La objeción de conciencia en el ámbito sanitario: tratamiento legal y jurisprudencial en una perspectiva comparada

Con respecto a la objeción de conciencia en el ámbito sanitario, el aspecto más complicado se centra en las intervenciones para interrumpir el embarazo, o bien para prevenirlo a través del suministro de anticonceptivos o, por el contrario, en las actuaciones dirigidas a lograr el embarazo a través de las técnicas de fecundación asistida. En algunos países, como Italia y Estados Unidos, el porcentaje de objetores es tan alto que a las mujeres se les impide el acceso a tales intervenciones. El Estado puede considerarse el principal responsable de situaciones como ésta cuando no prevé la necesaria regulación de la objeción de conciencia o cuando no impone el respeto de la legislación existente. En el trabajo se presta atención a las condiciones de legitimidad de las leyes sobre la objeción de conciencia que, a su vez, permiten evaluar la posible responsabilidad penal del sanitario que rechace una intervención debida, fuera de las condiciones en que el rechazo puede ser autorizadoConcerning the conscientious clauses regarding health services, a very worrying situation is found in performing abortions or providing contraception or, at the opposite, infertility treatments. In some countries like Italy and the United States, the percentage of objectors is so high that women are denied access to those medical services. Greater responsible for the situation is the State that fails to regulate the moral and religious objections of health care provider as well as to require compliance with the existing legislation. This work addresses the conditions that legitimate the recognition of the right to conscientious objection by the law; conditions that are also used to assess the potential criminal liability of physicians, due to their refusal to provide treatments outside the conditions under which rejection can be authorized by the la

An evaluation of 605 endoscopic examination in a rural setting, Lacor Hospital in Northern Uganda

Introduction: The aim of this study was to evaluate the profile of esophagogastroduodenal (EGDS) diseases diagnosed by upper endoscopy in a rural area of Uganda in a retro-protective study of 605 patients. Results: The mean age of patients with digestive symptoms was 39.7yrs (SD +/-16.11) and female gender predominated by 60% compared to the male (P value 0.000). Peasant farmers were the commonest group with GI symptoms requiring EGDS compared to the rest 72.1% v 27.9%. Epigastric pain was the commonest indication (58%) for EGDS, followed by chest pain (11%), abdominal pain (8.8%), dyspahgia (7.6%) and hematemesis (7.3%). The commonest endoscopy finding was gastritis (47.9%) followed by esophagitis (14.4%), cancer esophagus (5.1%), esophageal varicose (4%), PUD (2.3%), gastric cancer (1%). However 19.5% of patients had normal EGDS. There was a significant correlation between the outpatient diagnosis and endoscopy finding (P value 0.01, r = 0.144) and between endoscopy finding and histology findings (P value 0.001, r = 0.236). H. pylori was positive in 53% of patients with gastritis. Conclusion: Gastritis is the commonest lesion (47.9%) of which 53% have H pylori and Cance

Barriers and factors affecting personal protective equipment usage in St. Mary’s Hospital Lacor in Northern Uganda

Background: To protect health workers (HCWs) from risky occupation exposure, CDC developed the universal precautions (Ups) including Personal Protective Equipment (PPEs). However compliance to it by HCWs has remained poor even in high-risk clinical situation. The objective of this study was to identify and describe the factors that influence a HCWs’ decision to wear PPEs and the barriers that exist in preventing their use Methods: A cross-sectional survey was carried out in the St. Mary’s Hospital Lacor in all the wards to collected quantitative information as well as qualitative and observational data on PPE use Results: Out of the total 59 respondents, 2% do not know the purpose of PPE, 23.7% do not know how to don and doff PPEs, 13.6% do not use PPE even when indicated and 10% are not using an appropriate PPE. The main barriers relates to poor fitting and weak domestic gloves, few of aprons, frequent stock out and inadequate PPE as well as lack of training in PPE Conclusion: This study provides a baseline for measuring the effectiveness of interventions to improve compliance

Constitutionality of Non-Uniform Quarterly Fees

(Excerpt) In the United States, there are two different government entities entrusted with overseeing the administration of cases under title 11 of the United States Code (the “Bankruptcy Code”). In all but two states, the Office of the United States Trustee, which is a part of the Department of Justice, oversees the administration of bankruptcy cases. In North Carolina and Alabama, the two states that do not have a United States Trustee system, a Bankruptcy Administrator, which is funded by and housed in the Judicial Conference, oversees the administration of bankruptcy cases. The U.S. Trustees and the Bankruptcy Administrators generally have the same role in bankruptcy cases. Moreover, both collect quarterly fees based on quarterly disbursements that debtors in cases under Chapter 11 of the Bankruptcy Code make to their creditors. From 2002 until January 2018 Chapter 11 debtors all paid the same fees in both systems based on the same disbursement formula. In 2017, Congress changed the quarterly fee calculation for disbursements, codified in 28 U.S.C. § 1930(a)(6)(B) (the “2017 Amendment”) which increased quarterly fees in Chapter 11 cases only in those districts operating under the U.S. Trustee program. The Judiciary Committee report indicates this increase was because of the decline in bankruptcy filings that have traditionally funded a surplus of the U.S Trustee program. Congress, however, did not mandate this fee increase in those districts operating under the Bankruptcy Administrator program. Instead, Congress left the decision to the Judicial Conference to impose such fees in their discretion. This divergent fee increase has resulted in numerous Constitutional challenges by debtors and the United States Supreme Court has granted certiorari to resolve the Constitutionality issue. This memorandum summarizes the Constitutional conflict between the courts that has arisen when addressing the uniformity issue under the Bankruptcy Clause of the Constitution. Part I discusses Congressional authority over bankruptcy laws under the Bankruptcy Clause. Parts II and III discuss the limitation on Congressional bankruptcy power. Part IV discusses the circuit split that has arisen over the 2017 Amendment

Intestinal intussusception in an adult caused by helminthic parasitosis

Intestinal intussusception is an uncommon acute condition in adults and is most commonly caused by an intestinal tumor mass. Helminthic parasitosis is a widespread infection in Africa, and the load of worms is often high in individuals living in areas with inadequate sanitation. We report a case of intestinal obstruction caused by Ascaris lumbricoides infection, which was complicated by ileo-caecal intussusception and required surgical treatment in a 40-year-old Ugandan woman. This case reinforces the importance of anthelminthic prophylaxis in African rural areas

Breast cancer or metastasis? An unusual case of metastatic malignant pleural mesothelioma to the breast

Background: Metastases to the breast from extramammary malignancies are very rare, and ruling out the diagnosis of primary breast tumor is important in order to decide on clinical management and predict prognosis. Case presentation: Clinical examination revealed in a 49-year-old hairdresser a 3-cm hard lump adherent to the underlying layers in the right breast. Trucut biopsy was performed. Histology showed a solid proliferation of medium-sized neoplastic polygonal cells. Immunohistochemical analysis showed tumor cells diffusely positive for cytokeratin 8/18 and calretinin and focally positive for cytokeratin 5/6 and Wilms’ tumor 1, e-cadherin, and human bone marrow endothelial-1. Estrogen receptors and progesterone receptors were negative. The final diagnosis was metastatic epithelioid malignant pleural mesothelioma. Conclusions: Immunohistochemistry is an important tool for a conclusive diagnosis of malignant pleural mesothelioma. Owing to the degree of histological and immunohistochemical overlap, a high level of clinical suspicion is essential in order to avoid unnecessary mutilating surgery

The Role of Physical Layer Security in IoT: A Novel Perspective

This paper deals with the problem of securing the configuration phase of an Internet of Things (IoT) system. The main drawbacks of current approaches are the focus on specific techniques and methods, and the lack of a cross layer vision of the problem. In a smart environment, each IoT device has limited resources and is often battery operated with limited capabilities (e.g., no keyboard). As a consequence, network security must be carefully analyzed in order to prevent security and privacy issues. In this paper, we will analyze the IoT threats, we will propose a security framework for the device initialization and we will show how physical layer security can effectively boost the security of IoT systems