Understanding the impact of the COVID-19 outbreak on vulnerable populations in Malaysia through an ethical lens: A study of non-state actors involved in aid distribution

Background: Globally, vulnerable populations have been disproportionately affected by the COVID-19 pandemic and subsequent responses, such as lockdown measures and mass vaccinations. Numerous ethical challenges have arisen at different levels, be it at the policy-making level or on the ground. For example, policymakers have to contain a highly contagious disease with high morbidity using scarce resources, while minimizing the medium- to long-term social and economic impacts induced by containment measures. This study explores the impact of COVID-19 on vulnerable populations in Malaysia by using an intersectional framework that accounts for overlapping forms of marginalization. Methods: This study utilizes in-depth qualitative data obtained from 34 individuals and organizations to understand the impact of the COVID-19 outbreak on vulnerable populations in Malaysia. We utilize four principles of ethics to guide our coding and interpretation of the data – namely beneficence, non-maleficence, justice and autonomy. We utilize a frequency analysis to roughly understand the types of ethical issues that emerged. Using hermeneutic content analysis (HCA), we then explore how the principles interact with each other. Results: Through the frequently analysis, we found that although beneficence was very prevalent in our dataset, so was a significant amount of harm – as perpetuated through injustice, the removal or lack of autonomy and maleficence. We also unearthed a worrying landscape of harm and deep systemic issues associated with a lack of support for vulnerable households – further exacerbated during the pandemic. Conclusions: Policy recommendations for aid organizations and society to mitigate these ethical problems are presented, such as long overdue institutional reforms and stronger ethical practices rooted in human rights principles, which government agencies and aid providers can then use in the provision of aid to vulnerable populations.

Thermodynamic Rarity Assessment of Mobile Phone PCBs: A Physical Criticality Indicator in Times of Shortage

Rising prices in energy, raw materials, and shortages of critical raw materials (CRMs) for renewable energies or electric vehicles are jeopardizing the transition to a low-carbon economy. Therefore, managing scarce resources must be a priority for governments. To that end, appropriate indicators that can identify the criticality of raw materials and products is key. Thermodynamic rarity (TR) is an exergy-based indicator that measures the scarcity of elements in the earth’s crust and the energy intensity to extract and refine them. This paper uses TR to study 70 Mobile Phone (MP) Printed Circuit Boards (PCBs) samples. Results show that an average MP PCB has a TR of 88 MJ per unit, indicating their intensive use of valuable materials. Every year the embedded TR increases by 36,250 GWh worldwide -similar to the electricity consumed by Denmark in 2019- due to annual production of MP. Pd, Ta and Au embedded in MP PCBs worldwide between 2007 and 2021 contribute to 90% of the overall TR, which account for 75, 600 and 250 tones, respectively, and increasing by 11% annually. This, coupled with the short lifespan of MP, makes PCBs an important potential source of secondary resources.

The Great Lockdown in the Wake of COVID-19 and Its Implications: Lessons for Low and Middle-Income Countries

Concern for public health has been growing with the increasing volume of cases of COVID-19 in India. To combat this pandemic, India has implemented nationwide lockdowns, and unlocking phases continue with certain restrictions in different parts of the country. The lockdown has required people to adopt social-distance measures to minimize contacts in order to reduce the risks of additional infection. Nevertheless, the lockdown has already impacted economic activities and other dimensions of the health of individuals and society. Although many countries have helped their people through advanced welfare protection networks and numerous support aids, several emerging economies face specific difficulties to adapt to the pandemic due to vulnerable communities and scarce resources. However, certain lower-income countries need more rigorous analysis to implement more effective strategies to combat COVID-19. Accordingly, the current systematic review addresses the impacts of the COVID-19 pandemic and lockdowns in India in relation to health and the economy. This work also provides further information on health inequalities, eco-nomic and social disparities in the country due to the COVID-19 pandemic and lockdowns and also contributes pragmatic suggestions for overcoming these challenges. These observations will be useful to the relevant local and national officials for improving and adopting novel strategies to face lockdown challenges

Clapping From the Arena

Climate change is a serious global issue and concern that is attributed to change. A change of climate that is directly or indirectly related to human activity, that which alters the composition of the global atmosphere and which in addition to natural climate variability observed over comparable time periods. There is therefore no doubt that the earth is warming, and the climate changing. Despotism and the rule of despots as agents of democracy has created a rift in the issue of climate change on its citizenry in the southern zone of Plateau State in the area of health, water shortages, cutting meals due to the economic recession in Nigeria. Research has shown that climate change can create a conflict, and it does have a direct effect on scarce resources required to sustain life. Water is at the heart of human existence. Global warming has a major impact on global water cycle, hence on rainfall, soil moisture, rivers, and sea levels. If climate change is not tackled urgently, the calamity will be enormous.

Iran’s state can manage intensified new-model protests

Significance In November, farmers gathered in Isfahan to complain about water scarcity. Teachers, miners, pensioners and municipal workers have also protested in recent months against a background of high inflation, as government spending is curtailed by the effects of US sanctions. Impacts The government may crack down on new efforts by hydrocarbons workers and others to adopt trade union-style practices. Geographically based competition between groups seeking scarce resources such as water and electricity is likely to intensify. High inflation is likely to persist as the government struggles to balance its budget, with the likelihood of further subsidy cuts. Western efforts to back protests will help hardliners further sideline calls for reform, citing national security and religious identity.

Evaluation of the effect of JSC RZD transportation infrastructure availability on the risks of losses in the process of transportation

Aim. The availability of transportation infrastructure facilities affects the quality of the transportation services provided by JSC RZD. At the same time, this effect may significantly differ depending on the operating conditions of the transportation infrastructure or a specific railway line and can cause various degrees of risk of damage to the transportation process. Such risks are defined as risks of train-hour losses due to transportation infrastructure failures. Planning dependability management activities under conditions of scarce resources requires targeted identification of the transportation infrastructure facilities whose availability most significantly affects the magnitude of the risks of damage to the transportation process. The aim of the paper is to develop a method for evaluating daily availability and identifying its correlation with the risk of train-hour losses. Methods. The authors used the methods of risk management, probability theory and mathematical statistics, correlation and regression analysis. Results. The paper suggests representing the daily availability indicator of JSC RZD’s transportation infrastructure facilities as a two-parameter gamma distribution and describing its effect on the risks of the transportation process with a regression model. Conclusions. The paper’s findings can be used as part of transportation infrastructure dependability planning and targeted allocation of resources, as well as for substantiating the dependability indicator when evaluating the practical capacity of railway lines and utilization ratio and in a number of other operational tasks.

How not to count the health benefits of family planning

Several influential organisations have attempted to quantify the costs and benefits of expanding access to interventions—like contraceptives—that are expected to decrease the number of pregnancies. Such health economic evaluations can be invaluable to those making decisions about how to allocate scarce resources for health. Yet how the benefits should be measured depends on controversial value judgments. One such value judgment is found in recent analyses from the Disease Control Priority Network (DCPN) and the Study Group for the Global Investment Framework for Women’s and Children’s Health. Noting the decrease in the number of pregnancies expected to result from providing access to family planning, DCPN and the Study Group claim that a substantial benefit of such interventions is averting the stillbirths and child deaths that would have resulted from those pregnancies. We argue that health economic analyses should not count such averted deaths as benefits in the same way as saved lives. First, by counting averted stillbirths and child deaths as a benefit but not counting as a cost the lives of babies who survive, DCPN and the Study Group implicitly commit themselves to antinatalism. Second, this method for calculating the benefits of family planning interventions implies that infertility treatments are harmful. Determining how potential people should be treated in health economic analyses will require grappling with population ethics.

Market Efficient Portfolios in a Systemic Economy

Diversification vs. Diversity – How is the Efficiency of Markets Affected? Prices aggregate information that is dispersed in the economy; they thereby facilitate the allocation of scarce resources. Inefficiencies may arise from deviations of market prices from their fundamental values. In “Market Efficient Portfolios in a Systemic Economy”, Awiszus, Capponi, and Weber investigate the impact of the trade-off between diversity and diversification on inefficiencies in secondary markets due to asset illiquidity and leverage constraints of financial institutions. The authors identify two key determining factors. These are the systemic significance of the banks and the statistical properties of the fundamental asset shocks. Systemic significance is driven by the banks’ target leverage, their trading strategies, and the illiquidity characteristics of the assets. The paper demonstrates that portfolio diversification is typically not efficient. In fact, efficient portfolio holdings may strongly deviate from this standard paradigm, especially if the banks have similar characteristics.

Reciprocity and Resources

Reciprocity has been deployed as the moral concept underpinning an obligation to ensure that health care workers (HCW) who work during a pandemic have access to essential goods, such as personal protective equipment (PPE), and as a principle for giving priority to HCW for scarce resources, such as intensive care beds or ventilators. In this paper I examine the concept of reciprocity, arguing that it is best understood as a form of fairness, or “fair return for services rendered.” This interpretation works well in explaining our obligation to provide HCW with PPE and other risk-mitigation resources, but I give reasons to suggest that it does not support an obligation to prioritize HCW for scarce medical interventions.

Opportunities and Barriers of Telemedicine in Rheumatology: A Participatory, Mixed-Methods Study

Despite all its promises, telemedicine is still not widely implemented in the care of rheumatic and musculoskeletal diseases (RMDs). The aim of this study is to investigate opportunities, barriers, acceptance, and preferences concerning telemedicine among RMD patients and professional stakeholders. From November 2017 to December 2019, a participatory, mixed-methods study was conducted, consisting of (1) expert interviews (n = 27) with RMD patients and professional stakeholders, (2) a national paper-based patient survey (n = 766), and (3) focus groups (n = 2) with patient representatives and rheumatologists. The qualitative findings indicate that patients equate personal contact with physical face-to-face contact, which could be reduced by implementing telemedicine, thus negatively influencing the patient–doctor relationship. Correspondingly “no personal contact with the doctor” is the main reason (64%) why 38% of the surveyed patients refuse to try telemedicine. Professional stakeholders expect telemedicine to contribute to the effective allocation of scarce resources in rheumatology care. The main barriers reported by stakeholders were the scarcity of time resources in RMD care, the absence of physical examinations, and organizational challenges associated with the implementation of telemedicine in RMD care. While the exact integration of telemedicine into routine care has yet to be found, the consequences on the patient-physician relationship must be permanently considered.