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Peptide-fluorophore conjugates (PFCs) have been expeditiously utilized for metal ion recognition owing to their distinctive characteristics. Selective detection and quantification of aluminum is essential to minimize health and environmental risks. Herein, we report the synthesis and characterization of a new chemoprobe with aggregation-induced emission characteristics by chemically conjugating rhodamine-B fluorophore with a tripeptide. The probe revealed ß-sheet secondary conformation in both solid and solution states, as confirmed by FT-IR, PXRD, and CD experiments. AIE characteristics of the probe in water-MeCN mixtures revealed the formation of spherically shaped nanoaggregates with an average size of 353 ± 7 nm, as confirmed by SEM, TEM, and DLS studies. The probe exhibited a large stokes shift (175 nm) and displayed selective colorimetric and fluorometric responses towards Al3+ ions with an extremely low detection limit (51 nm) and a fast response time (≤15 s). Comparative NMR studies confirmed the cleavage of spirolactam ring upon aluminum binding. The probe's practicality was enhanced through integration into test strips and thin films, allowing solid-phase detection of Al3+ ions. Furthermore, an RGB-Arduino enabled optosensing device has been developed to enable instant quantifiable analysis of aluminum concentrations in real-time conditions.
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Occupational falls are often initiated by trips. Mechanical perturbations applied onto the tripped foot are different for different types of tripping obstacles. The present study aimed to determine how different types of tripping obstacles affect balance recovery after trips. Sixty-four healthy adults participated in an experimental study. They were instructed to perform several walking trials, during which two trips were randomly induced, one by a pole-like obstacle and the other by a board-like obstacle. Balance recovery after trips was measured and compared between the two obstacles. Results showed that the board-like obstacle led to longer step-off time, shorter recovery step duration, and smaller minimum hip height, suggesting that the risk of trip-initiated falls could be higher with the board-like obstacle vs. the pole-like obstacle. This finding presents the need for future research to consider the influence of obstacle type when exploring mechanisms for trips and falls.
Occupational falls are often initiated by trips. For better knowledge about trips and falls, this study examined the effects of tripping obstacles on balance recovery after trips. Knowledge obtained here could be useful for improving workers' awareness and assessment of the risk of trip-initiated falls in their workplace.
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In the construction industry, falls, slips, and trips (FST) account for 42.3% of all accidents. The primary cause of FST incidents is directly related to the deterioration of workers' body stability. To prevent FST-related accidents, it is crucial to understand the interaction between physical fatigue and body stability in construction workers. Therefore, this study investigates the impact of fatigue on body stability in various construction site environments using Dynamic Time Warping (DTW) analysis. We conducted experiments reflecting six different fatigue levels and four environmental conditions. The analysis process involves comparing changes in DTW values derived from acceleration data obtained through wearable sensors across varying fatigue levels and construction environments. The results reveal the following changes in DTW values across different environments and fatigue levels: for non-obstacle, obstacle, water, and oil conditions, DTW values tend to increase as fatigue levels rise. In our experiments, we observed a significant decrease in body stability against external environments starting from fatigue Levels 3 or 4 (30% and 40% of the maximum failure point). In the non-obstacle condition, the DTW values were 9.4 at Level 0, 12.8 at Level 3, and 23.1 at Level 5. In contrast, for the oil condition, which exhibited the highest DTW values, the values were 10.5 at Level 0, 19.1 at Level 3, and 34.5 at Level 5. These experimental results confirm that the body stability of construction workers is influenced by both fatigue levels and external environmental conditions. Further analysis of recovery time, defined as the time it takes for body stability to return to its original level, revealed an increasing trend in recovery time as fatigue levels increased. This study quantitatively demonstrates through wearable sensor data that, as fatigue levels increase, workers experience decreased body stability and longer recovery times. The findings of this study can inform individual worker fatigue management in the future.
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Industria de la Construcción , Fatiga , Humanos , Fatiga/fisiopatología , Adulto , Masculino , Equilibrio Postural/fisiología , Dispositivos Electrónicos Vestibles , Accidentes por Caídas/prevención & controlRESUMEN
BACKGROUND: Thailand has expressed interest in joining the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP), a twelve-country plurilateral trade agreement whose original incarnation included the United States of America (USA). When the USA withdrew from this agreement, key intellectual property clauses relevant to pharmaceuticals were suspended. These could be reinstated should the CPTPP Parties decide to do so. METHODS: This study uses two scenarios to cost the impact the CPTPP would have had on Thailand's 2020 hepatitis C treatment regime if Thailand joined the CPTPP and suspended clauses were reinstated. RESULTS: Joining the CPTPP could have increased the cost more than tenfold if suspended CPTPP clauses were reinstated and Thailand was not willing or able to issue compulsory licenses. Based on the 2020 budget, the price for this possible scenario could have reduced hepatitis C treatment coverage by 90%. CONCLUSIONS: Acceding to trade agreements such as the CPTPP that require increasing intellectual property protection, could compromise Thailand's hepatitis C program and other national treatment programs reliant on affordable generic medicines. The CPTPP could also prevent Thailand from relying on its own pharmaceutical capabilities to manufacture medicines needed to sustain its treatment programs.
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Hepatitis C , Cooperación Internacional , Tailandia , Humanos , Hepatitis C/tratamiento farmacológico , Estados Unidos , Propiedad Intelectual , Antivirales/uso terapéutico , Medicamentos Genéricos/uso terapéuticoRESUMEN
Objectives: To describe findings from an otolaryngology-specific needs assessment tool in Zimbabwe. Methods: Surveys were developed and shared with Low-Middle Income Country (LMIC) hosting institutions in Zimbabwe and to High-Income Country surgical trip participants (HIC). Respondents were otolaryngologists identified online and through professional networks who had participated in a surgical trip. Results: The most common procedures Zimbabwe otolaryngologists reported treating were adenotonsillectomy (85.7%), chronic rhinosinusitis (71.4%), chronic otitis (57.1%), and head and neck tumor intervention (57.1%). The most common untreatable conditions that host physicians wanted to treat were skull base surgery (71.4%), flap reconstructions (57.1%), and laryngotracheal reconstruction (57.1%). The largest discrepancy between host desires and visiting team offerings were flap reconstruction (57.1%), nasal bone deformities (37.1%), and laryngotracheal reconstruction (17.1%). Perceptions of short-term surgical trips (STST) were recorded for host and visiting teams, and important differences between the public and private sectors of care in Zimbabwe were also identified. Conclusion: The surveys utilized in this study served as a bidirectional needs assessment of the requirements and care goals of host institutions and visiting teams in Zimbabwe. Differences between public and private sectors of care, particularly regarding infrastructure, resources, and surgical goals, were revealed, and the results can be utilized as part of efforts to maximize efforts within global surgical partnerships. Level of Evidence: VI.
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Cambodia has experienced exponential economic growth in recent years and is expected to graduate from least developed country (LDC) status within the next decade. Membership of the World Trade Organization (WTO) will require Cambodia to grant product and process patents for pharmaceuticals upon LDC graduation. This study aims to measure the impact of the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) on the price of HIV and hepatitis C medicine in Cambodia once it graduates from LDC status and is obliged to make patents available for pharmaceutical products and processes. Using scenarios based on likely outcomes of accession to the TRIPS Agreement, it measures the impact on the price of the HIV treatment program and compares that impact with the hepatitis C treatment program. Graduation from LDC status would be expected to result in a modest increase in the cost of the antiretroviral (ARV) treatment program and very large increases in the cost of the direct acting antivirals (DAA) treatment program. If annual treatment budgets remain constant, patent protection could see 1,515 fewer people living with HIV able to access ARV treatment and 2,577 fewer people able to access DAA treatment (a drop in treatment coverage of 93%).
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Infecciones por VIH , Accesibilidad a los Servicios de Salud , Hepatitis C , Propiedad Intelectual , Cambodia/epidemiología , Humanos , Hepatitis C/tratamiento farmacológico , Hepatitis C/epidemiología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Patentes como Asunto/legislación & jurisprudencia , Países en Desarrollo/economía , Antivirales/uso terapéutico , Antivirales/provisión & distribución , Antivirales/economía , Cooperación Internacional/legislación & jurisprudencia , Fármacos Anti-VIH/uso terapéutico , Fármacos Anti-VIH/economía , Costos de los MedicamentosRESUMEN
BACKGROUND: This study analyzed a large outbreak of coronavirus disease 2019 (COVID-19) that occurred during a high school field trip in the Jeonbuk region and aimed to identify risk factors for COVID-19 infection, with the goal of preventing such outbreaks in the future. METHODS: A retrospective cohort study of 737 participants, including 668 students and 69 staff at High School A, was designed to describe the epidemiological characteristics of this large COVID-19 outbreak. Logistic regression analysis was performed to calculate relative risks (odds ratios [ORs]) and 95% confidence intervals (CIs). RESULTS: There were 190 confirmed cases (174 students, 16 staff), with an attack rate of 25.8%. Small outbreaks were decreasing before the field trip, but this trend reversed after the trip, leading to larger outbreaks. Logistic regression showed an OR of 2.39 (95% CI, 1.66-3.43; p<0.05) for COVID-19 infection among field trip participants. Among them, 11th graders had an OR of 2.32 (95% CI, 1.53-3.52; p<0.05) compared to 10th graders, while no significant risk difference was found within same-grade teams. CONCLUSION: There was a high risk for COVID-19 transmission during extracurricular activities with a large number of participants, such as field trips, even after the nationwide Omicron variant epidemic subsided. Even when students are separated into teams and follow different routes, it is challenging to design routes that entirely prevent contact between teams. Thus, programs should be designed carefully, and students with symptoms should be identified before and during the program to isolate them promptly.
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BACKGROUND: Treadmill belt-accelerations are a commonly utilised surrogate for tripping, but their physiological validity is unknown. This study examined if a treadmill belt-acceleration induces lower limb muscle activation responses similar to a trip on a walkway. METHODS: 38 older people (65+ years) experienced one treadmill belt-acceleration and one walkway obstacle trip in random order. Muscle responses were assessed bilaterally using surface electromyography on the rectus femoris (RF), tibialis anterior (TA), semitendinosus (ST) and gastrocnemius medial head (GM). Unperturbed muscle activity, post-perturbation onset latency, peak magnitude, time to peak and co-contraction index (CCI) were examined. RESULTS: Muscle activity in the right ST was greater during unperturbed walking on the treadmill compared to walkway (P=0.011). Compared to a treadmill belt-acceleration, a walkway trip elicited faster onset latencies in all muscles; greater peak magnitudes in the left RF, TA, GM and right GM; faster time to peaks in the left TA and right GM; and lower knee and ankle muscle CCI (P<0.05). CONCLUSIONS: Walkway trips and treadmill belt-accelerations elicit distinct muscle activation patterns. While walkway trips induced faster and larger muscle responses, treadmill belt-accelerations involved greater co-contraction. Therefore, treadmill belt-accelerations may not accurately simulate the muscle responses to trips.
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Marcha , Músculo Esquelético , Humanos , Anciano , Músculo Esquelético/fisiología , Marcha/fisiología , Caminata/fisiología , Electromiografía , AceleraciónRESUMEN
INTRODUCTION: Studies relating alcohol outlet density around homes to alcohol consumption produce mixed results. One possible explanation is that people travel to outlets away from their homes. This study aims to characterise individuals' trips to outlets, describe these trip locations relative to other activities and estimate associations between alcohol outlet density and trips to outlets. METHODS: This cross-sectional study used 2014-2018 household travel data from the Victoria Integrated Survey of Travel and Activity. We estimated the average change in the cumulative travel characteristics associated with each additional trip to bars and liquor stores, accounting for complex trips to multiple destinations. Logistic regression models estimated odds that individuals travelled to outlets in relation to outlet density in their home local government area (LGA). RESULTS: Among 23,512 respondents, 378 (1.6%) travelled to any bar and 79 (0.3%) any liquor store the survey day. Bar trips added 8.2 km (95% confidence interval [CI] 4.6, 11.8) and 18.1 min (95% CI 13.6, 22.6) to cumulative travel; 41% of attended bars were co-located in participants' home LGA. Greater bar and liquor store density within the home LGA were associated with overall trips to these outlet types. DISCUSSION AND CONCLUSIONS: Individuals travel beyond their residential area to bars, but travel to liquor stores closer to home. Bar and liquor store density within individuals' home LGA were associated with trips to outlets. Trips to local bars in near home comprised a minority of trips to bars in this sample. Studies of retail alcohol access should account for trips to bars away from home.
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Bebidas Alcohólicas , Comercio , Humanos , Estudios Transversales , Consumo de Bebidas Alcohólicas/epidemiología , MercadotecníaRESUMEN
CONTEXT: To facilitate the manufacturing of COVID-19 medical products, in October 2020 India and South Africa proposed a waiver of certain intellectual property (IP) provisions of a World Trade Organization (WTO) agreement. After nearly two years, a narrow waiver agreement that did little for vaccine access passed the ministerial despite the pandemic's impact on global trade, which the WTO is mandated to safeguard. METHODS: The authors conducted a content analysis of WTO legal texts, key-actor statements, media reporting, and the WTO's procedural framework to explore legal, institutional, and ideational explanations for the delay. FINDINGS: IP waivers are neither legally complex nor unprecedented within WTO law, yet these waiver negotiations exceeded their mandated 90-day negotiation period by approximately 18 months. Waiver opponents and supporters engaged in escalating strategic framing that justified and eventually secured political attention at head-of-state level, sidelining other pandemic solutions. The frames deployed discouraged consensus on a meaningful waiver, which ultimately favored the status quo that opponents preferred. WTO institutional design encouraged drawn-out negotiation while limiting legitimate players in the debate to trade ministers, empowering narrow interest group politics. CONCLUSIONS: Despite global political attention, the WTO process contributed little to emergency vaccine production, suggesting a pressing need for reforms aimed at more efficient and equitable multilateral processes.
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COVID-19 , Vacunas , Humanos , Cooperación Internacional , Negociación , COVID-19/epidemiología , Comercio , Política , Propiedad IntelectualRESUMEN
Shoe outsole design strongly influences slip and fall risk. Certain tread features that can be readily measured have been shown to predict friction performance. This research aimed to replicate those findings and quantify their ability to predict slipping. Participants (n = 34) were exposed to a low friction oil-coated floor surface, while wearing slip-resistant shoes. The coefficient of friction (COF) of each shoe were predicted based on tread surface area, the presence of a bevel, and hardness. The COF was measured, and the slip outcome was determined. Predicted and measured COF were correlated, and measured COF was a sensitive predictor of slip outcome. The relationship of predicted COF on slip outcome was weaker than anticipated and was not statistically significant. This study partially confirmed the ability of previous regression equations to predict COF. However, the effect size was weaker than previously reported and predicted COF was not sensitive for predicting slips.
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Pisos y Cubiertas de Piso , Zapatos , Humanos , Fricción , Estudios ProspectivosRESUMEN
OBJECTIVE: The aim of the study was to discuss the catastrophic consequences of inequitable vaccine distribution and analyze the main challenges to address it, helping to guide efforts to address inequities in vaccine coverage. METHODS: All published papers written in English were searched through PubMed, Web of Science, and Google Scholar with the combination of relevant terms of COVID-19 vaccine inequity. RESULTS: In this paper, we first outlined the scope of inequitable vaccine distribution and identify its truly catastrophic consequences. Next, from the perspectives of political will, free markets, and profit-driven enterprises based on patent and intellectual property protection, we analyzed in depth the root causes of why this phenomenon is so difficult to combat. In addition, some specific and crucial solutions that should be undertaken in the long term were also put forward in order to provide a useful reference for the authorities, stakeholders, and researchers involved in addressing this worldwide crisis and the next one. CONCLUSIONS: Achieving COVID-19 vaccine equity faces funding gaps, vaccine nationalism, and barriers to access to intellectual property and technology. Thus, the scope of global vaccine inequity is immense, and its repercussions will continue to be felt worldwide, especially among the world's most vulnerable residents, both adults and children. Beyond fundamental issues, the growing vaccine hesitancy and unreliable distribution in low-income countries must be addressed.
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COVID-19 , Vacunas , Adulto , Niño , Humanos , Vacunas contra la COVID-19 , COVID-19/prevención & control , TecnologíaRESUMEN
La expiración de patentes farmacéuticas sobre medicamentos favorece la realización de prácticas comerciales dentro del sector que obstaculizan la entrada de los medicamentos genéricos. La creación de terapias digitales a través de la incorporación de componentes digitales en productos farmacéuticos tradicionales es una alternativa innovadora que combina la aportación de un valor añadido a un producto farmacéutico obsoleto a la vez que aborda problemas sanitarios serios de forma transformadora. Este tipo de prácticas podría ayudar a las empresas farmacéuticas a mantener su hueco de mercado tras la expiración de la patente de un medicamento superventas. (AU)
The expiry of pharmaceutical patents on medical products encourages commercial practices within the sector that hinder the entry of generic medicines. The creation of digital therapies through the incorporation of digital components into traditional pharmaceuticals is an innovative alternative that combines adding value to an obsolete pharmaceutical product while addressing serious health problems in a transformative way. Such practices could help pharmaceutical companies to maintain their market niche after the patent expiry of a blockbuster drug. (AU)
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Propiedad Intelectual de Productos y Procesos Farmacéuticos , Estabilidad de Medicamentos , Legislación de Medicamentos , InvencionesRESUMEN
PROBLEM: Worn shoes are an important contributor to occupational slip and fall injuries. Tools to assess worn tread are emerging; imaging tools offer the potential to assist. The aim of this study was to develop a shoe tread scanner and evaluate its effectiveness to predict slip risk. METHODS: This study analyzed data from two previous studies in which worn or new slip-resistant shoes were donned during an unexpected slip condition. The shoe tread for each shoe was scanned using a portable scanner that utilized frustrated total internal reflection (FTIR) technology. The shoe tread parameters of the worn region size (WRS) for worn shoes and total contact area for new shoes were measured. These parameters were then used to predict slip risk from the unexpected slip conditions. RESULTS: The WRS was able to accurately predict slip risk, but the contact area was not. DISCUSSION: These findings support that increased WRS on the shoe outsole is associated with worse slip outcomes. Furthermore, the tool was able to offer robust feedback across a wide range of tread designs, but the results of this study show that the tool may be more applicable for slip-resistant shoes that are worn compared to their new counterparts. SUMMARY: This study shows that FTIR technology utilized in this tool may be a useful and portable method for determining slip risk for worn shoes. PRACTICAL APPLICATIONS: This tool has the potential to be an efficient, objective, end-user tool that improves timely replacement of shoes and prevention of injuries.
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Diazooxonorleucina , Zapatos , Humanos , TecnologíaRESUMEN
PROBLEM: Compared to other industries, construction workers have higher risks for serious fall injuries. This study describes the burden and circumstances surrounding injuries related to compensable slip, trip, and fall (STF) claims from private construction industries covered by the Ohio Bureau of Workers' Compensation. METHODS: STF injury claims in the Ohio construction industry from 2010-2017 were manually reviewed. Claims were classified as: slips or trips without a fall (STWOF), falls on the same level (FSL), falls to a lower level (FLL), and other. Claim narratives were categorized by work-related risk and contributing factors. Demographic, employer, and injury characteristics were examined by fall type and claim type (medical-only (MO, 0-7â¯days away from work, DAFW) or lost-time (LT, ≥8 DAFW)). Claim rates per 10,000 estimated full-time equivalent employees (FTEs) were calculated. RESULTS: 9,517 Ohio construction industry STF claims occurred during the 8-year period, with an average annual rate of 75 claims per 10,000 FTEs. The rate of STFs decreased by 37% from 2010 to 2017. About half of the claims were FLL (51%), 29% were FSL, 17% were STWOF, and 3% were "other." Nearly 40% of all STF claims were LT; mostly among males (96%). The top three contributing factors for STWOF and FSL were: slip/trip hazards, floor irregularities, and ice/snow; and ladders, vehicles, and stairs/steps for FLL. FLL injury rates per 10,000 FTE were highest in these industries: Foundation, Structure, and Building Exterior Contractors (52); Building Finishing Contractors (45); and Residential Building Construction (45). The highest rate of FLL LT claims occurred in the smallest firms, and the FLL rate decreased as construction firm size increased. Discussion and Practical Applications: STF rates declined over time, yet remain common, requiring prevention activities. Safety professionals should focus on contributing factors when developing prevention strategies, especially high-risk subsectors and small firms.
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Industria de la Construcción , Masculino , Humanos , Ohio/epidemiología , Indemnización para Trabajadores , NieveRESUMEN
Severe and fatal falls involving ladders commonly occur during transitions across the ladder and another support surface. Slipping is a common initiating event in ladder falls. This study characterized the friction requirements and body kinematics of descending roof-to-ladder transitions with and without a walk-through extension. Healthy adults who regularly climb ladders (n = 17) completed descending roof-to-ladder transitions, while foot-rung kinetics and body kinematics were recorded. The peak required coefficient of friction (RCOF) with respect to the plane of the shoe sole was calculated. The RCOF and body angle were calculated using their resultant values and projections in the frontal and sagittal planes. Foot angle was calculated in the sagittal plane. Repeated-measures ANOVA determined that compared to a walk-through ladder, a traditional ladder was associated with a higher RCOF in the medial-lateral (ML) direction (F1,16 = 190.07, p < 0.001) and a lower RCOF in the anterior-posterior (AP) direction (F1,16 = 11.02, p = 0.004), but had no significant relationship with the resultant RCOF (F1,16 = 0.098, p = 0.76). Spearman's rho tests performed across all testing configurations identified significant associations between foot angle and overall RCOF (rs = -0.724, p < 0.001), foot angle and AP RCOF (rs = -0.871, p < 0.001), and frontal plane body angle and ML RCOF (rs = 0.782, p < 0.001). Clustering in the data suggests that ladder attachments reduced frontal plane kinematics, which altered the direction of RCOF by reducing the medial-lateral component. These results have implications for designing rungs with good friction in multiple directions and the potential for body position monitoring in ladder tasks.
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While global health leaders call disparities in access to COVID-19 vaccines an 'apartheid,' this gap is not the first such disparity. The recurrence of these gaps in low and middle-income countries and especially in Africa, raises questions about their determinants and about the persistent failures of global health institutions to remediate them. We interrogate these determinants and questions by examining: (1) the distribution of COVID-19 vaccines; (2) primary determinants of vaccine access including availability and affordability; (3) factors affecting availability (hoarding, COVAX, and manufacturing capacity); and (4) factors affecting affordability (pricing, intellectual property rights (IPR), the TRIPS waiver and a potential pandemic treaty). We conclude that IPR constrained the affordability and availability of COVID-19 vaccines in ways inadequately addressed by COVAX and a waiver compromise thwarted by political, corporate, and philanthropic interests. While stronger limits to IPR in a pandemic treaty and a reformed International Health Regulations will not resolve structural inequities, they could meaningfully expand LMIC autonomy to protect public health. We urge equity-seeking Global South and North actors to fight for such IPR reforms as small and meaningful steps towards a more equitable global health order. Otherwise, criminally racist 'apartheids' will continue to be the norm when it comes to the distribution of essential health goods during global health emergencies.
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COVID-19 , Vacunas , Humanos , Vacunas contra la COVID-19 , Apartheid , COVID-19/epidemiología , COVID-19/prevención & control , ÁfricaRESUMEN
PURPOSE: As hand and upper extremity outreach trips increase, guidelines for assessing quality of care are being established. The Global Quality in Upper Extremity Surgery and Training investigators have published validated quality measures deemed to be essential for outreach trips to low and middle-income countries (LMICs). The purpose of this study was to assess baseline implementation of these quality measures across nine international hand surgery outreach sites to LMICs. Additionally, we investigated barriers and facilitators to implementing quality measures and documentation of their implementation. METHODS: We included nine of 12 scheduled 2019 Touching Hands Project trips, excluding independent outreach and teaching mission trips without surgical logs. The team leader from each site received an online questionnaire assessing the documentation and implementation of all 22 quality measures, as well as educational efforts. RESULTS: A total of 350 surgeries were performed in 2019 with seven reported minor complications and no major complications or mortalities. For analysis, 20 of 22 quality measures were included. Of 20 included validated quality measures, 10 were implemented across all surgical outreach sites. Two sites (Bolivia, Nepal) implemented all of the validated quality measures. Quality measures with the lowest implementation rates included ensuring availability of continuous electricity and oxygen supply with associated documentation of a backup plan. All outreach sites reported formal educational efforts. CONCLUSIONS: Implementation of validated quality measures across surveyed outreach sites is variable, indicating an opportunity for improvement. Standardizing documentation of quality measure implementation for each site, confirming availability of resources, increasing accountability by the visiting teams, and fostering stronger relationships with local health care, may increase quality measure implementation and improve quality health care delivery and patient safety in LMICs. CLINICAL RELEVANCE: Benchmarking the implementation of validated quality measures across hand surgical outreach trips provides an opportunity to improve the quality of health care delivered during future hand surgical outreach efforts.
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Indicadores de Calidad de la Atención de Salud , Especialidades Quirúrgicas , Humanos , Estados Unidos , Atención a la Salud , Mano/cirugía , Extremidad SuperiorRESUMEN
The second wave of the COVID-19 pandemic had left heart-wrenching impacts on all facets of life in general and the availability, accessibility, and affordability of medicines and vaccines in particular. Rather, the world has been divided into two groups regarding access to medicine and vaccines as haves and have-nots. The rich countries had pre-ordered the vaccines of COVID-19 along with the holding of the same. The pandemic situation was further worsened, given the Trade-Related Intellectual Property Rights (TRIPS) in practice and restrictions on sharing technology of vaccines, medicines, and life-saving equipment. In this context, India and South Africa have proposed the joint proposal and garnered support for waiving off TRIPS to ensure equity, accessibility, and affordability of vaccines and the same as public goods. In this review, we emphasize that global justice is one of the important elements of normative international theories, which focus on all the moral obligations from the world's rich to the world's poor. The paper also questions and argues that if the rich countries fail to go by the principles of global justice, can the Indian and South African (SA) patent diplomacy play a catalyst role in global justice? The review concludes with an emphasis on global solidarity, and the acceptance of joint India-South Africa's "patent diplomacy" for TRIPS waiver would result in mass production and fair distribution, making the COVID-19 medicines and technologies available to everyone regardless of their poor-rich status.