This is an update (third edition) of the BACPR Standards & Core Components and represents current evidence-based best practice and a pragmatic overview of the structure and function of Cardiovascular Prevention and Rehabilitation Programmes (CPRPs) in the UK. The previously described seven standards... have now been reduced to six but without sacrificing any of the key elements and with a greater emphasis placed on measurable clinical outcomes, audit and certification. Similarly, the second edition provided an overview of seven core components felt to be essential for the delivery of quality prevention and rehabilitation, and this too has been reduced to six. The interplay between cardio-protective therapies and medical risk factors is almost impossible to disentangle for the vast majority of patients and even if specific drug therapies are deployed exclusively for risk factor modulation, the indirect effect will also be cardio-protective. Thus, these have been combined into a single core component – medical risk management.
more
Задачей данных рекомендаций является помочь врачам общей практики правильно диагностировать эти распространенные типы головных болей, грамотно распознавать при...знаки серьезных заболеваний, проявляющихся головной болью, и, при необходимости, направлять пациентов за специализированной помощью. Целью настоящих рекомендаций является предоставление четких и легко выполнимых алгоритмов врачам, не являющимся экспертами в области головных болей.
more
Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
more
By almost any measure, human health is better now than at any time in history. Life expectancy has soared from 47 years in 1950–1955, to 69 years in 2005–2010, and death rates in children younger than 5 years of age have decreased substantially, from 214 per thousand live births in 1950–1955, ...to 59 in 2005–2010. But these gains in human health have come at a high price: the degradation of nature’s ecological systems on a scale never seen in human history. A growing body of evidence shows that the health of humanity is intrinsically linked to the health of the environment, but by its actions humanity now threatens to destabilise the Earth’s key life-support systems.
As a Commission, we conclude that the continuing degradation of natural systems threatens to reverse the health gains seen over the last century. In short, we have mortgaged the health of future generations to realise economic and development gains in the present.
Despite present limitations, the Sustainable Development Goals provide a great opportunity to integrate health and sustainability through the judicious selection of relevant indicators relevant to human wellbeing, the enabling infrastructure for development, and the supporting natural systems, together with the need for strong governance.
more
информационный листок о курении табака через кальян и последствиях для здоровья
The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca...l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
more
Full Report.
In response to a call by the United Nations Secretary-General and the Governments of Guinea, Liberia and Sierra Leone, an international team conducted an Ebola Recovery Assessment. The aim was to contribute towards laying the foundation for short-, medium- and long-term recovery while ...the medical emergency response continues to tackle the epidemic. This report is a contribution to ongoing efforts by the Governments of Guinea, Liberia and Sierra Leone to design their national Ebola virus disease recovery strategies
more
Pan African Medical Journal 2017;27:215. doi: 10.11604/pamj.2017.27.215.12994
Miscellaneous
Child and adolescent psychiatric emergencies
Chapter J.1
Tuberculosis (TB) is, and should be, a curable disease; however, each year significant numbers of patients acquire or develop drug-resistant TB, which has a much lower cure rate. Patients with drug-resistant TB have a high prevalence of symptoms; hence, staff caring for these patients should h...ave some familiarity with palliative care, so that general palliative care principles are available to all patients. The timely identification, and addressing, of adverse events occurring during the treatment course is considered as general palliative care for those receiving curative treatment. This publication summarizes the general palliative care approach, which is recommended for use in settings and services that occasionally treat palliative care patients, but do not provide palliative care as the main focus of their work. The review focuses on 18 high TB priority countries of the WHO European Region.
more
PLOS ONE | https://doi.org/10.1371/journal.pone.0210937
February 5, 2019
Last Mile delivery presents a unique challenge in making health commodities available in the developing world. This guide, designed for in-country practitioners and decisionmakers, uses a range of real world examples to support selection and design of last mile distribution approaches which respond ...to specific challenges.
more
Promising Approaches to Combination HIV Prevention Programming in Concentrated Epidemics
AIDSTAR-One CASE STUDY SERIES May 2010
The WHO page addresses diarrhoeal diseases, one of the leading causes of death among children under five, which can be prevented through clean water, improved hygiene, and vaccinations. It emphasizes the importance of oral rehydration solutions (ORS) and zinc supplementation for treatment, as well a...s preventive measures like breastfeeding and handwashing. The WHO supports global strategies to reduce diarrhoea-related deaths through education and improved healthcare systems.
Including new recommendations for the use of ORS and zinc Supplementation for Clinic-Based Healthcare Workers.
more
Цель этого документа – повысить уровень осознания актуальности приоритетных направлений научных исследований по проблеме ТБ/ВИЧ (то есть по тем направлениям, кот...орые требуют срочного финансирования и внимания ученых), содействовать координации информационно-пропагандистской работы и стимулировать финансирование научных изысканий. Поставленная задача заключается в наращивании темпов осуществления высококачественных и интегрированных вмешательства по борьбе с ТБ/ВИЧ в условиях ограниченных ресурсов. В документе дается описание пересмотренной повестки дня по приоритетным научным вопросам, в основе которой лежат недавно полученные фактические данные по шести ключевым проблемам коинфекции ТБ и ВИЧ.
more