Health, solidarity and justice : a discourse theoretical perspective

PhDThis thesis analyses the relationship between health, solidarity, and justice from a discourse theoretical perspective. Jürgen Habermas links justice to free, uncoerced, and inclusive processes of discursive consensus building. The realisation of these rational discourses, however, depends on a sense of solidarity between participants: solidarity is the counterpart of justice. Yet, in modern capitalism solidarity is the scarcest social resource. This leaves societies with the task of reconstructing the conditions that would make solidarity, and therefore justice, sustainable. This thesis argues that health offers an important contribution to this project. Habermas‟s universal pragmatics is used to analyse different concepts of health, and in adopting the perspective of the participant an intersubjective understanding of health is proposed. Placed within Habermas‟s theory of society, health is conceptualised as a sub-system of the lifeworld that contributes to social reproduction at the cultural, normative, and personality levels by: reproducing lay and medical knowledge; nurturing social solidarity through nets of formal and informal healthcare; and contributing to the development of personalities capable of and motivated to joining relationships of mutual recognition. These last two contributions reveal the relevance of health in fostering conditions for justice. The growing literature on the social determinants of health is explored to the conclusion that the relationship between health and justice is reciprocal and closer than commonly assumed. This insight is then applied to the context of the right to health. The thesis refutes different liberal challenges to the right to health and explores the right from the perspective of Habermas‟s reconstruction of the system of rights and procedural paradigm of law. The thesis concludes that discourse theory provides a better understanding of the relationship between health and justice, and therefore, better grounds for interpreting health as a legitimate human right

CASO NÚMERO 1/2018: “A MORTE E O WHATSAPP”

Caso relatado na Reunião de Discussão de Casos Clínicos do Hospital Universitário Prof. Polydoro Ernani de São Thiago, iniciada pelos Profs. Jorge Dias de Matos, Marisa Helena César Coral e Rosemeri Maurici da Silva, em julho de 2017. No dia 8 de março de 2018, no auditório do HUPEST, realizou-se a apresentação e discussão do caso cujo registro é apresentado a seguir

A Latin American, Portuguese and Spanish consensus on a core communication curriculum for undergraduate medical education

The autors would like to acknowledge the contributions of the participantsin the panel of experts. Their comments have helped us to reach moresuitable learning outcomes.They also want to thank the Universidad Francisco de Vitoria (Madrid, Spain)the financial support for the achievement of the projectTo present learning outcomes in clinical communication for a Core Curriculum for medical undergraduate students in Latin America, Portugal and Spain (LAPS-CCC) and to establish an expert network to support a transnational implementation. Through an iterative process, an international group of 15 experts developed an initial set of learning outcomes following a review and discussion of relevant international and local literature. A two-round Delphi survey involving 46 experts from 8 countries was performed. Quantative and qualitative analisis permited the definition of the final consensus. The initial proposal included 157 learning outcomes. The Delphi process generated 734 comments and involved the modification, deletion and addition of some outcomes. At the end of the process, a consensus was reached on 136 learning outcomes grouped under 6 competency domains with a high overall acceptance (95.1 %). The learning outcomes of this proposal provide a guide to introduce, support and develop communication curriculae for undergraduate medical studies in the countries involved or in other Spanish- or Portuguese-speaking countries. The online version of this article (doi:10.1186/s12909-016-0610-8) contains supplementary material, which is available to authorized users

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Perfil de saúde escolar na Escola da Rede Municipal da Costa da Lagoa - Florianópolis.

Trabalho de Conclusão de Curso - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departamento de Pediatria, Curso de Medicina, Florianópolis, 199

II Fórum do "Grupo de Estudos do Fim da Vida do Cone Sul": definições, recomendações e ações integradas para cuidados paliativos na unidade de terapia intensiva de adultos e pediátrica

Cuidado paliativo é uma forma de abordagem que visa a melhoria da qualidade de vida de pacientes e seus familiares que enfrentam doenças ameaçadoras à vida, através da prevenção, da identificação e do tratamento precoces dos sintomas de sofrimento físico, psíquico, espiritual e social. Todo paciente criticamente enfermo deve receber cuidados paliativos desde a internação, o que torna de primordial importância a educação e o treinamento dos intensivistas para a implantação destes cuidados nas unidades de terapia intensiva, tanto para atendimento de adultos como pediátrico. Em continuidade aos planos da Câmara Técnica de Terminalidade e Cuidados Paliativos da Associação de Medicina Intensiva Brasileira e, levando em consideração o conceito previamente apontado, foi realizado em outubro de 2010, durante o Congresso Brasileiro de Terapia Intensiva, o IIºForum do "Grupo de Estudos do Fim da Vida do Cone Sul", com o objetivo de elaborar recomendações pertinentes aos cuidados paliativos a serem prestados aos pacientes críticamente enfermos

Strategies of the brands Louis Vuitton and Alfred Dunhill in 2009: A Comparative Study

The goal of this diploma thesis is to penetrate the surface of the haute couture fashion houses marketing communication and to describe the communicated content. In this publication the author wants to reach the symbols and myths which stand behind the luxury marketing. The exemplar for the attempt mentioned will be the advertising campaigns of the two world well-known fashion houses - Louis Vuitton and Alfred Dunhill. The first part establishes the theoretical fond for the analyses of luxury marketing. For that reason the Czech and the international general publications are being used. A necessary part of the opening is the presentation of the both fashion houses for a better grasp of the historical connotations and of the complex consciousness of their professional background and their promotional motivation. The second part analyses the images chosen with an application of the comparison and the description. The important component of this part is the confrontation of the analyzed images with the historical facts and the cultural realia which allow us to overreach to the analyses of the narration and to the disclosure of the metatextual structures