Direito Administrativo Global: Reflexões sobre estratégia e substância à luz de O Príncipe de Niccolò Machiavelli

Aware of the countless questions that globalization raises, and specifically the problems of legitimacy and accountability of power in the global legal space, we propose to reflect one of the solution projects that have gained notoriety in recent years, notably, the Global Administrative Law project. Also, we will carry out this weighting through the help of lectures given in a classic of political strategy, namely in The Prince, by Niccolò Machiavelli. The objective will be an innovative reflection on the substantial and strategic benefits of the Global Administrative Law project, compared to other projects.Conscientes de los innumerables interrogantes que plantea la globalización, y en concreto los problemas de legitimidad y responsabilidad del poder en el espacio jurídico global, nos proponemos reflexionar sobre uno de los proyectos de solución que han cobrado notoriedad en los últimos años, en concreto, el proyecto de Derecho Administrativo Global. Asimismo, llevaremos a cabo esta ponderación a través de la ayuda de lecturas realizadas en un clásico de la estrategia política, concretamente en El Príncipe, de Nicolás Maquiavelo. El objetivo será una reflexión innovadora sobre las ventajas sustanciales y estratégicas del proyecto de Derecho Administrativo Global, en comparación con otros proyectos.Cientes das inúmeras interpelações que a globalização suscita, e concretamente dos problemas de legitimidade e responsabilização do poder no espaço jurídico global, propomo-nos refletir um dos projetos de solução que tem ganho notoriedade nos últimos anos, notadamente, o Direito Administrativo Global. Mais. Realizaremos esta ponderação com o auxílio das preleções efetuadas em um clássico de estratégia política, designadamente em O Príncipe, de Niccolò Machiavelli. O objetivo será uma reflexão inovadora sobre os benefícios materiais e estratégicos do projeto de Direito Administrativo Global, em comparação com projetos outros

A descolonização intelectual : Albert Camus e o direito à democracia

Cientes das inúmeras vantagens para o Direito que uma abordagem interdisciplinar proporciona, propusemo-nos, com a presente dissertação, a dar destaque à relação entre a Arte, o Direito e as Relações Internacionais, mediante a análise da obra O Estrangeiro de Albert Camus. Nessa medida, e considerando outros trabalhos do autor, como os seus ensaios filosóficos e jornalísticos, desenvolvemos um conceito novo - a Descolonização Intelectual -, com o objetivo de dar o nosso contributo para uma das questões controversas do Direito Internacional: O Direito de Autodeterminação dos Povos e a possível existência de um Direito à Democracia. Assim, criando paralelos, entre a vertente literal e a vertente metafísica do conceito de descolonização, assim como entre o passado e o presente, desenvolvemos a contribuição literal dos intelectuais para o processo de descolonização da Argélia, no passado, ao mesmo tempo que exploramos os benefícios de uma descolonização intelectual metafísica no presente. De tal processo, extraímos a convicção da existência de um direito à democracia no campo metafísico, mas não no literal. Por assim ser, e por força das decorrências analisadas, concluímos pela inevitabilidade, a longo prazo, da concretização do campo literal, isto é, da criação de um direito à democracia na ordem jurídica internacional.Aware of the advantages for Law that an interdisciplinary approach provides, we propose, with this dissertation, to highlight the relationship between Art, Law and International Relations, through the analysis of the work The Stranger by Albert Camus. To that extent, and considering other works by the author, such as his philosophical and journalistic essays, we developed a new concept - Intellectual Decolonization -, with the aim of giving our contribution to one of the controversial questions of International Law: The Right of Self-Determination of Peoples and the possible existence of a Right to Democracy. Thus, by creating parallels between the literal and the metaphysical part of the concept of Decolonization, as well as between the past and the present, we developed the literal contribution of intellectuals to the process of decolonization in Algeria in the past, while exploring the benefit of an intellectual decolonization in the present. From such a process, we extract the conviction of the existence of a right to democracy in the metaphysical field, but not in the literal. For this reason, and due to the consequences analyzed, we conclude that the creation of a right to democracy is inevitable in the long run

Acesso a Tratamento Endovascular para Acidente Vascular Cerebral Isquémico em Portugal

Introduction: Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. Material and Methods: A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. Results: A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. Conclusion: The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitals.Introdução: A aprovação do tratamento endovascular para o acidente vascular cerebral isquémico obrigou à reorganização dos cuidados de saúde em Portugal. Os nove centros que realizam tratamento endovascular não estão distribuídos equitativamente pelo território, o que poderá causar acesso diferencial a tratamento. O principal objetivo deste estudo é realizar uma análise descritiva da frequência e métricas temporais do tratamento endovascular em Portugal continental e seus distritos. Material e Métodos: Estudo de coorte nacional multicêntrico, incluindo todos os doentes com acidente vascular cerebral isquémico submetidos a tratamento endovascular em Portugal continental durante um período de dois anos (julho 2015 a junho 2017). Foram colhidos dados demográficos, relacionados com o acidente vascular cerebral e variáveis do procedimento. Taxas de tratamento endovascular brutas e ajustadas (ajuste indireto a idade e sexo) foram calculadas por 100 000 habitantes/ano para Portugal continental e cada distrito. Métricas de procedimento como tempo entre instalação, primeira porta e punção foram também analisadas. Resultados: Foram registados 1625 tratamentos endovasculares, indicando uma taxa bruta nacional de tratamento endovascular de 8,27/100 000 habitantes/ano. As taxas de tratamento endovascular entre distritos variaram entre 1,58 e 16,53/100 000/ano, com taxas mais elevadas nos distritos próximos a hospitais com tratamento endovascular. O tempo entre sintomas e punção femural entre distritos variou entre 212 e 432 minutos. Conclusão: Portugal continental apresenta uma taxa nacional de tratamento endovascular elevada, apresentando, contudo, assimetrias regionais no acesso. As métricas temporais foram comparáveis com as observadas nos ensaios clínicos piloto

Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: One-Year Follow-up.

BACKGROUND AND OBJECTIVES Declines in stroke admission, intravenous thrombolysis, and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the impact of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), intravenous thrombolysis (IVT), and mechanical thrombectomy over a one-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020). METHODS We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, intravenous thrombolysis treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. RESULTS There were 148,895 stroke admissions in the one-year immediately before compared to 138,453 admissions during the one-year pandemic, representing a 7% decline (95% confidence interval [95% CI 7.1, 6.9]; p<0.0001). ICH volumes declined from 29,585 to 28,156 (4.8%, [5.1, 4.6]; p<0.0001) and IVT volume from 24,584 to 23,077 (6.1%, [6.4, 5.8]; p<0.0001). Larger declines were observed at high volume compared to low volume centers (all p<0.0001). There was no significant change in mechanical thrombectomy volumes (0.7%, [0.6,0.9]; p=0.49). Stroke was diagnosed in 1.3% [1.31,1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82,2.97], 5,656/195,539) of all stroke hospitalizations. DISCUSSION There was a global decline and shift to lower volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared to the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year. TRIAL REGISTRATION INFORMATION This study is registered under NCT04934020

Global Impact of COVID-19 on Stroke Care and IV Thrombolysis

Objective To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. Methods. We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results. There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] −11.7 to −11.3, p \u3c 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI −13.8 to −12.7, p \u3c 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI −13.7 to −10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2–9.8, p \u3c 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions. The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months