15 July 2021. This report describes the demographics, clinical presentation, clinical outcomes, and risk factors among people living with HIV (PLHIV) who have been hospitalized for suspected or confirmed COVID-19.
The specific objectives of the analysis were to:
describe the clinical char...acteristics and outcomes of PLHIV hospitalized for COVID-19
assess whether PLHIV hospitalized with COVID-19 were at increased risk of presenting with severe or critical illness at admission and were at increased risk of in-hospital death compared to individuals not infected with HIV
assess risk factors associated with severe or critical illness at hospital admission and of in-hospital death among PLHIV hospitalized for COVID-19.
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This document describes the ethical values that are most important to the nursing profession in Ontario. It also provides scenarios of ethical situations in which there is a conflict of values. Nurses are encouraged to use these scenarios for reflection and discussion. No solutions are offered becau...se there is no one solution that is best in all situations. The behavioural directives are intended to help nurses work through ethical situations and provide information about the College of Nurses of Ontario’s (CNO’s) expectations for ethical conduct. These are taken into account when CNO Committees assess nurses’ practices. Nurses need to consider behavioural directives carefully when making decisions about ethical care as this process will strengthen their practice.
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This guide assumes the reader already has a general understanding of the Care Group methodology. It is highly recommended that all Care Group implementers familiarize themselves with the contents of theCare Groups: A Training Manual for Program Design and Implementation,and, ideally,to participate i...n an in-person training on Care Groups, before commencing Care Group activities. This guide is meant to serve as a companion to the Care Group Training Manual; and additional details on all topics covered in this guide are provided in the Training Manual. This guide may also be used by program evaluators, as a means to assess the extent to which Care Groups were implemented in accordance with theevidence-based model and their potential contribution to program outcomes.
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In order to meet changing global population needs and consumer expectations, healthcare systems worldwide are under transformation and face restructuring. As systems adapt and shift their emphasis in response to the disparate requests for healthcare services, oppor-tunities emerge for nurses, especi...ally the APN, to meet these demands and unmet needs (Bryant-Lukosius et al. 2017; Carryer et al. 2018; Cassiani & Zug 2014; Cooper & Docherty 2018; Hill et al. 2017; Maier et al.2017). In 2002, the International Council of Nurses (ICN) pro-vided an official position on Advanced Practice Nursing (ICN 2008a). Since that time, worldwide development has increased significantly and simultaneously this field of nursing has matured. ICN felt that a review of its position was needed to assess the relevance of the definition and characteristics offered in 2002. This guid-ance paper defines diverse elements such as assump-tions and core components of the APN. The attributes and descriptors presented in this paper are intended to promote a common vision to continue to enable a greater understanding by the international nursing and healthcare communities for the development of roles commonly identified as Clinical Nurse Specialist (CNS) and Nurse Practitioner (NP).
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- Module 1: Understanding modelling approaches for sexual, reproductive, maternal, newborn, child and adolescent health, and nutrition
Coronavirus disease 2019 (COVID-19) has a wide range of documented effects. It directly causes death and disability for some people infected. However, disruption to... essential health services, resources allocated to mitigation and therefore away from essential health service delivery, and the overall impact on the economy and society must also be considered within the response to COVID-19. Understanding the magnitude of all of these effects is an essential part of developing mitigation polices.
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVID-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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The purpose of this reference manual to support learning of ETAT + principles and to complement your clinical training and practice. The manual is for use before, during, and after an ETAT + course.
This manual contains the necessary information to help you to:
• Triage all sick children when th...ey arrive at a health facility, into the
following categories:
those with emergency signs
those with priority signs
those who are non-urgent cases
• Assess a child’s airway and breathing and give appropriate treatments
• Assess the child’s circulatory status and level of consciousness
• Manage shock, coma, and convulsions in a child
• Assess and manage severe dehydration in a child with diarrhoea
• Plan, implement, and evaluate ETAT in your own working area in your hospital
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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading ...to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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The aim of this survey was to provide evidence-based recommendations to improve the overall quality of Emergency Medical Services (EMS) in Ukraine, with a special focus on the oblasts (administrative regions) of Luhansk and Donetsk. The objectives were to: describe the EMS system in Ukraine with reg...ards to its capacity, utilization and efficiency across selected geographic regions and catchment areas to assess the utilization and outcomes of current prehospital EMS care; identify perceived needs in key areas based on input from local stakeholders, including EMS providers, hospital-care providers administrative staff and patients; create an evaluation model of EMS performance; and provide recommendations for improvements to the EMS system in Ukraine.
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During fresh fruit and vegetables (FFV) production, water is used for a variety of purposes. Even the water was conventionally treated and disinfected, it may still potentially contain human pathogens, albeit at low concentrations. A risk assessment, appropriate to the national or local production c...ontext, should be conducted to assess the potential risks associated with a specific water source or supply in order to devise the appropriate risk mitigation strategies.
Since the 48th session of Codex Committee on Food Hygiene (CCFH) noted the importance of water safety and quality in food production and processing, FAO and WHO has undertaken the work on this subject. This report describes the output of the third in a series of meetings, which examined appropriate and fit-for-purpose microbiological criteria for water used with fresh fruit and vegetables. The advice herein will support decision making when applying the concept of fit-for-purpose water for use in the pre- and post-harvest production of fresh fruit and vegetables.
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Environmental Research Letters
Microplastic debris floating at the ocean surface can harm marine life. Understanding the severity of this harm requires knowledge of plastic abundance and distributions. Dozens of expeditions measuring microplastics have been carried out since the 1970s, but they ha...ve primarily focused on the North Atlantic and North Pacific accumulation zones, with much sparser coverage elsewhere. Here, we use the largest dataset of microplastic measurements assembled to date to assess the confidence we can have in global estimates of microplastic abundance and mass. We use a rigorous statistical framework to standardize a global dataset of plastic marine debris measured using surface-trawling plankton nets and coupled this with three different ocean circulation models to spatially interpolate the observations. Our estimates show that the accumulated number of microplastic particles in 2014 ranges from 15 to 51 trillion particles, weighing between 93 and 236 thousand metric tons, which is only approximately 1% of global plastic waste estimated to enter the ocean in the year 2010. These estimates are larger than previous global estimates, but vary widely because the scarcity of data in most of the world ocean, differences in model formulations, and fundamental knowledge gaps in the sources, transformations and fates of microplastics in the ocean.
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The toolkit provides guidance on where to get started, including the structures and resources that should be put in place at the national and health-care facility level, through a stepwise approach in low-resource settings. As the ultimate goal of an AMS programme is sustainable behaviour change in ...physicians’ antibiotic prescribing practices, the toolkit also provides detailed guidance on how to plan, perform and assess AMS interventions – including feedback on antibiotic use over time. Finally, the toolkit provides an overview of the competencies an AMS team needs to guide health-care professionals in changing their antibiotic prescribing behaviours.
Please note that this course is part of a training package, so please register for the complementary course WHO Policy Guidance on Integrated Antimicrobial Stewardship Activities so that you can complete your learning journey.
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nt. J. Environ. Res. Public Health 2014, 11(12), 13097-13116; https://doi.org/10.3390/ijerph111213097
Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate chang...e risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change.
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Injection Safety and Safe Disposal of Medical Waste National Communication Strategy and Health Care Waste Management Standard
Operating Procedures (SOPs).
The overall objective of the consultancy was to review and align the three national technical and communication guiding documents on HCWM to th...e WHO Blue Book and other global standards and recommendations. The specific objectives of the assignment were ; to establish how well aligned the Kenya Healthcare Waste Management Guidelines, 2011, are to the WHO Blue Book on healthcare waste management, global recommendations and other global conventions on environmental protection; to establish the extent to which the Kenya Injection Safety and Safe Disposal of Medical Waste National Communication Strategy is aligned to the National Health Communication Guidelines, 2013; to determine the extent to which the current Standard Operating Procedures are aligned to the best available technologies (BAT) and best environmental practices (BEP) and international practices; and to assess current health care waste management practices at the health facilities supported by the GEF project.
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Curr HIV/AIDS Rep. 2022; 19(1): 37–45.
Published online 2022 Jan 29. doi: 10.1007/s11904-021-00589-4.
COVID-19 has had an unprecedented impact on the cascade-of-care among PLWH in LAC. There is a need for
longitudinal studies that assess clinic implication of these pandemic interactions in LAC.
Onchocerca volvulus transmitted by repeated bites of infected blackflies (Simulium spp.). These blackflies breed along fast-flowing rivers and streams, close to remote villages located near fertile land where people rely on agriculture.
There is a need to reinforce skills of national and district... health workers to know and identify the disease, understand the risk factors according to the context and living conditions of the affected communities, and promote the implementation of public health interventions. With the shift from control to elimination, large areas in Africa require mapping to assess whether transmission is active, and treatment required. A sampling strategy named Onchocerciasis elimination mapping has been developed to help countries conduct those assessments and start treatment where needed.
This course examines the epidemiology of Onchocerciasis, clinical aspects, impact, diagnosis, treatment and control, elimination, public health interventions and role of community health workers
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Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 25, No. 12, December 2019 2183
Buruli ulcer is a neglected tropical disease caused by Myocobacterium ulcerans; it manifests as a skin lesion, nodule, or ulcer that can be extensive and disabling. To assess the global burden and the progress ...on disease control, we analyzed epidemiologic data reported by countries to the World Health Organization during 2010–2017.
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Many countries have made significant progress in the implementation of World Health Organization recommended preventive chemotherapy strategy, to eliminate lymphatic filariasis (LF). However, pertinent challenges such as the existence of areas of residual infections in disease endemic districts pose... potential threats to the achievements made. Thus, this study was undertaken to assess the importance of these areas in implementation units (districts) where microfilaria (MF) positive individuals could not be found during the mid-term assessment after three rounds of mass drug administration.
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To support its R&D activities on Chagas disease, DNDi launched the Chagas Clinical Research Platform (CCRP). The platform brings together partners, experts, and stakeholders to provide support for evaluation and development of new treatments for Chagas disease. The patient-centred platform aims to f...acilitate clinical research, provide a forum for technical discussions, develop a critical mass of expertise, and strengthen institutional research capacities. In addition, it identifies and reviews priority needs, works towards standardization of methodology to assess drug efficacy and reviews alternatives for using current approved drugs (new schemes, doses, combination) and special scenarios (resistance).
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This was a Phase 3, multi-center, randomized, open-label, parallel-group, active control study where 273 male and female patients with first stage Trypanosoma brucei gambiense HAT were treated at six sites: one trypanosomiasis reference center in Angola, one hospital in South Sudan, and four hospita...ls in the Democratic Republic of the Congo between August 2005 and September 2009 to support the registration of pafuramidine for treatment of first stage HAT in collaboration with the United States Food and Drug Administration. Patients were treated with either 100 mg of pafuramidine orally twice a day for 10 days or 4 mg/kg pentamidine intramuscularly once daily for 7 days to assess the efficacy and safety of pafuramidine versus pentamidine. Pregnant and lactating women as well as adolescents were included.
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The objectives of the meeting were:
1. To step up the commitment of national authorities and technical and financial partners toWHO’s elimination objective for g-HAT.
2. To share achievements, challenges and views on the elimination goal among countries and implementing partners.
3. To assess t...he status of critical technical aspects to be solved in research and development of drugs and diagnostic tools, epidemiology, vector control and animal reservoirs.
4. To define the mechanisms for strengthening and organizing collaboration and coordination among stakeholders.
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