What every clinician should know
February 2020Earth's Future 8(2):e2019EF001377.The water planetary boundary attempts to provide a global limit to anthropogenic water cycle modifications, but it has been challenging to translate and apply it to the regional and local scales at which water problems and management typically occur. We... develop a cross‐scale approach by which the water planetary boundary could guide sustainable water management and governance at subglobal contexts defined by physical features (e.g., watershed or aquifer), political borders (e.g., city, nation, or group of nations), or commercial entities (e.g., corporation, trade group, or financial institution).
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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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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...ular disease risk factors, management strategies and service delivery, in diverse settings and diverse populations, are equally critical to improving outcomes in low- and middle-income countries. Focusing on examples drawn from four cardiovascular diseases — coronary artery disease, stroke, diabetes and kidney disease — we argue that ethnicity, culture and context matter in determining the risk factors for disease as well as the comparative effectiveness of medications and other interventions, particularly diet and lifestyle interventions.
Conclusion
We believe that a host of cohort studies and randomized control trials currently being conducted or planned in low- and middle-income countries, focusing on previously understudied race/ethnic groups, have the potential to increase knowledge about the cause(s) and management of cardiovascular diseases across the world.
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6th edition 13 January 2021 CR 2021.6.10, uploaded on 27 May 2021
Find eight editions: Deutsch | English | Español | Français | Italiano | Português | Tiếng Việt | Türkçe
https://covidreference.com/download
4ª edição
Nos próximos meses, a COVID Reference apresentará atualizações regulares e narrará os dados científicos o mais coerente possível.
6a edición clínica. Nuevo: 4. Vacunas (26 de abril); Nuevo: 5. Pruebas y procedimientos de diagnóstico (7 de abril); Nuevo: 7. COVID-19 persistente (7 de abril)
Il nuovo mini-textbook
Nei prossimi mesi, COVID Reference presenterà aggiornamenti regolari e racconterà i dati scientifici nel modo più completo possibile.
La 3ieme édition du nouveau mini-manuel.
Au cours des mois à venir COVID Reference publiera des mises à jour régulières.
Tại nhiều quốc gia, cú sốc của làn sóng kiểm dịch thứ nhất đã lắng xuống, số ca bệnh cũng đã giảm, việc gỡ bỏ các lệnh phong tỏa đang được xem xét hoặc đã được thực hiện ở nhiều nơi. Vũ Hán đã mở cửa trở lại. Nhưng ph...ải chăng ta đang bị đánh lừa bởi vẻ ngoài? Liệu làn sóng dịch bệnh thứ hai có xảy ra không, và nếu có thì khi nào chúng sẽ đến?
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Canadian Journal of Microbiology 25 June 2021 https://doi.org/10.1139/cjm-2020-0572
A survival guide for clinicans.
3rd edition.
Jamieson D and Kellerman S. Journal of the International AIDS Society 2016, 19:20917 http://www.jiasociety.org/index.php/jias/article/view/20917 | http://dx.doi.org/10.7448/IAS.19.1.20917
La lutte contre la tuberculose est une des priorités du ministère de la santé. C’est ainsi que le Plan Stratégique National de lutte contre la Tuberculose 2013-2017 du Sénégal a inscrit dans son programme d’actions la préoccupation de mieux d’améliorer la prise en charge des personnes ...vulnérables, dont les prisonniers. L’état de santé est un indicateur clef du bien être de la société, et les prisons servent de miroir. Une bonne compréhension des conditions sanitaires des détenus pourrait contribuer à améliorer le système de santé publique d’un pays. L’environnement carcéral est bien reconnu comme un lieu où les conditions de vie sont propices à la concentration de l’ensemble des maladies de la société, en premier lieu, les morbidités infectieuses.
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ecancer has just published a comprehensive set of guidelines for paediatric cancer surgery, applicable to low and high resource settings across the world. You can read the guidelines online
The guidelines have been developed by the International Society of Paediatric Surgical Oncology (IPSO) with... authors from both High Income Countries and Lower and Middle Income Countries, and have been further validated by experts in the respective fields with the aim of providing evidence-based information for surgeons who care for children with cancer.
These guidelines include information on the care and treatment of children with malignancies, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumours (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life.
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