There is an expanding market of no- and low-alcohol beverages (NoLos). However, their effects on global ethanol consumption and public health are still questioned. Policies and regulations about NoLos’ availability, acceptability and affordability are lacking and evidence about their benefits is l...imited. Concerns have been raised about the impact of NoLos in reducing alcohol consumption and its associated harm and the possible drawbacks and implications, such as misleading minors, pregnant women, abstainers or those seeking to stop drinking about their actual ethanol content. Further, there are concerns about the implications of NoLo branded products being displayed close to the brand’s main alcoholic beverages and their potential to subtly lead to new occasions of drinking. There is a need to monitor their consumption and impact on aggregated alcohol consumption to understand the public health implications of NoLos. The alcohol by volume content of NoLos must be defined, harmonised and clearly labelled. NoLo marketing needs to be regulated to protect children, pregnant women and those seeking to stop drinking. Fiscal and pricing policies to reduce the affordability of products with higher strengths of ethanol may favour a shift towards lower alcohol strength beverages.
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The Look Back Study (LBS) focuses on the water and sanitation and hygiene (WASH) component of the project but some additional information was collected along side the WASH data. This data has been compared to the baseline survey data that was reported at start of the project (see tables in annex D t...o this report).
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Undernutrition increases the risk of tuberculosis (TB) and in turn TB can lead to malnutrition. Undernutrition is therefore highly prevalent among people with TB. It has been demonstrated that undernutrition is a risk factor for progression from TB infection to active TB disease and that undernutrit...ion at the time of diagnosis of active TB is a predictor of increased risk of death and TB relapse. However, the evidence concerning the effect of nutritional supplementation on TB prevention and health outcomes among people with TB had not previously been systematically reviewed. This guideline provides guidance on the principles and recommendations for nutritional care and support of patients with TB as part of their regular TB care
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The third edition, released in 2018, has grown to include a total of 18 chapters, contributed by 20 experts and authors from many countries. The goal remains the same: to educate primary care providers on the best practices in TB diagnosis, treatment and follow-up. All articles are richly illustrate...d, and most include quizzes and CME questions for self learning. The 3rd edition includes new chapters on MDR-TB, adverse effects of TB drugs, adherence monitoring strategies, and nutritional support. There is also content on how to manage children with TB, care for patients co-infected with TB and HIV, how to read and interpret chest x-rays, and how to avoid common pitfalls in TB management.
To download book chapters or the whole book go to the website: http://www.letstalktb.org/download/
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From 2011 until 2016, a multi-actor programme was run in five countries to improve the life chances and living conditions of people experiencing exclusion and marginalisation of various kinds. This programme worked with local leaders, organisations and movements as well as various institutions and a...uthorities
focusing on older people, those with mental health issues, people with disabilities, ethnic minorities, people displaced by war and youth at risk. Many initiatives were developed that had lasting effects on the ways in which these groups valued themselves and in which they are valued by society.
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These guidelines provide a recommendation on iodine thyroid blocking (ITB), via oral administration of stable iodine, as an urgent protective action in responding to a nuclear accident. This recommendation aims to support emergency planners, policy makers, public health specialists, clinicians and o...ther relevant stakeholders, in order to strengthen public health preparedness for radiation emergencies in WHO Member States as required by the International Health Regulations (IHR) and in line with the international safety standards (GSR Part 7). The scope of the guidelines is confined to public health aspects of planning and implementation of ITB before and during a radiation emergency, such as dosage and timing of ITB administration, adverse effects of stable iodine, its packaging, storage, and distribution.
These guidelines supersede the 1999 WHO Guidelines for Iodine Prophylaxis following Nuclear Accidents.
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This publication seeks to describe the best treatments and practices based on the scientific evidence available at the time of writing as evaluated by the authors and may change as a result of new research. Readers need to apply this knowledge to patients in accordance with the guidelines and laws o...f their country of practice. Some medications may not be available in some countries and readers should consult the specific drug information since not all the unwanted effects of medications are mentioned.
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The health impact of radiological and nuclear emergencies can last for decades. Lessons learned from past radiological and nuclear accidents have demonstrated that the mental health and psychosocial consequences can outweigh the direct physical health impacts of radiation exposure. International rad...iation emergency preparedness and response standards outline provisions for mitigating these effects. Yet, practical guidance for addressing the mental health and psychosocial aspects of radiation emergencies remains scarce.
This framework aims to promote integration between the MHPSS and radiation protection fields. It is intended for officials and specialists involved in radiation emergency planning and risk management as well as MHPSS experts working in health emergencies.
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Monkeypox is an emerging viral zoonosis with symptoms similar to those observed in smallpox patients, although less severe. Since the global eradication of smallpox in 1980, monkeypox has emerged as the most important orthopoxvirus in humans. The Advisory Committee on Variola Virus Research (ACVVR) ...which meets annually to oversee smallpox research has highlighted the importance of diagnostics that could distinguish between variola and other strains of orthopoxviruses, including monkeypox virus. The ACVVR encourages the positive effects of current smallpox research on all orthopoxviruses, specifically monkeypox, such as the development of diagnostic tools.
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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 health care is lim...ited. 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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Human African trypanosomiasis (HAT) has been an alarming global public health issue. The disease affects mainly poor and marginalized people in low-resource settings and is caused by two subspecies of haemoflagellate parasite, Trypanosoma brucei and transmitted by tsetse flies. Progress made in HAT ...control during the past decade has prompted increasing global dialogue on its elimination and eradication. The disease is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2020 and to terminate its transmission globally by 2030, along-side other Neglected Tropical Diseases (NTD). Several methods have been used to control tsetse flies and the disease transmitted by them. Old and new tools to control the disease are available with constraints.
Currently, there are no vaccines available. Efforts towards intervention to control the disease over the past decade have seen considerable progress and remarkable success with incidence dropping progressively, reversing the upward trend of reported cases. This gives credence in a real progress in its elimination. This study reviews various control measures, progress and a highlight of control issues, vector and parasite barriers that may have been hindering progress towards its elimination.
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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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n 2015, Member States of the United Nations adopted the 2030 Agenda for Sustainable Development and its accompanying Sustainable Development Goals (SDGs), with the third goal of the agenda focusing on health – good health and well-being. This has the attainment of universal health coverage (UHC) a...s its umbrella target. Since then, the WHO Regional Office for Africa has been supporting countries plan, and monitor progress towards this goal. This report represents an analysis of the evidence so far countries are making towards this goal, and includes the effect COVID-19 has had on its attainment so far. It also makes recommendations on how countries can prioritize their health actions post COVID-19, in a manner that allows acceleration of progress towards UHC.
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery ...of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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Recently, Sri Lanka has been impacted by multiple natural disasters. Sri Lanka experienced a landslide in October 2014, and flooding in December 2014.8 Sri Lanka withstood the worst drought conditions witnessed in four decades in 2016; the extreme drought conditions extended into 2017 and produced s...ubstantial economic and social effects. The drought was responsible for an increase in national poverty levels, due to reduced cultivation income, especially for rural farmers. ... In May 2017, Sri Lanka experienced continuous rains causing flash floods and extreme devastation. However, despite natural disasters and challenges posed by a complex political environment, Sri Lanka’s financial performance remained largely satisfactory in the first half of 2017.
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Climate change is a growing concern for Bangladesh because 90 percent of the country is approximately 10 feet above sea level. An evaluation was completed which discovered that high tides in Bangladesh were increasing 10 times more rapidly than the global average. This predicted rapid increase in se...a levels places Bangladesh four times higher than the global average. By 2050, approximately 20 percent of the inhabited land in Bangladesh will be inundated by the sea resulting in displacement for nearly 20 million people. The Government of Bangladesh has implemented policies and plans to focus on climate change concerns, but there is still much work to be completed.
Bangladesh is a nation which will continue to experience the devastating effects of climate change. These concerns for the nation are recognized and the Government of Bangladesh is working progressively to implement mitigation and preparedness measures along with making national economic and transportation improvements to better sever and protect the people of Bangladesh.
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Early Childhood Matters is a journal about early childhood. It looks at specific issues regarding the development of young children, in particular from a psychosocial perspective. It is published twice per year by the Bernard van Leer Foundation.
On Page 54 of this issue the article titled: "Par...enting in times of war: supporting caregivers and children in crisis" can be found. In this article: Humanitarian interventions to support and guide parents and caregivers in times of war can mitigate the negative effects of violence and chaos on children and promote their resilience and development. This article highlights recent findings from the International Rescue Committee’s parenting programmes in Syria, underscoring the importance of such programmes not only in strengthening caregiving practices but also in addressing the psychological needs of parents.
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This publication is intended for professionals training or practicing in mental health and not for the general public. The opinions
expressed are those of the authors and do not necessarily represent the views of the Editor or IACAPAP. This publication seeks to
describe the best treatments and pra...ctices based on the scientific evidence available at the time of writing as evaluated by the authors and may change as a result of new research. Readers need to apply this knowledge to patients in accordance with the guidelines and laws of their country of practice. Some medications may not be available in some countries and readers should consult the specific drug information since not all dosages and unwanted effects are mentioned. Organizations, publications and websites are cited or linked to illustrate issues or as a source of further information. This does not mean that authors, the Editor or IACAPAP endorse their content or recommendations, which should be critically assessed by the reader. Websites may also change or cease to exist.
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The impact of maternal mental health problems on infants in high income countries has been identified mostly in terms of psychosocial and emotional development, thanks to the groundbreaking early work of Spitz (2) and of Bowlby (3), who studied the emotional needs of infants and mother-child attachm...ent. Subsequently, a large body of literature, also from HICs, documented the effects of maternal mental health on the child's psychological development (4), intellectual competence(5), psychosocial functioning (6) and rate of psychiatric morbidity (7, 8).
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