Care for persons with noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease, is a major health priority for most countries worldwide, particularly for low-middle income countries where the problem seems to be worsening. Globally,... research demonstrates that the vast majority of people with NCDs receive suboptimal care. Many people living with chronic conditions remain undiagnosed and unaware of their condition, while many others remain untreated or with inadequate control. Meanwhile the premature mortality caused by NCDs remains high in many countries. In response to the global epidemic of NCDs, the World Health Organization (WHO) launched the Global Strategy for the Prevention and Control of Noncommunicable Diseases in 2012, which establishes 9 voluntary global targets and indicators to be considered by Member States when formu- lating national plans to combat NCDs.
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The current global crises, including climate, COVID-19, and environmental change, requires global collective action at all scales. These broad socio-ecological challenges require the engagement of diverse perspectives and ways of knowing and the meaningful engagement of all generations and stages of... personal and professional development. The combination of systems thinking, change management, quality improvement approaches and models, appreciative/strength-based approaches, narratives, storytelling and the strengths of Indigenous knowledges, offer synergies and potential that can set the stage for transformative, strengths-based education for sustainable healthcare (ESH).
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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Saúde Soc. São Paulo, v.30, n.1, e200450, 2021
Desde março de 2020, quando a Organização Mundial de Saúde declarou que o mundo vivia uma pandemia de covid-19, acompanhamos um quadro sanitário sem precedentes nos últimos 100 anos. As medidas atuais contra a ...doença têm como objetivo o controle da transmissão e envolvem ações individuais e coletivas de higiene e distanciamento físico, enquanto a busca por uma vacina se apresenta como a esperança para vencer a pandemia. Considerando o contexto social de clamor por uma nova vacina, este ensaio crítico discute o paradoxo e as contradições da relação indivíduo-sociedade no contexto da covid-19 à luz da hesitação vacinal como fenômeno histórico e socialmente situado. Este ensaio aponta que as tomadas de decisão sobre (não) vacinar ou sobre (não) seguir as medidas preventivas e de controle da propagação da covid-19 são conformadas por pertencimentos sociais e atravessadas por desigualdades que tendem a se exacerbar. A infodemia que cerca a covid-19 e a hesitação vacinal refletem a tensão entre o risco cientificamente validado e o risco percebido subjetivamente, também influenciada pela crise de confiança na ciência. Percepções de risco e adesão a medidas de saúde extrapolam aspectos subjetivos e racionais e espelham valores e crenças conformados pelas dimensões política, econômica e sociocultural.
Also available in Englisch http://www.scielo.br/j/sausoc/a/rQFs3PMLgZprt3hkJMyS8mN/?format=pdf&lang=en
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Undernutrition increases the risk of tuberculosis (TB) and in turn TB can lead to malnutrition. Undernutrition is therefore highly prevalent among people with TB. It has been demonstrated that undernutrition is a risk factor for progression from TB infection to active TB disease and that undernutrit...ion at the time of diagnosis of active TB is a predictor of increased risk of death and TB relapse. However, the evidence concerning the effect of nutritional supplementation on TB prevention and health outcomes among people with TB had not previously been systematically reviewed. This guideline provides guidance on the principles and recommendations for nutritional care and support of patients with TB as part of their regular TB care
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Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile, ...coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis.
Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics.
Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19.
Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
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These guidelines provide a recommendation on iodine thyroid blocking (ITB), via oral administration of stable iodine, as an urgent protective action in responding to a nuclear accident. This recommendation aims to support emergency planners, policy makers, public health specialists, clinicians and o...ther relevant stakeholders, in order to strengthen public health preparedness for radiation emergencies in WHO Member States as required by the International Health Regulations (IHR) and in line with the international safety standards (GSR Part 7). The scope of the guidelines is confined to public health aspects of planning and implementation of ITB before and during a radiation emergency, such as dosage and timing of ITB administration, adverse effects of stable iodine, its packaging, storage, and distribution.
These guidelines supersede the 1999 WHO Guidelines for Iodine Prophylaxis following Nuclear Accidents.
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This document provides interim guidance on the management of the blood supply in response to the pandemic outbreak of coronavirus disease (COVID-19). It emphasizes the importance of being prepared and responding quickly and outlines key actions and measures that the blood services should take to mit...igate the potential risk to the safety and sufficiency of the blood supplies during the pandemic.
It should be read in conjunction with WHO Guidance for National Blood Services on Protecting the Blood Supply During Infectious Disease Outbreaks, which provides general guidance on the development of national plans to respond to any emerging infectious threats to the sufficiency or safety of the blood supply.
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This primer aims to guide health professionals on engaging with WASH-related issues. It gives an overview of WASH interventions and the status of WASH services globally and outlines key linkages with health. It provides examples of key actions that health actors can take to ensure WASH efforts effec...tively protect public health and highlights World Health Organization (WHO) activities to support those actions.
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In 2009, WHO’s Second International Conference on Buruli Ulcer Control and Research resolved to strengthen the capacity of national laboratories to confirm cases of the disease, but advised that “efforts are still needed to develop simple diagnostic tools usable in the field as well as disabilit...y prevention methods”.
In 2013, WHO and the Foundation for Innovative New Diagnostics convened a meeting of Buruli ulcer experts in Geneva, Switzerland (9) at which two priority unmet needs in diagnosis were identified:
a diagnostic test for early detection of Buruli ulcer in symptomatic patients with sufficient positive predictive value to put patients on appropriate treatment; and
a screening test at the primary health care or community level for symptomatic patients with ulcer
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Front. Med., 27 November 2020 | https://doi.org/10.3389/fmed.2020.594728. The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; workin...g conditions for recruitment and retention; accreditation and recognition of workers; professional support/up-skilling and; monitoring and evaluation. For each action, a summary of LMICs-specific evidence and prompts was developed to stimulate reflection and learning. To support implementation, rural pathways exemplars from different WHO regions were also compiled. Field-testing showed the Checklist is fit for purpose to guide holistic planning and benchmarking of rural pathways, irrespective of LMICs, stakeholder, or health worker type.
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Using antimicrobials responsibly is an essential component ofefforts to contain antimicrobial resistance (AMR), and to ensurethat patients receive appropriate treatment. The WHO global action plan on AMR emphasizes the importance of training healthcare professionals in antimicrobial prescribing and ...stew-ardship (AMPS). There are several challenges, however, such asthe wide range of healthcare professionals involved in the pre-scribing process, and the heterogeneity of prescribing rights and practices of different professional groups within and between countries. One way to address these challenges is through developing competencies, which define the minimum standards that all antimicrobial prescribers should reach.
Clinical Microbiology and Infection 25 (2019) 13e19
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Objetivos:
- Reforzar la importancia del informe anatomopatológico en el manejo del cáncer
de mama, como elemento fundamental para la toma de decisiones.
- Estandarizar los procedimientos de las técnicas anatomopatológicas a nivel
nacional.
- Establecer los factores pronósticos morfoló...gicos, inmunohistoquímicos y
moleculares validados actualmente.
- Establecer un protocolo de informe anatomopatológico completo, reproducible y
estandarizado, orientado a contribuir en el manejo clínico y en la elaboración de
bases de datos.
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Comprehensive Reviews in Food Science and Food Safety, Vol.12 (2013) pp.234-248
In 2006, the Institute of Food Technologists (IFT) published an Expert Report entitled “Antimicrobial Resistance: Implications for the Food System” (IFT 2006). That report summarized current scientific knowledge pe...rtaining to the public-health impact of antimicrobial use in the food system and the development and control of antimicrobial resistance. Since that time, intense interest in this topic has continued within the regulatory and scientific communities as well as the general public. This IFT Scientific Status Summary serves to update that 2006 IFT Expert Report by briefly reviewing new scientific evidence relevant to the goals of the initial report and providing a number of key observations and conclusions.
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The Federal Ministry of Health of Ethiopia (FMOH), the National Disaster Risk Management Commission (NDRMC) and other government actors together with UN agencies (UNICEF, UNHCR, WHO and WFP) and nutrition development partners call for all parties involved in the response to emergencies in Ethiopia t...o provide appropriate, prompt support for the feeding and care of infants, young children and their mothers. This is a critical for supporting child survival, growth and development and preventing malnutrition, illness and death. This joint statement has been issued to help secure immediate, coordinated, multi- sectoral action on infant and young child feeding (IYCF) in emergencies.
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Updated 2022. This guide addresses the care pathway from presentation of the patient to a health facility to patient discharge. It considers different levels of disease severity, from asymptomatic individuals to critically ill patients. Accounting for variations in the benefits and harms of chest im...aging in different situations, remarks are provided to describe the circumstances under which each recommendation would benefit patients. The guide also includes implementation considerations for different settings, provides suggestions for impact monitoring and evaluation and identifies knowledge gaps meriting further research.
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DEM supporting material
• Person stories
• Role plays
• Case scenarios
• Treatment planning handouts
• Treatment planning suggestions
• Multiple choice questions
• Video link
Activity 3: mhGAP DEM module – assessment
La Agencia Española de Medicamentos y Producto Sanitarios (AEMPS) está monitorizando de manera continua con los expertos de las agencias europeas, la EMA y el resto de agencias mundiales todos los datos relativos al uso de medicamentos para tratar la COVID-19. Se trata de... un escenario que puede ir cambiando por la enorme cantidad de datos, comunicaciones y publicaciones que se están generando a nivel mundial. El presente documento técnico tiene la finalidad de guiar el manejoclínicode los pacientes conCOVID-19 con un doble objetivo: lograr el mejor tratamiento del paciente que contribuya a su buena evolución clínica; y garantizar los niveles adecuados de prevención y control de la infección para la protección de los trabajadores sanitarios y de la población en su conjunto.
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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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Orientations provisoires
9 août 2021
Le présent document vise à décrire un ensemble minimal d'activités de surveillance recommandées au niveau national pour détecter et surveiller la prévalence relative des variantes du SRAS-CoV-2 et à présenter un ensemble d'activités pour la caractér...isation et l'évaluation du risque que présentent ces variantes. k posés par ces variants. Un ensemble d'indicateurs est également fourni pour normaliser la surveillance et la déclaration publique de la circulation des variants.
Ce document est principalement destiné aux autorités de santé publique nationales et infranationales et aux partenaires qui soutiennent la mise en œuvre de la surveillance des variantes du SRAS-CoV-2.
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