Intensive Care Med (2009) 35:9–29DOI 10.1007/s00134-008-1336-9
Although thousands of papers have been devoted tohospital-acquired pneumonia (HAP), many controversiesremain, and management of HAP is probably often sub-optimal. Several reviews or guidelines have been pub-lished rec...ently, mostly by North American initiatives(CDC, ATS). Three European Societies (ERS, ESCMID andESICM) were interested in producing a document thatcould complement in some way the last IDSA/ATS guidelines published 3 years ago. In addition, the Helics
working group supported this initiative.
more
Successful detonation of an improvised nuclear device (IND) would be a catastrophic event, causing an unprecedented number of injuries and lives lost, as well as economic, political, and social disruption. However, an effective medical response and an infrastructure prepared to protect itself from f...allout could save tens of thousands of lives. Since 2001, all levels of government, academic institutions, and professional organizations have done significant work to enhance our ability to prepare for and respond to a nuclear detonation. The following manual is intended to simplify and translate the necessary protective actions and medical response modalities in order to make them more accessible and easier to translate into practice. The approach of this manual is to provide a common baseline application for various allied response disciplines (to include senior operational responders, emergency managers, public health advisors, and municipal, State, and Federal executives and elected officials). This manual will enhance mutual understanding of the basics of nuclear response.
more
Antimicrobial resistance (AMR) is a serious public health concern with economic, social and political implications that are global in scope, and cross all environmental and ethnic boundaries. As a global threat, AMR risks the achievements of modern medicine, and has the po...tential to impact overall global development. It is important, therefore, to elevate AMR beyond health as part of a larger development agenda in the context of the Sustainable Development Goals (SDGs). This report provides in-depth technical discussions in areas that have direct implications to the containment of AMR as a development agenda. The report is organized in five chapters which served as the technical background documents for the Biregional Technical Consultation on AMR in Asia, 14-15 April 2016. More information from the meeting is available in the WHO Meeting Report: Biregional Technical Consultation on Antimicrobial Resistance in Asia. The meeting was the first time senior officials from the Ministry of Health and Ministry of Agriculture across Asia came together to tackle AMR
more
These guidelines provide a recommendation on iodine thyroid blocking (ITB), via oral administration of stable iodine, as an urgent protective action in responding to a nuclear accident. This recommendation aims to support emergency planners, policy makers, public health specialists, clinicians and o...ther relevant stakeholders, in order to strengthen public health preparedness for radiation emergencies in WHO Member States as required by the International Health Regulations (IHR) and in line with the international safety standards (GSR Part 7). The scope of the guidelines is confined to public health aspects of planning and implementation of ITB before and during a radiation emergency, such as dosage and timing of ITB administration, adverse effects of stable iodine, its packaging, storage, and distribution.
These guidelines supersede the 1999 WHO Guidelines for Iodine Prophylaxis following Nuclear Accidents.
more
TECHNICAL NOTE III
WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC, 2017
The purpose of this guidance is to assist WHO Member States, and other stakeholders, in the establishment and development of programmes of integrated surveillance of antimicrobial resistance in foodborne bacteria (i.e., bacteria commonly transmitted by food). In this guidance, “integrated surveill...ance of antimicrobial resistance in foodborne bacteria” is defined as the collection, validation, analyses and reporting of relevant microbiological and epidemiological data on antimicrobial resistance in foodborne bacteria from humans, animals, and food, and on relevant antimicrobial use in humans and animals. Integrated surveillance of antimicrobial resistance in foodborne bacteria therefore includes data from relevant food chain sectors (animals, food and humans) and includes data on both antimicrobial resistance and antimicrobial use. Integrated surveillance of antimicrobial resistance for foodborne bacteria expands on traditional public health surveillance to include multiple elements of the food chain, and to include antimicrobial use data, to better understand the sources of infection and transmission routes.
more
The report provides the much-needed evidence to design interventions for children in Kenya and as such we urge partners to use this report as a document for planning for children.
In recognition that Female Genital Mutilation (FGM) is not only a harmful practice but a violation of human rights, Kenya has adopted a robust legal framework. The country has ratified several international legal instruments that have become part of the Kenyan law as provided for in Article 2 of the... constitution.
more
The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance networks for 2013–2015. AMC in both sectors, exp...ressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors. Estimated data on AMC for pigs and poultry were used for the first time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically-significant (p < 0.05) associations between AMC and AMR for fluoroquinolones and Escherichia coli in both sectors, for 3rd- and 4th-generation cephalosporins and E. coli in humans, and tetracyclines and polymyxins and E. coli in animals. In humans, there was a statistically-significant association between AMC and AMR for carbapenems and polymyxins in Klebsiella pneumoniae. Consumption of macrolides in animals was significantly associated with macrolide resistance in Campylobacter coli in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd- and 4th-generation cephalosporin and fluoroquinolone resistance in E. coli from humans was associated with corresponding AMC in humans, whereas resistance to fluoroquinolones in Salmonella spp. and Campylobacter spp. from humans was related to consumption of fluoroquinolones in animals. These results suggest that from a ‘One-health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
more
A Meand to enhancing HIV prevention in key populations. This document has been developed out of the increasing need to set up standards and procedures to prevent and respond to violence against key populations.
This pocket guide offers basic information needed for the medical management of victims of radiation incidents in an easy-to-understand manner.
Alcohol contributes significantly to the disease and mortality burden in the WHO European Region, and primary health care systems play an important role in reducing the impact of harmful alcohol use. Screening and brief interventions (SBIs) for alcohol are an evidence-informed approach to addressing... the needs of the many patients presenting in primary care who may benefit from reducing their alcohol consumption. This manual provides information to plan training and support for primary care practitioners to confidently deliver SBI for alcohol problems to their patients. The manual outlines the background and evidence base for SBI, and gives practical advice on establishing an implementation programme as well as detailed educational materials to develop the knowledge and skills of participants in organized training sessions.
more
In 2015, 5.9 million children under age five died (1). The major causes of child deaths globally are pneumonia, prematurity, intrapartum-related complications, neonatal sepsis, congenital anomalies, diarrhoea, injuries and malaria (2). Most of these diseases and conditions are at least partially cau...sed by the environment. It was estimated in 2012 that 26% of childhood deaths and 25% of the total disease burden in children under five could be prevented through the reduction of environmental risks such as air pollution, unsafe water, sanitation and inadequate hygiene or chemicals.
more
Testing and diagnosis of hepatitis B (HBV) and C (HCV) infection is the gateway for access to both prevention and treatment services, and is a crucial component of an effective response to the hepatitis epidemic. Early identification of persons with chronic HBV or HCV infection enables them to recei...ve the necessary care and treatment to prevent or delay progression of liver disease. Testing also provides an opportunity to link people to interventions to reduce transmission, through counselling on risk behaviours and provision of prevention commodities (such as sterile needles and syringes) and hepatitis B vaccination.
more