BackgroundClimate change is one of the great challenges of our time. The consequences of climate change on exposed biological subjects, as well as on vulnerable societies, are a concern for the entire scientific community. Rising temperatures, heat waves, floods, tornadoes, hurricanes, droughts, fir...es, loss of forest, and glaciers, along with disappearance of rivers and desertification, can directly and indirectly cause human pathologies that are physical and mental.
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Руководство ВОЗ по политике и практике информирования о рисках при чрезвычайных ситуациях (ИРЧС)
Externalising disorders
Chapter D.2
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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In this report, we describe early childhood trauma and its effects, offer promising strategies for ECE programs and systems to help young children who have experienced trauma, and present recommendations for state policymakers and other stakeholders looking to support trauma-informed ECE for this vu...lnerable group.
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This Practice Parameter reviews the evidence from research and clinical experience and highlights significant advances in the assessment and treatment of posttraumatic stress disorder since the previous Parameter was published in 1998. It highlights the importance of early identification of posttrau...matic stress disorder, the importance of gathering information from parents and children, and the assessment and treatment of comorbid disorders. It presents evidence to support trauma-focused psychotherapy, medications, and a combination of interventions in a multimodal approach.
Journal of the American Academy of Children & Adolescents Psychiatry, Vol. 49 No. 4 APRIL 2010 pp.414-430
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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Our spiritual health profoundly impacts our physical health, well-being, and quality of life. Just as medical professionals care for our bodies and minds, spiritual care practitioners care for our spirits. The increasing need for spiritual care makes these practitioners even more crucial. However, m...any of us have limited access to quality, professional spiritual care. At times of struggle, this lack of spiritual care can have a negative impact on our health and well-being.Investigators and researchers are creating a growing body of evidence for the innumerable benefits of professional spiritual care, yet many people still do not have a lot of accurate information about these practitioners. To create this publication, the six largest healthcare chaplaincy organizations in North America collaborated to share the facts about spiritual care and practitioners’ roles, training, and standards.By providing evidence and dispelling myths, the thousands of spiritual care practitioners represented by these organizations hope to increase access to spiritual care for the benefit of all.
accessed July 2020
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Euro Surveillance 2014;19(47):pii=20970, p.31-37
Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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This Review summarizes many of the persistent biological alterations associated with childhood maltreatment including changes in neuroendocrine and neurotransmitter systems and pro-inflammatory cytokines in addition to specific alterations in brain areas associated with mood regulation. Finally, I d...iscuss several candidate gene polymorphisms that interact with childhood maltreatment to modulate vulnerability to major depression and PTSD and epigenetic mechanisms thought to transduce environmental stressors into disease vulnerability.
Neuron Review, vol. 89, March 2, 2016 pp.892-909
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Afr J Tradit Complement Altern Med. (2016) 13(4):123-131
Out of 400 questionnaires distributed to the participants, 389 were returned with data acceptable for analysis. Ages of the participants ranged from 18 to 75 years (Mean=43 + 11.6). Out of the 272 (69.9%) participants who conceded that th...ey had used medicinal herbs at least once, 30 (7.7%) participants used medicinal herbs frequently while 242 (62.2 %) rarely used the herbs. At least 20 plant species belonging to 16 families were reportedly used by the participants. Asteraceae was the most common plant family reportedly used by the participants. Allium sativum and Dicoma anomala, reportedly used by 21.0% and 14.3% respectively, were the most commonly used medicinal herbs in this population. In addition, boosting the immune system and treating gastrointestinal ailments, apparently cited by 32% and 28% participants respectively, were the most commonly reported reasons for using medicinal herbs.
http://dx.doi.org/10.21010/ajtcam.v13i4.17
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Planificación y Gestión Integral de la Pandemia COVID-19 en Paraguay. Una integración de herramientas analíticas epidemiológicas,
económicas y sociales
Although Kenyans enjoy comparatively good health, the prevalence of
chronic disease is increasing and our ageing population is placing evergrowing pressures on the finite resources of our health system.
This open access book not only describes the challenges of climate disruption, but also presents solutions. The challenges described include air pollution, climate change, extreme weather, and related health impacts that range from heat stress, vector-borne diseases, food and water insecurity and ch...ronic diseases to malnutrition and mental well-being.
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