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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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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Background: Atherosclerotic cardiovascular diseases (ASCVD) including myocardial infarction, stroke and peripheral arterial disease continue to be major causes of premature death, disability and healthcare expenditure globally. Preventing the accumulation of cholesterol-containing atherogenic lipopr...oteins in the vessel wall is central to any healthcare strategy to prevent ASCVD. Advances in current concepts about reducing cumulative exposure to apolipoprotein B (apo B) cholesterol-containing lipoproteins and the emergence of novel therapies provide new opportunities to better prevent ASCVD. The present update of the World Heart Federation Cholesterol Roadmap provides a conceptual framework for the development of national policies and health systems approaches, so that potential roadblocks to cholesterol management and thus ASCVD prevention can be overcome.
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Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing guidelines is poor. A major revision of the GINA r...eport was published in 2014, and updated in 2015, reflecting an evolving understanding of heterogeneous airways disease, a broader evidence base, increasing interest in targeted treatment, and evidence about effective implementation approaches. During development of the report, the clinical utility of recommendations and strategies for their practical implementation were considered in parallel with the scientific evidence.
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Despite the increasing uptake of information and communication technologies (ICT) within healthcare services across developing countries, community healthcare workers (CHWs) have limited knowledge to fully utilise computerised clinical systems and mobile apps. The ‘Introduction to Information and ...Communication Technology and eHealth’ course was developed with the aim to provide CHWs in Malawi, Africa, with basic knowledge and computer skills to use digital solutions in healthcare delivery. The course was delivered using a traditional and a blended learning approach.
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Taenia saginata is a zoonotic tapeworm that is of economic importance in countries where cattle are kept. The parasite is transmitted from human tapeworm carriers (taeniosis) to bovines (cysticercosis) by excretion of eggs or proglottids containing eggs into the environment via the stool. Bovines ca...n then ingest the eggs through contaminated feed or water. After ingestion, the eggs hatch and release oncospheres in the small intestines, where the oncospheres penetrate the intestinal wall to reach the blood circulation. This distributes them throughout the body, but primarily to muscle tissue, where they develop into cysticerci. For humans to become infected with T. saginata, raw or undercooked bovine meat or offal containing infective cysts must be consumed. Bovine cysticercosis has been associated with various environmental factors related to water sources, such as animals having access to surface water, flooding of pastures and proximity to wastewater sources.
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Las personas con el VIH también corren el riesgo de contraer TB. Lea este folleto hoy para aprender sobre la TB y el VIH. Luego comparta lo que aprenda con su familia y sus amigos.
Handreichung der Diakonie Deutschland, welches sich ausführlich mit den Ansprüchen von Leistungsberechtigten nach AsylbLG für Leistungen der Eingliederungshilfe, Kinder- und Jugendhilfe oder Hilfe zur Pflege über § 6 Abs. 1 und 2 AsylbLG auseinandersetzt. Zusätzlich gebe diese Arbeitshilfe rec...htsdurchsetzende Hinweise.
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Nature Medicine, https://doi.org/10.1038/s41591-021-01283-z
21 May 2021. PACK Home: Information and advice for the home
Available in English, Afrikaans and isiXhosa
Slideset updated regularly to include the latest data and guidance on COVID-19 risk and management in special populations, including children and pregnant women, and persons with comorbidities.
26 March 2021 Slideset updated regularly to include the latest data on the evolution and duration of COVID-19 symptoms and prevalence and duration of natural immunity.
Lancet Planet Health 2021; 5: e542–52
Climate Change 2021: The Physical Science Basis. Contribution of Working Group I to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change
Коронавирусная инфекция COVID-19: инфекционная безопасность в эндоскопическом отделении
Научная справка
8 апреля 2020 г.
В ответ на растущую пандемию COVID-19 и нехватку ресурсов и реагентов для молекулярного тестирования, многие производители диагностич...ских тестов разработали и начали продавать простые в использовании экспресс-системы, позволяющие выполнять тестирование вне лабораторий. Эти простые тестовые наборы основаны либо на обнаружении белков вируса COVID-19 в респираторных образцах (например, мокроте, мазке из зева), либо на обнаружении в крови или сыворотке человека антител, образующихся в ответ на инфекцию.
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An IPCC Special Report on climate change, desertification,
land degradation, sustainable land management, food security,
and greenhouse gas fluxes in terrestrial ecosystems.
The systematic surveillance of antibiotic use and antibiotic re-sistance prevalence in humans and animals is imperative for managingbacterial infectious disease (JPIAMR, 2019;WHO, 2015). Many low-income countries currently face substantial challenges in building national surveillance systems due to ...a lack of infrastructure and resources,resulting in a shortage of systematic data (FAO/OIE/WHO, 2018)
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A role for nuclear techniques
Antimicrobials play a critical role in the treatment of human and animal (aquatic and terrestrial) diseases, which has led to their widespread application and use. Antimicrobial resistance (AMR) is the ability of microorganisms to stop an antibiotic, such as an antimic...robial, antiviral or antimalarial, from working against them. Globally, about 700 000 deaths per year arise from resistant infections as a result of the fact that antimicrobial drugs have become less effective at killing resistant pathogens. Antimicrobial chemicals that are present in environmental compartments can trigger the development of AMR. These chemicals can also cause antibiotic-resistant bacteria (ARB) to further spread antibiotic resistance genes (ARG) because they may have an evolutionary advantage over non-resistant bacteria.
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PLOS Medicine | https://doi.org/10.1371/journal.pmed.1002514 March 1, 2018