Public Health and the Environment | Geneva 2009
For the Fiscal Year 2014-2015, the Health Sector continued to implement interventions and strategies meant to improve the availability, accessibility and utilization of quality healthcare services across public and private health facilities; and to ensure the reduction of the burden of communicable ...and non-communicable diseases in Rwanda. This annual report highlights key achievements registered by the health sector during the Fiscal Year 2014-2015. Achievements are highlighted under three big components: Health Programs, Health Systems Support and Budget Execution.
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The clinical guidelines and protocols for the practice of emergency medicine presented in this document are designed to be a useful resource not only for those wishing to become emergency medicine specialists, but also for general practitioners and other healthcare providers tasked with caring for p...atients in hospital emergency departments. Healthcare providers using this Emergency Medicine Clinical Guideline (EMCG) are provided with fundamental concepts and principles essential to emergency medicine and the management of patients with undifferentiated emergency conditions.
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Clinical Guidelines. Diagnosis and Treatment Manual.
Tobacco use is the leading preventable cause of death worldwide and is a major risk factor for cardiovascular disease (CVD). Both prevention of smoking initiation among youth and smoking cessation among established smokers are key for reducing smoking prevalence and the associated negative health co...nsequences. Proven tobacco cessation treatment includes pharmacotherapy and behavioral support, which are most effective when provided together. First-line medications (varenicline, bupropion, and nicotine replacement) are effective and safe for patients with CVD. Clinicians who care for patients with CVD should give as high a priority to treating tobacco use as to managing other CVD risk factors. Broader tobacco control efforts to raise tobacco taxes, adopt smoke-free laws, conduct mass media campaigns, and restrict tobacco marketing enhance clinicians' actions working with individual smokers.
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The document provides inforation on tobacco use (health effects, quitting, benefits of quitting, e-cigarettes etc.) in a descriptive way.
sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support ...optimal care. The South African Thoracic Society (SATS) first published a guideline for the management of chronic persistent asthma in 1992, which has subsequently been revised several times.
The main aim of the present document was to revise and update SATS’ statement on the suggested management of chronic asthma, based on the need to promote optimal care and control of asthma, together with the incorporation of new concepts and drug developments. This revised document reinforces optimal care and incorporates the following primary objectives to achieve the recent advances in asthma care:
• continued emphasis on the use of inhaled corticosteroids (ICS) as the foundation of asthma treatment
• to reduce the reliance on short-acting beta-2 agonist (SABA) monotherapy for asthma symptoms
• to incorporate the evidence and strategy for the use of the combination of an ICS and formoterol for acute symptom relief (instead of a SABA)
• to incorporate the evidence and strategy for the use of as-needed ICS-long-acting beta agonists (LABA) for patients with infrequent symptoms or ‘mild’ asthma
• to incorporate the evidence and strategy for the use of a long-acting muscarinic antagonist (LAMA) in combination with ICS-LABA; and
• to incorporate the evidence and strategy for the use of and management with a biologic therapy in severe asthma.
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The video titled "Personalizing Selection of Inhaled Delivery Systems in COPD" discusses the complexities healthcare professionals face when prescribing inhaled therapies for chronic obstructive pulmonary disease (COPD). It highlights the diverse range of available medications and delivery systems, ...noting that while medication categorization has been extensively studied, guidance on selecting appropriate inhaler devices remains limited and lacks consensus in COPD guidelines. The video proposes a novel strategy to address this issue, aiming to enhance the personalization of inhaled therapy for COPD patients.
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Age-standardized estimates of current tobacco use, tobacco smoking and cigarette smoking (Tobacco control: Monitor)
The Public Health Burden of Secondhand Exposure to Commercial Tobacco Smoke Secondhand smoke, the combination of smoke from burning commercial tobacco* products and the smoke breathed out by a person who is smoking, is deadly.
While smoking prevalence has decreased over the past 30 years, the total number of smokers worldwide has continued to increase due to population growth, contributing significantly to disease burden.
Are there immediate and long-term health benefits of quitting for all smokers?
The Public Health Burden of Commercial Tobacco Use
The burden of disease and death from commercial tobacco* use in the United States is
overwhelmingly caused by cigarettes and other combustible tobacco products.
The article from the African Journal of Thoracic and Critical Care Medicine provides updated guidelines on endoscopic lung volume reduction (ELVR) for treating advanced emphysema, a severe form of chronic obstructive pulmonary disease (COPD), which is prevalent in South Africa and other low- and mid...dle-income countries. The guidelines focus on identifying suitable patients based on specific criteria, such as age, lung function, and the presence of hyperinflation, while ruling out contraindications like pulmonary hypertension and recent smoking.
ELVR aims to reduce lung volume in the most damaged areas, improving breathing mechanics and quality of life. Various devices, including endobronchial valves, intrabronchial valves, and coils, are reviewed with evidence from clinical trials supporting their use. The guidelines emphasize careful patient selection and recommend only performing ELVR in specialized centers due to its high cost and risk of complications, such as pneumothorax.
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Occupational exposures to respirable crystalline silica occur in a variety of
industries and occupations because of its extremely common natural occurrence and the wide uses of materials and products that contain it. At least 1.7 million U.S. workers are potentially exposed to respirable crystallin...e silica [NIOSH 1991], and many are exposed to concentrations that exceed limits defined by current regulations and standards.
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The Johns Hopkins Medicine webpage on occupational lung diseases provides an overview of lung conditions caused by exposure to harmful substances in the workplace. It explains various types of occupational lung diseases, including asbestosis, silicosis, coal workers' pneumoconiosis, and hypersensiti...vity pneumonitis. The page outlines common symptoms such as chronic cough, shortness of breath, and chest tightness. It emphasizes the importance of early diagnosis and effective treatment to manage symptoms and prevent disease progression. Additionally, the webpage highlights preventive measures, including workplace safety practices and protective equipment, to minimize the risk of exposure.
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The article "An Official ATS Workshop Report: Issues in Screening for Asthma in Children" summarizes discussions from a workshop organized by the American Thoracic Society (ATS) on the challenges of asthma screening in children. The report reviews the effectiveness of population-based asthma screeni...ng programs, highlights the limitations of current methods, and discusses case detection as an alternative. It assesses asthma's impact as a public health issue, explores the feasibility of screening tests, and examines the economic and practical challenges. The workshop concludes that broad population-based screening may not be justified without better evidence and targeted efforts to improve follow-up care and treatment access.
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The article "Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review" analyzes factors contributing to poor asthma control in African youth. Based on studies conducted between 2014 and 2019 in Nigeria, Uganda, and South Africa, the review identifies key... challenges such as limited access to asthma diagnosis, inadequate use of inhaled corticosteroids, and environmental and socio-economic factors. It finds that urban living, older age, and concurrent allergic conditions significantly affect asthma management. The study emphasizes the need for improved diagnostic tools, better access to treatment, and tailored public health interventions to enhance asthma outcomes in African children.
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The Incontrol video is a play put together by the ACACIA STUDY GROUP to address several misconceptions that people have about asthma.