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Item type:Publication, What is care and what is not caring? The challenges of cultural diversity(Universidad Compultense Madrid, 2020-11-01)This article uses evidence from Peru to examine issues of care and its absence, both in the sense of “giving care” and concern with someone or something. The two cases analyzed bring into consideration separate couples trying to agree on the care obligations of non-custodial male fathers and the distance between the care practices of indigenous Amazonians and urban Peruvian society. The discussion highlights emotions, motivations, systems of morality, and cultural identities that support care and define the lines beyond which denial of care may be inevitable and even defensible. The argument points to privileged status of hope as an emotion of particular importance in systems of care on a personal and collective level and also with respect to States and national policies. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Analysing governments’ progress on the right to health(World Health Organization, 2024-05-01)Objective To examine the influence of varying articulations of the right to health under domestic constitutions, legislation and jurisprudence on the scope of legal protection for health. Methods We investigated legal recognition of the right to health, by conducting a three-level search. First, we searched databases containing constitutional texts. Second, we did a thematic analysis of those constitutional texts with explicit constitutional recognition of health rights, employing NVivo for coding. For the 54 World Health Organization (WHO) Member States without explicit constitutional provisions, we explored statutory paths, judicial constructions and instances where both methods contributed to the acknowledgement of health rights. Lastly, we confirmed evidence of jurisprudence constructing a right to health based on a combination of domestic law and international human rights norms incorporated directly into the text. Findings We identified 140 WHO Member States with a constitutionalized right to health. Our analysis suggests there are notable variations in the legal scope of protection for health, including breadth of entitlements and the possibility of enforcing these rights through the legal system. We also highlight the critical importance of constitutional acknowledgement, legislative measures, and judicial interpretations in shaping the legal entitlements to health-care services, affecting their accessibility and financial support. Conclusion The analysis offers insights for policy-makers to assess different approaches to health-related entitlements, with implications for health financing and the evaluation of Member States' strides towards universal access to comprehensive care. This analysis also illuminates how distinct formulations of the right to health have varied effects on reducing health disparities. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Reconciling Emotional Caregiving and Self-Fulfilment: Peruvian Migrants in Switzerland Supporting Parents in Peru(Wiley, 2023-02-11)This article explores filial transnational caregiving from a subjective and emotional perspective. It analyses the relationship between pursuit of personal fulfilment and concern for parental well‐being among Peruvian migrants in Switzerland whose parents remain in Peru. Based on in‐depth interviews, we analyse the importance assigned to personal goals, the resignification of filial obligations, and how migrants reconcile the desire to be a ‘good’ son or daughter with the desire for self‐fulfilment. This process, strongly shaped by gender and social class, involves the negotiation of distinct principles of autonomy and filial obligation prevailing in the country of origin and destination. Turning our attention to less explored emotions, such as pride and a sense of fulfilment, we show how to deal with principles that may be in tension, migrant children construe the pursuit of self‐fulfilment and the desire to accomplish family responsibilities as interdependent dynamics in the context of filial transnational caregiving. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Diagnosis of Pregnancy Complications Using Blind Ultrasound Sweeps Performed by Individuals Without Prior Formal Ultrasound Training(Lippincott Williams and Wilkins, 2023-05-01)To estimate the diagnostic accuracy of blind ultrasound sweeps performed with a low-cost, portable ultrasound system by individuals with no prior formal ultrasound training to diagnose common pregnancy complications. Methods: This is a single-center, prospective cohort study conducted from October 2020 to January 2022 among people with second- and third-trimester pregnancies. Nonspecialists with no prior formal ultrasound training underwent a brief training on a simple eight-step approach to performing a limited obstetric ultrasound examination that uses blind sweeps of a portable ultrasound probe based on external body landmarks. The sweeps were interpreted by five blinded maternal-fetal medicine subspecialists. Sensitivity, specificity, and positive and negative predictive values for blinded ultrasound sweep identification of pregnancy complications (fetal malpresentation, multiple gestations, placenta previa, and abnormal amniotic fluid volume) were compared with a reference standard ultrasonogram as the primary analysis. Kappa for agreement was also assessed. Results: Trainees performed 194 blinded ultrasound examinations on 168 unique pregnant people (248 fetuses) at a mean of 28±5.85 weeks of gestation for a total of 1,552 blinded sweep cine clips. There were 49 ultrasonograms with normal results (control group) and 145 ultrasonograms with abnormal results with known pregnancy complications. In this cohort, the sensitivity for detecting a prespecified pregnancy complication was 91.7% (95% CI 87.2-96.2%) overall, with the highest detection rate for multiple gestations (100%, 95% CI 100-100%) and noncephalic presentation (91.8%, 95% CI 86.4-97.3%). There was high negative predictive value for placenta previa (96.1%, 95% CI 93.5-98.8%) and abnormal amniotic fluid volume (89.5%, 95% CI 85.3-93.6%). There was also substantial to perfect mean agreement for these same outcomes (range 87-99.6% agreement, Cohen range 0.59-0.91, P<.001 for all). Conclusion: Blind ultrasound sweeps of the gravid abdomen guided by an eight-step protocol using only external anatomic landmarks and performed by previously untrained operators with a low-cost, portable, battery-powered device had excellent sensitivity and specificity for high-risk pregnancy complications such as malpresentation, placenta previa, multiple gestations, and abnormal amniotic fluid volume, similar to results of a diagnostic ultrasound examination using a trained ultrasonographer and standard-of-care ultrasound machine. This approach has the potential to improve access to obstetric ultrasonography globally. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, My family needed me': exploring caring dimensions and care circulation among older Venezuelans on the move in Peru(Oxford University Press, 2025-03-01)The humanitarian, political, and socio-economic crisis in Venezuela has generated an unprecedented migration to other South American countries. In the last six years, Peru has become the second receptor of Venezuelan people after Colombia and the first regarding asylum seekers. In this article, we follow recent contributions regarding the concept of care circulation to ask: how the case of older Venezuelans on the move illustrates the multidimensionality of care circulation? How these care arrangements can be understood from an age and gender perspective? Through three life stories, we discuss how older Venezuelans on the move practice care for the benefit of the whole family based on family arrangements and negotiations and how, as a result, care circulates in multiple directions and can generate conflicts and power imbalance for the older ones.1