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Government policy interventions to reduce human antimicrobial use: A systematic review and evidence map

Van Katwyk, S. R.; Grimshaw, J. M.; et al (2019) C2

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...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 Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.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. more

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A national survey of public awareness of antimicrobial resistance in Nigeria

Chukwu, E., Oladele, D., Awoderu, O. et al. Antimicrobial Resistance & Infection Control (2020) CC

Background: One of the objectives of the Global Action Plan by the World Health Organization (WHO) to contain antimicrobial resistance (AMR), is to improve global awareness through effective communication and education. Comprehensive information on the level of awareness of AMR among Nigerian public... more

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World Heart Federation Cholesterol Roadmap 2022

Ray, K.K.; Ference, B.A.; Séverin, T. et al. World Heart Federation (2022) CC

Background: Atherosclerotic cardiovascular diseases (ASCVD) including myocardial infarction, stroke and peripheral arterial disease continue to be major causes of premature death, disability and healthcare expenditure globally. Preventing the accumulation of cholesterol-containing atherogenic lipopr... more

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Trend analysis of cardiovascular disease mortality, incidence, and mortality-to-incidence ratio: results from global burden of disease study 2017

Amini, M.; Zayeri, F.; Salehi, M. BioMed Central (2021) CC

Background Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the trend in CVD incidence, mortality, and mortality-to-... more

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Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review

Durão, S.; Burns, J.; Schmidt, B. et al. BMC Public Health (2023) CC

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. more

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Prevention and management of CVD in LMICs: why do ethnicity, culture, and context matter?

Anand, S.; Bradshaw, C.; Prabhakaran, D. BMC Medicine (2020) CC

Background Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease. Main text While improving the availability and delivery of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovasc... more

Impact of climate change on non-communicable diseases due to increased ambient air pollution

Breitner-Busch, S.; Mücke, H.; Schneider, A. et al. Journal of Health Monitoring (2023) CC

Background: The impacts of air pollutants on health range from short-term health impairments to hospital admissions and deaths. Climate change is leading to an increase in air pollution.

Qualitative assessment of community health workers’ perspective on their motivation in community-based primary health care in rural Malawi

Ndambo, M.K.; Munyaneza, F.; Aron, M.B. et al. BMC Health Services Research (2022) CC

Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to enhance their programmatic activities. Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose. Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal- lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi- tive work environment through supportive relationships between CHWs and supervisors enables the CHWs. Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec- tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance, manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha- sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided to the patients and communities, along with building supportive systems to recognize the work done by CHWs for the primary health care systems. more

Task-shifting to improve asthma education for Malawian children: a qualitative analysis

Nkhalamba, L.; Rylance, S.; Muula, S. A. et al. Human Resources for Health (2021) CC

Background Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a... more

Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa

Mphahlele, R.; Lesosky, M.; Masekela, R. BMJ Open Respiratory Research (2023) CC

Background Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and ris... more

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Case Formulation in Young People with Post-Traumatic Stress Disorder and First-Episode Psychosis

Halpin, E., Kugathasan, V., Hulbert, C., Alvarez-Jimenez, M. & Bendall, S Journal of Clinical Medicine (2016) CC

Background: Evidence based treatment interventions for young people with first-episode psychosis (FEP) and trauma histories is lacking. Although case formulation (CF) has been widely regarded in cognitive behavioural therapy manuals as beneficial, there is limited empirical research examining how cl... more

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Social Costs of the COVID-19 Pandemic

P. Pereznieto; I. Oehler The Independent Panel (2021) CC

Background paper 9 The Independent Panel for Pandemic Preparedness and Response May 2021

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Ebola emergency preparedness in EU Member States: Conclusions from peer-review visits to Belgium, Portugal and Romania

ECDC (European Centre for Disease Prevention and Control) (2015) CC2

This report presents the main characteristics of Ebola emergency preparedness in three EU Member States. Findings are organised in five sections: preparedness planning, organisational structures, recourses and capacities, intersectoral and cross-border collaboration, and country-specific findings

Implementation plan and monitoring and evaluation framework of the WHO European framework for action to achieve the highest attainable standard of health for persons with disabilities 2022–2030

World Health Organisation (WHO) (2022) C_WHO

This background document (‎EUR/RC72/BG/7)‎ was considered and adopted by the WHO Regional Committee for Europe at its 72nd session (‎Tel Aviv, Israel, 12–14 September 2022)‎, together with the working document (‎EUR/RC72/7)‎ and information document (‎EUR/RC72/INF./4)‎. The Regiona... more

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ARTs Based Therapy for Survivors of Trauma and Abuse in Government and NGO-Run Children's Home for Girls in Delhi

Save the Children (2016) C1

This article identifies the three core defining characteristics of healing environments for children and young people who have been exposed to chronic adversity and trauma. A large body of evidence highlights the pervasive and devastating developmental impacts of such exposure but there is also emer... more

Patient Safety Incident Reporting and Learning Systems - Technical report and guidance

World Health Organization WHO (2020) C_WHO

Against this background of nearly 20 years of experience of research, development and improvement in patient safety, the role of incident and adverse event reporting, as well as the benefits that derive from it, is still a work in progress.This document has two main purposes: • to provide an up... more

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Plantetary Security in Search of Drivers of Violence and Conflict Part II

H. Visser, de Bruin S., Knoop J. , et al. (2019) CC

Inferences through Machine Learning.Background Report. What are the major origins and drivers of different types of conflict? Sorting out the main causes of conflict and war is difficult and often shaped by ideological believes. Even today, historians and political scientists have discussions on... more

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Dermatological Preparations For The Tropics
recommended

Peter Bakker; Herman Woerdenbag; Vincent Gooskens; Ben Naafs, et al. (2012) C_WHO

A formulary of dermatological preparations and background information on therapeutic choices, production and dispensing. 2nd edition

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Potential Ebola Therapies and Vaccines

World Health Organization (2014)

This document builds on the Background document prepared for the September 4-5, 2014 Consultation. It includes proposed elements to consider during the development of a framework to assist decision-making at global and national level. The aim of the document is to assist Member States and releva... more

Rapid ﬁeld entomological assessment during yellow fever outbreaks in Africa

World Health Organization WHO (2015) C_WHO

Methodological field approaches for scientists with a basic background in entomology to prepare and implement a yellow fever entomological assessment during outbreaks

Dermatological Preparations For The Tropics recommended

Dermatological Preparations For The Tropics
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