Food security, human health and wellbeing largely depend on biodiversity. Biodiversity supports agriculture through ecosystem services such as pollination and water purification, and provides access to natural medicines,
which are the primary source of health care for 4 billion people worldwide
The WHO Living guideline: Drugs to prevent COVID-19 contains the Organization’s most up-to-date recommendations for the use of drugs to prevent COVID-19. The latest version of this living guideline is available in pdf format (via the ‘Download’ button) and via an online platform.
Guidelines ...regarding the use of drugs to treat (rather than prevent) COVID-19 are included in a separate WHO document, Therapeutics and COVID-19: living guideline, that can via an online platform and in pdf format (or click ‘PDF’ in top right corner of online platform). Guidelines regarding the clinical management of COVID-19 patients are included in a further document, COVID-19 Clinical management: Living guideline, that can be accessed via an online platform and in pdf format (or click ‘PDF’ in top right corner of online platform).
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (...SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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In 2012, all Member States of the World Health Organization (WHO) endorsed a historical target to reduce premature mortality from noncommunicable diseases
(NCD). This commitment was echoed in 2015 by the United Nations Sustainable Development Goals, which included a target to reduce premature morta...lity (the
measure of unfulfilled life expectancy and deaths between the ages of 30 and 70 years) from NCD by 30% by the year 2030. The Sustainable Development Goals are especially relevant to cardiovascular disease (CVD), the leading cause of death globally, with increasing prevalence in low- and middle-income countries (LMIC).
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Atherosclerotic lower-extremity peripheral artery disease (PAD) is increasingly recognized as an important cause of cardiovascular morbidity and mortality that affects more than 230 million people worldwide. Traditional cardiovascular risk factors, including advanced age, smoking, and diabetes, are ...strongly linked to an increase risk of PAD. Although PAD has been historically underappreciated compared to coronary artery disease and stroke, greater attention on PAD in recent years has led to important new epidemiologic insights in the areas of thrombosis, inflammation, dyslipidemia, and microvascular disease. In addition, the concept of polyvascular disease, or clinically-evident atherosclerosis in multiple arterial beds, is increasingly identified as a particularly malignant cardiovascular disease worthy of special clinical attention and further study. It is noteworthy that PAD may increase the risk of adverse outcomes in similar or even greater magnitude than coronary disease or stroke. In this review, we highlight important new advances in the epidemiology of PAD with a particular focus on polyvascular disease, emerging biomarkers, and differential risk pathways for PAD compared to other atherosclerotic diseases.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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Unmet mental health needs in the Region of the Americas are a leading source of morbidity and mortality, which result in tremendous health, social, and economic consequences. The COVID-19 pandemic has exacerbated the mental health crisis in the Region, necessitating urgent action at the highest leve...ls of government and across sectors to build back better mental health now and for the future. This landmark report is the result of the PAHO High-Level Commission on Mental Health and COVID-19. It provides an analysis of the mental health situation in the Region, followed by a series of recommendations and corresponding actions to support countries in the Americas to prioritize and advance mental health using human rights- and equity-based approaches.
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Las necesidades de salud mental insatisfechas en la Región de las Américas son una de las principales causas de morbimortalidad, y tienen enormes consecuencias sociales, económicas y para la salud. La pandemia de COVID-19 ha exacerbado la crisis de la salud mental en la Región, por lo que se nec...esita una acción urgente en los niveles más altos del gobierno y en todos los sectores con el propósito de reconstruir para mejorar los sistemas y servicios de salud mental ahora y en el futuro. En este histórico informe, elaborado por la Comisión de Alto Nivel de la OPS sobre Salud Mental y COVID-19, se presenta un análisis de la situación de la salud mental en las Américas, seguido de una serie de recomendaciones y sus puntos de acción correspondientes, a fin de ayudar a los países a priorizar y promover la salud mental con enfoques basados en los derechos humanos y la equidad.
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The overall objective of the framework is to support WHO and Members States in meaningful engagement of people living with NCDs, and mental health and neurological conditions to co-create and enhance related policies, programmes and services. This framework will contribute to advancing understanding..., knowledge and action on meaningful engagement and related participatory approaches from an evolving evidence base. It provides practical guidance and actions for transitioning from intention to action to operationalize meaningful engagement.
The aim of the framework is to guide people working at WHO and in Member States in ensuring meaningful engagement with individuals with lived experience. WHO will advocate for, provide technical assistance and operationalize implementation at its three levels (headquarters, regional and country offices) and will support Member States in implementation at national level through established processes and procedures.
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Positionen, Lernziele und methodische Empfehlungen.
Mit diesem Dokument soll die Diskussion um mögliche Konzepte zur Erweiterung der medizinischen Ausbildung um das disziplinübergreifende Fachgebiet Global Health anzuregen, bestehende fachliche Ressourcen unter diesem Dach zu vereinen und von stu...dentischer Seite Beiträge für eine Aufwertung von Public Health, International Health sowie globalen sozialen Fragen in der medizinischen Ausbildung zu leisten.
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The publication is designed to provide Ipas staff, trainers, partners and other health-care providers with access to up-to-date, evidence-based recommendations. In general, the recommendations are the same as those in the World Health Organization’s 2012 Safe Abortion: Technical and Policy Guidanc...e for Health Systems, Second edition. In rare cases, the recommendations have been modified due to the settings where Ipas works. In addition, if there is more current evidence to inform the recommendations, they will be updated here.
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This technical brief presents the current options for safe storage and point of use water treatment. It is intended to help field staff working in a variety of locations to decide upon the most appropriate course of action for providing safe water for the communities in which they work. The effectiv...eness of household water treatment options now and in the future rely to a huge extent on user compliance; it is critical that users are involved in the decision making process, and are aware of the purpose, how to use, maintain and manage their household water options. The brief therefore details relevant hygiene promotion steps for the different treatment options.
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The key updates include: content update in various sections based on new evidence; design changes for enhanced usability; a streamlined and simplified clinical assessment that includes an algorithm for follow-up; inclusion of two new modules
- Essential Care and Practice that includes general guid...elines and Iminterventions and implementation module to support the proposed interventions by necessary infrastructure and resources; and, revised modules for Psychoses, Child and Adolescent Mental and Behavioural Disorders and Disorders due to Substance Use
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'Ethical Issues in Obstetrics and Gynecology' represents the results of carefully researched and considered discussion. The guidelines are intended to provide material for consideration and debate about ethical aspects of our discipline for member organisations and their constituent membership.
Vol 5 No 27 | ISSN 2039-2117 (online) | ISSN 2039-9340 (print) | The rate of sexual victimization of mentally retarded children is alarming and it goes unnoticed because the perpetrators could be parents, step- parents, relatives, well-respected individuals by family members, neighbours and educator...s. Drawing from labelling theory that the mentally retarded have low IQ, majority of perpetrators tend not to get arrested because of lack of evidence. Research indicates that educators struggle to identify the psychological, behavioural and physical symptoms of sexual abuse owing to their limited training. Having employed systematic review as methodology, this research study found that mentally retarded children are prone to HIV/AIDS, PTSD and feelings of helplessness owing to uninvolvement of parents, dysfunctional communities, poverty and their inability to differentiate between abuse and affection. Based on the findings, the recommendations are that: (1) extensive training for professionals, families and community members be executed to protect children with intellectual disability. Furthermore, the rights of the mentally retarded children must be respected in the court of law when reporting sexual abuse.
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This publication outlines public health aspects of alcohol use and harm in WHO South East Asia Region Countries. It summarizes Global Regional and country specific data and also discusses aspects of alcohol control that are important in the context of the Region. The possible future trend of alcohol... use in the Region is also analysed and current and future barriers to effective alcohol control in countries of the Region are discussed.
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A comprehensive compilation is provided of the medicinal plants of the Southeast Asian country of Myanmar (formerly Burma). This contribution, containing 123 families, 367 genera, and 472 species, was compiled from earlier treatments, monographs, books, and pamphlets, with some medicinal uses and pr...eparations translated from Burmese to English. The entry for each species includes the Latin binomial, author(s), common Myanmar and English names, range, medicinal uses and preparations, and additional notes. Of the 472 species, 63 or 13% of them have been assessed for conservation status and are listed in the IUCN Red List of Threatened Species (IUCN 2017). Two species are listed as Extinct in the Wild, four as Threatened (two Endangered, two Vulnerable), two as Near Threatened, 48 Least Concerned, and seven Data Deficient. Botanic gardens worldwide hold 444 species (94%) within their living collections, while 28 species (6%) are not found any botanic garden. Preserving the traditional knowledge of Myanmar healers contributes to Target 13 of the Global Strategy for Plant Conservation
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Disinfection of drinking-water supplies has been one of the most significant public health advancements of the last century with respect to reducing waterborne disease.
Although chlorine has been used as the disinfectant of choice for public drinking-water supplies for the past century, a numbe...r of emerging or alternative compounds are used or are being considered for the disinfection of drinking-water.
This series reviews the state of the knowledge on the application, efficacy and toxicity of bromine, iodine and silver as drinking-water disinfectants.
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Traditionally, understanding of the psychiatric and psychological effects of trauma have been developed from studies with adults and then applied to trauma-exposed children with some modifications. While this is an important step to understanding the sequelae of trauma in children and adolescents, t...he adverse developmental effects of traumatic exposures on the rapidly evolving neurological, physical, social and psychological capacities of children calls for a developmentally sensitive framework for understanding, assessing and treating trauma-exposed children.
ournal of Child and Adolescent Mental Health 2013: 1-14
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