽  
Psychological Impact ◽  
Health Resources ◽  
World Health ◽  
Regional Government ◽  
General Anxiety ◽  
Self Confidence ◽  
Health Organization

BACKGROUND The World Health Organization (WHO) declared COVID-19 a ‘public health emergency of international concern. Both worry and anxiety are the common psychological impact during the pandemic. The level of and determinants for worry and anxiety during COVID-19 are not well explored. OBJECTIVE The present study aimed to explore the associations of demographic and environmental factors with worry toward COVID-19 and general anxiety among people in Taiwan. METHODS In total, 1970 respondents were recruited through a Facebook advertisement and completed an online survey on worry toward COVID-19, general anxiety during the pandemic, and individual and environmental factors. RESULTS In total, 51.7% and 43.4% of respondents reported high levels of worry toward COVID-19 and general anxiety, respectively. Worse self-rated mental health, lower self-confidence in COVID-19 management, and insufficient mental health resources were significantly associated with high levels of both worry toward COVID-19 and general anxiety. Lower perceived confidence in COVID-19 management by the regional government was significantly associated with a higher level of worry toward COVID-19. Lower perceived social support was significantly associated with a higher level of general anxiety during the COVID-19 pandemic. CONCLUSIONS The results showed that high levels of worry toward COVID-19 and general anxiety were prevalent during the disease outbreak. Multiple individual and environmental factors related to worry toward COVID-19 and general anxiety were identified. CLINICALTRIAL

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 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 Magnesium Sulphate For Tetanus, review of two cases

Medicinus ◽  
2020 ◽  
Vol 7 (4) ◽  
pp. 112
Author(s):  
Tirta Darmawan Susanto
Keyword(s):  
Intensive Care ◽  
Autonomic Dysfunction ◽  
Magnesium Sulphate ◽  
Case Series ◽  
Clinical Findings ◽  
Muscle Spasm ◽  
World Health ◽  
Control Muscle ◽  
Hospitalization Period ◽  
Health Organization

<div class="WordSection1"><p><strong>Introduction</strong><strong>: </strong>Tetanus is critically ill disease with long term hospitalization period. It need to be carefully monitored, usually in intensive care unit and involves critical care physicians. Benzodiazepine is preferred by World Health Organization (WHO) for muscle spasm control in tetanus, but it will be less costly if magnesium sulphate can be used alone to control spasm and autonomic dysfunction in tetanus. We report a series of 2 tetanus cases that were treated using magnesium sulphate to provide a brief clinical description about the use of magnesium sulphate in tetanus. We also give a brief review on epidemiology, pathophysiology, clinical findings, diagnosis, and treatment of tetanus to provide implications for intensive care physicians. Methods : Case series report</p><p><strong>Results : </strong>Two patients with tetanus was given magnesium sulphate infusion to control muscle spasm and autonomic dysfunction with good results as expected. Both of them were survive and discharged home in healthy condition.</p><p><strong>Conclusions :</strong></p><p>Magnesium sulphate can also be used to control muscle spasm and autonomic dysfunction although WHO recommend benzodiazepines for controlling muscle spasm. Intensive care physicians should have enough knowledge about tetanus and how it should be managed adequately to ensure survival from tetanus.</p></div>

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).

Use of the World Health Organization Access, Watch, and Reserve Classification to Follow Trends in Prescription of Antibiotic Use in Two Pediatric Intensive Care Units in Rio de Janeiro, Brazil

2020 ◽  
Vol 15 (03) ◽  
pp. 155-160
Author(s):  
André Ricardo Araujo da Silva ◽  
Cristina Vieira de Souza Oliveira ◽  
Cristiane Henriques Teixeira ◽  
Izabel Alves Leal
Keyword(s):  
Time Series ◽  
Intensive Care ◽  
Time Series Analysis ◽  
World Health Organization ◽  
Pediatric Intensive Care ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
World Health ◽  
The World ◽  
Health Organization

Abstract Objective The recommended percentage of antibiotic use in pediatric intensive care units (PICUs) using the World Health Organization (WHO) Access, Watch, and Reserve (AWaRE) classification is not known. Methods We have conducted an interrupted time series analysis in two PICUs in Rio de Janeiro, Brazil, over a period of 18 months. The type of antibiotics used was evaluated using the WHO AWaRE classification, and the amount of antibiotic was measured using days of therapy/1,000 patient-days (DOT/1000PD) after implementation of an antimicrobial stewardship program (ASP). The first and last semesters were compared using medians and the Mann–Whitney's test. The trends of antibiotic consumption were performed using time series analysis in three consecutive 6-month periods. Results A total of 2,205 patients were admitted, accounting for 12,490 patient-days. In PICU 1, overall antibiotic consumption (in DOT/1000PD) was 1,322 in the first 6 months of analysis and 1,264.5 in the last 6 months (p = 0.81). In PICU 2, the consumption for the same period was 1,638.5 and 1,344.5, respectively (p = 0.031). In PICU 1, the antibiotics classified in the AWaRE groups were used 33.2, 57.9, and 8.4% of the time, respectively. The remaining 0.5% of antibiotics used were not classified in any of these groups. In PICU 2, the AWaRE groups corresponded to 30.2, 60.5, and 9.3% of all antibiotics used, respectively. There was no use of unclassified antibiotics in this unit. The use of all three groups of WHO AWaRE antibiotics was similar in the first and the last semesters, with the exception of Reserve group in PICU 2 (183.5 × 92, p = 0.031). Conclusion A significant reduction of overall antibiotic use and also in the Reserve group was achieved in one of the PICU units studied. The antibiotics classified in the Watch group were the most used in both units, representing ∼60% of all the antibiotics consumed.

scholarly journals Safeguarding the Maintenance Hemodialysis Patient Population during the Coronavirus Disease 19 Pandemic

2020 ◽  
Vol 49 (3) ◽  
pp. 259-264 ◽  
Author(s):  
Bjorn Meijers ◽  
Piergiorgio Messa ◽  
Claudio Ronco
Keyword(s):  
Intensive Care ◽  
Hemodialysis Patient ◽  
Preventive Measures ◽  
Geographic Location ◽  
World Health ◽  
Maintenance Hemodialysis ◽  
Social Environments ◽  
The World ◽  
Health Organization ◽  
Social Separation

The World Health Organization has recognized the pandemic nature of the coronavirus disease 19 (COVID-19) outbreak. A large proportion of positive patients require hospitalization, while 5–6% of them may need more aggressive therapies in intensive care. Most governments have recommended social separation and severe measures of prevention of further spreading of the epidemic. Because hemodialysis (HD) patients need to access hospital and dialysis center facilities 3 times a week, this category of patients requires special attention. In this editorial, we tried to summarize the experience of our centers that hopefully may contribute to help other centers and colleagues that are facing the coming wave of the epidemic. Special algorithms for COVID-19 spreading in the dialysis population, recommendations for isolation and preventive measures in positive HD patients, and finally directions to manage logistics and personnel are reported. These recommendations should be considered neither universal nor absolute. Instead, they require local adjustments based on geographic location, cultural and social environments, and level of available resources.

The Institutional Active Aging Paradigm in Europe (2002–2015)

2019 ◽  
Vol 60 (3) ◽  
pp. 406-415 ◽  
Author(s):  
Raúl López-López ◽  
Mariano Sánchez
Keyword(s):  
World Health ◽  
Critical Examination ◽  
Active Aging ◽  
The European Union ◽  
Reductive Treatment ◽  
Health Organization ◽  
Ideal Framework ◽  
Point Of Departure ◽  
The Eu ◽  
The Ideal

Abstract Background and Objectives The paradigm of active aging has been slowly gaining ground in Europe as the ideal framework for public policy and for responding to the population’s aging. Taking the work by Rune Ervik as its point of departure, this article updates his conclusions on conceptualizations and policies of active aging by performing a study of the institutional discourses in the matter produced by the World Health Organization (WHO), the Organization for Economic Cooperation and Development (OECD), and the European Union (EU). Methods A corpus of 15 WHO, OECD, and EU documents published in the period 2002–2015 and tackling active aging were analyzed qualitatively through a combination of content and thematic analysis, based on a scheme integrated by deductive and inductive iterative manual and computerized codification. Results The institutional discourses on active aging analyzed have not changed dramatically in the period considered. However, a divergent path has emerged regarding the accent placed on participation and contribution in the construction of the paradigm: the more socially productive and health-oriented WHO discourse is slowly separating from the more economically productive and labor-oriented discourses of the EU and OECD. Discussion and Implications The institutional paradigm on active aging is evolving into a reductive treatment of a phenomenon that is multidimensional. International institutions and researchers should pay closer attention and forge a path toward an honest and critical examination of the real conditions and expectations of older people concerning the discursive and practical proposals of active aging, in all its different forms.

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