Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60% of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disab...ility and mortality at much lower costs and significantly reduces the need for secondary and tertiary care. Estimates suggest that almost 52% of all conditions can be managed at the
primary care level.
In order to ensure comprehensive primary health care, close to where people live, Sub- Centres should be strengthened as Health and Wellness Centres (H&WC), staffed by appropriately trained primary health care team. The Medical officer of the Primary Health Centre would oversee the functioning of the SC/HWC that falls in that area.
Services include those that (i) can be delivered at the level of the household and outreach sites in the community by suitably trained frontline workers, (ii) those that are delivered by a team headed by a mid-level health provider, at the level of the Sub-Centre/Health and Wellness Centre and (iii) the referral support and continuity of care within the district health system in rural and urban areas. The package of services is in Box. States would need to either phase in these services or add on additional services based on state specific and local context.
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Updated Guideline.
The Emergency Triage Assessment and Treatment (ETAT) guidelines provide guidance on the most common emergency conditions in children presenting at the health facility. These include but are not limited to airway obstruction and other breathing problems; circulatory impairment or ...shock; severely altered CNS function (coma or convulsive seizures); and severe dehydration which require urgent appropriate care to prevent death.
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The war in Gaza has resulted in thousands of amputations, including early estimates of over 1000 children, all of whom have immediate and life-long needs. Surgical amputations performed under extremely difficult conditions are likely to be sub-optimal, meaning many of those amputated will require fu...rther surgery. People with amputations also require early and ongoing rehabilitation and access to a long-term prosthetics service. In Gaza, at present, none of this is possible due to damage or destruction of services, premises, displacement and scattering of rehabilitation professionals around Gaza strip and abroad and insecurity.
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Q13: Are strategies aimed at improving community attitudes towards mental, neurological and substance use conditions (e.g. anti-stigma campaigns) feasible and effective?
Q8: For people with dementia, what is the role of a medical review (including comorbid physical and mental conditions and medication use)?
Key facts
- An estimated 1.28 billion adults aged 30–79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries
- An estimated 46% of adults with hypertension are unaware that they have the condition.
- Less than half of adults (42%) with hypertension are... diagnosed and treated.
- Approximately 1 in 5 adults (21%) with hypertension have it under control.
- Hypertension is a major cause of premature death worldwide.
- One of the global targets for noncommunicable diseases is to reduce the prevalence of hypertension by 33% between 2010 and 2030.
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The World Health Organization (WHO) fact sheet on Chronic Obstructive Pulmonary Disease (COPD) provides an overview of this common lung condition characterized by persistent respiratory symptoms and airflow limitation.
4 march 2022
What have we learned about the symptoms of Long COVID or Post COVID-19 condition so far? How long does it last, when should you worry, and what treatments are recommended? WHO’s Dr Janet Diaz explains in Science in 5.
The World Health Organization (WHO) fact sheet on Chronic Obstructive Pulmonary Disease (COPD) provides an overview of this common lung condition characterized by persistent respiratory symptoms and airflow limitation.
The World Health Organization (WHO) fact sheet on Chronic Obstructive Pulmonary Disease (COPD) provides an overview of this common lung condition characterized by persistent respiratory symptoms and airflow limitation.
The World Health Organization (WHO) fact sheet on Chronic Obstructive Pulmonary Disease (COPD) provides an overview of this common lung condition characterized by persistent respiratory symptoms and airflow limitation.
The World Health Organization (WHO) fact sheet on Chronic Obstructive Pulmonary Disease (COPD) provides an overview of this common lung condition characterized by persistent respiratory symptoms and airflow limitation.
This film shows a mother with engorged breasts and suggests ways she can try to resolve the condition.
Overview
Learning objectives
• Promote respect and dignity for people with depression.
• Recognize common symptoms of depression.
• Know the assessment principles of depression.
• Know the management principles of depression.
• Perform an assessment for depression.
• Use effective... communication skills in interactions with people with depression.
• Assess and manage physical health conditions as well as depression.
• Assess and manage emergency presentations of depression (see Module: Self-harm/
suicide).
• Provide psychosocial interventions for people with depression and their carers.
• Deliver pharmacological interventions as needed and appropriate, considering special
populations.
• Plan and perform follow-up for depression.
• Refer to specialists and link with outside services where appropriate and available.
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The mhGAP community toolkit: field test version is an integral part of WHO's Mental Health Gap Action Programme (mhGAP), and aims at scaling up services for people with mental health conditions to achieve universal health coverage.
The toolkit provides guidance for programme managers on how to i...dentify local mental health needs and tailor community services to match these needs. It offers practical information and necessary tools for community providers to promote mental health, prevent mental health conditions and expand access to mental health services.
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The Model Disability Survey (MDS) is a general population survey that provides detailed and nuanced information about how people with and without disabilities conduct their lives and the difficulties they encounter, regardless of any underlying health condition or impairment.
There is a substantial and ever-increasing unmet need for rehabilitation worldwide, which is particularly profound in low- and middle
-income countries. The availability of accessible and affordable rehabilitation is necessary for many people with health conditions to remain as independent as possi...ble, to participate in education, to be economically productive, and fulfil meaningful life roles.
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mhGAP is based on evidence-based technical guidelines (4) and provides a set of tools and
training packages to extend service provision. The mhGAP Intervention Guide (mhGAP-IG)
for MNS disorders in non-specialized health settings (8) is a clinical decision-making tool
for assessing and managing p...riority MNS conditions (depression, psychoses, epilepsy, child
and adolescent mental and behavioural disorders, dementia, disorders due to substance
use, self-harm and suicide).
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Preliminary overview of refugees and migrants self-reported impact of COVID-19
The study surveyed over 30,000 refugees and migrants living in 170 countries. Many of the respondents had fled war or dire economic conditions in their home country only to be faced with the additional challenges posed b...y COVID-19. Travel restrictions including border closures, suspension of resettlement travel, and last-minute deportation left many stranded or forced to stay in cramped, makeshift shelters or detention centers. Amid these uncertain, precarious conditions, many migrants described either a lack of access to health services or a fear of seeking them out — even if they were experiencing COVID-19 symptoms.
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