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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
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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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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a
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t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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The Asthma Control Questionnaire (ACQ)1 was developed and validated to measure the primary clinical goal of asthma management as identified by international guidelines. They indicate that to achieve good control, treatment should minimise day and night time symptoms, activity limitation, airway narr
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owing and rescue bronchodilator use and thus reduce the risk of life-threatening exacerbations and long-term morbidity. The importance of including all aspects of control in the assessment of individual patients was emphasised by a recent factor analysis which showed that clinical asthma is composed of distinct components which are not closely correlated with each other.6 However, in some studies it may not be possible to collect airway calibre or short-acting β2-agonists data. Previous analysis of non-clinical trial data suggested that when ACQ scores are analysed as group data, the heterogeneity of the way in which individual patients present with inadequate control is lost in the estimation of the mean and the need to measure each individual component of asthma control may become unnecessary. In this analysis, ACQ data from a clinical trial was used to evaluate the measurement properties (reliability, responsiveness, validity and interpretability), of three shortened versions of the ACQ. In addition, we have examined whether the precision and accuracy of estimating the effect of the intervention on asthma control was maintained when the two questions concerning airway calibre and short-acting β2-agonists use were omitted from the trial analysis.
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Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of
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the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
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Цей посібник повністю відповідає рекомендаціям Міжвідомчого постійного комітету (IASC) та «Операційним рекомендаціям щодо психічного здоров’я та психосоціальної
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підтримки під час планування роботи з біженцями», які вимагають багатосекторної відповіді, спрямованої на вирішення проблем у сфері психічного здоров’я та соціальних наслідків гуманітарних надзвичайних станів і переміщення. Він також підтримує досягнення основної мети Комплексного плану дій ВООЗ у сфері психічного здоров’я на 2013–2020 рр., а саме — надання комплексних, інтегрованих спільнотних послуг у сфері психічного здоров’я та соціальної допомоги, які легко інтегрувати в поточну систему.
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MhGAP-IG – это примерное руководство, поэтому крайне важно адаптировать его в соответствии с уникальной национальной или местной ситуацией. Пользователи могут выбра
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ь свои варианты приоритетных состояний или мер по адаптации и реализации Руководства в зависимости от имеющихся в наличии и преобладающих ресурсов.
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CH 3: Psychosocial interventions, treatment of emotional disorders.
World Health Organization
(2015)
C_WHO
[Updated 2015]
Scoping question: What is the effectiveness of psychosocial interventions, including caregiver skills training, for emotional disorders in children and adolescents?
The document contains 2 decision trees, the first short one is to act fast and the second is to design better interventions
لإسعافات الأولية النفسية: دليل العاملين في الميدان
This guide covers psychological first aid which involves humane, supportive and practical help to fellow human beings suffering serious crisis events. It is written for people in a position to help other
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s who have experienced an extremely distressing event. It gives a framework for supporting people in ways that respect their dignity, culture and abilitiies.
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Psychological first aid: Guide for field workers. Первая психологическая помощь: руководство для работников на местах. (Russian Version)
recommended
World Health Organization WHO, War Trauma Foundation and World Vision International
Всемирная организация здравоохранения
(2014)
C_WHO
Данное руководство разработано в качестве стандартного пособия по оказанию первой психологической помощи для использования в странах с низким и средним уровнем
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охода. Приведенная здесь информация является типовой, и ее следует соответствующим образом адаптировать к местным условиям и культурным особенностям людей, которым вы будете оказывать помощь. В этой публикации, одобренной многими международными организациями, отражены новые научные данные и общее мнение международного профессионального сообщества об оптимальных путях оказания поддержки людям, только что пережившим тяжелые травмирующие события.
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Під час гуманітарних надзвичайних станів у загальних закладах охорони здоров’я має бути принаймні один медичний працівник, який, працюючи під супервізією, буде
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проможний оцінювати та вести пацієнтів із психічними, неврологічними розладами та розладами, пов’язаними зі вживанням психоактивних речовин.«Посібник mhGAP з надання допомоги під час гуманітарних надзвичайних станів» — простий ресурс, орієнтований на практичну роботу, метою якого є досягнення цієї мети.
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COVID-19 pandemic has taken the entire world by surprise, creating the greatest global catastrophe since WWII, impacting all spheres of our societies, including health, economy, social protection, as well as security, and human rights. The virus affects people and communities indiscriminately in all
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parts of the world, with particularly strong impact on poorer communities, especially those already suffering from the humanitarian consequences caused by conflicts, social-economic problems or disasters.
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У цьому модулі описано основні принципи медичної допомоги людям, які її потребують, зокрема людям з ПНПР-розладами, а також їхнім доглядачам.
У першому підрозділі
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ього модуля подаються загальні принципи клінічної практики.
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Psychological first aid: Guide for field workers
recommended
When terrible things happen in our communities, countries and the world, we want to reach out a helping hand to those who are affected. This guide covers
psychological first aid which involves humane, supportive and practical help to fellow human beings suffering serious crisis events. It is writt
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en for people in a position to help others who have experienced an extremely distressing event. It gives a framework for supporting people in ways that respect their dignity, culture and abilities. Despite its name, psychological first aid covers both social and psychological support.
Available in various languages: http://www.who.int/mental_health/publications/guide_field_workers/en/
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This manual is designed to orient helpers to offer psychologicalfirst aid (PFA) to people following a serious crisis event. PFA involves humane, supportive and practical assistance for people who are distressed, in ways that respect their dignity, culture and abilities. PFA is an approach that can b
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e learned by both professionals and non-professionals who are in a position to help people impacted by very distressing events
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