The EU's air quality directives (2008/50/EC Directive on Ambient Air Quality and Cleaner Air for Europe and 2004/107/EC Directive on heavy metals and polycyclic aromatic hydrocarbons in ambient air) set pollutant concentrations thresholds that shall not be exceeded in a given period of time. In case... of exceedances, authorities must develop and implement air quality management plans. These plans should aim to bring concentrations of air pollutants to levels below the limit and target values.
Selected EU standards and the World Health Organization (WHO) guidelines are summarised in the table below. These apply over differing periods of time because the observed health impacts associated with the various pollutants occur over different exposure times.
The WHO guideline values are set for the protection of health, and are generally stricter than the comparable politically agreed EU standards.
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The health and socioeconomic crisis triggered by the COVID-19 pandemic has hit the countries of Latin America hard and laid bare the profound inequities about which numerous international, regional and national reports have sounded warnings in recen...t decades. In this context, the historical political and economic exclusion and marginalization of the more than 800 indigenous peoples in the region has been accentuated as a result of insufficient State responses to the crisis, which have not adequately considered the collective rights of these peoples and have had little cultural relevance.
This document provides an overview of the situation of indigenous peoples in the region in the face of the COVID-19 pandemic. It analyses both the State’s and indigenous peoples’ own responses to the crisis, as well as offering a set of recommendations to rectify the neglect of these peoples in the management of the pandemic, centring on their collective rights.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper ...bute-to-highlight medbox">health care is limited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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This document provides interim guidance on the prevention, identification and management of health worker infection in the context of COVID-19. It is intended for occupational ...-to-highlight medbox">health departments, infection prevention and control departments or focal points, health facility administrators and public health authorities at both the national and facility level.
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The following information provides guidance to health care providers attending to the medical needs of HIV-infected adults (including pregnant women) or children displaced from disaster areas who have not yet secured HIV care in the areas where they... have relocated.
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- HHS Panel on Antiretroviral Guidelines for Adults and Adolescents
- HHS Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission
- HHS Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children
- HHS Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults & Adolescents
- HHS Panel on Guidelines for the Prevention and Treatment of Opportunistic Infection in HIV-Infected Children
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Section One
summarizes UNHCR’s mandate of international protecdtion and the aim and principles of emergency
response;
Section Two
deals with emergency management;
Section Three
covers the vital sectors and problem areas in refugee emergencie...s, including health, food, sanitation
and water, as well as key field activities underpinning the operations such as logistics, community
services and registration. The chapters in this section start with a summary so that readers, who
might not need the full level of detail in each of these chapters, can understand the basic principles of
the subject quickly;
Section Four
gives guidance on the support to field operations, primarily administration and staffing;
The Appendices
include a “Toolbox” which gathers, in one location, the standards, indicators and useful references
used throughout the handbook;
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Learn the ETAT+ guidelines on how to resuscitate a newborn baby who is born not breathing in this exciting 3D simulation training app. Navigate around a virtual reality hospital, find the equipment you need and quiz yourself with interactive quizzes, multiple-choice questions (MCQs) and perform simu...lated procedures.
In this simulated scenario, you are faced with a baby who is born not breathing and have to use your clinical skills to follow the ETAT + guidelines and save the baby's life. You are working against the clock and must select the correct medical equipment and carry out the key life-saving steps needed.
ETAT + guidelines for the management of paediatric emergencies are currently used for training healthcare professionals in Kenya, Uganda, Rwanda, Zimbabwe, Zambia, Malawi, Tanzania, Sierra Leone and Myanmar and are supported by the UK's Royal College of Paediatrics and Child Health.
LIFE (Life-saving Instruction for Emergencies) is a new smartphone and virtual reality (VR) medical simulation training platform for teaching healthcare workers in Africa and low-resource settings how to save lives using a fun and challenging 3D game. LIFE allows nurses, doctors, medical students, trainees and healthcare workers who want to learn key resus skills on their own smartphones, to enter a realistic 3D hospital environment using the latest game-engine technology to try out their skills on simulated patients.
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Senegal has adopted the World Health Organization’s (WHO’s) three-pronged strategy for combating malaria in pregnancy (MiP): (1) intermittent preventative treatment in pregnancy (IPTp)1 via directly observed therapy (DOT), (2) distribution and u...se of insecticidetreated nets (ITNs), and (3) case management of MiP. The country began implementing IPTp in 2003.2 Senegal’s National Malaria Control Program (NMCP) has shown strong leadership in supporting key malaria interventions. 3
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Wits Reproductive Health and HIV Institute (Wits RHI) is involved in an effort to curb the COVID-19 pandemic that is facing South Africa and the world at large. Prof. Helen Rees is a member of the team advising the ...t medbox">Health Minister on COVID-19 (MAC). She is part of the Clinicians Group, the Research group and the Incident Management Team (IMT). Prof. Rees is Co-Chair of the South African arm of the Solidarity study
This is a World Health Organisation (WHO) coordinated trial that will generate high quality evidence on COVID-19 treatment options. Prof Helen is also the International Coordinator for the global Crown Coronation study. This study is aimed at looking at strategies to protect healthcare workers.
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Obesity is a global health problem. Its worldwide prevalence has tripled between 1975 and 2016, reaching a prevalence in Chile of 34.4%, according to the National Health Survey 2016-2017. If this co...ndition corresponds to a risk factor or primary disease is a widely discussed issue. It is recognized as a disease by the American Medical Association and World Health Organization,
based on its metabolic and hormonal features, such as dysregulation of appetite, abnormal energy balance and endocrine dysfunction, among others. Its main environmental risk factors are the consumption of ultra-processed foods and sedentariness. Preventive measures at the population level are fundamental, emphasizing promotion and prevention using a transdisciplinary approach. The individual approach in the management of obesity should improve the quality of life, avoid early mortality, reduce cardiovascular risk, and reduce the progression to type 2 diabetes and incidence of cancer. Thus, an adequate management and
control of obesity would have a great impact in our society.
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INTRODUCTION: Lower extremity peripheral artery disease (PAD) is increasing in prevalence in low- and middle-income countries creating a large health care burden. Clinical management may require sub...stantial resources but little consideration has been given to which treatments are appropriate for less advantaged countries.
EVIDENCE ACQUISITION: The aim of this review was to systematically appraise published data on the costs and effectiveness of PAD treatments used commonly in high-income countries, and for an international consensus panel to review that information and propose a hierarchy of treatments relevant to low- and middle-income countries.
EVIDENCE SYNTHESIS: Pharmacotherapy for intermittent claudication was found to be expensive and improve walking distance by a modest amount. Exercise and endovascular therapies were more effective and exercise the most cost-effective. For critical limb ischemia, bypass surgery and endovascular therapy, which are both resource intensive, resulted in similar rates of amputation-free survival. Substantial reductions in cardiovascular events occurred with use of low cost drugs (statins, ACE inhibitors, anti-platelets) and smoking cessation.
CONCLUSIONS: The panel concluded that, in low- and middle-income countries, cardiovascular prevention is a top priority, whereas a lower priority should be given to pharmacotherapy for leg symptoms and revascularisation, except in countries with established vascular units.
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Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months.
"Around half of children across Eur...ope and Central Asia – or 92 million children – are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia.
Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region.
As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to:
- Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans
Invest in heat health action plans and primary health care to more adequately support heat-related illness among children
- Invest in early warning systems, including heat alert systems
- Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress
- Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure
- Secure the provision of safe water, particularly in countries with deteriorating water quality and availability.
UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress.
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R4D conducted a thorough desk review and qualitative fiscal space analysis, 19 interviews about financing for the three diseases and the extent of alignment between public financial management systems and ...health policy objectives, and a validation workshop with government officials.
Tanzania’s disease response faces a triple transition challenge: replacing donor funding, closing the resource gap that would exist even with donor funding, and more efficiently delivering on disease response objectives.
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Barriers to the prompt and effective diagnosis and treatment of malaria exist at both the community and health facility level. Household surveys measure malaria case management at the population lev...el with standard indicators that assess treatment-seeking behavior, access to diagnostic testing, and access to appropriate treatment. Performance on these indicators varies widely from country to country. Among countries with Demographic and Health Surveys (DHS) or Malaria Indicator Surveys (MIS) completed between 2014 and 2016, advice and treatment was sought for a median of 47% of children under age 5 with fever.
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Biodiversity and Health in the Face of Climate Change pp 47–66
This chapter reviews the emerging importance of pollen allergies in relation to ongoing climate change. Allergic diseases have been increasing in prevalence over the last decades, par...tly as the result of the impact of climate change. Increased sensitisation rates and more severe symptoms have been the partial outcome of: increased pollen production of wind-pollinated plants resulting in long-term increased abundance of pollen in the air we breathe; earlier shifts of airborne pollen seasons making occurrence of allergic symptoms harder to predict and deal with efficiently; increased allergenicity of pollen causing more severe health effects in allergic individuals; introduction of new, invasive allergenic plant species causing new sensitisations; environment-environment interactions, such as plants and hosted microorganisms, i.e. fungi and bacteria, which comprise a complex and dynamic system, with additive, presently unforeseeable influences on human health; environment-human interactions, as the consequence of a combination of environmental factors, like air pollution, global warming, urbanisation and microclimatic variability, which create a multi-resolution spatiotemporal system that requires new processing technologies and huge data inflow in order to be thoroughly investigated. We suggest that novel, real-time, personalised pollen information services, like mobile-app risk alerts, must be developed to provide the optimum first line of allergy management.
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WASH Ex-Post Evaluation Series - Water Communications and Knowledge Management (CKM) Project
This evaluation examines the sustainability of selected components of the USAID/Indonesia Environmental Services Program (ESP), which was implemented f...rom 2004–2010. Among other objectives, this activity sought to improve health and livelihoods of Indonesians through enhanced and expanded access to key environmental services.
Following up on the program seven years after it ended, this evaluation addresses the sustainability of ESP’s capacity-building efforts with Indonesian municipal water utilities, known as Perusahaan Daerah Air Minum (PDAM), and financial mechanisms to improve utility management and expanded water access in urban areas.
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Burns are a global public health problem, accounting for close to 200,000 deaths annually. The majority of these occur in low- and middle-income countries, where a number of constraints complicate the public ...x">health task of addressing burns. While the primary prevention of burns in low- and middle-income countries is a pressing need, the World Health Organization (WHO) also actively encourages further development of burn-care systems, including the training of health-care providers in the appropriate triage and management of people with burns.
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This Tuberculosis guide has been developed jointly by Médecins Sans Frontières and Partners In Health. It aims at providing useful information to the clinicians and health staff for the comprehens...ive management of tuberculosis. Forms of susceptible and resistant tuberculosis, tuberculosis in children, and HIV co-infection are all fully addressed.
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This Tuberculosis guide has been developed jointly by Médecins Sans Frontières and Partners In Health. It aims at providing useful information to the clinicians and health staff for the comprehens...ive management of tuberculosis. Forms of susceptible and resistant tuberculosis, tuberculosis in children, and HIV co-infection are all fully addressed.
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User GuideThe toolkit is composed of three sections: Hospital and Health System Resources - includes a readiness assessment tool, the starting point in developing or enhancing a successful Antimicrobial Stewardship Program (ASP). The tool, a check...list developed by the CDC, should be shared with senior management, a senior leader for quality, purchasing directors, clinic managers, nurse managers, key physician leaders, risk managers, pharmacy leaders, infection preventionists and hospital epidemiologists, laboratory staff and information technology staff. For ease of use, it is divided into two sections, one for those just beginning a program, the other for those who wish to enhance an existing program. Clinician Resources - includes webinars, clinical evidence supporting appropriate use of antibiotics, implementation guides and related articles.Patient Resources - includes frequently asked questions, pamphlets and handouts on how patients can best engage in their care and resources on appropriate use of antibiotics.
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