PNAS 119 (8) e2113947119 | https://doi.org/10.1073/pnas.2113947119
Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, m...easure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.
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second edition
Included more self-measured blood pressure (SMBP)-focused content with tools and resources.
Showcased more tools to find patients with potentially undiagnosed HTN.
Added new strategies that focus on chronic kidney disease testing and identification.
Во многих странах суицид является одной из главных причин смерти среди детей и подростков. Одна из главных задач психиатрических служб – выяв-ление молодых людей ...з группы риска и предложение эффективных методов лечения. Данная глава содержит обзор суицидальности детей и подростков. Несуицидальные самоповреждения также будут рассмотрены, но основное внимание будет уделено суицидальным попыткам и завершенным суицидам. Обзор включает данные эпидемиологии, сведения о факторах риска и осо-бенностях этиологии, клинических проявлениях, диагностике, лечении и про-филактике. Поскольку акцент мы сделали на клинических проблемах, в этот обзор не вошли сведения о нейропсихобиологии суицидальности.
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Brussels, December 16. 2016
Цель этой главы – дать представление об эпидемиологических данных, возрасте начала, течении, подтипах, этиологии, клинических проявлениях, дифференциальной диагн...остике и лечении БР у детей и подростков.
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Surveys are needed to guide trachoma control efforts in Mozambique, with WHO guidelines for intervention based on the prevalence of trachomatous inflammation–follicular (TF) in children aged 1–9 years and the prevalence of trichiasis in adults aged 15 years and above. We conducted surveys to com...plete the map of trachoma prevalence in Mozambique, concluding that it still represents a significant public health problem in many areas of Mozambique.
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The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist i...n various combinations in different individuals, to date there is limited evidence on how to integrate these for optimal monitoring of children with asthma. The aims of this ERS Task Force were to describe the current practise and give an overview of the best available evidence on how to monitor children with asthma.
22 clinical and research experts reviewed the literature. A modified Delphi method and four Task Force meetings were used to reach a consensus.
This statement summarises the literature on monitoring children with asthma. Available tools for monitoring children with asthma, such as clinical tools, lung function, bronchial responsiveness and inflammatory markers, are described as are the ways in which they may be used in children with asthma. Management-related issues, comorbidities and environmental factors are summarised.
Despite considerable interest in monitoring asthma in children, for many aspects of monitoring asthma in children there is a substantial lack of evidence.
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This guide provides a systematic, practical approach to support primary care and other healthcare professionals to improve the care of peopel over the age of 18 years with difficult to manage asthma.
The arrival and rapid spread of the mosquito-borne viral disease Chikungunya across the Americas is one of the most significant public health developments of recent years, preceding and mirroring the subsequent spread of Zika. Globalization in trade and travel can lead to the importation of these vi...ruses, but climatic conditions strongly affect the efficiency of transmission in local settings. In order to direct preparedness for future outbreaks, it is necessary to anticipate global regions that could become suitable for Chikungunya transmission. Here, we present global correlative niche models for autochthonous Chikungunya transmission. These models were used as the basis for projections under the representative concentration pathway (RCP) 4.5 and 8.5 climate change scenarios. In a further step, hazard maps, which account for population densities, were produced. The baseline models successfully delineate current areas of active Chikungunya transmission. Projections under the RCP 4.5 and 8.5 scenarios suggest the likelihood of expansion of transmission-suitable areas in many parts of the world, including China, sub-Saharan Africa, South America, the United States and continental Europe. The models presented here can be used to inform public health preparedness planning in a highly interconnected world.
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Lancet Planet Health 2017 Published Online November 6, 2017 http://dx.doi.org/10.1016/S2542-5196(17)30141-9
Поэтому уже давно возникала мысль о том,что подробный комментарий по вопросам научных знаний и практическогоопыта, лежащих в основе политики ВОЗ по борьбе ...с туберкулезом, являлся бысущественным элементом технического сотрудничества ВОЗ с ее государствамичленами. Данная книга, написанная в форме вопросов и ответов, являетсяпервым шагом в этом направлении. Я надеюсь, что она станет доступной длявсех специалистов, участвующих в борьбе с туберкулезом, организаторов здравоохранения и администраторов, ответственных за формирование и выполнение национальных программ борьбы с туберкулезом, а также всех медицинскихработников, ежедневно решающих конкретные задачи борьбы с туберкулезомна местах.
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The goal of this best practice guideline is to strengthen collaborative practice among nurses, because effective collaborative practice is essential for working in health-care organizations.
In this guideline, we focus on collaborative practice amongst three types of nursing professionals – reg...istered nurse (RN), registered practical nurse (RPN) and nurse practitioner (NP) – and explore what fosters healthy work environments for them, aware that collaboration must align with the needs of the patient or client.
This best practice guideline was developed to assist nurses, nursing leaders, other health professionals and senior managers to enhance positive outcomes for patients/clients individual/family/group/community), nurses, and the organization through intra-professional collaborative practice.
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This report reviews and analyses the Affordable Medicines Programme, which was introduced in Ukraine in April 2017 to provide patients with improved access to 23 outpatient medicines for the treatment of chronic noncommunicable diseases. The evaluation combines both quantitative and qualitative anal...ysis. The findings confirm that the Programme has contributed to a significant increase in access to needed outpatient medicines in Ukraine. Further, while implementation was successful overall, uptake across regions was uneven. The report concludes by listing a number of policy options to support the sustainability and expansion of the Affordable Medicines Programme.
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Towards gender - transformative HIV and TB responses
На пути к гендерно-преобразовательным мерам против ВИЧ и ТБ
Цель настоящего доклада — повысить осведомленность о деменции как
одной из приоритетных проблем общественного здравоохранения, сформу-
лировать подход к этой п...облеме с точки зрения общественного здравоох-
ранения и призвать к принятию надлежащих мер на международном
и национальном уровнях на основе принципов вовлечения, интеграции,
справедливости и доказательности.
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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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The aim of the SATG was to produce a triage scale for use throughout South Africa. The group was multi-disciplinary and comprised doctors, nurses and paramedics. The result of the SATG’s activities is the South African Triage Scale (SATS), a physiology and symptom based scale which prioritises int...o one of four colours and can be used in hospital Emergency Centres as well as in the pre-hospital setting. The SATS has been validated in the public, private health care setting as well as pre-hospital.
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