Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 13.227
Filtrar
1.
Vaccimonitor (La Habana, Print) ; 30(2)mayo.-ago. 2021.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1252323

RESUMO

En diciembre de 2019 en Wuhan, provincia China de Hubei, se notificó un caso de neumonía de etiología desconocida. Con posterioridad se diagnosticó como un síndrome agudo respiratorio severo (SARS, por sus siglas en inglés) causado por un coronavirus denominado SARS-CoV-2.1 A principios de marzo de 2020, la Organización Mundial de la Salud (OMS) notificó casi 100.000 casos positivos y 3.880 víctimas mortales en 47 países, convirtiéndose en pandemia la enfermedad COVID-19 que ha afectado al mundo hasta la actualidad.2 La pandemia de la COVID-19 ha tenido un gran impacto en la vida de las personas y la sociedad en su conjunto y ha causado perjuicios a la economía mundial, afectándose sectores como turismo, recreación, viajes internacionales, educación, entre otros. Para la salud humana, ha tenido repercusión en términos de enfermedad, discapacidad y elevado número de muertes, así como en las complejas interrogantes impuestas a la ciencia para contener el impacto de la misma. La implementación de una estrategia dirigida a mitigar la dispersión de la enfermedad incluye numerosas acciones de salud pública, entre ellas: la higiene de las manos, el uso extendido y obligatorio de la mascarilla, el distanciamiento social y la vacunación.3 Una vacuna contra la COVID-19, esperada ansiosamente por el mundo, debe ser una vacuna segura y eficaz que permita poder reanudar un estilo de vida normal, libre de las medidas de restricción recomendadas y que evite que se saturen los servicios de salud. La carrera por la invención y desarrollo de una vacuna contra la COVID-19 no tiene precedentes en la era moderna y ha comprometido como nunca antes a la ciencia, llevando a la movilización e intercambio de datos en un período muy corto; a la coordinación acelerada, a nivel mundial, de los procesos regulatorios para el desarrollo de vacunas y fármacos; así como a la creación de marcos de colaboración internacional donde se incluyen, junto a la OMS, la Alianza Global para las Vacunas (GAVI), la Coalición para la Promoción de Innovaciones en pro de la Preparación ante Epidemias (CEPI) y el Fondo de Acceso Global para Vacunas COVID-19 (COVAX, por su siglas en inglés).4 El proceso de desarrollar un nuevo producto farmacéutico es caro e implica una inversión considerable de tiempo. Como promedio, se precisan 10 años desde el momento en que se descubre una molécula hasta que se comercializa el producto, con un costo de millones de dólares. Acortar los tiempos de este proceso es de los retos más importantes, donde la etapa de desarrollo clínico es la que se ve más presionada en todo momento.1 El desarrollo clínico de una vacuna implica un número de fases por las que debe transcurrir el producto farmacéutico. En el caso particular de las vacunas contra la COVID-19, las fases se han ido llevando a cabo simultáneamente, bajo aprobaciones rápidas. Varias vacunas ya han recibido autorizaciones para el uso de emergencia y se están utilizando para inmunizar a las personas.5) Desafortunadamente, acortar el tiempo para que las vacunas estén disponibles, puede conllevar a problemas éticos relacionados con la investigación, el desarrollo y aquellos que se puedan presentar en las etapas de distribución y acceso equitativo a las mismas.6 Para que la investigación en seres humanos que sea éticamente justificada, debe haber un balance favorable de beneficios para el sujeto y la sociedad, sobre los riesgos a los que el individuo se expone. Entre los dilemas éticos a los que se enfrentan los investigadores, uno de los más complejos en el caso de las vacunas contra la COVID-19, es el empleo de grupo control o placebo en los estudios clínicos, si tenemos en cuenta que esta es una enfermedad nueva, con limitaciones de las opciones de tratamiento y de elevada mortalidad, todo lo cual implica un alto riesgo para este grupo. Según el diseño del estudio, los participantes incluidos en el grupo placebo podrían infectarse en dependencia del tiempo de permanencia en dicho grupo, la tasa de transmisión local donde se realiza el ensayo clínico y las medidas preventivas adoptadas por cada uno de los participantes.7 Uno de los escenarios que puede afrontar el investigador cuando se usa placebo, es que el tratamiento (fármaco o vacuna) resulte efectivo, entonces, una parte de los participantes perdería la oportunidad de recibir ese beneficio, lo cual nos llevaría a decidir que todos los voluntarios reciban la profilaxis y sacrificar el conocimiento y valor social que aportan los estudios con grupos placebo.8) Actualmente, algunos desarrolladores de vacunas han esbozado la obligación ética de ofrecer la vacuna a participantes que hayan recibido placebo en los ensayos clínicos, para que queden protegidos contra la COVID- 19 y, además, para la contribución a la investigación.8 Otro tema de discusión global y que compete a la bioética relacionada a las vacunas contra la COVID-19, es la distribución justa dentro de una población una vez que las vacunas están disponibles en el mercado. ¿Qué criterios deben utilizarse? ¿Qué personas deben recibirla primero dentro de una población? ¿Quiénes tienen prioridad, y por qué? Es un criterio general entre los especialistas, que el personal de salud que se encuentra en la primera línea de batalla contra la COVID-19, debe ser el primero en acceder a la vacuna, lo cual previene el daño directo e indirecto a los mismos, al prevenir la propagación del SARS-CoV-2 en las instalaciones médicas, protegiendo de este modo a los grupos de pacientes que acuden con mayor frecuencia a los hospitales con diagnóstico de cáncer o con tratamiento de hemodiálisis.6 La crisis sanitaria mundial causada por el SARS-CoV-2 no tiene precedentes y el acceso a la vacuna se ha mostrado difícil desde el inicio. Es un hecho que los países desarrollados se han apresurado desde antes de la comercialización a adquirir y contratar cantidades suficientes de la vacuna para su población, siendo entonces el panorama aún más sombrío para los países de bajos ingresos.6 Debido a la pandemia, las operaciones logísticas de las vacunas también se ven afectadas por lo que se convierten en obstáculos para garantizar la distribución mundial de manera coordinada e interconectada (fabricación, distribución de la cadena de suministro, cadena de frío, almacenamiento, etc.). De ahí, el llamado constante de la OMS a lograr y mantener el compromiso de los gobiernos a garantizar un acceso equitativo y a colaborar en planes multinacionales como COVAX, CEPI y GAVI para asegurar la fabricación y distribución de vacunas contra la COVID-19.4 Con el fin de hacer el bien para todos y ante la premura de obtener resultados terapéuticos eficaces para enfrentar y mitigar la pandemia, no se deben sacrificar las normas científicas, la integridad y trasparencia del proceso de revisión de las vacunas y se debe cumplir con los principios éticos fundamentales que se exigen en las investigaciones en humanos(AU)


Assuntos
Humanos , Masculino , Feminino , Ética , Vacinas contra COVID-19/uso terapêutico
2.
Can Vet J ; 62(5): 445-446, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33967282
3.
Hist Philos Life Sci ; 43(2): 63, 2021 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-33928412

RESUMO

This paper examines the case of Ebola, ça Suffit trial which was conducted in Guinea during Ebola Virus Disease (EVD) outbreak in 2015. I demonstrate that various non-epistemic considerations may legitimately influence the criteria for evaluating the efficacy and effectiveness of a candidate vaccine. Such non-epistemic considerations, which are social, ethical, and pragmatic, can be better placed and addressed in scientific research by appealing to non-epistemic values. I consider two significant features any newly developed vaccine should possess; (1) the duration of immunity the vaccine provides; and (2) safety with respect to the side effects of the vaccine. Then, I argue that social and ethical values are relevant and desirable in setting the parameters for evaluating these two features of vaccines. The parameters that are employed for setting up the criteria for assessing the features might have far-reaching implications on the well-being of society in general, and the health conditions of several thousand people in particular. The reason is that these features can play a decisive role during the evaluation of the efficacy and effectiveness of the vaccine. I conclude by showing why it is necessary to reject the concept of epistemic priority, at least when scientists engage in policy-oriented research.


Assuntos
Vacinas contra Ebola/administração & dosagem , Ética , Doença pelo Vírus Ebola/prevenção & controle , Fatores Sociais , Vacinas contra Ebola/normas , Guiné , Doença pelo Vírus Ebola/psicologia , Humanos
4.
Bioethics ; 35(5): 446-455, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33829525

RESUMO

This article poses an invitation for bioethicists to engage with loneliness as a bioethics and public health concern. I argue that loneliness is a relevant issue for bioethicists for three main reasons: it causes ill-health; particularly in the age of Covid-19, it is becoming prominent on the clinical and public health agenda, affecting millions worldwide; and it engenders several ethical and philosophical questions as a social determinant of health with a rich conceptual background. In what follows I first review the link between loneliness and ill-health and argue that it should concern bioethicists because of this link. I also demonstrate how pertinent the issue of loneliness is being considered nowadays, and mark this as another reason for bioethicists to become engaged. I then move on to define loneliness and its various forms, drawing from modern and contemporary philosophers. The way we choose to cope with the pandemic of loneliness depends in part on its theoretical underpinnings, as well as its empirical scope. Theory thus combines with empirical data in order to devise and implement a rational public health policy, necessitating the kind of interdisciplinary approach that is the bedrock of bioethics. I conclude by suggesting future areas of research and recommendations.


Assuntos
Bioética , COVID-19/psicologia , Ética , Solidão , Saúde Pública/ética , Determinantes Sociais da Saúde/ética , Eticistas , Humanos , SARS-CoV-2 , Isolamento Social , Apoio Social
5.
Can Vet J ; 62(4): 325-326, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33867545
6.
Digital Transformation. Knowledge Capsules;1PAHO/EIH/IS/21-011.
Monografia em Inglês | PAHO-IRIS | ID: phr-53732

RESUMO

The use of artificial intelligence in public health is growing and getting more presence. This knowledge capsule has the objective of increasing aware on this discipline necessary guiding principles, its components and sub-fields and the uses it has. Although this tool presents a linkage between the artificial intelligence and the eight principles for the digital transformation of public health and propose the main considerations to be taken for its implementation.


Assuntos
Direção e Governança do Setor de Saúde , Inteligência Artificial , Sistemas de Informação , Sistemas de Informação em Saúde , Informação , COVID-19 , Saúde Pública , Ética
7.
CMAJ Open ; 9(1): E295-E301, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33785477

RESUMO

BACKGROUND: The quality of case reports, which are often the first reported evidence for a disease, may be negatively affected by a rush to publication early in a pandemic. We aimed to determine the completeness of reporting (COR) for case reports published on coronavirus disease 2019 (COVID-19). METHODS: We conducted a systematic search of the PubMed database for all single-patient case reports of confirmed COVID-19 published from Jan. 1 to Apr. 24, 2020. All included case reports were assessed for adherence to the CARE (Case Report) 31-item checklist, which was used to create a composite COR score. The primary outcome was the mean COR score assessed by 2 independent raters. Secondary outcomes included whether there was a change in overall COR score with certain publication factors (e.g., publication date) and whether there was a linear relation between COR and citation count and between COR scores and social media attention. RESULTS: Our search identified 196 studies that were published in 114 unique journals. We found that the overall mean COR score was 54.4%. No one case report included all of the 31 CARE checklist items. There was no significant correlation between COR with either citation count or social media attention. INTERPRETATION: We found that the overall COR for case reports on COVID-19 was poor. We suggest that journals adopt common case-reporting standards to improve reporting quality.


Assuntos
COVID-19/epidemiologia , Lista de Checagem/normas , Editoração/normas , Relatório de Pesquisa/normas , Bibliografia de Medicina , Bibliometria , COVID-19/diagnóstico , COVID-19/virologia , Gerenciamento de Dados , Estudos Epidemiológicos , Ética , Fidelidade a Diretrizes , Humanos , Avaliação de Resultados em Cuidados de Saúde , Relatório de Pesquisa/tendências , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Mídias Sociais/estatística & dados numéricos
8.
Span J Psychol ; 24: e16, 2021 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-33745483

RESUMO

A sample of 641 participants were presented with four decision-making tasks during the first stages of the COVID-19 lockdown in Spain: The dictator game, framing problems, utilitarian/deontological and altruistic/egoistic moral dilemmas. Participants also completed questionnaires on mental health status and experiences related to the COVID-19 pandemic. We used boosted regression trees (an advanced form of regression analysis based on machine learning) to model relationships between responses to the questionnaires and decision-making tasks. Results showed that the psychological impact of the COVID-19 pandemic predicted participants' responses to the framing problems and utilitarian/deontological and altruistic/egoistic moral dilemmas (but not to the dictator game). More concretely, the more psychological impact participants suffered, the more they were willing to choose the safest response in the framing problems, and the more deontological/altruistic were their responses to moral dilemmas. These results suggest that the psychological impact of the COVID-19 pandemic might prompt automatic processes.


Assuntos
Ansiedade/psicologia , COVID-19 , Tomada de Decisões , Depressão/psicologia , Estresse Psicológico/psicologia , Adolescente , Adulto , Idoso , Altruísmo , Teoria Ética , Ética , Feminino , Humanos , Aprendizado de Máquina , Masculino , Saúde Mental , Pessoa de Meia-Idade , Princípios Morais , Análise de Regressão , SARS-CoV-2 , Espanha , Adulto Jovem
9.
Can Vet J ; 62(3): 211-212, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33692575
10.
Washington, D.C.; OPS; 2021-03-11.
em Português | PAHO-IRIS | ID: phr-53338

RESUMO

Este documento fornece orientações a todo o pessoal da Organização Mundial da Saúde responsável por planejar e administrar exercícios de definição de prioridades de pesquisa. Este guia tem como base uma coletânea de exemplos de boas práticas e metodologias extraídas da OMS e de outras organizações. O documento formula uma abordagem sistemática para orientar, como um todo, o Planejamento, a Implementação, a Publicação e a Avaliação (PIPA) dos processos de definição de prioridades de pesquisas. O documento foi elaborado de maneira a permitir a flexibilidade adequada a todos os tipos de definições de prioridades de pesquisa, sejam essas centradas em doenças específicas, utilizando abordagens nacionais ou roteiros globais, ou envolvendo um grupo pequeno de especialistas durante uma emergência ou uma consulta global de vários meses de duração.


Assuntos
Pesquisa , Ética , Criatividade , Política Pública , Saúde Pública , Orientação , Planejamento em Saúde
11.
Washington, D.C.; OPS; 2021-03-04.
em Espanhol | PAHO-IRIS | ID: phr-53337

RESUMO

En este documento se brinda orientación para todos los funcionarios de la Organización Mundial de la Salud (OMS) y la Organización Panamericana de la Salud que necesiten planificar y gestionar un ejercicio de asignación de prioridades de investigación. Se basa en una serie de ejemplos de buenas prácticas y métodos extraídos de toda la OMS y de fuera de ella. Plantea un método sistemático para planificar, aplicar, publicar y evaluar el proceso de asignación de prioridades. Las orientacióones están elaboradas para que sean flexibles, de modo que se adecuen a todo tipo de ejercicios de asignación de prioridades de investigación, ya sea para una sola enfermedad, un enfoque a nivel nacional u hojas de ruta mundiales, y ya sea que participe un grupo reducido de expertos durante una emergencia o que se trate de una consulta mundial de meses de duración.


Assuntos
Pesquisa , Ética , Criatividade , Política Pública , Política de Saúde , Saúde Pública , Orientação , Planejamento em Saúde
12.
Can Vet J ; 62(2): 109-110, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33542548
13.
Hist Philos Life Sci ; 43(1): 28, 2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33620613

RESUMO

Prevention of age-related disorders is increasingly in focus of health policies, and it is hoped that early intervention on processes of deterioration can promote healthier and longer lives. New opportunities to slow down the aging process are emerging with new fields such as personalized nutrition. Data-intensive research has the potential to improve the precision of existing risk factors, e.g., to replace coarse-grained markers such as blood cholesterol with more detailed multivariate biomarkers. In this paper, we follow an attempt to develop a new aging biomarker. The vision among the project consortium, comprising both research and industrial partners, is that the new biomarker will be predictive of a range of age-related conditions, which may be preventable through personalized nutrition. We combine philosophical analysis and ethnographic fieldwork to explore the possibilities and challenges of managing aging through bodily signs that are not straightforwardly linked to symptomatic disease. We document how the improvement of measurement brings about new conceptual challenges of demarcating healthy and unhealthy states. Moreover, we highlight that the reframing of aging as risk has social and ethical implications, as it is generative of normative notions of what constitutes successful aging and good citizenship.


Assuntos
Envelhecimento , Antropologia Cultural , Biomarcadores/sangue , Saúde , Risco , Ética , Humanos
14.
Can Vet J ; 62(1): 11-12, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33390593
16.
BMC Med Ethics ; 22(1): 6, 2021 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-33494754

RESUMO

BACKGROUND: Critical public health measures implemented to mitigate the spread of the novel coronavirus disease (COVID-19) pandemic have disrupted health research worldwide, including HIV prevention research. While general guidance has been issued for the responsible conduct of research in these challenging circumstances, the contours of the dueling COVID-19 and HIV/AIDS pandemics raise some critical ethical issues for HIV prevention research. In this paper, we use the recently updated HIV Prevention Trials Network (HPTN) Ethics Guidance Document (EGD) to situate and analyze key ethical challenges related to the conduct of HIV prevention research during the COVID-19 pandemic as well as identify potential areas for refinement of the guidance document based on this unprecedented state of affairs. MAIN BODY: Necessary actions taken for HIV prevention research studies due to the COVID-19 pandemic involve an array of ethical issues including those related to: (1) risk mitigation; (2) behavior change; (3) compounding vulnerability; (4) community engagement; (5) trial reopening; and 6) shifting research priorities. CONCLUSIONS: In the context of the dueling HIV and COVID-19 global pandemics, research teams and sponsors must be nimble in responding to the rapidly changing environment by being sensitive to the associated ethical issues. The HTPN EGD provides a rich set of tools to help identify, analyze and address many of these issues. At the same time, future refinements of the HPTN EGD and other research ethics guidance could be strengthened by providing explicit advice regarding the ethical issues associated with disrupted research and the reopening of studies. In addition, additional consideration should be given to appropriately balancing domains of risk (e.g., physical versus social), addressing the vulnerability of research staff and community partners, and responding to un-anticipatable ancillary care needs of participants and communities. Appropriately addressing these issues will necessitate conceptual work, which would benefit from the careful documentation of the actual ethical issues encountered in research, the strategies implemented to overcome them, and their success in doing so. Throughout all of these efforts, it is critical to remember that the HIV pandemic not be forgotten in the rush to deal with the COVID-19 pandemic.


Assuntos
Pesquisa Biomédica/ética , COVID-19 , Códigos de Ética , Ética , Infecções por HIV/prevenção & controle , Pandemias , COVID-19/epidemiologia , COVID-19/prevenção & controle , Ética em Pesquisa , Saúde Global , Serviços de Saúde , Pesquisa sobre Serviços de Saúde/ética , Humanos , Saúde Pública , Pesquisadores , Características de Residência , Risco , SARS-CoV-2
17.
Clin Med (Lond) ; 21(2): e122-e125, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33376107

RESUMO

There is an urgent need for an ethical framework to help us address the local and national challenges that we face as clinicians during the COVID-19 pandemic. We propose four key commitments from which a practical and consistent ethical approach can be derived. These commitments are to articulate the needs, rights and interests of the different stakeholders affected by any policy; to be accountable and transparent, recognising that people are autonomous individuals with values and concerns of their own; to consider the impact of our actions on the sustainability of the NHS, infrastructure, service demands and staff welfare; and to treat everybody equitably, with all deserving of consideration and care. Implementing these commitments will require a number of specific actions. We must put in place frameworks enabling clear advocacy for each competing objective; communicate policy and practice effectively to the public; promote integration of decision-making among social, primary, secondary and tertiary care and reduce or stop unnecessary or inefficient interventions; minimise health inequalities; and build spare capacity into the system.In this article, we expand on these actions, and note the legal context in which this would be delivered.


Assuntos
COVID-19 , Pandemias , Formulação de Políticas , Ética , Humanos , Pandemias/prevenção & controle , SARS-CoV-2
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...