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Lack of trained providers capable of identifying which labouring women could benefit from assisted vaginal birth (AVB), and of safely performing the procedure is a major barrier for its use. Education and training are, therefore, considered crucial for building skills and confidence in conducting AV
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B and there is evidence that it would be welcomed by healthcare providers. However, acquiring and maintaining AVB skills is a complex task that requires a supportive environment, mentorship, supervision and accountability. As with other practices to manage infrequent procedures and complications, continuous education and on-site supervision are essential to ensure the safe and sustainable use of AVB.
more
Children continue to be exposed to powerful food marketing, which predominantly promotes foods high in saturated fatty acids, trans-fatty acids, free sugars and/or sodium and uses a wide variety of marketing strategies that are likely to appeal to children. Food marketing has a harmful impact on chi
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ldren’s food choice and their dietary intake, affects their purchase requests to adults for marketed foods and influences the development of their norms about food consumption. Food marketing is also increasingly recognized as a children’s rights concern, given its negative impact on several of the rights enshrined in the United Nations Convention on the Rights of the Child.This WHO guideline provides Member States with recommendations and implementation considerations on policies to protect children from the harmful impact of food marketing, based on evidence specific to children and to the context of food marketing. Guidelines on other policies to improve the food environment are currently under development.
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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
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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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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
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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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An interdisciplinary approach to address global health challenges such as the Covid-19 pandemic, climate change, loss of biodiversity, human migration has been framed by the One Health approach. This approach is promoted at global level by the Tripartite of the World Health Organisation, the World A
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nimal Health Organisation, the Food and Agriculture Organisation of the United Nations, recently joint by the United National Environment Program to form the Quadripartite. The German government through its Ministry of Economic Cooperation and Development supports this approach with its One Health strategy and investment in several technical cooperation projects.
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Lancet Infectious Diseases Volume 22, Issue 11e327-e335.
In February, 2022, WHO published new guidelines with six recommendations to update the global public health strategy against schistosomiasis, including expansion of preventive chemotherapy eligibility from the predominant group of
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school-aged children to all age groups (2 years and older), lowering the prevalence threshold for annual preventive chemotherapy, and increasing the frequency of treatment. This Review, written by the 2018-2022 Schistosomiasis Guidelines Development Group and its international partners, presents a summary of the new WHO guideline recommendations for schistosomiasis along with their historical context, supporting evidence, implications for public health implementation, and future research needs.
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In this era, grand challenges lies in biodiversity loss, climate change, and global noncommunicable diseases signify that planet and humanity are in crisis. Scholarly evidence from human and animal kingdom suggest that there is an optimism in planetary health which can provide a unique and novel con
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cept where efforts toward survival and remediation can be made. With accurate navigation, the current challenges can be mitigated leading to a new reality, one in which the core value is the well‐being of all. This paper discusses the drivers of planetary health and the role of community health workers (CHWs) in making health‐care system more resilient that can produce multiple benefits to community and overall planetary health. A web‐based international database such as Google, Google Scholar, SCOPUS/MEDLINE/PubMed, and JSTOR was searched relevant to a planetary health framework. The study findings suggest that CHWs can offer health care interventions through environmental health cobenefits across the spectrum of health effects of climate change cause and effects. These actions have been divided into four major categories (i. health care promotion and prevention, ii. health care strengthening, iii. advocacy, and iv. education and research) that CHWs perform through a variety of roles and functions they are engaged in protecting planetary health. CHWs contribute toward achieving sustainable development goals such as planetary health and focus on environment sustainability and well‐being of entire mankind.
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Introduction: Considering the global prevalence of coronavirus disease 2019 (COVID-19), a vaccine is being developed to control the disease as a complementary solution to hygiene measures—and better, in social terms, than social distancing. Given that a vaccine will eventually be produced, informa
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tion will be needed to support a potential campaign to promote vaccination.
Objective: The aim of this study was to determine the variables affecting the likelihood of refusal and indecision toward a vaccine against COVID-19 and to determine the acceptance of the vaccine for different scenarios of effectiveness and side effects.
Materials and Methods: A multinomial logistic regression method based on the Health Belief Model was used to estimate the current methodology, using data obtained by an online anonymous survey of 370 respondents in Chile.
Results: The results indicate that 49% of respondents were willing to be vaccinated, with 28% undecided or 77% of individuals who would potentially be willing to be inoculated. The main variables that explained the probability of rejection or indecision were associated with the severity of COVID-19, such as, the side effects and effectiveness of the vaccine; perceived benefits, including immunity, decreased fear of contagion, and the protection of oneself and the environment; action signals, such as, responses from ones' family and the government, available information, and specialists' recommendations; and susceptibility, including the contagion rate per 1,000 inhabitants and relatives with COVID-19, among others. Our analysis of hypothetical vaccine scenarios revealed that individuals preferred less risky vaccines in terms of fewer side effects, rather than effectiveness. Additionally, the variables that explained the indecision toward or rejection of a potential COVID-19 vaccine could be used in designing public health policies.
Conclusions: We discovered that it is necessary to formulate specific, differentiated vaccination-promotion strategies for the anti-vaccine and undecided groups based on the factors that explain the probability of individuals refusing or expressing hesitation toward vaccination.
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In Control: A Practical Handbook for Professionals Working in Health Emergencies Internationally RKI
The greatest risk to persons engaging in international medical emergency response is poor preparation.
The In Control handbook hopes to provide a remedy.
At the time of writing, we are living through the Coronavirus (COVID-19) pandemic, a health emergency that disregards physical borders, brin
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gs into focus social inequalities and affects people on every continent. This shared challenge requires unprecedented measures and the collaboration of the brightest minds to support global health protection through this crisis and beyond. Healthcare infrastructures have to be strengthened, public health capacities and processes upgraded, medical countermeasures and vaccinations found and psychosocial side-effects treated.
Solidarity is the normative order of the day and the human species has to collaborate to face this invisible threat. Hiding and living in fear is not an option in this interconnected world. We have both a responsibility and an opportunity to make substantial contributions to a safer, healthier and more sustainable future for us all.
The existence of this handbook is an impressive example of solidarity. Over 50 authors from more than 15 institutes and organisations have come together voluntarily within a very short time to make their expertise available and enable cross-sectoral thinking. Knowledge is bundled, resources are combined, information gaps are filled. The In Control handbook is not a theoretical treatise of possible dangers, but a collection of subject-matter expertise, written by experts and practitioners who have shaped health topics over the past 20 years in the most diverse corners of the world.
The Centre for International Health Protection at the Robert Koch Institute (RKI) is collaborating with its partners and investing heavily in the build-up of operational know-how and capacity to support health crisis response abroad. This is done by preparing and enabling professionals to deploy safely across the world to assist those in need. In Control addresses the multi-faceted challenges of an international deployment. Readers will find not only technical medical information, but also insights into, for example, the fragility of our environment, the cultural differences that influence risk communication or the dilemmas arising from social distancing. Legal principles are highlighted, along with ethical guidance to ensure that our actions and decisions correspond to the highest moral standards.
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KEY MESSAGES
Always talk to a GBV specialist first to understand what GBV services are available in your area. Some services may take the form of hotlines, a mobile app or other remote support.
Be aware of any other available services in your area. Identify services provided by humanitarian pa
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rtners such as health, psychosocial support, shelter and non-food items. Consider services provided by communities such as mosques/ churches, women’s groups and Disability Service Organizations.
Remember your role. Provide a listening ear, free of judgment. Provide accurate, up-to-date information on available services. Let the survivor make their own choices. Know what you can and cannot manage. Even without a GBV actor in your area, there may be other partners, such as a child protection or mental health specialist, who can support survivors that require additional attention and support. Ask the survivor for permission before connecting them to anyone else. Do not force the survivor if s/he says no.
Do not proactively identify or seek out GBV survivors. Be available in case someone asks for support.
Remember your mandate. All humanitarian practitioners are mandated to provide non-judgmental and non-discriminatory support to people in need regardless of: gender, sexual orientation, gender identity, marital status, disability status, age, ethnicity/tribe/race/religion, who perpetrated/committed violence, and the situation in which violence was committed. Use a survivor-centered approach by practicing:
Respect: all actions you take are guided by respect for the survivor’s choices, wishes, rights and dignity.
Safety: the safety of the survivor is the number one priority.
Confidentiality: people have the right to choose to whom they will or will not tell their story. Maintaining confidentiality means not sharing any information to anyone.
Non-discrimination: providing equal and fair treatment to anyone in need of support.
If health services exist, always provide information on what is available. Share what you know, and most importantly explain what you do not. Let the survivor decide if s/he wants to access them. Receiving quality medical care within 72 hours can prevent transmission of sexually transmitted infections (STIs), and within 120 hours can prevent unwanted pregnancy.
Provide the opportunity for people with disabilities to communicate to you without the presence of their caregiver, if wished and does not endanger or create tension in that relationship.
If a man or boy is raped it does not mean he is gay or bisexual. Gender-based violence is based on power, not someone’s sexuality.
Sexual and gender minorities are often at increased risk of harm and violence due to their sexual orientation and/or gender identity. Actively listen and seek to support all survivors.
Anyone can commit an act of gender-based violence including a spouse, intimate partner, family member, caregiver, in-law, stranger, parent or someone who is exchanging money or goods for a sexual act.
Anyone can be a survivor of gender-based violence – this includes, but isn’t limited to, people who are married, elderly individuals or people who engage in sex work.
Protect the identity and safety of a survivor. Do not write down, take pictures or verbally share any personal/identifying information about a survivor or their experience, including with your supervisor. Put phones and computers away to avoid concern that a survivor’s voice is being recorded.
Personal/identifying information includes the survivor’s name, perpetrator(s) name, date of birth, registration number, home address, work address, location where their children go to school, the exact time and place the incident took place etc.
Share general, non-identifying information
To your team or sector partners in an effort to make your program safer.
To your support network when seeking self-care and encouragement.
more
Asthma is the most common chronic disease in children, imposing a consistent burden on health system. In recent years, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (LMICs). Host (genetics, atopy) and environmental fa
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ctors (microbial exposure, exposure to passive smoking and air pollution), seemed to contribute to this trend. The increased prevalence observed in metropolitan areas with respect to rural ones and, overall, in industrialized countries, highlighted the role of air pollution in asthma inception. Asthma accounts for 1.1% of the overall global estimate of “Disability-adjusted life years” (DALYs)/100,000 for all causes. Mortality in children is low and it decreased across Europe over recent years. Children from LMICs particularly suffer a disproportionately higher burden in terms of morbidity and mortality. Global asthma-related costs are high and are usually are classified into direct, indirect and intangible costs. Direct costs account for 50–80% of the total costs. Asthma is one of the main causes of hospitalization which are particularly common in children aged < 5 years with a prevalence that has been increased during the last two decades, mostly in LMICs. Indirect costs are usually higher than in older patients, including both school and work-related losses. Intangible costs are unquantifiable, since they are related to impairment of quality of life, limitation of physical activities and study performance. The implementation of strategies aimed at early detect asthma thus providing access to the proper treatment has been shown to effectively reduce the burden of the disease.
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Water is the lifeblood of planetary health and human civilisation. As a critical source of fresh water, rivers underpin civilisations, past and present. However, rivers constantly change in response to environmental and human pressures. Protecting global river systems from climate change and other a
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nthropogenic activities (e.g., mining, pollution, dam construction), and understanding the interactions with human health (e.g., through the spread of water-borne and infectious diseases) has become a critical concern.
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An Economist Intelligence Unit briefing paper | The Economist Intelligence Unit (EIU) undertook a study aimed at assessing the degree of commitment of 15 countries within the AsiaPacific region to integrating those with mental illness into their communities. The research was commissioned and funded
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by Janssen Asia Pacific, a division of Johnson & Johnson Pte. Ltd. This report focuses on the results of this benchmarking study, called the Asia-Pacific Mental Health Integration Index. Drawing on lessons from the EIU’s 2014 European Mental Health Integration Index, this edition index compares the level of effort in each of the countries on indicators associated with integrating individuals suffering from mental illness into society. Data for the Index was collected between March and May 2016. The set of 18 indicators were grouped into four categories.
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The document emphasizes integrating environmental considerations into nutrition programs. It introduces a screening tool piloted across ten projects to identify environmental risks and opportunities, fostering sustainable practices in food systems. The tool promotes collaboration, co-learning, and a
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ctionable steps to align nutrition goals with environmental sustainability, ensuring long-term benefits for health and ecosystems.
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Куріння, вживання та наркотичних речовин серед підлітків, які навчаються: поширення й тенденції в Україні
О. М. Балакірєва,Т. В. Бондар, Ю. Ю. Приймак et al.
Український інститутсоціальних дослідженьімені Олександра Яременка, unicef, emcdda
(2015)
Куріння, вживання алкоголю та наркотичних речовин серед підлітків, які навчаються: поширення й тенденції в Україні : За результатами дослідження 2015 року в рамках м
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жнародного проекту «Європейське опитування учнів щодо вживання алкоголю та інших наркотичних речовин – ESPAD»
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The authors conduct an integrated survey of Antimicrobial Resistant Organisms (AMR) in drinking water, wastewater and surface water in three settings in Bangladesh: rural households, rural poultry farms, and urban food markets. Results show that untreated water discharged from rural households, poul
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try farms and urban markets are major contributors to surface water pollution and antibiotic resistant bacteria genes, calling for increased surveillance and monitoring.
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This article summarises the process involved in developing the updated guideline and includes an infographic to highlight key IPC recommendations from the guideline, following the patient care pathway from the community to a healthcare facility to discharge.
