Globally gender remains a key factor in differing health outcomes for men and women. This article analyses the particular relevance of gender for debates about global health and the role for international human rights law in supporting improved health outcomes during public health emergencies. Looking specifically at the recent Ebola and Zika outbreaks, what we find particularly troubling in both cases is the paucity of engagement with human rights language and the diverse backgrounds of women in these locations of crisis, when women‐specific advice was being issued. We find the lessons that should have been learnt from the Ebola experience have not been applied in the Zika outbreak and there remains a disconnect between the international public health advice being issued and the experience of pervasive structural gender inequalities among those experiencing the crises. In both cases we find that responses at the outbreak of the crisis presume that women have economic, social or regulatory options to exercise the autonomy contained in international advice. The problem in the case of both Ebola and Zika has been that leaving structural gender inequalities out of the crisis response has further compounded those inequalities. The article argues for a contextual human rights analysis that takes into account gender as a social and economic determinant of health.
The sustainable development goals (SDGs) adopted by the United Nations in 2015 include a new target for global health: SDG 3 aims to “ensure healthy lives and promote well-being for all at all ages.” Dementia care of good quality is particularly important given the projected increase in the number of people living with the condition. A range of assistive technologies have been proposed to support dementia care. However, the World Health Organization estimated in 2017 that only one in 10 of the 1 billion or more people globally who could benefit from these technologies in some way actually has access to them. For people living with dementia, there has been little analysis of whether assistive technologies will support their human rights in ways that are consistent with the United Nations Convention on the Rights of Persons with Disabilities. The aim of this paper is to examine the relevant provisions of the convention and consider their implications for the use of assistive technologies in dementia care. Assistive technologies can clearly play an important role in supporting social engagement, decision-making and advance planning by people living with dementia. However, concerns exist that some of these technologies also have the potential to restrict freedom of movement and intrude into privacy. In conclusion, an analysis of the implications of assistive technologies for human rights laws is needed to ensure that technologies are used in ways that support human rights and help meet the health-related SDG 3.
The challenge of how to collect and harness complaints data to improve the quality of healthcare at a systemic level warrants further research. Scope also exists for researching health complaints commissions and other "meta-regulatory" bodies to explore how to make these processes fairer and better able to meet the complex needs of complainants, health professionals, health services and society.
The respiratory health of workers exposed to polyvinylchloride (PVC) dust has been investigated in 818 men sampled from the work force of a factory manufacturing PVC. In a crosssectional survey, the lung function and prevalences of respiratory symptoms and chest radiographic abnormalities were compared with estimates of individual PVC dust exposures based o, detailed occupational histories and current measurements of respirable PVC dust. Complaints of slight exertional dyspnoea were associated with PVC dust exposure, though age and smoking effects were much stronger. The forced expired volume in one second (FEV,) and forced vital capacity (FVC) were inversely related to dust exposure after age, height, and smoking effects had been taken into account. This effect was seen principally in cigarette smokers, and there was suggestive evidence that PVC dust exposure and cigarette smoking interacted in the reduction of FEV, and FVC. Gas transfer factor was not related to dust exposure. The chest radiographs were read according to the ILO U/C classification by three experienced readers. One reader recorded a low prevalence of small rounded opacities, and these were not related to age or dust exposure. Another reader recorded a higher prevalence of small rounded opacities category 0/1 or more, and these were related to age but not to dust exposure. The third reader recorded the highest prevalence of small rounded opacities (though none greater than category 1/1), and these were independently related both to age and to PVC dust exposure, indicating an effect of PVC dust on the appearances of the chest radiograph. These appearances were so slight that only the higher sensitivity of this reader in the interpretation of profusion of small rounded opacities on the ILO U/C scale enabled detection of this effect of PVC dust. In conclusion, exposure to PVC dust is associated with some deterioration of lung function, slight abnormalities of the chest radiograph, and complaints of slight dyspnoea. The mean decline in FEVy associated with the average dust exposure experienced in the study was small, though some of the men with higher dust exposures may have suffered clinically important 1h)ss of lung function as a result of their occupation.
The paper commends the wisdom of reliance on 'soft law', international guidance that leaves plenty of room for each nation to construct its response in conformity with its own cultural and value requirements.
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