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Universal Health Coverage UHC and 90-90-90 Strategy
This brief considers the rationale for shielding individuals at high risk of severe disease or death from COVID-19 in low- and middleincome countries. It provides an overview of proposed approaches to shielding, discusses the categories of individuals who may be identified for shielding, and outline...s the likely difficulties of these measures and ways to mitigate them.more
Der Artikel "Händedesinfektion unter den Bedingungen der SARS-CoV-2-Pandemie" war am 4.5.2020 online vorab erschienen und ist nun in der regulären Ausgabe des Epidemiologischen Bulletins 19/2020 zu finden.
Bei vielen schwer erkrankten Menschen muss mit einer im Verhältnis zu anderen schweren ARE längeren Behandlung mit Beatmung/zusätzlichem Saürstoffbedarf gerechnet werden. Da weder eine Impfung noch eine spezifische Therapie derzeit zur Verfügung stehen, müssen alle Massnahmen darauf ausgericht...et sein, die Verbreitung der Erkrankung so gut wie möglich zu verlangsamen. Es gibt 3 Komponenten: A) Verhinderung der Ausbreitung durch Fallfindung und Absonderung von engen Kontaktpersonen, B) soziale Distanz schaffen und C) gezielter Schutz von vulnerablen Gruppen, die aktiviert und intensiviert werden müssen ent-sprechend der jeweils aktuellen Lagemore
Mund-Nasen-Bedeckung im öffentlichen Raum als weitere Komponente zur Reduktion der Übertragungen von COVID-19. Strategieergänzungen zu empfohlenen Schutzmaßnahmen und Zielen (3. Update) Das RKI empfiehlt ein generelles Tragen einer Mund-Nasen-Bedeckung (MNB) in bestimmten Situationen im öffentl...ichen Raum als einen weiteren Baustein, um Risikogruppen zu schützen und den Infektionsdruck und damit die Ausbreitungsgeschwindigkeit von COVID-19 in der Bevölkerung zu reduzieren. Diese Empfehlung beruht auf einer Neubewertung aufgrund der zunehmenden Evidenz, dass ein hoher Anteil von Übertragungen unbemerkt erfolgt, und zwar bereits vor dem Auftreten von Krankheitssymptomen. Ziel des im Epidemiologischen Bulletin 19/2020 veröffentlichten Artikels ist es, eine kurze Übersicht zum fachlichen Hintergrund der Empfehlung zu geben und zu erläutern, welche Dinge hierbei zu berücksichtigen sind.more
In einem häufig verwendeten Modellierungskonzept, den so genannten SEIR-Modellen,1-3 wird die Bevölke-rung in verschiedene Gruppen unterteilt, und die Dy-namik der Infektionen und Erkrankungen wird über eine Modellierung der Übergänge zwischen diesen Gruppen nachgebildet. Die Buchstaben S...EIR stehen für die empfänglichen (susceptible), latent infizierten (exposed – infiziert, aber noch nicht infektiös), symp-tomatisch infektiösen (infectious) und schließlich ver-storbenen oder genesenen (recovered) Anteile der Be-völkerungmore
COVID-19 disproportionately affects the poor and vulnerable. Community health workers are poised to play a pivotal role in fighting the pandemic, especially in countries with less resilient health systems. Drawing from practitioner expertise across four WHO regions, this article outlines the targete...d actions needed at different stages of the pandemic to achieve the following goals: (1) PROTECT healthcare workers, (2) INTERRUPT the virus, (3) MAINTAIN existing healthcare services while surging their capacity, and (4) SHIELD the most vulnerable from socioeconomic shocks. While decisive action must be taken now to blunt the impact of the pandemic in countries likely to be hit the hardest, many of the investments in the supply chain, compensation, dedicated supervision, continuous training and performance management necessary for rapid community response in a pandemic are the same as those required to achieve universal healthcare and prevent the next epidemic.
BMJ Global Health2020;5:e002550. doi:10.1136/bmjgh-2020-002550more
Barasa, E.; et al.KEMRI-Wellcome Trust Research Programme and African Academy of Sciences
(2020)
CC
Physical distancing measures are important to reduce COVID-19 transmission. However, when stringently applied, they can result in negative health and socio-economic impacts. This report draws on a rapid review of available literature, case studies from across Africa and expert knowledge to make reco...mmendations on adapting classic physical distancing measures to the contextual realities in Africa and on mitigating potential negative impacts.more
Настоящее руководство «Клиническое ведение случаев COVID-19» базируется на
вышеуказанных стратегических приоритетах и адресовано клиницистам, участвующим в
оказа...ии помощи пациентам с подозреваемой или подтвержденной инфекцией COVID-19.
Оно не предназначено для того, чтобы заменить индивидуальное клиническое суждение или
консультацию специалиста, но призвано помочь клиническим работникам в обеспечении
наиболее эффективного ведения случаев. Повышенное внимание в настоящем руководстве
уделяется вопросам, касающимся особых и уязвимых групп населения, таких как дети,
пожилые люди и беременные женщины.
Interim guidance on clinical management COVID-19more
Updated 10 August 2020
This document presents an essential medicines list (EML) to manage patients in intensive care units (ICUs) with suspected or confirmed COVID-19 diagnosis, which includes active ingredients with dosage form and concentration, and are preferably in the WHO Model Lists of Essent...ial Medicines 2019; based on clinical presentations and symptoms identified and prioritized in World Health Organization (WHO) and Surviving Sepsis Campaign (SSC) guidelines and the evidence presented in these guidelines.more
24 marzo 2020
El objetivo de este documento es elaborar una lista de medicamentos esenciales para manejar los pacientes en unidades de cuidados intensivos con sospecha o diagnóstico confirmado de COVID -19. Incluye principios activos con su forma farmacéutica y concentración —preferentemente e...ntre los recogidos en la Lista Modelo de Medicamentos Esenciales de la OMS (2019)—, con base en los cuadros clínicos y los síntomas identificados y priorizados en las guías de la OMS y de Surviving Sepsis Campaign y en las evidencias presentadas en dichas guías.more
This article deals with the burning issue of moral decision-making by major church assemblies, such as regional and general synods. Moral decisions by church assemblies have created many conflicts in churches in the past and at times did an injustice to the prophetic testimony of church...es in society. The question arises as follows: To what extent should church assemblies be involved in moral decision-making? The central theoretical argument of this study is that although the notion of a ‘biblical ethic’ is valid, synods and council of churches should be extremely cautious and even hesitant to formulate moral decisions because of differences in hermeneutical approaches and the principle that the church is primarily the ‘local congregation of believers’. The church is not in the first instance a national, general or international social structure that should pass conclusive resolutions and that testifies by way of moderators or elected church leaders. To unfurl this central theoretical argument, the researcher refers to the current hermeneutical discourses and proposes certain ideas regarding the possible role of the church with respect to moral decision-making. In view of the information provided, a point of view is advocated regarding the way in which churches could be involved in moral decision-making today.more
The International Council of Nurses (ICN) Code of Ethics ([1], p. 5) specifies the nurse’s role of promoting “an environment in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected”. The Malta Code of Ethics supports this for nurse...s and midwives [2], stating that the nurse is to “recognize and respect the uniqueness of every patient/client’s biological, psychological, social and spiritual status and needs”. Since patients are attended by different members of the multi-disciplinary team, these codes of ethics also address the holistic care of health care professionals that contribute towards patients’ safety. Examples of some heroes in nursing are given, whereby, their being in care generated signs of spirituality in their attempts to address patients’ needs, while their caring attitude instilled hope and healing.more
Spirituality involves a sense of connectedness, meaning making and transcendence. There is abundant published research that focuses on the importance of spirituality to patients and their families during times of illness and distress. However over the last decade there has also been a growing awaren...ess about the importance of considering the need to address peoples’ spiritual needs in the workplace. Engaging in ones own personal spirituality involves connecting with the inner self, becoming more self aware of ones humanity and limitations. Engaging with ones personal spirituality can also mean that people begin to greater find meaning and purpose in life and at work. This may be demonstrated in the workplace by collegial relationships and teamwork. Those who engage with their own spirituality also engage more easily with others through a connectedness with other staff and by aligning their values with the respective organization if they fit well with ones personal values.more
BMJ Global Health2020;5:e002914. doi:10.1136/bmjgh-2020-002914
The evidence produced in mathematical models plays a key role in shaping policy decisions in pandemics. A key question is therefore how well pandemic models relate to their implementation contexts. Drawing on the cases of Ebola and in...fluenza, we map how sociological and anthropological research contributes in the modelling of pandemics to consider lessons for COVID-19. We show how models detach from their implementation contexts through their connections with global narratives of pandemic response, and how sociological and anthropological research can help to locate models differently. This potentiates multiple models of pandemic response attuned to their emerging situations in an iterative and adaptive science. We propose a more open approach to the modelling of pandemics which envisages the model as an intervention of deliberation in situations of evolving uncertainty. This challenges the ‘business-as-usual’ of evidence-based approaches in global health by accentuating all science, within and beyond pandemics, as ‘emergent’ and ‘adaptive’.more
Se calcula que en 2015 había en el mundo 17,8 millones de mujeres de 18 años o mayores infectadas por el VIH, cifra que equivale al 51% de los adultos que viven con VIH. Las adolescentes y las jóvenes se ven especialmente afectadas; en 2015 constituían el 60% de los individuos entre 15 a 24 año...s de edad que vivían con el VIH, representando también el 58% de las infecciones por el VIH de adquisición reciente en los jóvenes de ese grupo de edad. En muchos países las mujeres que viven con el VIH carecen de acceso equitativo a servicios de salud de buena calidad, y enfrentan muchas formas de estigma y discriminación que se entrecruzan. Más aun, estas mujeres son desproporcionadamente vulnerables a la violencia, en particular las violaciones de sus derechos sexuales y reproductivos.more
Every year, an estimated 15 million babies are born preterm – before 37 weeks of pregnancy. That is more than 1 in 10 live births. Approximately 1 million children die each year worldwide due to complications from their early birth. Those that survive often face a lifetime of ill-health including ...disability, learning difficulties, and visual and hearing problems.
Half of the babies born at or below 32 weeks (2 months early) die in low-income settings, due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all these babies survive.more
Examining nursing practice guidelines to improve quality of care for patients with sepsis in low income countries is required. • A large amount of information about best practice standards in sepsis management is available for healthcare professionals; however, implementation and adherence to prac...tice guidelines recommended by the Surviving Sepsis Campaign remains low in low income countries.more
The goal of this best practice guideline is to strengthen collaborative practice among nurses, because effective collaborative practice is essential for working in health-care organizations.
In this guideline, we focus on collaborative practice amongst three types of nursing professionals – reg...istered nurse (RN), registered practical nurse (RPN) and nurse practitioner (NP) – and explore what fosters healthy work environments for them, aware that collaboration must align with the needs of the patient or client.
This best practice guideline was developed to assist nurses, nursing leaders, other health professionals and senior managers to enhance positive outcomes for patients/clients individual/family/group/community), nurses, and the organization through intra-professional collaborative practice.more