Mental health workers' perceptions and perspectives on the right to health and a human rights-based approach to mental health: A case study of the Chitwan District in Nepal

Over the last decade, there have been increasing calls for respecting and integrating human rights into health, including into mental health policies, plans, and programmes. The convergence of mental health and the right to health has implications for health workers, as they are the key translators of policy- and programme-related decisions into practice. This thesis is a qualitative research study which follows a case-study approach situated in the Programme for Improving Mental Health Care in Nepal. It aims to explore the perceptions and perspectives of health workers in the Chitwan district in Nepal on the use of a human rights-based approach (HRBA) to mental health. The specific objectives are to (1) examine existing evidence on the use of an HRBA to advance health; (2) explore perspectives on the right to health among mental health workers in Nepal; (3) explore health workers’ perceptions of the application of an HRBA to mental health in planning and service provision; and (4) develop a conceptual framework regarding the use of an HRBA to mental health. The literature review identified some plausible positive evidence on the use of an HRBA to advance health, but also highlighted the very limited quantity and quality of the evidence and the difficulty in determining with certainty the direct influence of an HRBA to health. No studies were identified that explored an HRBA to mental health in low- or middle-income countries. The qualitative research highlighted that participants were aware of human rights, but faced difficulty in understanding their meaning and application, including an HRBA. An HRBA to health and related plans requires an understanding of both the health system context and involvement of health workers. A conceptual framework was developed of an HRBA to mental health to help guide the application of an HRBA in mental health planning and service provision. Recommendations are provided

Monthlong Intubated Patient with Life-Threatening COVID-19 and Cerebral Microbleeds Suffers Only Mild Cognitive Sequelae at 8-Month Follow-up: A Case Report.

OBJECTIVE: To elaborate on possible cognitive sequelae related to COVID-19, associated cerebrovascular injuries as well as the general consequences from intensive care. COVID-19 is known to have several, serious CNS-related consequences, but neuropsychological studies of severe COVID-19 are still rare. METHODS: M., a 45-year-old man, who survived a severe COVID-19 disease course including Acute Respiratory Distress Syndrome (ARDS), cerebral microbleeds, and 35 days of mechanical ventilation, is described. We elaborate on M's recovery and rehabilitation process from onset to the 8-month follow-up. The cognitive functions were evaluated with a comprehensive screening battery at 4 weeks after extubation and at the 8-month follow-up. RESULTS: Following extubation, M. was delirious, reported visual hallucinations, and had severe sleeping difficulties. At about 3 months after COVID-19 onset, M. showed mild to moderate deficits on tests measuring processing speed, working memory, and attention. At assessments at 8 months, M. performed better, with results above average on tests measuring learning, memory, word fluency, and visuospatial functions. Minor deficits were still found regarding logical reasoning, attention, executive functioning, and processing speed. There were no lingering psychiatric symptoms. While M. had returned to a part-time job, he was not able to resume previous work-tasks. CONCLUSION: This case-study demonstrates possible cognitive deficits after severe COVID-19 and emphasizes the need of a neuropsychological follow-up, with tests sensitive to minor deficits. The main findings of this report provide some support that the long-term prognosis for cognition in severe COVID-19 may be hopeful

Los sistemas de salud y el derecho a la salud: una evaluación de 194 países

he paper traces the evolution and working of the Global Equity Gauge Alliance (GEGA) and its efforts to promote health equity. GEGA places health equity squarely within a larger framework of social justice, linking findings on socioeconomic and health inequalities with differentials in power, wealth, and prestige in society. The Alliance's 11 country-level partners, called Equity Gauges, share a common action-based vision and framework called the Equity Gauge Strategy. An Equity Gauge seeks to reduce health inequities through three broad spheres of action, referred to as the 'pillars' of the Equity Gauge Strategy, which define a set of interconnected and overlapping actions. Measuring and tracking the inequalities and interpreting their ethical import are pursued through the Assessment and Monitoring pillar. This information provides an evidence base that can be used in strategic ways for influencing policy-makers through actions in the Advocacy pillar and for supporting grassroots groups and civil society through actions in the Community Empowerment pillar. The paper provides examples of strategies for promoting pro-equity policy and social change and reviews experiences and lessons, both in terms of technical success of interventions and in relation to the conceptual development and refinement of the Equity Gauge Strategy and overall direction of the Alliance. To become most effective in furthering health equity at both national and global levels, the Alliance must now reach out to and involve a wider range of organizations, groups, and actors at both national and international levels. Sustainability of this promising experiment depends, in part, on adequate resources but also on the ability to attract and develop talented leadership.0000-0001-9706-89060000-0003-3258-283757192264926Cuenc

Group meetings after critical illness-Giving and receiving strength

Introduction: An increasing number of intensive care patients are surviving critical illness, but many develop mental, cognitive and physical impairments after discharge. Adapting to a new life situation, often with major challenges, implies the need of support. Therefore, it is important to develop interventions aimed at promoting recovery. Objective: The aim was to describe former intensive care patients feelings of sharing their experience of critical illness with other former patients. Method: Former intensive care patients (n = 17) participated in group meetings and wrote about their thoughts in a notebook after each group meeting. To deepen the understanding of the former patients experience 11 of the former patients were interviewed. The notes in the notebooks and the interviews were analysed using qualitative content analysis. Findings: Meeting others revealed to the former patients new dimensions of being critically ill, and they both gave and received strength from each other. The meetings were meaningful as they gained insight into other patients lives, and realised what it meant to survive intensive care. Conclusions: The group meetings meant sharing experiences and understanding the process of survival after critical illness. Giving and receiving strength from others helped the participants to go further. (C) 2017 Elsevier Ltd. All rights reserved.Funding Agencies|Department and Anesthetics, Operations and Speciality Surgery Center, Region Ostergotland, Sweden</p

The right to the highest attainable standard of health

This chapter introduces the right to the highest attainable standard of health, which is enshrined in several legally binding international treaties, as well as numerous national constitutions. It outlines the complementary relationship between public health and the right to the highest attainable standard of health, and provides a framework for analysing this human right. This analytical framework is then applied, by way of illustration, to neglected diseases, mental disability, sexual and reproductive health, and water and sanitation. The conclusion identifies the key features of a health system from the perspective of the right to the highest attainable standard of health

The right to the highest attainable standard of health

This chapter introduces the right to the highest attainable standard of health, which is enshrined in several international treaties, as well as numerous national constitutions, giving rise to legally binding obligations on States. It outlines the complementary relationship between public health and the right to the highest attainable standard of health, and provides a framework for analysing this human right. This analytical framework, which deepens understanding of, and helps to identify appropriate responses to, public health issues, is then applied, by way of illustration, to neglected diseases, mental disability, sexual and reproductive health, and water and sanitation. The conclusion identifies the key features of a health system from the perspective of the right to the highest attainable standard of health