Overview of global organ donation and transplantation in 2020

Objective At present, the novel coronavirus pneumonia (COVID-19) pandemic is still raging in certain regions around the globe, and the prevention and control of the pandemic should be strengthened. Under the challenges of respective social environment and allocation of medical resources, and support from the inertia and inherent productivity of the system on which the industry depends, extensive attempts are being delivered to push forward the work of organ donation and transplantation in each country. Under the guidance of national experts and committee members, Shanxi Provincial Human Organ Procurement and Allocation Service Center was established on August 28, 2018 approved by the former Shanxi Provincial Health and Family Planning Commission. It is the only independent non-profit medical institution in Shanxi Province. In this article, the system construction of citizen's organ donation and transplantation fitting national and provincial conditions was further explored according to the data analysis of organ donation and transplantation in the United States and Spain during the COVID-19 pandemic combined with the implementation of organ donation work in Shanxi Provincial Human Organ Procurement and Allocation Service Center.Copyright © 2021 The authors.

Recent Trends and Characteristics of Genitourinary Fistulas in Rwanda

INTRODUCTION AND OBJECTIVE: Genitourinary fistulas (GU) in Rwanda have significantly increased in recent years. We previously reported an increase in the proportion of vesicouterine, vesicocervical and uterovaginal fistulas, with the majority occurring after Cesarean section. Our goal is to examine the characteristics of our the most recent cohort. METHOD(S): A cross-sectional study was conducted of women presenting for evaluation to the International Organization for Women and Development (IWOD) in Kigali, Rwanda, from 2018 to 2019, and 2022. No data was collected during years 2020 and 2021, due to the COVID-19 pandemic. Data was collected from medical records and included region of residence, surgical history, presence of fistula, and type. RESULT(S): A total of 434 women were evaluated, of these 194 (44.7%) were diagnosed with GU fistula. In 2018, fistula types were 40 (52%) vesicovaginal, 5 (6%) urethral, 5 (6%) ureterovaginal, 23 (30%) vesicoureterine or vesicocervical, and 7 (9%) juxtacervical. In 2019, the fistula types were 26 (41%) vesicovaginal, 4 (6%) urethral, 6 (10%) ureterovaginal, 17 (27%) vesicoureterine or vesicocervical, and 10 (16%) juxtacervical. In 2022, the fistula types were 33 (61%) vesicovaginal, no urethral fistula reported, 7 (13%) ureterovaginal, 8 (15%) vesicoureterine or vesicocervical, and 6 (11%) juxtacervical. CONCLUSION(S): In comparison to our prior cohort, recent data shows a stable proportion of types of fistulas. The increased number of vesicouterine, vesicocervical, and juxtacervical fistula may be higher due to increased performance of Cesarean sections.

Inclusive policies for health financing towards universal health coverage in Pakistan: direct or indirect taxes

Purpose: The unresolved crisis scenario and a prolonged COVID-19 pandemic increased social inequalities, mainly affecting the most vulnerable groups to access health services. The data in Pakistan show that health coverage benefits less than half of the population and a weak health system forces households to finance their health with out-of-pocket expenses. Therefore, it is a pending task to guarantee universal health coverage and design sustainable and inclusive policies to finance and provide health services. This study aims to offer a unique solution for health financing to Pakistan. Design/methodology/approach: This study uses the VECM model by employing the data from Pakistan to indicate sustainable policies for health financing. Finding(s): The results of this research show that direct taxes have a positive impact on public health expenditure;on the contrary, indirect taxes have a negative impact;it also confirms the importance of considering the direct tax based on high-income quintiles to guarantee equality and Access to health for all that contributes to human development. Practical implications: This article leads to the design of a new health system that will be useful for improving the health of Pakistan by presenting a solution to enhance health financing. Meanwhile, Pakistan will experience better conditions in the face of health crises. Social implications: Improving health financing through the equality approach can provide public access to the health system and strengthen the positive effects of the health system on socio-economic relations. Originality/value: This paper provides a unique solution for the ministry of health of Pakistan, International organisations and national authorities to reach a high level of health coverage without any cost to the financial system and increase the cost of living of the Pakistani people. Highlights: Increase efficient health financing by integrating health coverage programmes. Implementing direct taxes based on income quintiles improves health equality. Indirect tax policies will not positively contribute to health financing. Improving health financing efficiency decreases health inequality.Copyright © 2022, Emerald Publishing Limited.

Navigating international order transition in the Indo Pacific

The world is in crisis. The Covid pandemic and the ongoing Russia-Ukraine war signify a potential order transition in the international system. The Indo Pacific is at the center of gravity of great power competition between the US and China. How have policy elites in the region perceived the potential order transition against the background of US-China strategic competition? How have states, including both great and secondary powers, chosen different strategies to cope with security and economic turbulence in the Indo Pacific? This special issue intends to shed some light on these questions by critically examining the diverse perceptions and policy choices of the United States, China, South Korea, India, Japan, Indonesia, and the UK during the period of potential order transition in the Indo Pacific. It provides an academic platform for scholars to engage in this 'order transition' topic from different theoretical perspectives as well as from respective national angles in the Indo Pacific. It suggests that the complexity of the international order itself has made the 'order transition' more complicated and difficult than before. It is the best of times, it is the worst of times, and it is the most challenging time for state leaders and scholars alike. [ FROM AUTHOR] Copyright of Pacific Review is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Establishing local manufacture of PPE for healthcare workers in the time of a global pandemic.

A face shield is a secondary personal protective equipment (PPE) for healthcare workers (HCW). Worn with the appropriate face masks/respirators, it provides short term barrier protection against potentially infectious droplet particles. Coronavirus disease 2019 (COVID-19) caused a spike in demand for PPE, leading to a shortage and risking the safety of HCW. Transport restrictions further challenged the existing PPE supply chain which has been reliant on overseas-based manufacturers. Despite the urgency in demand, PPE must be properly tested for functionality and quality. We describe the establishment of local face shields manufacture in Western Australia to ensure adequate PPE for HCW. Ten thousand face shields for general use (standard) and for ear, nose and throat (ENT) specialist use were produced. Materials and design considerations are described, and the face shields were vigorously tested to the relevant Standards to ensure their effectiveness as a protective barrier, including splash and impact resistance. Comparative testing with traditional and other novel face shields was also undertaken. Therapeutic Goods Administration (TGA) licence was obtained to manufacture and supply the face shields as a Class I medical device. The swiftness of process is a credit to collaboration from industry, academia and healthcare.

Introduction

This book critically examines the roles played by developing countries, in partnership with major multilateral agencies and their bilateral counterparts, in addressing agricultural and rural development as a way to achieve economic transformation and food for all. The book explores the questions of what member nations of the United Nations, working with international organizations, have been able to achieve thus far in food and agriculture and in economic transformation;how they have responded to the rapidly changing external environment and factors internal to the organizations;and how well equipped they are to address future challenges of poverty, food security and nutrition, inequality, climate change, degradation of natural resources, and conflict, in the face of rapidly deteriorating natural resources and advancing science. Discovering the answers to these questions makes this discussion all the more urgent. Most importantly, we explore the roles of the traditional international organizations established in the post-Second World War period vis-à-vis new actors, philanthropists, and the private sector in contributing to growth and development. The COVID-19 pandemic has laid bare the structural weaknesses among the mightiest economies of income inequalities, lack of universal access to health, and lack of trust in government. Smaller Asian Tigers-Taiwan, Singapore, and South Korea-in addition to China, where the pandemic originated-had smarter responses, demonstrating their superior state capacity. What are the lessons of history for national, regional, and global governance?. © Uma Lele, Manmohan Agarwal, Brian C. Baldwin, and Sambuddha Goswami 2021.

Observing Caribbean Elections During the Pandemic: Challenges and Best Practices

This paper examines how the practice of international election observation in the Commonwealth Caribbean was affected by the COVID-19 pandemic. Many countries were faced with the decision on whether to conduct or delay elections during the pandemic. Between March 2020 and June 2022, 10 out of 12 Commonwealth Caribbean countries held elections. All these countries, except for Barbados, have had their elections observed by at least one regional or international organization during the last two decades. The closure of borders and the various quarantine requirements had practical implications for maintaining this trend during the pandemic. Most countries that regularly invite international observers did not have their pandemic held elections observed. This paper considers the reasons for the absence of observers in some elections and explores the adjustments observer groups have had to make during the last two years. The discussion also explores how Caribbean countries were able to indicate their commitment to holding free and fair elections in the absence of observers. For the countries that had observers, the discussion examines how these missions navigated issues of cost, shorter invitation periods, challenges in international travel, the recruitment of suitable observers and local pandemic protocols and conditions. (English) [ FROM AUTHOR]

WHO approves? Relative trust, the WHO, and China's COVID-19 vaccines.

This paper aims to answer a general question: whether an international organization (IO) is able to shape public opinion in the context of the COVID-19 pandemic. Since the pandemic took hold in early 2020, countries across the globe have switched gear from prevention to vaccination. Most had to not only secure a sufficient supply of vaccines, but also to curb vaccine hesitancy among their populations. Can endorsement by an international organization like the World Health Organization (WHO) enhance a vaccine's acceptability? Based on a survey experiment conducted in Taiwan, our study leverages the special relationship between China and Taiwan to show that WHO endorsement can induce acceptance of Chinese vaccines among Taiwanese people. However, the effect is found to be contextual in the sense that it only works when people's trust in the WHO is higher than their trust in the vaccine's country of origin. Our study not only contributes to the literature of IO legitimacy by empirically showing IOs' causal effects on public opinion, but also sheds light on how a vaccine's credibility can be enhanced to promote vaccination uptake. Supplementary Information: The online version contains supplementary material available at 10.1007/s11558-022-09481-1.

NCRI's Consumer Forum: Patients promoting evidence-based medicine and evidence-based policy

Background: Since its inception in 2000 the UK’s National Cancer Research Institute (‘NCRI’) has committed to involve Consumers (patents and public) representatives in all aspects of its work. Methods: Consumers are recruited in open competition, trained for specific NCRI roles, and supported to work beyond those roles. The NCRI Consumer Forum contains 140 members from all four UK nations, providing a pool of experienced advocates working in all areas of cancer research. The membership reflects the geographic diversity of the four UK nations. Results: 75% of Consumers work with research funders or organisations outside the NCRI Partners. In the 2021 census, more than 50 such organisations were identified, including local, national and international organisations, charities, NHS Trusts, online communities and patient groups. Consumers work or have worked with industry including Big Pharma, biotechs and medical device manufacturers. They serve on Trial Management/Steering Groups, sit on research funding committees and hold governance or accountability posts, eg Board members, Charity Trustees, NHS Commissioners. All have worked on patient information, including websites, videos and audio. During the COVID-19 pandemic in 2020-21 the Consumer Forum worked collaboratively with the UK Coronavirus Cancer Monitoring Project to create, distribute and analyse a survey asking cancer patients what was important to them for COVID-19 and cancer research. Results informed the direction of Covid-19 and cancer research in the UK. This collaboration continued with regular discussion around new research areas and collaboration on peer-reviewed journal articles. Consumers work/have worked with strategic bodies in the UK and beyond eg NICE, MHRA, HRA, BBMRI-ERIC, EORTC. Consumers have provided responses to two recent UK Government consultations, inputting into the strategy of the UK regulatory environment via the MHRA clinical trials regulation and shaping the future strategy for cancer care and research via the national 10-year cancer plan. Conclusions: The NCRI Consumer Forum is a group of Patients and Carers promoting evidence-based medicine and evidence-based policy in the UK and beyond. Legal entity responsible for the study: NCRI. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Health crisis and the EU’s HERA: amplifying partial organizing with resourcing for stability, agility, and evolvability

What design recommendations can be made for European Union (EU) organizing its health crisis preparedness and emergency response? The EU has recently established the Health Emergency Response and Health Authority (HERA) for coping with crises. However, as an international organization that lacks a legal means of extending its mandate over EU member states, HERA can potentially fail in its mission. To help prevent this potential failure, we make design recommendations that draw on resourcing theory to complement the limited-or partial-organizing capabilities of HERA. The design recommendations are tailored to three schemas that the analysis of the stakeholder feedback suggests: stability, agility, and evolvability. We outline HERA's current actions and deliverables as mandated in its founding and suggest additional examples of ways to amplify crisis preparedness and emergency response. These recommendations stem from the proposed resourcing perspective within the constraints of an international, partial organization. We conclude with implications for future research and practice, focusing on how stability, agility and evolvability can amplify the HERA's ability to meet its expectations.

The EU, Hungary, and Russian vaccine diplomacy.

Since the Fidesz-KDNP alliance rise to power in April 2010 the relations between Hungary and the institutions of the European Union have been becoming more and more strained. A proponent of illiberal democracy, Prime Minister Viktor Orbán has pursued a foreign policy shaped by nationalism, often disregarding Brussels stance and provoking conflict. The institutions have accused Hungary of abandoning the principles of liberal democracy and rejecting the European values and threatened to impose sanctions. Orbán played the Euroscepticism card domestically and with the members of the Visegrád Group that supported Hungary in its opposition to the EU's common policy concerning the migrant crisis of 2015. While some may consider Orbán a populist, his Brussels policy can strengthen Hungary's position in the Union. This paper studies how Budapest and Brussels interacted against the backdrop of the COVID-19 pandemic in 2020-2021 and what influence Russia had on that interaction. Hungary, having deviated from the course of Europeanisation in its foreign policy, has become increasingly inclined to position itself as a sovereign state, whose government stands up for its national interest and thereby comes into conflict with Brussels. In 2020, this trend developed into the Hungarian National Security Strategy based on the three foundational tenets: 1) Hungary recognizes the global changes and the emergence of an alternative world order;2) Hungary needs to build relationships with other global actors (Russia and China) besides the European Union that (as well as the West, in general) became a considerably weaker element of the international system;and 3) Hungary's policy is framed in the Berlin-Moscow-Istanbul triangle. To sum up, the de-Europeanization backslide within the Hungarian foreign policy manifests itself in Orban's rhetoric against Brussels, in his idea of the Visegrád Group as a prospective part of the Paris-Berlin axis, and in the reinforcement of the Hungary-Russia relations. The article demonstrates how Budapest leverages Russia's vaccine diplomacy to exert pressure on Brussels when Hungarian interests are at stake. The author dismisses the notion of Hungary as of a Russia's Trojan horse, because such view on the Orban's policy concerning the EU institutions is oversimplified and wants to emphasize that Hungary and Russia pursue different interests. The main finding of this study is that Orbán's EU policy is in itself manipulative, aimed at conforming the European foreign policy to the politician's own views. His eventual success would have a significant impact on the transformation of the EU. (English) [ FROM AUTHOR] Представлено развитие отношений между Венгрией и институтами Европейского Союза в связи с фактором России в период пандемии COVID-19. Рассматриваются особенности венгерской дипломатии по во- просам интеграции в контексте строительства нелиберальной демократии, политики открытости в отношении Востока и сотрудничества с Россией в преодолении последствий коронавирусной пандемии. Делается вывод, что, используя ситуацию кризиса и находясь в конфликте с Брюсселем относительно европейских ценностей, Будапешт пытается изменить правила игры в ЕС в соответствии с своими национальными интересами. (Russian) [ FROM AUTHOR] Copyright of Tomsk State University Journal of History is the property of Tomsk State University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Deceased Donor Transplantation During Covid Times: Success Story From State in India

In India, live donor transplantation is more common than deceased donor transplantations. The enactment of The Transplantation of Human Organ and tissue Act in India in the year 1994 legalized organ donation after brainstem death. In-hospital donor coordinators have been defined as one of the leading practices for deceased organ donation worldwide. The Transplant Procurement Manager is a healthcare specialist dedicated to deceased donation. Aim and objectives: The role of TPM in organ donation. To improve the deceased organ donation process. Materials and methods: KIMS Hospital, Kerala initiated an educational and international cooperation approach based on the implementation of a specialized program for healthcare professionals in 2019. It includes on-site training, international internship, hospital visits, and international experts visiting KIMS hospital to ensure best practices. KIMS appointed an in-hospital transplant procurement manager (TPM) to coordinate potential donors at intensive care units. The TPM became actively involved in the deceased organ donation (DDP) process. The cornerstone of the success was early and proactive identification of potential donors. Results: After 3 years of collaboration and following the initiation of TPM at KIMS, deceased organ donation activity increase markedly in the hospital. When compared 2020 vs 2019, a 60% increase was observed from 30 to 50 organs transplanted in the same period of time even against COVID pandemic effects worldwide. The conversion rate increased from 0% in 2018 to 21.4% in 2019. Conclusion: The hospital-based organ procurement units headed by transplant procurement managers (TPM), the role of hospitals, and the collaboration between a local and international organization in improving the deceased donor transplantation played a key role in good outcomes of donation and transplant programs. When the COVID-19 pandemic resulted in the suspension of the transplant programs across the country, the deceased donation and transplantation activity in Kerala were going unabated.

Ethics in Laboratory Medicine: Lessons from the COVID-19 pandemic

Professional societies in many countries have developed ethics policies and guidance materials for laboratory medicine which, just like any other area of medicine, must adhere to high ethical standards in order to assure quality and safety in health care. In particular, the International Organization for Standardization (ISO) in the accreditation standard ISO 15189:2012 "Medical laboratories − Requirements for quality and competence" has dedicated a specific section to this issue. However, the COVID-19 pandemic has raised the awareness of the urgent need to reassess and update ethical codes, and has highlighted current challenges and critical issues, such as access to diagnostics and laboratory testing, the value of laboratory information and the need for well-integrated diagnostic information. In the present paper, proposals are made for the updating of ethical codes currently required in laboratory medicine.

Analysis of the renewed European Medical Device Regulations in the frame of the non - EU regulatory landscape during the COVID facilitated change.

The term "Medical devices" includes technology-based devices or articles, both basic and complex. Due to these types of variations, a strict, robust, transparent, and sustainable regulatory framework is required. In recent clinical practice, incidents including the breast implant and the hip replacement crisis have made it necessary to improve the regulatory and compliance approaches for the industry to ensure the manufacturing and distribution of safe and innovative MDs within the EU. In response to this, the EU revised the laws governing medical devices and in vitro diagnostics to align with the developments of the sector, address critical safety issues and support innovation. The new regulation (EU) 2017/745 on Medical Devices (MDR) is now applicable from May 26 2021 and the In Vitro Diagnostic Medical Devices Regulation (EU) 2017/746 will take effect from May 2022.In this review, we aim to provide an update on the new Medical Device Regulations in the context of the current medical needs of the world, and also to give a glimpse at the non-EU regulatory landscape. Finally, we take a look at the closed-system transfer devices (CSTD) and COVID facilitated changes promoting demand for continuous improvement and trends in the pharmaceutical and medical industry related areas.

Internally displaced people in Lagos: environmental health conditions and access to healthcare in the context of COVID-19

The paper documents environmental health conditions and healthcare access challenges faced by internally displaced people (IDPs) from Borno State living in informal settlements in Lagos, Nigeria, in 2020, during the early stages of the COVID-19 pandemic. This qualitative study with 32 IDPs suggests a high vulnerability to COVID-19. Their accommodation often lacked basic sanitation including water and toilet facilities;overcrowding and high population density restricted ability to adhere to social distancing;and IDPs experienced serious consequences from lockdown, as the majority depended on daily wages, and did not receive food packages or other support from the State. Finally, there were obstacles to accessing healthcare. We highlight the importance of an integrated approach, consolidating the efforts of communities, non-governmental organisations, environmental and public health, and international organisations to address the health and well-being issues of IDPs in urban informal settlements.

Adjustment of in vitro Fertilization Clinic Management during COVID-19 Pandemic: A Study among Laboratory Staff in Indonesia

BACKGROUND AND OBJECTIVES: The Ministry of Health as a national authority and several international organizations highly recommend that each in vitro fertilization (IVF) clinic conducts reviews for service regulations and makes adjustments for the patient’s services according to the COVID-19 pandemic. AIM: A survey of IVF clinic management in Indonesia during the COVID-19 pandemic needs to be carried out so that the results of the survey can be used as an evaluation material for the management to improve services safely. METHODS: This cross-sectional survey was conducted among 49 IVF laboratory staff members of Indonesian Society of Human Embryologists from 42 IVF clinics in Indonesia. We administered an online questionnaire containing several questions related to the management of IVF clinic services during the COVID-19 pandemic based on a search of scientific literature. RESULTS: Several services adjustments have been made by IVF clinic management in response to the COVID-19 pandemic to minimize transmission of the virus in the IVF clinic. The IVF clinic management revised the service regulations and the patient services procedure was also undergone several adjustments, to minimize the COVID-19 transmission. CONCLUSIONS: Several IVF clinic managements adjustments were made by IVF clinic management in Indonesia as an early response to the COVID-19 pandemic. Clinic managements compile several adjustments to the service regulations during the COVID-19 pandemic as one of the readiness of IVF clinics in providing safe services for patients and staff.

Application of Safety Protocols for International Cleft Outreach Programs During the COVID-19 Pandemic: Global Smile Foundation Precaution Guidelines and Implications

Background/Purpose: Since COVID-19 was declared a worldwide pandemic by the World Health Organization (WHO) in March of 2020, foundation-based cleft outreach programs to Low- and Middle-Income Countries (LMICs) were halted considering global public health challenges, scarcity of capacity and resources, and travel restrictions. This led to an increase in the backlog of untreated patients with cleft lip and/or palate, with new challenges to providing comprehensive care in those regions. Resumption of international outreach programs requires an updated course of action to incorporate necessary safety measures in the face of the ongoing pandemic. In this manuscript, we outline safety protocols, guidelines, and recommendations implemented in Global Smile Foundation's (GSF) most recent outreach trip to Beirut, Lebanon. Methods/Description: COVID-19 safety protocols for outreach cleft care and an Action Response Plan were developed by the GSF team based on the published literature and recommendations from leading international organizations. Results: GSF conducted a 1-week surgical outreach program in Beirut, Lebanon, performing 13 primary cleft lip repairs, 7 cleft palate repairs, and 1 alveolar bone grafting procedure. Safety protocols were implemented at all stages of the outreach program, including patient pre-selection and education, hospital admission and screening, intraoperative care, and post-operative monitoring and follow-up. Conclusions: Organizing outreach programs in the setting of infectious diseases outbreaks should prioritize the safety and welfare of patients and team members within the program's local community. The COVID-19 protocols and guidelines described may represent a reproducible framework for planning future similar outreach initiatives in high risk conditions.