This Review summarizes many of the persistent biological alterations associated with childhood maltreatment including changes in neuroendocrine and neurotransmitter systems and pro-inflammatory cytokines in addition to specific alterations in brain areas associated with mood regulation. Finally, I d...iscuss several candidate gene polymorphisms that interact with childhood maltreatment to modulate vulnerability to major depression and PTSD and epigenetic mechanisms thought to transduce environmental stressors into disease vulnerability.
Neuron Review, vol. 89, March 2, 2016 pp.892-909
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This literature review summarizes the link between psychological well-being and entrepreneurial outcomes for small and medium-size enterprises in fragile, conflict, and violence–affected contexts. It identifies potentially promising, scalable psychosocial training interventions, based on cognitive...-behavioral therapy approaches, that can be adapted and implemented to improve psychological health at the individual level, that could lead to better business performance at the firm level.
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Abridged version. In this abridged version of the Evidence-based Clinical Practice Guidelines for the Follow-Up of at-risk neonates, we provide recommendations for the care of newborns up to 2 years of age, corresponding to the first phase of their follow-up. The recommendations are intended for all... health sector staff responsible for the primary care of these neonates: general practitioners, family practitioners, pediatricians, neonatologists, pediatric ophthalmologists, pediatric otolaryngologists, nursing professionals, specialists in other fields, and multidisciplinary staff involved in the care process. The purpose of these guidelines is to facilitate policy implementation processes carried out by decision-makers and members of government bodies, and will also be useful for parents, mothers, and caregivers. The main topics covered by this document include the hospital discharge criteria, including screening tests; information and support for parents, mothers, and caregivers; screening at the follow-up visit, and the frequency of follow-ups until the infant is 2 years of age. These guidelines do not address matters related to nursing or comorbidities.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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The COVID-19 HEalth caRe wOrkErs Study (HEROES): Regional Report from the Americas is a multicenter prospective cohort study to assess the impact of the COVID-19 pandemic on the mental health of health care workers in 26 countries on four continents and how it is affected by several factors at diffe...rent interrelated levels: individual, family, occupational, and social. This brief report presents the evidence generated from the baseline survey of 11 participating countries in the Region of the Americas. Using validated scales, the findings show high rates of depressive symptoms, suicidal ideation, and psychological distress in several countries of the Region. The spirit of the project is not only to generate quality scientific evidence on the mental health of health care workers, but also to help develop interventions (both individual and institutional) and policies to address the negative impacts of the COVID-19 pandemic on mental health.
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Sistema General de Seguridad Social en Salud – Colombia Guía No. GPC-2015-51
This document describes the ethical values that are most important to the nursing profession in Ontario. It also provides scenarios of ethical situations in which there is a conflict of values. Nurses are encouraged to use these scenarios for reflection and discussion. No solutions are offered becau...se there is no one solution that is best in all situations. The behavioural directives are intended to help nurses work through ethical situations and provide information about the College of Nurses of Ontario’s (CNO’s) expectations for ethical conduct. These are taken into account when CNO Committees assess nurses’ practices. Nurses need to consider behavioural directives carefully when making decisions about ethical care as this process will strengthen their practice.
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Cholera is a diarrheal disease caused by the bacterium Vibrio cholera. The infection primarily spreads through contaminated water and food. Symptoms include the onset of acute diarrhea and/or vomiting, muscle cramps, and body weakness. If untreated, the infection can result in rapid dehydration and ...death within hours.
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This report seeks to uncover the extent to which global goals crowd in international financing, inform domestic policy priorities, and navigate progress toward development outcomes in low- and middle-income countries (LICs and MICs). Our report:
Provides a historical perspective on how ODA financin...g was aligned with the MDGs, and the perceived influence of global goals in shaping domestic priorities
Offers a baseline of ODA financing to the SDGs and a forward-looking perspective in translating past lessons learned from the MDGs era into actionable insights
Using a pilot methodology developed by AidData, we analyze ODA flows during the MDGs era (2000-2013) and approximate baseline financing for each goal prior to the adoption of Agenda 2030 in September 2015. The dataset used in the report, Financing to the SDGs, Version 1.0, provides project-level data on estimated Official Development Assistance (ODA) commitments to the 17 Sustainable Development Goals (SDGs) from 2000 to 2013. In this report, we also draw upon the responses of nearly 7,000 public, private, and civil society leaders from AidData’s novel 2014 Reform Efforts Survey to assess how national-level policymakers perceive the MDGs in light of their domestic reform priorities, and what this may mean for the SDGs.
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Cardiovascular diseases (CVDs) have collectively remained the leading causes of death worldwide and substantially contribute to loss of health and excess health system costs. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study has tracked trends in death and disability since 1990 a...nd has provided an updated perspective on the status of cardiovascular health globally, regionally, and nationally.
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Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in... community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
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La carga de la diabetes es enorme, posicionándola como uno de los principales desafíos que enfrenta la salud pública en la actualidad. Actualmente, se estima que 62 millones de personas viven con diabetes en la Región de las Américas y las proyecciones muestran que su prevalencia seguirá aumen...tando en los próximos años. La Región muestra el mayor número de años de vida saludable perdidos (ya sea por discapacidad o muerte prematura) debido a la diabetes en todo el mundo. Los altos costes asociados a su tratamiento producen una pesada carga económica. Sus complicaciones pueden afectar seriamente la calidad de vida de las personas que viven con diabetes, sus familias y la sociedad y sobrecargar los sistemas de salud. Este informe muestra los últimos datos comparables internacionalmente sobre la diabetes y sus principales factores de riesgo por año, país y sexo. También incluye un resumen de la respuesta de los sistemas de salud de los países a la diabetes, incluidos planes nacionales, objetivos, vigilancia, directrices y acceso a medicamentos y tecnologías esenciales, y sintetiza información sobre las complicaciones relacionadas con la diabetes y la estrecha relación entre la diabetes y otras patologías, como enfermedades cardiovasculares, tuberculosis y COVID-19.
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Emerging evidence and experience to inform risk management in a warming world
One Health 5 (2018) 34–36
Cerebrum. 2016 Jul-Aug; 2016: cer-10-16.
Published online 2016 Jul 1.
The information provided here can be used to understand the current situation, increase attention to preterm births in Rwanda and to inform dialogue and action among stakeholders. Data can be used to identify the most important risk factors to target and gaps in care in order to identify and impleme...nt solutions for improved outcomes.
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Haiti, one of the poorest countries in the world, was devastated by an earthquake in 2010. The disaster uncovered the realities of a non-existent mental health care system with only ten psychiatrists nationwide. Attempts were made to assess the increased prevalence of mental illness, likely due to t...he trauma to which many were exposed. Several interventions were carried out with aims to integrate mental health into primary health care services. The interplay between socio-cultural beliefs and health (both mental and physical) in Haiti has been widely commented upon by both foreign aid and local caregivers. Observations frequently highlight barriers to the willingness of patients to seek care and to their acceptance of biomedicine over traditional Vodou beliefs. The perception of Haitian beliefs as barriers to the availability and acceptance of mental health care has intensified the difficulty in providing effective recommendations and interventions both before and after the earthquake. Argued in this review is the importance of considering the interactions between socio-cultural beliefs and mental health when developing models for the prevention, screening, classification and management of mental illness in Haiti. These interactions, especially relevant in mental health care and post-disaster contexts, need to be acknowledged in any healthcare setting. The successes and failures of Haiti’s situation provide an example for global consideration.
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The guidelines presented in this document are designed to provide a useful resource for healthcare professionals involved in clinical case management. They were developed taking into consideration services provided at different levels within the health system and resources available. These guideline...s are intended to standardize care at both tertiary and secondary levels of service delivery across different socio economic stratifications of our society.
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