Improving the quality of hospital antibiotic use is a major goal of WHO’s global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally.... We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions.
www.thelancet.com/lancetgh Vol 7 July 2019
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We will soon be piloting a project titled “Integrating Spirituality into Patient Care” that will form “spiritual care teams” to assess and address patients’ spiritual needs in physician outpatient practices within Adventist Health System, the largest Protestant healthcare system ... in the United States.This paper describes the goals, the rationale, and the structure of the spiritual care teams that will soon be implemented, and discusses the barriers to providing spiritual care that health professionals are likely to encounter.Spiritual care teams may operate in an outpatient or an inpatient setting, and their purpose is to provide health professionals with resources necessary to practice whole person healthcare that includes spiritual care.We believe that this project will serve as a model forfaith-based health systems seeking to visibly demonstrate their mission in a way that makes them unique and expresses their values.Not only does this model have the potential to be cost-effective, but also the capacity to increase the quality of patient care and the satisfaction that health professionals derive from providing care.If successful, this model could spread beyond faith-based systems to secular systems as well both in the U.S. and worldwide.
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Contributions in International Seminars 1988 -2008
Intercultural Pastoral Care and Counselling, no. 20
nContraception and Reproductive Medicine (2017) 2:26 DOI 10.1186/s40834-017-0053-6
Young women in Burkina Faso and Mali are increasingly using modern contraceptives for family planning; however, the LAPM contraceptive prevalence rate remains low. Our analysis indicates that social norms around idea...l family size for both men and women continue to drive young women’s choices around family planning and impede use of LAPMs. To increase modern contraceptive use and curb fertility rates, local governments and development organizations should focus on women’s empowerment and include male partners.
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Updated version – September 2020
The COVID-19 pandemic is affecting everyone. Globally, millions of people have been infected with the virus, while hundreds of thousands have lost their lives. In Moldova, the pandemic is placing an ever-increasing pressure on the health care and social protectio...n systems, causing major disruptions to economic processes and limitations to social life, deepening inequalities and proving how vulnerable we are.
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This technical report presents results from the FEEDcities Project – eastern Europe and central Asia. This cross-sectional survey was conducted in Ashgabat, Turkmenistan in October 2016 to evaluate the local urban food environment. It characterized the vending sites, the food offered and the nutri...tional composition of the industrial and homemade street foods available in these settings. It also described the nutritional composition of ready-to-eat foods sold in supermarkets and at vending sites in food courts. The policy implications of the findings are outlined.
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La recherche des contacts – associée à un dépistage rigoureux, à l’isolement et à la prise en charge des cas – est une stratégie clé pour interrompre les chaînes de transmission du SRAS-CoV-2 et réduire la mortalité associée à la COVID-19.
El rastreo de contactos, junto con las pruebas diagnósticas sólidas, el aislamiento y la atención de casos, es una estrategia fundamental para interrumpir las cadenas de transmisión del SARS-CoV-2 y reducir la mortalidad causada por la COVID-19.
Orientations provisoires, 1er février 2021
La recherche des contacts – associée à un dépistage rigoureux, à l’isolement et à la prise en charge des cas – est une stratégie clé pour interrompre les chaînes de transmission du SRAS-CoV-2 et réduire la mortalité associée... à la COVID-19.
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Many critical questions remain about the effectiveness of COVID-19 vaccines in real-world settings. These questions can only be answered in post-introduction vaccine effectiveness studies.This guidance document outlines an approach to leverage existing surveillance systems for Severe Acute Respirato...ry Infection (SARI) to estimate COVID-19 vaccine effectiveness (VE) in preventing SARI associated with laboratory-confirmed SARS-CoV-2 using existing SARI surveillance systems. The approach uses the test-negative design to evaluate VE; cases are SARI patients who tested positive for SARS-CoV-2, and controls are SARI patients who tested negative for SARS-CoV-2.
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Nat Med (2021). https://doi.org/10.1038/s41591-021-01381-y
March 2021. “A Decade of Destruction: Attacks on health care in Syria,” highlights with chilling detail how this 10-year war strategy has turned hospitals from safe havens into no-go zones where Syrian civilians now fear for their lives.
This study aimed to analyze the geographical distribution of coronavirus disease 2019 (COVID-19) and to identify high-risk areas in space and time for the occurrence of cases and deaths in the indigenous population of Brazil. This is an ecological study carried out between 24 March and 26 October 20...20 whose units of analysis were the Special Indigenous Sanitary Districts. The Getis-Ord General G and Getis-Ord Gi* techniques were used to verify the spatial association of the phenomena and a retrospective space–time scan was performed. There were 32 041 confirmed cases of COVID-19 and 471 deaths. The non-randomness of cases (z score = 5.40; P < 0.001) and deaths (z score = 3.83; P < 0.001) were confirmed. Hotspots were identified for cases and deaths in the north and midwest regions of Brazil. Sixteen high-risk space–time clusters were identified for the occurrence of cases with a higher RR = 21.23 (P < 0.001) and four risk clusters for deaths with a higher RR = 80.33 (P < 0.001). These clusters were identified from 22 May and were active until 10 October 2020. The results indicate critical areas in the indigenous territories of Brazil and contribute to better directing the actions of control of COVID-19 in this population.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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