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Antibiotic resistance has been recognized as a major global health threat and optimizing prescribing is one of the most effective measures to preserve the effectiveness of antibiotics. The quality of prescribing depends mostly on those pres
...
cribers belonging to clinical medical specialties having direct contact with patients. These doctors, who comprise the majority of antibiotic prescribers,undergo long-term undergraduate and postgraduate training that shapes their professional knowledge and behaviour
J Antimicrob Chemother2019;74: 3611–3618doi:10.1093/jac/dkz375 Advance Access publication 3 September 2019
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Non-pharmaceutical interventions (NPI) are public health measures that aim to prevent and/or control SARS-CoV-2 transmission in the community. As long as there is no effective and safe vaccine to protect those at risk of severe COVID-19, NPI are the
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most effective public health interventions against COVID-19. These ECDC guidelines detail available options for NPI in various epidemiologic scenarios, assess the evidence for their effectiveness and address implementation issues, including potential barriers and facilitators.
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Heart failure (HF) is a global public health concern with disproportionate socioeconomic, morbidity and mortality burden on low- and middle-income countries (LMICs). This review summarises contemporary data on the demographic and clinical characteri
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stics, aetiologies, treatment, economic burden and outcomes of HF in LMICs. Patients with HF in LMICs are younger than those from high-income countries (HICs) and present at advanced stages of the disease. Hypertension, ischaemic heart disease (IHD), cardiomyopathy (CMO), and rheumatic heart disease (RHD) are the leading causes of HF in LMICs. The contribution of infectious diseases to HF remains prominent in many LMICs. Most health facilities in LMICs lack adequate diagnostic tools for HF, and the use of evidence-based medical and device therapies is suboptimal. Further, HF in LMICs is associated with prolonged hospital stay and high in-hospital and one-year mortality. Finally, HF has profound economic impact on individual patients who, mostly, have no health insurance, and on societies where patients are young, comprising those who have the greatest potential to contribute to economic productivity.
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Background: COVID-19 is a global public health crisis that affects all sectors; studying the impact of this pandemic on the delivery of cardiology services in Africa is crucial as COVID-19-related cardiovascular complications may worsen the CVD burd
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en in this already highly affected and resource-limited continent
Methods: This was a cross-sectional e-survey study conducted amongst cardiologists in African countries. The primary outcome was the change in service delivery in African cardiology units during the on-going COVID-19 pandemic. The secondary outcomes were the satisfaction of cardiologists with regards to the workload and factors associated with this satisfaction.
Results: There was a significant reduction in working time and the number of patients consulted by week during this pandemic (p<0.001). In general, there was a decrease in the overall activities in cardiovascular care delivery. The majority of cardiology services (76.5%) and consulting programs (85%) were adjusted to the pandemic. Only half of the participants were satisfied with their workload. Reconfiguration of the consultation schedule was associated with a reduced satisfaction of participants (p=0.02).
Conclusions: COVID-19 is associated with an overall reduction in cardiology services rendered in Africa. Since the cardiovascular burdens continue to increase in this part of the World and the risk of cardiovascular complications linked to SARS COV2 remains unchanged cardiology, departments in Africa should anticipate a significant surge of cardiology services demanded by patients after the COVID-19 pandemic.
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Objective: To conduct a landscape assessment of public knowledge of cardiovascular disease risk factors and acute myocardial infarction symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) awareness and training in three underserved communities in Brazil.
Metho
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ds: A cross-sectional, population-based survey of non-institutionalised adults age 30 or greater was conducted in three municipalities in Eastern Brazil. Data were analysed as survey-weighted percentages of the sampled populations.
Results: 3035 surveys were completed. Overall, one-third of respondents was unable to identify at least one cardiovascular disease risk factor and 25% unable to identify at least one myocardial infarction symptom. A minority of respondents had received training in CPR or were able to identify an AED. Low levels of education and low socioeconomic status were consistent predictors of lower knowledge levels of cardiovascular disease risk factors, acute coronary syndrome symptoms and CPR and AED use.
Conclusions: In three municipalities in Eastern Brazil, overall public knowledge of cardiovascular disease risk factors and symptoms, as well as knowledge of appropriate CPR and AED use was low. Our findings indicate the need for interventions to improve public knowledge and response to acute cardiovascular events in Brazil as a first step towards improving health outcomes in this population. Significant heterogeneity in knowledge seen across sites and socioeconomic strata indicates a need to appropriately target such interventions.
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GMS Zeitschrift für MedizinischeAusbildung 2015, Vol. 32(5),ISSN 1860-3572
Internationalizing higher education is considered to be a major goal for universities in Germany and many medical students aspire to include international experiences into their academic training. However, the exact meani
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ng of “internationalizing” medical education is still poorly defined, just as is the possible pedagogic impact and effects. Against this background, this article presents the special track curriculum on global health (in German: Schwerpunktcurriculum Global Health, short: SPC) at Justus Liebig University Giessen, which was established in 2011 as a comprehensive teaching program to integrate international perspectives and activities systematically into the clinical years of the medical curriculum
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DHS Methodological Report No. 20
This study used Service Provision Assessment (SPA) and Demographic and Health Survey (DHS) data from Haiti, Malawi, and Tanzania to compare traditionally used additive methods with a data reduction method— ... principal component analysis (PCA).
We scored the quality of health facilities with three approaches (simple additive, weighted additive, and PCA) for two constructs: quality of services, with only facilities-level data, and quality of care, which incorporates observation and client data. We ranked facilities as high, medium, or low quality based on their scores. Our results indicated that the rankings change with the scoring methodology. There was more consistency in the rankings of facilities by the simple additive and PCA methods than the weighted additive and PCA-based rankings. This may be due to the low factor loadings and little variance explained by the first component in the PCA. We aggregated facility scores to their respective DHS clusters (Haiti, Malawi) or regions (Tanzania) and geographically linked them to women interviewed in DHS surveys to test associations between the use of family planning services and the quality environment, as measured with each index. more
This study used Service Provision Assessment (SPA) and Demographic and Health Survey (DHS) data from Haiti, Malawi, and Tanzania to compare traditionally used additive methods with a data reduction method— ... principal component analysis (PCA).
We scored the quality of health facilities with three approaches (simple additive, weighted additive, and PCA) for two constructs: quality of services, with only facilities-level data, and quality of care, which incorporates observation and client data. We ranked facilities as high, medium, or low quality based on their scores. Our results indicated that the rankings change with the scoring methodology. There was more consistency in the rankings of facilities by the simple additive and PCA methods than the weighted additive and PCA-based rankings. This may be due to the low factor loadings and little variance explained by the first component in the PCA. We aggregated facility scores to their respective DHS clusters (Haiti, Malawi) or regions (Tanzania) and geographically linked them to women interviewed in DHS surveys to test associations between the use of family planning services and the quality environment, as measured with each index. more
As the COVID-19 pandemic continues to threaten health and food systems around the world, the 2020 Global Nutrition Report calls on governments, businesses and civil society to step up efforts to address malnutrition in all its forms.
The COVID-19 pandemic poses an additional and critical challenge in a fragile humanitarian context, where the population is already highly vulnerable and lives in often overcrowded settlements where distancing is impossible, and with limited access to basic
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health services and hygiene. Further spread of COVID-19 in the EHoA region will burden the already complex humanitarian situation with devastating consequences.
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The emergence and transmission of zoonotic diseases are driven by complex interactions
between health, environmental, and socio-political systems. Human movement is considered
a significant and increasing factor in these processes, yet forced migr
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ation remains an
understudied area of zoonotic research–due in part to the complexity of conducting interdisciplinary
research in these settings.
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc
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e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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The evolving epidemic of type 2 diabetes mellitus has challenged health-care professionals. It stands among the leading causes of mortality in the present world. It warrants new and versatile approaches to improve mortality and the associated huge q
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uality-adjusted life years lost to it once diagnosed. A possible venue to lower the incidence is to assess the safety and efficacy of various diabetes prevention strategies. Diet and exercise have a well-developed role in the prevention of weight gain and, ultimately, diabetes mellitus type II in high-risk individuals. However, high-risk individuals can also benefit from adjunct pharmacotherapy. In light of this information, we decided to conduct a systematic review of randomized controlled trials. This article summarizes the evidence in the literature on the pharmacological prevention of diabetes in high-risk individuals.
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The epidemiology of wheeze in children, when assessed by questionnaires, is dependent on parents' understanding of the term “wheeze”.
In a questionnaire survey of a random population sample of 4,236 children aged 6–10 yrs, parents' definition of wheeze was assessed. Predictors of a correct
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definition were determined and the potential impact of incorrect answers on prevalence estimates from the survey was assessed.
Current wheeze was reported by 13.2% of children. Overall, 83.5% of parents correctly identified “whistling or squeaking” as the definition of wheeze; the proportion was higher for parents reporting wheezy children (90.4%). Frequent attacks of reported wheeze (adjusted odds ratio (OR) 3.0), maternal history of asthma (OR 1.5) and maternal education (OR 1.5) were significantly associated with a correct answer, while the converse was found for South Asian ethnicity (OR 0.6), first language not English (OR 0.6) and living in a deprived neighbourhood (OR 0.6).
In summary, the present study showed that misunderstanding could lead to an important bias in assessing the prevalence of wheeze, resulting in an underestimation in children from South Asian and deprived family backgrounds. Prevalence estimates for the most severe categories of wheeze might be less affected by this bias and questionnaire surveys on wheeze should incorporate measures of parents' understanding of the term wheeze.
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The “Declaration for Accelerated Malaria Mortality Reduction in Africa” is a statement signed by African health ministers reaffirming their commitment to reducing malaria-related mortality. It pledges strengthened leadership, increased domestic
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financing for malaria control programs, and the implementation of current technical guidelines. The ministers emphasize the need to invest in data technologies, enhance cross-sector collaboration, and build partnerships for financing, research, and innovation in order to intensify malaria control efforts at both national and subnational levels.
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We can't stop at almost. 2025 Goalkeeper Report
recommended
2025 is the first year of this century where child deaths will increase.
But we can stop this reversal before it becomes a trend, even in a time of tight budgets.
With proven solutions and next-generation innovations that do more with less, we can save millions of children's lives, protect the pro
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gress we've fought so hard for, and wipe out diseases that have plagued humanity for generations.
You can download different languages : English, German, French, Spanish, Russian, Chinese
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Fast ist nicht genug. 2025 Goalkeeper Report
recommended
2025 ist das erste Jahr dieses Jahrhunderts, in dem die Kindersterblichkeit steigen wird.
Aber wir können diese Umkehrung stoppen, bevor sie zu einem Trend wird, selbst in Zeiten knapper Budgets.
Mit bewährten Lösungen und Innovationen der nächsten Generation, die mit weniger mehr erreichen, k
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önnen wir Millionen von Kinderleben retten, die Fortschritte schützen, für die wir so hart gekämpft haben, und Krankheiten ausmerzen, die die Menschheit seit Generationen plagen.
Sie können verschiedene Sprachen herunterladen: Englisch, Deutsch, Französisch, Spanisch, Russisch, Chinesisch
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Ne nous arrêtons pas à mi-chemin. Rapports
recommended
2025 sera la première année de ce siècle où le nombre de décès d'enfants augmentera.
Mais nous pouvons mettre fin à ce renversement de tendance avant qu'il ne devienne une norme, même en période de restrictions budgétaires.
Grâce à des solutions éprouvées et à des innovations de nou
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velle génération qui permettent de faire plus avec moins, nous pouvons sauver la vie de millions d'enfants, protéger les progrès pour lesquels nous nous sommes battus si durement et éradiquer les maladies qui affligent l'humanité depuis des générations.
Vous pouvez télécharger différentes langues : anglais, allemand, français, espagnol, russe, chinois
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2025 es el primer año de este siglo en el que aumentará la mortalidad infantil.
Pero podemos detener este retroceso antes de que se convierta en una tendencia, incluso en una época de presupuestos ajustados.
Con soluciones probadas e innovaciones de última generación que permiten hacer más c
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on menos, podemos salvar la vida de millones de niños, proteger los avances por los que tanto hemos luchado y erradicar enfermedades que han azotado a la humanidad durante generaciones.
Puede descargar diferentes idiomas: inglés, alemán, francés, español, ruso y chino.
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The objectives of the research presented in this report were to identify case studies of community-led HIV-related health and social inclusion service delivery organizations in eastern and southern Africa; describe the typologies of the services pro
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vided; and identify evidence of their service delivery and contribution beyond HIV, including advancing universal health coverage.
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Policy Brief, Updated in March 2017
Key messages
• Sex workers have the right to equal protection under the law, regardless of the legal status of sex work.
• Sex workers have the right to access HIV, sexually transmitted infection (STI) and other ... health services free from the threat of violence, intimidation, incarceration, and stigma and discrimination.
• Justice and law enforcement sectors, together with the health sector and sex worker communities, should work in partnership to reform relevant legislation, policies and practices.
• Capacity development of all partners is critical to the success of the HIV response among sex workers. more
Key messages
• Sex workers have the right to equal protection under the law, regardless of the legal status of sex work.
• Sex workers have the right to access HIV, sexually transmitted infection (STI) and other ... health services free from the threat of violence, intimidation, incarceration, and stigma and discrimination.
• Justice and law enforcement sectors, together with the health sector and sex worker communities, should work in partnership to reform relevant legislation, policies and practices.
• Capacity development of all partners is critical to the success of the HIV response among sex workers. more
