The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults over 18, including those with type 2 diabetes. It emphasizes accurate blood pressure measurement, recommending ambulatory or home monitoring to confirm di...agnosis. Cardiovascular risk and target organ damage should be assessed, considering age, lifestyle, and other conditions. Initial treatment focuses on lifestyle changes such as diet, exercise, and smoking cessation, with medication advised for stage 1 hypertension at high cardiovascular risk or stage 2 hypertension. Regular monitoring and treatment adjustments are recommended to maintain target blood pressure levels, with specific guidance for people over 80 and those with additional conditions like diabetes or kidney disease. The guideline aims to reduce risks of heart attack, stroke, and other complications, supporting evidence-based treatment decisions in clinical practice.
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Palliative care for children with life-limiting illness is the active total care of the child’s body, mind, and spirit. It begins at diagnosis and continues regardless of whether the child receives treatment directed at the disease. It seeks to control all forms of suffering related to the illness..., including pain. It involves social, psychological, spiritual, and legal support to siblings, parents, and other close family members. Effective palliative care for children requires health professionals trained to assess symptoms, care for children of different ages and developmental stages, and to provide medicines in pediatric formulations. Care may be provided in tertiary care facilities, community health centers, and at home. The child’s best interest must inform all aspects of the treatment andcare, and the child’s rights must be protected at all times.
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As a lower-middle-income country (LMIC), South Africa (SA) bears
the burden of maternal and neonatal mortality similar to other sub-
Saharan African countries. According to the Saving Mothers Report
2017/19, there has been a progressive and sustained reduction
in institutional maternal mortality... (iMMR) in the past three triennia
(2010-2019), from 320 per 100,000 live births to 120 per 100,000 live
births.
According to the Rapid Mortality Survey, the country’s infant mortality
rate has declined from 29 deaths per 1000 live births in 2014 to 25
deaths per 1,000 live births in 2018. The institutional neonatal death
rate showed a slight decrease from 12,7 deaths per 1,000 live births in
2016 to the current level of 12 per 1,000 live births and has remained
static at this level for the past three years (saDHIS).
Working towards the Sustainable Development Goal (SDG) of reducing maternal mortality to below 70 per 100 000 live births and neonatal mortality to 12 deaths per 1000 live births, South Africa aims to reduce institutional maternal mortality, neonatal mortality and stillbirths by 50% by 2030.
This Maternal, Perinatal and Neonatal Health Policy provides a
framework for the delivery of quality, comprehensive, and integrated
MNH services and will guide the development and review of guidelines
and related MNH interventions, including strengthening of the service
delivery platform, governance, leadership and accountability for
the provision of quality MNH services, development of advocacy
messages, and guiding civil society priorities and community
initiatives. The policy will also guide the development and review of
academic curricula and the setting of research priorities.
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As of 12 December 2022, over 645 million people worldwide have been diagnosed with COVID-19, with over 6.6 million deaths (4).
The Omicron variant, which emerged in late November 2021, and its subvariants, are now the dominant circulating viruses, contributing to the ongoing surge in several countr...ies (4). Vaccination has substantially reduced case numbers and hospitalizations in many countries,but limitations in global access to vaccines mean that many populations, including those in low- and middle-income countries, remain vulnerable. Even in vaccinated individuals, uncertainties remain about duration of protection and efficacy, and the degree of crossprotection with new variants.
There remains a need for more effective treatment and management for those affected by COVID-19. The pandemic – and the
explosion of both research and misinformation – has highlighted the need for trustworthy, accessible and regularly updated living
guidelines to place emerging findings into context and provide clear recommendations for clinical practice
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The article "Asthma in South African adolescents: a time trend and risk factor analysis over two decades" investigates the prevalence and risk factors for asthma in Cape Town adolescents from 2002 to 2017. The study finds that while the overall prevalence of asthma remained similar, the severity of ...the condition increased significantly. Risk factors for asthma and severe cases include smoking, pet exposure, outdoor pollution, and living in informal housing. Despite these trends, underdiagnosis remains a concern, as only one-third of adolescents with current or severe asthma had been formally diagnosed. The article emphasizes the need for better public health strategies to address environmental exposures and improve asthma diagnosis and treatment.
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This report aims to estimate the economic cost of providing regular access to healthcare for migrants in an irregular situation, compared with the cost of providing treatment in emergency cases only. Two specific medical conditions – hypertension and prenatal care – were selected as examples, an...d their associated costs were calculated using an economic model. This model was then applied to three EU Member States: Germany, Greece and Sweden. The testing suggests that providing access to regular preventive healthcare for migrants in an irregular situation
would be cost-saving for governments.
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Stewardship is defined as “the careful and responsible management of something entrusted to one’s care”. It was originally applied in the health-care setting as a tool for optimizing antimicrobial use, termed “antimicrobial stewardship” (AMS). Stewardship has since be...en applied in the context of governance of the health sector as a whole, taking responsibility for the health and well-being of the population and guiding health systems at the national and global level.
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The recommendation in this document thus supersedes the previous WHO recommendation for the prevention of PPH as published in the 2012 guideline, WHO recommendations for the prevention and treatment of postpartum haemorrhage.
Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr...ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
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The purpose of these guidelines is to help health workers to participate in the process of continuous surveillance of safety and efficacy of the pharmaceutical products which are used in clinical practice, thus help to achieve the ultimate goal to make safer and more effective treatment available to... patients. This guideline addresses specifically the issues on what to report, why to report, when to report, where to report and how to report.
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This guide presents new knowledge and guidelines on the provision of care to persons living with HIV/AIDS, in accordance with the last guidelines of the World Health Organization (WHO) published in 2006 and adapted to the Rwandan national context. It thus responds to the need by the Ministry of Heal...th to improve the skills of the actors in the health sector as well as the quality of care and antiretroviral treatment offered in both public and private health facilities countrywide.
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One of the most obvious ways in which to ensure impartiality in a health care system is to require impartiality of all actors in the system, i.e. to give health care professionals a duty to treat everyone impartially and to deny them the ‘right’ to give their patients preferential treatment. And... one of the possible side-effects of allowing individual health care professionals to give preference to ‘their clients’ is to create inequality in health care. This paper explores the conflict and proposes that it can be right to give preference to ‘your’ patients in certain circumstances.
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Each year, about 210 million women become pregnant and about 140 million newborn babies are delivered. The sheer scale of maternal health issues makes maternal well being and survival vital concerns. A decade after The Lancet published a Series on maternal survival, a new Series of six papers brings... our knowledge of maternal health, its epidemiology, successes, and current failings together, and at a crucial time within the sustainable development framework to 2030. The Series concludes with a call to action setting out five key targets which need to be met to ensure the progression of broader sustainable development goals (SDGs).
Open Access
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PlosOne May 7, 2012 https://doi.org/10.1371/journal.pone.0036735 ; Safe drinking water is critical for health. Household water treatment (HWT) has been recommended for improving access to potable water where existing sources are unsafe. Reports of low adherence to HWT may limit the usefulness of thi...s approach, however.
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This joint publication by UNAIDS and WHO emphasizes the importance of integrating HIV prevention, testing, treatment and care and mental health services for people living with HIV. It provides a compilation of tools, best practices, recommendations and guidelines that facilitate the integration of i...nterventions and services to address the interlinked issues of mental health and HIV. This publication is intended for global, regional and national policy-makers; programme implementers including at subnational levels; organizations working in and providers of HIV and mental health services; civil society; and community-based and community-led organizations and advocates.
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The BBV/STI Glossary is a resource for interpreters, translators and others who work in a health setting. It offers an extensive list of English terms related to sexual health and blood-borne viruses (such as hepatitis), with easy to understand definitions.
Accessed 13th of November 2015.
This guideline provides health policy-makers and decision-makers in health professional training institutions with advice on the rationale for health-care providers’ use of counselling skills to address sexual health concerns in a primary health care setting
Nosocomial or health-facility-acquired infections are a serious issue, representing one of the most significant causes of morbidity and mortality in healthcare systems and consuming many scarce resources, especially in developing countries. Although much has been done, particularly in the hospital s...etting, to reduce the risk of these infections, the problem persists and demands innovative and cost-efficient solutions.
Although the care provided in most primary health care facilities is predominantly ambulatory with few or no inpatient beds, infection prevention is still important to minimize or eliminate the risks of facility-acquired infections and assure quality patient care.
Health facilities and hospitals should have written infection control procedures and guidelines in place and should also be monitoring that these procedures are adhered to in both inpatient and ambulatory care settings.
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This report reviews the latest evidence on what works to reduce HIV-related stigma and discrimination through key programmes to reduce stigma and discrimination and increase access to justice in the six settings of focus for the Global Partnership. It includes guidance for national governments and k...ey stakeholders on how stigma and discrimination harm; how the stigmatization process operates and how we can stop it; key principles of stigma- and discrimination-reduction efforts; an overview of common intervention approaches; recommendations based on the latest evidence for reducing HIV-related stigma and discrimination in the six settings; and an overview of considerations for monitoring the success of the programmatic interventions recommended for each setting.
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Areas for action include: increasing prioritisation and awareness of dementia; reducing the risk of dementia; diagnosis, treatment and care; support for dementia carers; strengthening information systems for dementia; and research and innovation.