Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are... constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.
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Вариативные рекомендации 24 сентября 2021 г.
Этот документ представляет собой текущие рекомендации ВОЗ. В них будут вноситься изменения и дополнения,
касающиеся нов...ых средств для лечения COVID-19, в том числе гидроксихлорохина и комбинации лопинавира и
ритонавира . Размещение, распространение и обновление данных рекомендаций происходит в приложении
MAGICapp, а их формат и структура обеспечивают для пользователей удобство работы и поиска. Реализована
функция постоянного обновления информации, относящейся к действующим положениям, которая позволяет
знакомиться с новыми данными наряду с актуальными рекомендациями. В разделе 4 описаны основные
методологические аспекты процедуры составления вариативных рекомендаций.
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Overview
16 Dec 2021. This interim guidance pertains to heterologous primary and heterologous boosting schedules of Covid-19 vaccines. It focuses on heterologous schedules combining multiple vaccine platforms (e.g. a vectored vaccine followed by an mRNA vaccine).
The COVID-19 pandemic has affected job satisfaction among healthcare workers; yet this has not been empirically examined in sub-Saharan Africa (SSA). We addressed this gap by examining job satisfaction and associated factors among healthcare workers in Ghana and Kenya during the COVID-19 pandemic. W...e conducted a cross-sectional study with healthcare workers (N = 1012). The two phased data collection included: (1) survey data collected in Ghana from April 17 to May 31, 2020, and (2) survey data collected in Ghana and Kenya from November 9, 2020, to March 8, 2021. We utilized a quantitative measure of job satisfaction, as well as validated psychosocial measures of perceived preparedness, stress, and burnout; and conducted descriptive, bivariable, and multivariable analysis using ordered logistic regression. We found high levels of job dissatisfaction (38.1%), low perceived preparedness (62.2%), stress (70.5%), and burnout (69.4%) among providers. High perceived preparedness was positively associated with higher job satisfaction (adjusted proportional odds ratio (APOR) = 2.83, CI [1.66,4.84]); while high stress and burnout were associated with lower job satisfaction (APOR = 0.18, CI [0.09,0.37] and APOR = 0.38, CI [0.252,0.583] for high stress and burnout respectively). Other factors positively associated with job satisfaction included prior job satisfaction, perceived appreciation from management, and perceived communication from management. Fear of infection was negatively associated with job satisfaction. The COVID-19 pandemic has negatively impacted job satisfaction among healthcare workers. Inadequate preparedness, stress, and burnout are significant contributing factors. Given the already strained healthcare system and low morale among healthcare workers in SSA, efforts are needed to increase preparedness, better manage stress and burnout, and improve job satisfaction, especially during the pandemic.
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Organización Mundial de la Salud. (2022). Recomendaciones provisionales sobre el uso de la vacuna CanSinoBIO Ad5-nCoV-S [recombinante] (Convidecia™) contra la COVID-19: orientaciones provisionales, primera publicación: 19 de mayo de 2022.
ABSTRACT
More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service del...ivery.
Digital health technologies can help address these challenges. They may be a tool
to reach Sustainable Development Goal 3.4 and reduce premature mortality from
non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation.
World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.
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CORONAVIRUS COVID-19 Manejo Clínico en Pediatría
Paraguay
The aim of these Guidelines is to provide a framework for the conservation and sustainable use of plants in medicine. To do this, the Guidelines describe the various tasks that should be carried out to ensure that where medicinal plants are taken from the wild, they are taken on a basis that is sust...ainable.
The Guidelines conform to the principles of Caring for the Earth, prepared in partnership by IUCN, UNEP and WWF. Caring for the Earth extends the message and scope of the World Conservation Strategy to an ethic of sustainable living, and explains how to integrate conservation with development. Its message is particularly relevant to the issue of medicinal plants, which in many parts of the world are being seriously depleted due to over-exploitation and loss of habitats, resulting in a lack of essential medicines and so reducing options for the future.
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Доклад на тему злоупотребление алкоголем в Российской Федерации: социально-экономические последствия и меры противодействия, который был утвержден Советом Общес...твенной палаты Российской Федерации .
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The message contained in this publication is clear: countries need a
public health system that can respond to the deliberate release of
chemical and biological agents. Regrettable though this message may
be, the use of poison gas in the war between Iraq and the Islamic
Republic of Iran in the 19...80s, the recent anthrax incidents in the United
States, and the attack with sarin nerve agent, six years earlier, on the
Tokyo underground, illustrate why it is necessary to prepare.
Russian and Japanese version available:
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This document aims to help EU/EEA public health authorities in the tracing and management of persons, including healthcare workers, who had contact with COVID-19 cases. It outlines the key steps of contact tracing, including contact identification, listing and follow-up, in the context of the COVID-...19 response.
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Available in Arabic, Chinese, English, French, Portuguese, Russian and Spanish
https://apps.who.int/iris/handle/10665/334254
El presente material es un aporte NO OFICIAL y volutario realizado a partir de la reunión clínica del equipo de Infectología Pediátrica PUC. Su objetivo
de aportar con un recurso educativo que contribuya a la actualización de los profesionales y estudiantes de la salud respecto a este problem...a de salud global.
La pandemia por SARS-CoV2 es una amenaza respecto a la cual existe un flujo de información en permanente y rápido cambio. Complemente siempre su lecturas con fuentes actualizadas.
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Q9: For carers of people with dementia, do interventions (psychoeducational, cognitive-behavioural therapy counseling/case management, general support, training of caregivers, multi-component interventions and miscellaneous interventions) when compared to placebo/comparator, produce benefits/harm in... the specified outcomes?
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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...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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Recommendations for in-patient management of COVID-19 in adult patients
Version 10, November 2020.
Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultu...ral practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess
and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex; and their natural, social and personal domains are highly variable due to diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of
light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such altitude, latitude and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment
and pollution, as well as by socioeconomic status and social networks. These attributes of the
social environment shape lifestyle choices that significantly modify CVD risk. An understanding
of how different domains of the environment, individually and collectively, affect CVD risk could
lead to a better appraisal of CVD, and aid in the development of new preventive and therapeutic
strategies to limit the increasingly high global burden of heart disease and stroke.
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