Haiti, one of the poorest countries in the world, was devastated by an earthquake in 2010. The disaster uncovered the realities of a non-existent mental health care system with only ten psychiatrists nationwide. Attempts were made to assess the increased prevalence of mental illness, likely due to t...he trauma to which many were exposed. Several interventions were carried out with aims to integrate mental health into primary health care services. The interplay between socio-cultural beliefs and health (both mental and physical) in Haiti has been widely commented upon by both foreign aid and local caregivers. Observations frequently highlight barriers to the willingness of patients to seek care and to their acceptance of biomedicine over traditional Vodou beliefs. The perception of Haitian beliefs as barriers to the availability and acceptance of mental health care has intensified the difficulty in providing effective recommendations and interventions both before and after the earthquake. Argued in this review is the importance of considering the interactions between socio-cultural beliefs and mental health when developing models for the prevention, screening, classification and management of mental illness in Haiti. These interactions, especially relevant in mental health care and post-disaster contexts, need to be acknowledged in any healthcare setting. The successes and failures of Haiti’s situation provide an example for global consideration.
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Posttraumatic stress disorder (PTSD) in children and adolescents occurs as a result of a child’s exposure to one or more traumatic events: actual or threatened death, serious injury, or sexual violence. The victim may experience the event, witness it, learn about it from close family members or fr...iends, or experience repeated or extreme exposure to aversive details of the event. Potentially traumatic events include physical or sexual assaults, natural disasters, and accidents.
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The course has an emphasis on health care in the US: "health care professionals need to understand this virus as more patients in the United States are confirmed to have EVD and patients are being transported to the US for treatment". Does anyone know of similar online courses (in English and/or Fre...nch) for health professionals in Sierra Leone, Liberia and Guinea? Courses that can be readily downloaded for offline use would be particularly valuableThe course is offered free for those wishing to obtain the information or for a nominal fee for nurses and physicians who desire CME credits (2.75 AMA PRA Category 1 CreditsTM for $25). to register go to: http://www.uab.edu/nursing/home/office-of-professional-development
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Journal of the International AIDS Society 2017, 20(Suppl 4):21644
National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living with HIV. Indeed, long centred around t...he hospital and reliant on physicians, the country's HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment. This study describes implementation of differentiated care in Médecins Sans Frontières (MSF)‐supported programmes and reports its outcomes.
https://doi.org/10.7448/IAS.20.5.21644
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The outbreak of the coronavirus is leading to increased challenges in clinical management and uncertainty among the general population. To support the advice and treatment of patients, we have updated our Knowledge Library to include an informative Learning Card about COVID-19.
This update contai...ns essential details, as well as references to reputable sources and the newest treatment recommendations from the institutes and authorities who are evaluating these developments on a daily basis. The Learning Card has been written, curated and extensively checked by our qualified team of international physicians.
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Solidarity” is an international clinical trial to help find an effective treatment for COVID-19, launched by the World Health Organization and partners.
The Solidarity Trial will compare four treatment options against standard of care, to assess their relative effectiveness against COVID-19. By... enrolling patients in multiple countries, the Solidarity Trial aims to rapidly discover whether any of the drugs slow disease progression or improve survival. Other drugs can be added based on emerging evidence.
Until there is sufficient evidence, WHO cautions against physicians and medical associations recommending or administering these unproven treatments to patients with COVID-19 or people self-medicating with them. WHO is concerned by reports of individuals self-medicating with chloroquine and causing themselves serious harm.
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The primary audience of these recommendations includes healthcare providers who are responsible for developing national and local health protocols (particularly those related to hypertensive disorders of pregnancy), and those directly providing care to pregnant women and their newborns, including mi...dwives, nurses, general medical practitioners, obstetricians, obstetric physicians, managers of maternal and child health programmes, and relevant staff in ministries of health, in all settings.
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Almost all organizations recommend masks for the general public. Unfortunately, earlier in the pandemic, many did exactly the opposite – due to limited data but also due to concerns about diminished mask supply for healthcare workers and out of fear that masked individuals might be tempted to igno...re rules of social distancing. In addition, conflicting national guidelines have led to variable public compliance. A few physicians, in line with some COVidiots, still argue against face masks
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MedPPE emphasizes the role and timing of health workers jobs and offers specific information to prevent the spread of COVID-19. The guidelines are aimed at all personnel working in health facilities, including security guards, administrative and cleaning personnel, transfer assistants, nurses, biome...dical and imaging technicians, surgeons, and physicians, among others.
MedPPE provides guidance for the use of PPE according to workers’ function, the level of care they provide, and the multiple environments of primary health care and hospitals. The tool also clarifies the type of PPE needed when performing aerosol-generating procedures and other activities related to the care of patients infected or suspected of being infected with COVID-19.
However, use of PPE alone is not enough to protect against COVID-19. Hand hygiene and proper PPE dressing and undressing procedures must also be followed, along with the proper disposal and management of waste.
MedPPE is available in Spanish, English, Portuguese and French for iOS and Android devices.
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Community-based interventions are vital for facilitating poststroke recovery, increasing community participation, and raising awareness about stroke survivors. To optimize recovery and community reintegration, there is a need to understand research findings on community-based interventions that focu...s on stroke survivors and their caregivers. Although nurses and community health workers (CHWs) are commonly involved in community-based interventions, less is known about their roles relative to other poststroke rehabilitation professionals (physical therapists, occupational therapists, and speech-language pathologists). Thus, the purpose of this review is to explore research focused on improving community-based stroke recovery for adult stroke survivors, caregivers, or both when delivered by nurses or CHWs.
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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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Biodiversity and healthy natural ecosystems, including protected areas in and around cities, provide ecosystem benefits and services that support human health, including reducing flood risk, filtering air pollutants, and providing a reliable supply of clean drinking water. These services help to red...uce the incidence of infectious diseases and respiratory disorders, and assist with adaptation to climate change. Access to nature offers many other direct health benefits, including opportunities for physical activity, reduction of developmental disorders and improved mental health.
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The toolkit provides guidance on where to get started, including the structures and resources that should be put in place at the national and health-care facility level, through a stepwise approach in low-resource settings. As the ultimate goal of an AMS programme is sustainable behaviour change in ...physicians’ antibiotic prescribing practices, the toolkit also provides detailed guidance on how to plan, perform and assess AMS interventions – including feedback on antibiotic use over time. Finally, the toolkit provides an overview of the competencies an AMS team needs to guide health-care professionals in changing their antibiotic prescribing behaviours.
Please note that this course is part of a training package, so please register for the complementary course WHO Policy Guidance on Integrated Antimicrobial Stewardship Activities so that you can complete your learning journey.
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To test for ethnic discrimination in access to outpatient health care services, we carry out
an email-correspondence study in Germany. We approach 3,224 physician offices in the 79
largest cities in Germany with fictitious appointment requests and randomized patients’
characteristics. We find t...hat patients’ ethnicity, as signaled by distinct Turkish versus Ger-
man names, does not affect whether they receive an appointment or wait time. In contrast,
patients with private insurance are 31 percent more likely to receive an appointment. Hold-
ing a private insurance also increases the likelihood of receiving a response and reduces the
wait time. This suggests that physicians use leeway to prioritize privately insured patients
to enhance their earnings, but they do not discriminate persons of Turkish origin based
on taste. Still, their behavior creates means-based barriers for economically disadvantaged
groups.
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SAMS team rose to meet these challenges, delivering world class COVID treatment with four newly established COVID hospitals complete with 100 ICU beds and state of the art equipment like ventilators, monitors, and oxygen generators. By using innovative technologies, SAMS’ physicians were able to s...hare the knowledge they gained treating
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The recommendations cover the level of blood pressure to start medication, what type of medicine or combination of medicines to use, the target blood pressure level, and how often to have follow-up checks on blood pressure. In addition, the guideline provides the basis for how physicians and other h...ealth workers can contribute to improving hypertension detection and management.
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Parasites & Vectors volume 11, Article number: 264 (2018)
Dengue creates a staggering epidemiological and economic burden for endemic countries. Without a specific therapy and with a commercial vaccine that presents some problems relative to its full effectiveness, initiatives to improve vector... control strategies, early disease diagnostics and the development of vaccines and antiviral drugs are priorities. In this study, we present the probable origins of dengue in America and the trajectories of its spread. Overall, dengue diagnostics are costly, making the monitoring of dengue epidemiology more difficult and affecting physicians’ therapeutic decisions regarding dengue patients, especially in developing countries. This review also highlights some recent and important findings regarding dengue in Brazil and the Americas. We also summarize the existing DENV polymerase chain reaction (PCR) diagnostic tests to provide an improved reference since these tests are useful and accurate at discriminating DENV from other flaviviruses that co-circulate in the Americas. Additionally, these DENV PCR assays ensure virus serotyping, enabling epidemiologic monitoring.
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Kinetoplastid parasites have caused human disease for millennia. Significant achievements have been made toward developing new treatments for leishmaniasis (particularly on the Indian subcontinent) and for human African trypanosomiasis (HAT). Moreover, the sustained decrease in the incidence of HAT... has made the prospect of elimination a tantalizing reality. Despite the gains, no new chemical or biological entities to treat kinetoplastid diseases have been registered in more than three decades, and more work is needed to discover safe and effective therapies for patients with Chagas disease and leishmaniasis. Advances in tools for drug discovery and novel insights into the biology of the host−parasite interaction may provide opportunities for accelerated progress. Here, we summarize the output from a gathering of scientists and physicians who met to discuss the current status and future directions in drug discovery for kinetoplastid diseases.
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (...SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed and undertreated which leads to high levels of morbid...ity and avoidable deaths. The consequences of poorly controlled asthma, including physical, mental, social, and economic impacts, are magnified in the poor on account of poor access to asthma services and sub-optimal quality of those services. With these guidelines, Kenya's Ministry of Health aims to work towards embedding asthma care in Universal Health Care (UHC) to ensure that quality asthma services are available in primary care settings with
referral networks strengthened for those who may require secondary and tertiary care. These national asthma guidelines will also ensure that treatment for asthma is standardized in both the public and the non-state health care sector.
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