Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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La détection directe des protéines virales du SRAS-CoV-2 (antigènes) dans les écouvillons nasaux et autres sécrétions respiratoires à l'aide de tests immunologiques à flux latéral (également appelés tests de diagnostic rapide, TDR) offre une méthode plus rapide et moins coûteuse pour te...ster le SRAS-CoV-2 que la méthode de référence, les tests d'amplification des acides nucléiques (TAAN). Ces lignes directrices provisoires offrent des recommandations sur les utilisations prioritaires des tests de diagnostic rapide à détection d'antigène (TDR-Ag) dans des populations et des contextes spécifiques, notamment (i) pour la détection primaire des cas chez les personnes symptomatiques suspectées d'être infectées et les personnes asymptomatiques à haut risque de COVID-19, (ii) pour la recherche des contacts, (iii) pendant les enquêtes sur les épidémies et (iv) pour surveiller les tendances de l'incidence de la maladie dans les communautés. Les TDR-AG répondant aux exigences minimales de performance peuvent être utilisés en dehors des milieux cliniques et des laboratoires, y compris dans les communautés, par des opérateurs formés conformément aux instructions. Le guide fournit en outre des recommandations sur la mise en œuvre, la sélection des produits et le stockage
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Ghana is attracting global attention for efforts to provide health insurance to all citizens through the National Health Insurance Scheme (NHIS). With the program’s strong emphasis on maternal and child health, an expectation of the program is that members will have increased use of relevant servi...ces. The NHIS does appear to enable pregnant women to access services and allow caregivers to seek care early for sick children, but both the quantitative and qualitative assessments also indicated that the poor and least educated were less likely to have insurance than their wealthier and more educated counterparts.
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The WHO Framework Convention on Tobacco Control (WHO FCTC) is an evidence-based treaty that reaffirms the right of all people to the highest standard of health and was developed in response to the globalization of the tobacco epidemic. Member States of the WHO South-East Asia Region have made... attempts to implement the demand and supply reduction strategies for tobacco control as recommended by the treaty. While recognizing the need to accelerate implementation of the WHO FCTC in the Region, this document has been developed to support the Member States in implementing the treaty using a ‘PRACTICAL’ Approach which pertains to identified demand and supply reduction strategies under the treaty.
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Módulo 2
Educadores y Defensores Comunitarios
Julio del 2017
Módulo 2: Educadores y defensores comunitarios. Para que los servicios de PrEP lleguen a los grupos poblacionales de manera efectiva y aceptable, se necesitan educadores y defensores comunitarios para aumentar la concientizaci...n acerca de la PrEP en sus comunidades. En este módulo se brinda información actualizada sobre la PrEP que debe considerarse al realizar actividades lideradas por la comunidad cuyo objetivo sea aumentar los conocimientos sobre la PrEP, promover la demanda de la PrEP y aumentar el acceso a la misma.
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Parasites & Vectors volume 11, Article number: 264 (2018)
Dengue creates a staggering epidemiological and economic burden for endemic countries. Without a specific therapy and with a commercial vaccine that presents some problems relative to its full effectiveness, initiatives to improve vector... control strategies, early disease diagnostics and the development of vaccines and antiviral drugs are priorities. In this study, we present the probable origins of dengue in America and the trajectories of its spread. Overall, dengue diagnostics are costly, making the monitoring of dengue epidemiology more difficult and affecting physicians’ therapeutic decisions regarding dengue patients, especially in developing countries. This review also highlights some recent and important findings regarding dengue in Brazil and the Americas. We also summarize the existing DENV polymerase chain reaction (PCR) diagnostic tests to provide an improved reference since these tests are useful and accurate at discriminating DENV from other flaviviruses that co-circulate in the Americas. Additionally, these DENV PCR assays ensure virus serotyping, enabling epidemiologic monitoring.
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Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No.: CD011386. DOI: 10.1002/14651858.CD011386.pub2
Free access from the website http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD011386.pub2
Watch a short film which accompanies this Cochrane Review and talks about applying ...the findings in relevant clinical settings at http://www.cochrane.org/news/new-evidence-helps-health-workers-fight-against-ebola
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Rev Panam Salud Publica. 2014;35(3):179–85
Screening programmes for tuberculosis (TB) among immigrants rarely consider the heterogeneity of
risk related to migrants’ country of origin. We assess the performance of a large screening programme in asylum seekers by analysing (i) the difference in yield and numbers needed to screen (NNS) by c...ountry and WHO-reported TB burden, (ii) the possible impact of screening thresholds on sensitivity, and (iii) the value of WHO-estimated TB burden to improve the prediction accuracy of screening yield.
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Módulo 4
Líderes
Julio del 2017
Módulo 4: Líderes. Este módulo tiene por objeto informar y actualizar a los líderes y a los encargados de tomar decisiones sobre la PrEP. Proporciona información sobre los beneficios y las limitaciones de la PrEP para que puedan considerar cómo pueden a...plicar la PrEP de manera más efectiva en sus propios entornos. También presenta una serie de preguntas frecuentes acerca de la PrEP y las respuestas correspondientes.
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The objectives of the meeting were to agree on coordinated and aligned support to the 3 countries’ national health recovery plans (Guinea, Liberia, Sierra Leone); to identify cross-cutting areas and opportunities for integration; to identify ways to improve implementation modalities; and to identi...fy actions including technical assistance needed to support the countries in the process of building resilient health systems.
The outcomes of the meeting consisted in proposed country action plans to move forward with the implementation of the recovery plans. The action plans includes:priorities and areas of work; activities needed to improve implementation modalities; technical assistance needs.
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Journal of the International Association of Providers of AIDS Care 2017, Vol. 16(3) 226–232
Methicillin-resistant Staphylococcus aureus(MRSA) strainsor multidrug-resistant S.aureus, initially described in 1960s,emerged in the last decade as a cause of nosocomial infections responsible for rapidly progressive, potential fatal diseases including life-threatening pneumonia, necrotizing fascii...tis, endocarditis, osteomyelitis, severe sepsis, and toxinoses such as toxic shock syndrome. A multifactorial range of independent risk factors for MRSA has been reported in literature and include immunosuppression,hemodialysis, peripheral malperfusion, advanced age, extended in-hospital stays, residency in long-term care facilities (LTCFs), inadequacy of antimicrobial therapy,indwelling devices, insulin-requiring diabetes, and decubitusulcers, among others.
Hindawi Canadian Journal of Infectious Diseases and Medical Microbiology Volume 2019, Article ID 8321834, 9 pageshttps://doi.org/10.1155/2019/8321834
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The document is structured into five sections. The first presents the key experiences and challenges that justify a renewal of the EPHFs. The second section updates the groundwork for the exercise of public health and provides a framework to inform the exercise of the new essential functions. The th...ird section proposes a new integrated approach for implementing the EPHFs. The fourth section presents a new list of 11 EPHFs related to each stage of this integrated approach. Finally, in the last section, considerations are put forth to guide EPHF implementation as a means of strengthening the health sector.
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Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them as effective as possible. With this in mind, this manual is... intended to be used a practical guide for policymakers and program
managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
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28 Jan. 2021. L’objet de ce document est de fournir des orientations provisoires sur la sécurité biologique en laboratoire applicable à l’analyse d’échantillons cliniques issus de patients.
Stigma toward individuals with mental disorders has been studied extensively. In the case of
Latin America and the Caribbean, the past decade has been marked by a significant increase in
information on stigma toward mental illness, but these findings have yet to be applied to mental health service...s in Latin America. The objective of this study was to conduct a systematic review of studies relating to stigma toward mental illness in Latin America and the Caribbean. The authors specifically considered differences in this region as compared with manifestations reported in Western European countries
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