Int J Health Policy Manag 2017, 6(10), 587–600
Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin ha...ve failed to produce better quality of care for the population and cost-effectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin’s public health sector, as well as the ability of key actors within the sector to address these problems.
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Version 1.7 Updated October 14, 2010 | Preschool PTSD Treatment (PPT) is a theory-driven, manualized protocol based on cognitive-behavioral therapy (CBT) with modifications for young children. Some of these modifications involve parent-child relationship dynamics that are salient for this age grou...p.
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BMC Medicine201210:107
https://doi.org/10.1186/1741-7015-10-107© Katchanov and Birbeck; licensee BioMed Central Ltd. 2012
Received: 10 July 2012Accepted: 24 September 2012Published: 24 September 2012
In 2011, the World Health Organization’s (WHO) mental health Gap Action Programme (mhGAP) r...eleased evidence-based epilepsy-care guidelines for use in low and middle income countries (LAMICs). From a
geographical, sociocultural, and political perspective, LAMICs represent a heterogenous group with significant differences in the epidemiology, etiology, and perceptions of epilepsy. Successful implementation of
the guidelines requires local adaptation for use within individual countries. For effective implementation and sustainability, the sense of ownership and empowerment must be transferred from the global health authorities to the local people. Sociocultural and financial barriers that impede the implementation of the guidelines should be
identified and ameliorated. Impact assessment and program revisions should be planned and a budget allocated to them. If effectively implemented, as intended, at the primary-care level, the mhGAP
guidelines have the potential to facilitate a substantial reduction in the epilepsy treatment gap and improve the quality of epilepsy care in resource-limited settings.
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Trastornos des ánimo
Capítulo E.4
Edition 2018
Editores: Matías Irarrázaval & Andres Martin
Traducción: Fernanda Prieto-Tagle & María Vidal
A Reference Guide for Program Managers and Policy Makers. 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 a...s 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
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Levels and Inequities
DHS Further Analysis Reports No. 110
This study shows large variations in maternal health indicators across high-priority counties in Kenya. Nairobi exceeds the national average on all maternal health indicators in this study, while other highpriority counties consist...ently are disadvantaged compared with Kenya as a whole in most maternal health indicators. Kisumu exceeds the national average in use of antenatal care, delivery in a health facility, and postnatal care, but not other indicators. Nakuru has fewer women with fertility risk and fewer women who report that the distance they must travel to reach a health facility is a problem.
This study identifies a number of inequities in maternal health indicators across socio-demographic characteristics in the high-priority counties—most in the distribution of delivery care and least in antenatal care. Inequities are also observed in fertility risk and postnatal care.
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Trastornos externalizantes
Capítulo D.1
Edición: Matías Irarrázaval & Andrés Martín
Traducción: Fernanda Prieto Tagle, Marta García Acuña
The conduct of paediatric anaesthesia presents many unique challenges. One of the most striking is the variabilityof behaviour and responses of children and their parents at induction. Behavioural problems, the need for restraint,difficult IV accessandco-morbiditiesadd complexity and...can make the art of maintaining a calm and smooth induction incredibly difficult. This tutorial will discuss sixof the common problems that arise at induction and how these may best be overcome.
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Medicina 2019, 55, 553; doi:10.3390/medicina55090553
Results: Twenty-one studies were analyzed, most of them demonstrating an association between the existence of burnout and the worsening of patient safety. High levels of burnout is more common among physicians and nurses, and it is associated wit...h external factors such as: high workload, long journeys, and ineffective interpersonal relationships. Good patient safety practices are influenced by organized workflows that generate autonomy for health professionals. Through meta-analysis, we found a relationship between the development of burnout and patient safety actions with a probability of superiority of 66.4%. Conclusion: There is a relationship between high levels of burnout and worsening patient safety.
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The early prevention project “Strong together!” supports refugee parents and their young children (0–4 years) in Berlin, Germany. It aims to mitigate the transmission of trauma to the generation born in exile. For refugee families who have only recently arrived in Germany, the COVID‐19 pande...mic poses a particularly great challenge. Not only are they confronted with numerous challenges in respect to rebuilding their lives in Germany after fleeing war and persecution, but are also vulnerable to conscious and unconscious anxieties, fantasies, and conflicts evoked by the pandemic and the threat it poses to their lives. This was observed in the context of the mother–child groups of “Strong together!”
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This report presents the key findings of the end-of-project assessment of households and
community health volunteers, conducted in 2017 in the Kamukunji and Embakasi sub-counties
of Nairobi, Kenya, for a Community Health Volunteers’ Decision Support System (CHV DSS)
intervention project. The re...port was prepared by the African Population and Health Research
Center (APHRC). The end-line survey was implemented by APHRC. Implementation of the CHV
DSS project is a joint collaboration among several partners, including APHRC, the City County
of Nairobi, sub-county health management teams (Kamukunji and Embakasi), and community
health volunteers. The opinions expressed in this report are those of the authors and do not
necessarily reflect the views of the donor organization, the County Innovation Challenge Fund
for Kenya.
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The World Climate and Security Report (WCSR) 2021 from the Expert Group of the International
Military Council on Climate and Security is a global assessment of the security dimensions of a changing
climate and effective means to address them. It is intended to inform timely climate and security po...licy
and action, and builds upon the analysis in the first WCSR, released in February 2020.
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The World Climate and Security Report (WCSR) 2021 from the Expert Group of the International Military Council on Climate and Security is a global assessment of the security dimensions of a changing climate and effective means to address them. It is intended to inform timely climate and security poli...cy and action, and builds upon the analysis in the first WCSR, released in February 2020.
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PlosOne December 10, 2014 https://doi.org/10.1371/journal.pone.0111913
Plastic pollution is ubiquitous throughout the marine environment, yet estimates of the global abundance and weight of floating plastics have lacked data, particularly from the Southern Hemisphere and remote regions. Here we re...port an estimate of the total number of plastic particles and their weight floating in the world's oceans from 24 expeditions (2007–2013) across all five sub-tropical gyres, costal Australia, Bay of Bengal and the Mediterranean Sea conducting surface net tows (N = 680) and visual survey transects of large plastic debris (N = 891). Using an oceanographic model of floating debris dispersal calibrated by our data, and correcting for wind-driven vertical mixing, we estimate a minimum of 5.25 trillion particles weighing 268,940 tons. When comparing between four size classes, two microplastic <4.75 mm and meso- and macroplastic >4.75 mm, a tremendous loss of microplastics is observed from the sea surface compared to expected rates of fragmentation, suggesting there are mechanisms at play that remove <4.75 mm plastic particles from the ocean surface.
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Chagas disease (CD) is a neglected tropical disease, endemic in Latin America, but due to migration and environmental changes it has become a global public health issue.
Background: A recent report by the Institute for Health Metrics and Evaluation (IHME) highlights that mental health receives little attention despite being a major cause of disease burden. This paper extends previous assessments of development assistance for mental health (DAMH) in two significant w...ays; first by contrasting DAMH against that for other disease categories, and second by benchmarking allocated development assistance against the core disease burden metric (disability-adjusted life year) as estimated by the Global Burden of Disease Studies. Methods: In order to track DAH, IHME collates information from audited financial records, project level data, and budget information from the primary global health channels. The diverse set of data were standardised and put into a single inflation adjusted currency (2015 US dollars) and each dollar disbursed was assigned up to one health focus areas from 1990 through 2015. We tied these health financing estimates to disease burden estimates (DALYs) produced by the Global Burden of Disease 2015 Study to calculated a standardised measure across health focus areas—development assistance for health (in US Dollars) per DALY.
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Background: COVID-19 is a global public health crisis that affects all sectors; studying the impact of this pandemic on the delivery of cardiology services in Africa is crucial as COVID-19-related cardiovascular complications may worsen the CVD burden in this already highly affected and resource-lim...ited continent
Methods: This was a cross-sectional e-survey study conducted amongst cardiologists in African countries. The primary outcome was the change in service delivery in African cardiology units during the on-going COVID-19 pandemic. The secondary outcomes were the satisfaction of cardiologists with regards to the workload and factors associated with this satisfaction.
Results: There was a significant reduction in working time and the number of patients consulted by week during this pandemic (p<0.001). In general, there was a decrease in the overall activities in cardiovascular care delivery. The majority of cardiology services (76.5%) and consulting programs (85%) were adjusted to the pandemic. Only half of the participants were satisfied with their workload. Reconfiguration of the consultation schedule was associated with a reduced satisfaction of participants (p=0.02).
Conclusions: COVID-19 is associated with an overall reduction in cardiology services rendered in Africa. Since the cardiovascular burdens continue to increase in this part of the World and the risk of cardiovascular complications linked to SARS COV2 remains unchanged cardiology, departments in Africa should anticipate a significant surge of cardiology services demanded by patients after the COVID-19 pandemic.
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Objective: To conduct a landscape assessment of public knowledge of cardiovascular disease risk factors and acute myocardial infarction symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) awareness and training in three underserved communities in Brazil.
Metho...ds: A cross-sectional, population-based survey of non-institutionalised adults age 30 or greater was conducted in three municipalities in Eastern Brazil. Data were analysed as survey-weighted percentages of the sampled populations.
Results: 3035 surveys were completed. Overall, one-third of respondents was unable to identify at least one cardiovascular disease risk factor and 25% unable to identify at least one myocardial infarction symptom. A minority of respondents had received training in CPR or were able to identify an AED. Low levels of education and low socioeconomic status were consistent predictors of lower knowledge levels of cardiovascular disease risk factors, acute coronary syndrome symptoms and CPR and AED use.
Conclusions: In three municipalities in Eastern Brazil, overall public knowledge of cardiovascular disease risk factors and symptoms, as well as knowledge of appropriate CPR and AED use was low. Our findings indicate the need for interventions to improve public knowledge and response to acute cardiovascular events in Brazil as a first step towards improving health outcomes in this population. Significant heterogeneity in knowledge seen across sites and socioeconomic strata indicates a need to appropriately target such interventions.
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The European Respiratory Society (ERS)/American Thoracic Society (ATS) Task Force on severe asthma includes an updated definition of severe asthma, a discussion of severe asthma phenotypes in relation to genetics, natural history, pathobiology and physiology, as well as sections on evaluation and tr...eatment of severe asthma where specific recommendations for practice are made. See the unabridged online version of the document for detailed discussion of the definition of severe asthma, phenotypes and recommendations for practice.
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Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laboratory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to ...sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
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