Over the past few decades and throughout the world, the landscape of adolescent health has been altered dramatically. Currently, the total population of adolescents between the ages of 10 and 19 years is 1.2 billion – the largest generation of young people in history. The vast majority of adolesce...nts (85%) live in developing countries where, in many areas, they make up more than a third of the population. They face a variety of different experiences given the diverse political, economic, social and cultural realities within their communities. Although, for many, adolescence is a period of learning and building confidence in a nurturing environment, for others it is a period of heightened risk and complex challenges.
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Chapter 10 of Pediatric Surgery: This chapter provides an overview of some of the challenges when providing anaesthesia care for children in Africa. The chapter reviews
the cardiac, respiratory, and renal differences of children in comparison to adults. Additionally, it addresses preoperative asses...sment, including guidelines for nothing by mouth (NPO, or nil per os), general and regional anaesthesia, intraoperative monitoring, airway management, and postoperative care
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The revised guidelines contain recommendations for specific administrative, environmental controls and respiratory protection, following the assessment made by an external group of experts convened as members of the Guideline Development Group. Moreover, these guidelines focus on interventions speci...fic to preventing transmission of Mycobacterium tuberculosis bridging with the core components of infection prevention and control programmes at the national and acute health care facility level
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Report on Main Findings
The review encompasses three complementary components: 1) a review of published literature 2000-2015 on NCDs and their risk factors; 2) qualitative interviews with key actors engaged in NCD research in Myanmar; and 3) additional reviews of Myanmar ethical committee inqui...ries and postgraduate research on NCDs in Myanmar. This report outlines the key findings from the three components including a synthesis of the key outcomes from the literature review and qualitative interviews, and an assessment of the gaps in the evidence against a framework of evidence needs.
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Interim guidance 19 March 2020
Severe acute respiratory infections treatment centre: practical manual to set up and manage a SARI treatment centre and a SARI screening facility in health care facilities
18 Janaury 2021
EU/EEA Member States and the UK have increased their laboratory capacity tremendously over the past 11 months as the majority of the Member States reported sufficient testing capacity until March 2021.
Many countries are adding rapid antigen detection tests (RADT) to their ...testing strategies in order to reduce pressure on RT-PCR testing.
Some Member States have already included RADT in their case definition.
The main bottlenecks, such as shortages of laboratory consumables and human resources, as well as sample storing facilities, continue to exist and may affect the overall laboratory response to COVID-19.
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27 May 2021
This is a document to support the use of pulse oximeter for assessment of suspected and confirmed cases of Covid-19 in the community.
It is a well-known fact that Covid-19 can present as “happy hypoxia” with minimum symptoms of severe respiratory distress despite significant low ox...ygen levels in the blood. The use of pulse oximeter for clinical assessment significantly augments decision making, save lives and provide high quality care. It allows for early detection of patients with hypoxia requiring either close monitoring in the community or timely referral for hospital care.
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This clinical pocket book - Respiratory Assessment and Oxygen Administration - is the forth edition from Clinical Pocket Reference for Nurses
Assessment and management of prolonged symptoms of COVID-19.
Introdução
Apesar de inicialmente ter sido considerada uma infecção aguda do sistema respiratório,
atualmente sabe-se do comprometimento multissistêmico e protraído da COVID-19 em alguns indivíduos [1]. Segundo dados prelimi...nares de estudos observacionais, estima-se que aproximadamente 10% dos pacientes com quadros leves a moderados de COVID-19 apresentam sintomas prolongados, que duram 3 semanas ou mais [2]. Essa condição tem sido chamada de COVID “longa”, “pós-aguda” ou
“síndrome pós-COVID-19”. Entre os pacientes que necessitam internação, especialmente em UTI, estes sintomas residuais podem ser muito mais frequentes: mais que 80% dos pacientes reportaram ao menos 1 sintoma após 60 dias do início do quadro.
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Combined questionnaire Core
Cases of monkeypox (MPX) acquired in the EU have recently been reported in nine EU Member States (Austria, Belgium, France, Germany, Italy, Portugal, Spain, Sweden, and the Netherlands).
Monkeypox (MPX) does not spread easily between people. Human-to-human transmission occurs through close contact ...with infectious material from skin lesions of an infected person, through respiratory droplets in prolonged face-to-face contact, and through fomites. The predominance, in the current outbreak, of diagnosed human MPX cases among men having sex with men (MSM), and the nature of the presenting lesions in some cases, suggest transmission occurred during sexual intercourse
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Int. J. Environ. Res. Public Health 2021, 18(24), 13339; https://doi.org/10.3390/ijerph182413339
The climate crisis threatens to exacerbate numerous climate-sensitive health risks, including heatwave mortality, malnutrition from reduced crop yields, water- and vector-borne infectious diseases, and... respiratory illness from smog, ozone, allergenic pollen, and wildfires. Recent reports from the Intergovernmental Panel on Climate Change stress the urgent need for action to mitigate climate change, underscoring the need for more scientific assessment of the benefits of climate action for health and wellbeing.
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At the global, national, and regional levels, there are several guidelines and guides regarding the preparedness, prevention, surveillance, and control of diseases caused by respiratory viruses; most initiatives focus on specific virus events or cases. During the coronavirus disease 2019 (COVID-19) ...pandemic, it has been found that even when there are strategies designed and planned for pandemics, it is necessary to strengthen and improve them. Planning for imminent threats, including those posed by respiratory viruses, contributes to strengthening the core capacities of the International Health Regulations (IHR [2005])
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Spirometry is required as part of the comprehensive evaluation of both adult and paediatric individuals with suspected or confirmed respiratory diseases and occupational assessments. It is used in the categorisation of impairment, grading of severity, assessment of potential progression and response... to interventions. Guidelines for spirometry in South Africa are required to improve the quality, standardisation and usefulness in local respiratory practice. The broad principles of spirometry have remained largely unchanged from previous versions of the South African Spirometry Guidelines; however, minor adjustments have been incorporated from more comprehensive international guidelines, including adoption of the Global Lung Function Initiative 2012 (GLI 2012) spirometry reference equations for the South African population.
All equipment should have proof of validation regarding resolution and consistency of the system. Daily calibration must be performed, and equipment quality control processes adhered to. It is important to have standard operating procedures to ensure consistency and quality and, additionally, strict infection control as highlighted during the COVID-19 pandemic.
Adequate spirometry relies on a competent, trained operator, accurate equipment, standardised operating procedures, quality control and patient co-operation. All manoeuvres must be performed strictly according to guidelines, and strict quality assurance methods should be in place, including acceptability criteria (for any given effort) and repeatability (between efforts).
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One of the first steps in developing a multisectoral action plan (MSAP) is to use a situation analysis to provide a comprehensive assessment of the health needs, prevailing risks and the context of the area to which the plan will apply. This will help countries, regions, provinces or cities intendi...ng to create a multisectoral action plan to align with the global commitments on targeting the four major NCDs: cardiovascular disease, diabetes, cancer and chronic respiratory diseases.
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he aetiology of asthma and allergic disease remains poorly understood, despite considerable research. The International Study of Asthma and Allergies in Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease, by establishing a standardized m...ethodology and facilitating international collaboration. Its specific aims are: 1) to describe the prevalence and severity of asthma, rhinitis and eczema in children living in different centres, and to make comparisons within and between countries; 2) to obtain baseline measures for assessment of future trends in the prevalence and severity of these diseases; and 3) to provide a framework for further aetiological research into genetic, lifestyle, environmental, and medical care factors affecting these diseases. The ISAAC design comprises three phases. Phase 1 uses core questionnaires designed to assess the prevalence and severity of asthma and allergic disease in defined populations. Phase 2 will investigate possible aetiological factors, particularly those suggested by the findings of Phase 1. Phase 3 will be a repetition of Phase 1 to assess trends in prevalence.
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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...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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Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequent in children. A task force supported by the European Respiratory Society has developed these evidence...-based clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years using nine Population, Intervention, Comparator and Outcome (PICO) questions. The task force conducted systematic literature searches for all PICO questions and screened the outputs from these, including relevant full-text articles. All task force members approved the final decision for inclusion of research papers. The task force assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
The task force then developed a diagnostic algorithm based on the critical appraisal of the PICO questions, preferences expressed by lay members and test availability. Proposed cut-offs were determined based on the best available evidence. The task force formulated recommendations using the GRADE Evidence to Decision framework.
Based on the critical appraisal of the evidence and the Evidence to Decision framework, the task force recommends spirometry, bronchodilator reversibility testing and exhaled nitric oxide fraction as first-line diagnostic tests in children under investigation for asthma. The task force recommends against diagnosing asthma in children based on clinical history alone or following a single abnormal objective test. Finally, this guideline also proposes a set of research priorities to improve asthma diagnosis in children in the future.
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