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1.
Eur J Sport Sci ; 24(7): 907-917, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38956789

RESUMO

The Multi-Action Plan (MAP) model presents an idiosyncratic framework for human performance. MAP research has categorised four Performance Types (PTs; T1-T4) using self-paced activities. Specifically, T1-4 present four distinct mental states experienced by athletes during performance, differing, among other aspects, in the level of effort and perceived control. However, transitions between PTs are yet to be empirically investigated. This study aimed to examine MAP in the hyperdynamic open-skill combat context of judo. We explored how judoka experienced PTs and the transition processes between these mental states. Six British, high-level judoka (n = 6; Mdnage = 19) were interviewed using a retrospective semi-structured interview schedule. Interpretative phenomenological analysis indicated that judo presents a hyperdynamic difficult-to-predict performance context due to the opponent and fighting rhythm. Second, participants strongly related to T2 and T3 and less to T1 and T4. They also reported experiences 'between' T2 and T3. Lastly, participants reported common transition pathways (e.g., T2-T3), typical transition cues, and specific trainable strategies to optimise performance. Findings are discussed in relation to existing literature. Lastly, we present limitations, applied, and research considerations.


Assuntos
Desempenho Atlético , Artes Marciais , Humanos , Artes Marciais/fisiologia , Artes Marciais/psicologia , Desempenho Atlético/psicologia , Desempenho Atlético/fisiologia , Masculino , Feminino , Adulto Jovem , Atletas/psicologia , Estudos Retrospectivos , Adulto
2.
Front Public Health ; 12: 1392558, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38975356

RESUMO

Homelessness in psychiatric patients in Flanders, Belgium, has never been investigated. Advocacy groups from patients with lived experience of psychiatric disorders have sounded the alarm on the scarcity of suitable housing options, the strain on psychiatric institutions, and the challenges faced by social service workers. To investigate the extent of the problem a survey on the topic was initiated. A "homelessness-in-mental-health-questionnaire" was designed by experts in the field. The social services of all Flemish psychiatric hospitals and all psychiatric wards in general hospitals were contacted and invited to complete this survey. 24 of 70 contacted services responded. The total number of homeless patients in the inpatient setting on an annual basis are estimated to an average 19.5%. 18% of homeless patients remain longer in admission due to the lack of housing options. 13.7% of homeless psychiatric patients are referred to a community care facility such as an assisted living facility. Social service respondents reported spending an average of 27.4% of their work time on housing issues. The main focus points according to the respondents are the lack of priority measures for homeless psychiatric patients, psychiatric problems as a barrier to housing options and the shortage of adapted housing capacity. The conclusion of this study is the need for comprehensive policy interventions to ensure an adequate supply of suitable social housing for psychiatric patients, accessible mental health care, alternative housing options and crisis accommodation facilities. We propose a 10-point action plan on housing for psychiatric patients for policymakers and politicians.


Assuntos
Habitação , Pessoas Mal Alojadas , Transtornos Mentais , Humanos , Bélgica , Pessoas Mal Alojadas/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Habitação/estatística & dados numéricos , Masculino , Inquéritos e Questionários , Feminino , Hospitais Psiquiátricos/estatística & dados numéricos , Adulto , Pessoa de Meia-Idade
3.
Public Health Rep ; : 333549241253787, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38868902

RESUMO

OBJECTIVES: To build on the success of wastewater surveillance during the COVID-19 pandemic, jurisdictions funded under the Centers for Disease Control and Prevention National Wastewater Surveillance System are looking to expand their wastewater programs to detect more pathogens. However, many public health agencies do not know how to use the collected wastewater data to formulate public health responses, underscoring a need for guidance. To address this knowledge gap, the Houston Health Department (HHD) developed a novel response framework that outlines an internal action plan that is tailored by pathogen type after detection of various pathogens in wastewater. MATERIALS AND METHODS: In July 2023, HHD met with subject matter experts (eg, bureau chiefs, program managers) in internal departments, including epidemiology, immunization, and health education, to discuss the general outline of the response framework and each department's anticipated role after pathogen detection. RESULTS: The internal framework established a flow for notifications and the actions to be taken by departments in HHD, with the goals of (1) ensuring timely and efficient responses to pathogen detections, (2) creating accountability within departments for taking their assigned actions, and (3) making certain that HHD was prepared for intervention implementation when a new pathogen was detected. PRACTICE IMPLICATIONS: As more public health agencies expand their wastewater surveillance programs to target additional pathogens, development of internal action plans tailored to departmental capacity and programs is an important step for public health agencies. The information compiled in this response framework can be a model for other public health agencies to adopt when expanding the scope of their wastewater monitoring systems.

4.
Artigo em Inglês | MEDLINE | ID: mdl-38872588

RESUMO

BACKGROUND: Despite significant measures, low- and middle-income countries (LMICs), including Pakistan, struggle to curtail non-prescription antibiotic sales, enforce regulations, and implement National Action Plan (NAP) against antimicrobial resistance (AMR). NAP Pakistan entails drug inspectors (DIs) to ensure prescription-based sales of antibiotics. This study seeks to understand the perspective of DIs regarding antimicrobial sales without prescription, underlying factors, and policy implementation status. METHODS: A qualitative study employing a semi-structured interview guide using in-depth interviews with purposively selected 17 DIs was conducted. Interviews were transcribed verbatim, and data were analyzed following a thematic analysis framework utilizing MAXQDA 2022 software. RESULTS: Five main themes emerged after data analysis: (1) drug inspector - the regulator of the antimicrobial armamentarium, (2) the policy context, (3) awareness regarding AMR, (4) barriers to combatting AMR, and (5) the way forward: strategies and recommendations. CONCLUSION: A weak regulatory framework, low level of awareness, quackery, vested interests, and socio-economic factors augment inappropriate antibiotic utilization. Opting for better policies and strengthening the DI fraternity as outlined in NAP Pakistan is recommended. Recognizing drug inspectors as effective surveilling units and mobilizing field force against irrational antibiotic utilization is the need of the hour and requires policy reformation.

5.
EBioMedicine ; 104: 105148, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38705102

RESUMO

BACKGROUND: People with chronic diseases are a commonly listed heat-vulnerable group in heat-health action plans. While prior research identifies multiple health conditions that may increase vulnerability to ambient heat, there is minimal evidence regarding the implications of multimorbidity (two or more chronic diseases). METHODS: From the statewide hospital registry of Queensland, Australia, we identified people aged ≥15 years who had emergency hospitalisation(s) between March 2004 and April 2016 and previously had 0, 1, 2, or ≥3 of five chronic diseases: cardiovascular disease, diabetes, mental disorders, asthma/COPD, and chronic kidney disease. We conducted time-stratified case-crossover analyses to estimate the odds ratio of hospitalisations associated with ambient heat exposure in people with different numbers, types, and combinations of chronic diseases. Ambient heat exposure was defined as a 5 °C increase in daily mean temperature above the median. FINDINGS: There were 2,263,427 emergency hospitalisations recorded (48.7% in males and 51.3% in females). When the mean temperature increased, hospitalisation odds increased with chronic disease number, particularly in older persons (≥65 years), males, and non-indigenous people. For instance, in older persons with 0, 1, 2, or ≥3 chronic diseases, the odds ratios associated with ambient heat exposure were 1.00 (95% confidence interval: 0.96, 1.04), 1.06 (1.02, 1.09), 1.08 (1.02, 1.14), and 1.13 (1.07, 1.19), respectively. Among the chronic diseases, chronic kidney disease, and asthma/COPD, either existing alone, together, or in combination with other diseases, were associated with the highest odds of hospitalisations under ambient heat exposure. INTERPRETATION: While individuals with multimorbidity are considered in heat-health action plans, this study suggests the need to consider specifically examining them as a distinct and vulnerable subgroup. FUNDING: Wellcome.


Assuntos
Hospitalização , Temperatura Alta , Multimorbidade , Humanos , Masculino , Feminino , Hospitalização/estatística & dados numéricos , Idoso , Pessoa de Meia-Idade , Adulto , Adolescente , Idoso de 80 Anos ou mais , Razão de Chances , Adulto Jovem , Doença Crônica/epidemiologia , Queensland/epidemiologia
6.
Hosp Pharm ; 59(3): 367-377, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38764988

RESUMO

Introduction: Antimicrobial resistance (AMR) is becoming a threat to global public health. Antimicrobial stewardship (AMS) program (ASP) is one of the 5 strategic areas in the Ghana National Action Plan to fight this menace. Assessment of the core elements of ASP in a hospital setting has been identified as a pragmatic way of identifying the barriers and facilitators for its effective implementation. Method: The World Health Organization's toolkit for assessment of the 7 core elements of ASP in hospitals in low and middle income countries was used for this situational analysis of public hospitals in 2 regions of Ghana. The core elements included leadership commitment, accountability and responsibility, pharmacy expertize, AMS actions and interventions, education and training, and periodic monitoring and surveillance. Data collected using a checklist were imported into STATA version 14 for descriptive and bivariate analyses. Results: 15 public hospitals were assessed with the toolkit. Most of them were primary health care facilities (n = 12, 80.0%), had bed capacities between 100 and 199 beds, less than 50 medical doctors (n = 12, 80.0%), less than 5 pharmacists (n = 10, 66.7%), and between 100 and 199 nurses. Performances in 4 out of the 7 core elements were most deficient and they included leadership commitment, pharmacy expertize, AMS actions (interventions) implemented, monitoring and surveillance of antibiotic use, and bacteria resistance rates. Pharmacist-led ASPs were also found to be associated with their formal training on AMS. Key barriers identified included lack of skilled human resources, lack of available time for AMS-related duties and poor laboratory infrastructure. Conclusion: There was sub-optimal performance for almost all the core elements of ASP in the public hospitals in Ghana hampered mostly by lack of skilled human and financial resources. Pharmacists must be empowered through formal training and certificate programs in infectious disease management and AMS principles and strategies to enhance their contribution toward ASPs in hospitals. The results from this study should encourage nationwide assessment of ASPs across hospital settings in Ghana to better evaluate the level of their implementation and address potential barriers to guide AMS policies and ASP strategy development toward the fight against AMR.

7.
Int J Biometeorol ; 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38709342

RESUMO

Extreme heat alerts are the most common form of weather forecasting services used in Australia, yet very limited studies have documented their effectiveness in improving health outcomes. This study aimed to examine the temporal changes in temperature-related mortality in relation to the activation of the heat-health alert and response system (HARS) in the State of Victoria, Australia. We examined the relationship between temperatures and mortality using quasi-Poisson regression and the distributed lag non-linear model (dlnm) and compared the temperature-mortality association between the two periods: period 1- prior-HARS (1992-2009) and period 2- post-HARS (2010-2019). Since the HARS heavily weights heatwave effects, we also compared the main effects of heatwave events between the two periods. The heatwaves were defined for three levels, including 3 consecutive days at 97th, 98th, and 99th percentiles. We also controlled the potential confounding effect of seasonality by including a natural cubic B-spline of the day of the year with equally spaced knots and 8 degrees of freedom per year. The exposure-response curve reveals the temperature mortality was reduced in period 2 in comparison with period 1. The relative risk ratios (RRR) of Period 2 over Period 1 were all less than one and gradually decreased from 0.86 (95% CI, 0.72-1.03) to 0.64 (95% CI, 0.33-1.22), and the differences in attributable risk percent increased from 13.2 to 25.3%. The reduction in the risk of heatwave-related deaths decreased by 3.4% (RRp1 1.068, 95% CI, 1.024-1.112 versus RRp2 1.034, 95% CI, 0.986-1.082) and 10% (RRp1 1.16, 95% CI, 1.10-1.22 versus RRp2 1.06, 95% CI, 1.002-1.119) for all groups of people. The study indicated a decrease in heat-related mortality following the operation of HARS in Victoria under extreme heat and high-intensity heatwaves conditions. Further studies could investigate the extent of changes in mortality among populations of differing socio-economic groups during the operation of the heat-health alert system.

8.
Pediatr Blood Cancer ; 71(7): e31041, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38715224

RESUMO

International and national oncofertility networks, including the US-led Oncofertility Consortium, FertiProtekt, and the Danish Network, have played pivotal roles in advancing the discipline of oncofertility over the last decade. Many other countries lack a shared approach to pediatric oncofertility health service delivery. This study aims to describe baseline oncofertility practices at Australian New Zealand Children's Haematology/Oncology Group centers in 2019-2021, describe binational priorities for care, and propose a 5-year action plan for best practice to be implemented by the newly formed Australian New Zealand Consortium in Children, Adolescents, and Young Adults (CAYA) Oncofertility (ANZCO).


Assuntos
Preservação da Fertilidade , Neoplasias , Humanos , Adolescente , Nova Zelândia , Preservação da Fertilidade/métodos , Criança , Neoplasias/terapia , Neoplasias/complicações , Adulto Jovem , Feminino , Austrália , Masculino , Adulto
9.
J Dent Educ ; 88 Suppl 1: 699-702, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38758047

RESUMO

Dentistry today is a profession which is facing several challenges: -Oral health is less good than thirty years ago, especially in thelow social-economic level countries and emerging countries. -A reduced or poorly distributed number of professionals, which necessarily implies unequal access to care. -Multiple social determinants which are more and more impacting oral health. To tackle these challenges, WHO launched the WHO Global Oral Health strategy which it goal is to guide Member States to: -develop ambitious national responses to promote oral health -reduce oral diseases, other oral conditions and oral health inequalities -strengthen efforts to address oral diseases and conditions as part of universal health coverage; and consider the development of targets and indicators, based on national and subnational contexts, building on the guidance to be provided by the WHO global action plan 2023-2030 on oral health.


Assuntos
Saúde Global , Saúde Bucal , Organização Mundial da Saúde , Humanos , Promoção da Saúde
10.
Environ Int ; 187: 108718, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38735079

RESUMO

Traditional heat health warning systems focus on severe and extreme heat events at the district or regional level, often overlooking localized risk and protective factors such as healthcare access and urban green spaces. This approach considers less the varying impacts of heat within cities, including the phenomenon of Urban Heat Islands (UHIs) and the diverse needs of different populations. To address these shortcomings, a need for the development of an Urban Heat Health Warning and Information System (UHHWIS) that operates within the framework of Heat Health Action Plans is needed. Such a system integrates national acute heat health warnings with city-specific assessments of UHI effects and other relevant factors. The technical implementation of the UHHWIS involves the calculation and preprocessing of basic factors such as the Normalised Difference Vegetation Index (NDVI), imperviousness, and UHI intensity. Additionally, further factors are assessed, spatially processed, and provided in accordance with Open Geospatial Consortium (OGC) standards. An iso-area analysis is conducted to evaluate the accessibility of protective factors, such as urban green spaces, drinking wells, hospitals, physicians, and pharmacies, based on the city's road topology. One crucial factor considered in the system is the casting of shadows, which is influenced by both time and location and facilitated through deck.gl. The developed template encompasses all these components into a unified system aimed at protecting vulnerable and risk groups, such as the elderly, through resilient, climate-adapted urban planning. The system provides warnings and information tailored to the urban morphology and prevailing conditions, complemented by a catalogue of potential short- to long-term measures focused on behavioral changes and climate-resilient urban planning strategies. The template can be adapted for use in various European cities, offering valuable insights to decision-makers in city administration for mitigating thermal stress and enhancing resilience against urban heat nowadays and in future.


Assuntos
Cidades , Temperatura Alta , Alemanha , Humanos , Mudança Climática
11.
Artigo em Chinês | MEDLINE | ID: mdl-38604679

RESUMO

On June 16, 2023, National Disease Control and Prevention Administration of the People's Republic of China, in collaboration with other ministries, formulated and issued the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023-2030). The implementation of this plan provides an important basis for achieving the targets set in the "Healthy China 2030" action plan and the implementation of the rural revitalization strategy. This paper describes the background, principles, targets, control strategies, safeguard measures and effectiveness evaluation of the plan, in order to guide the scientific and standardized implementation of actions for schistosomiasis elimination at the grassroots level, and facilitate the progress towards elimination of schistosomiasis in China with a high quality.


Assuntos
Esquistossomose , Humanos , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , China/epidemiologia
12.
BMC Pediatr ; 24(1): 284, 2024 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-38678177

RESUMO

BACKGROUND: Asthma is one of the most common chronic airway diseases in children. Preventing asthma exacerbation is one of the objectives of all asthma action plans. In patients with poor perception, it is difficult to identify acute asthma exacerbations by clinical asthma score, asthma control test or asthma control questionnaire. The aim of this study is to analyze whether children with asthma have changes in peak expiratory flow(PEF)before an acute asthma exacerbation and to evaluate the relationship between PEF and asthma exacerbation. METHODS: Basic information (including sex, age, atopy, etc.) and clinical information of asthmatic children who registered in the Electronic China Children's Asthma Action Plan (e-CCAAP) from 1 September 2017 to 31 August 2021 were collected. Subjects with 14 consecutive days of PEF measurements were eligible. Subjects in this study were divided into an exacerbation group and a control group. We analyzed the relationship between changes in PEF% pred and the presence of asthma symptoms. RESULT: A total of 194 children with asthma who met the inclusion criteria were included, including 144 males (74.2%) and 50 females (25.8%), with a male-to-female ratio of 2.88:1. The mean age of the subjects was 9.51 ± 2.5 years. There were no significant differences in sex, age, allergy history or baseline PEF between the two groups. In children with and without a history of allergy, there was no significant difference between the variation in PEF at 14 days. Patients who only had a reduced in PEF but no symptoms of asthma exacerbation had the greatest reduction in PEF compared to the other groups. The most common cause of acute exacerbations of asthma is upper respiratory tract infection. Among the causes of acute exacerbations of asthma, the variation in PEF caused by air pollution was significantly higher than that of other causes (P < 0.05). In acute exacerbations, the decrease in PEF was significantly greater in the exacerbation group than in the control group. In children with asthma symptoms, there was a decrease in PEF approximately 1.34 days before the onset of symptoms. CONCLUSION: Children with asthma show a decrease in PEF 1.34 days before the onset of asthma symptoms. We recommend that asthmatic children who show a decrease in PEF should step-up asthma therapy. The most common cause of acute exacerbations of asthma was upper respiratory tract infections, and the variation in PEF caused by air pollution was significantly higher than that caused by other factors.


Assuntos
Asma , Progressão da Doença , Humanos , Asma/fisiopatologia , Asma/complicações , Feminino , Masculino , Criança , Pico do Fluxo Expiratório , China/epidemiologia , Adolescente
13.
Artigo em Alemão | MEDLINE | ID: mdl-38639816

RESUMO

BACKGROUND AND AIMS: Heat extremes are associated with considerable health risks, especially for vulnerable groups. To counteract these risks, public health policy calls for protective measures to be linked to heat warnings. Such links do not generally exist in Germany, with the exception of the heat inspections and consultations carried out by the Hessian health authorities since 2004. The aims of this work were to identify the structures and processes of the Hessian heat inspections and heat consultations and to derive findings for acute response to heat in residential care and nursing facilities. METHODS: We conducted 14 qualitative, semi-structured interviews with experts from the Hessian health authorities as well as with managers of residential care and nursing facilities. The analysis of the interview protocols was carried out using content-structuring qualitative content analysis. In addition, documents from the supervisory authority were analyzed. RESULTS: Every year, up to 370 heat inspections are carried out in the approximately 2500 inpatient facilities in Hesse. They are either integrated into already planned inspections or carried out separately; they focus on preventive and acute measures. In principle, heat protection can be easily integrated into the daily routine of residential health facilities. High staff turnover and lack of resources pose challenges. DISCUSSION: Inspections and consultations on heat management raise awareness of hot weather health risks and support the establishment of preventive measures. The Hessian system is a suitable orientation for other federal states.


Assuntos
Casas de Saúde , Alemanha , Humanos , Casas de Saúde/estatística & dados numéricos , Instituições Residenciais/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Temperatura Alta/efeitos adversos , Transtornos de Estresse por Calor/prevenção & controle , Transtornos de Estresse por Calor/epidemiologia
14.
Vaccine ; 42(9): 2326-2336, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38448324

RESUMO

This study examined the performance and structures of national immunization program in five middle-income Southeast Asian countries - Malaysia, Thailand, Philippines, Viet Nam, and Myanmar, and analyzed how the different structures relate to the difference in program performance to identify effective strategies in the study countries that facilitated good immunization performance. Data were derived from published literature, and WHO/UNICEF/Gavi databases, with 2010 as the baseline year. UMICs Malaysia and Thailand maintained ≥90 % coverage from 2010 to 2020 and even during the COVID-19 pandemic in 2021. LMICs Viet Nam and donor-supported Myanmar also achieved 80-90 % coverage for most routine vaccines in 2020. The Philippines have not reached ≥90 % coverage since 2010, with the maximum only 72 % (MCV1 and Polio3) in 2020. All study countries prioritize immunization and increased government financing since 2010 by minimum 91 % in Malaysia and 1897 % in Myanmar. However, Myanmar still largely depended on donor support with government financing only 32 % of immunization costs in 2021. The Philippines funds 100 % of immunization costs and ensures sustainable financing for the NIP through earmarked "sin tax" revenues from alcohol and tobacco. Donor support influenced new vaccine introductions among the study countries, with Gavi countries Myanmar and Viet Nam introducing more new vaccines, compared to Gavi-ineligible Malaysia and Thailand. The Philippines reported vaccine stock-outs every year amounting to 28 stock-outs events from 2010 to 2019, compared to only 1-4 stockouts in the other study countries. Donor support, innovative financing, and domestic vaccine manufacturing all play an important role in the efficient delivery of immunization services as demonstrated by the several new vaccine introductions and high immunization rates in Myanmar though Gavi and UNICEF support, additional annual $1.2 billion budget for health and immunization from "sin taxes" in the Philippines, and lack of stockouts for vaccines sourced at affordable prices from domestic manufacturers in Viet Nam.


Assuntos
Programas de Imunização , Cobertura Vacinal , Humanos , Países em Desenvolvimento , Sudeste Asiático
15.
Environ Pollut ; 347: 123769, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38499173

RESUMO

In response to regional ozone (O3) pollution, Chinese government has implemented air pollution control measures in recent years. Here, a case study was performed at an O3-polluted city, Wuhu, in Yangtze River Delta region of China to investigate O3 variation trend and the relationship to its precursors after implementation of Clean Air Action Plan Phase II, which aims to reduce O3 pollution. The results showed that peak O3 concentration was effectively reduced since Clean Air Action Plan Phase II. Due to significant NOx reduction, O3 formation tended to shift from volatile organic compound (VOC)-limited regimes to NOx-limited regimes during 2018-2022. VOC/NOx ratios measured in 2022 revealed that peak O3 concentration tended to respond positively to NOx. Apart from high-O3 period, Wuhu was still in a VOC-limited regime. The relationship of maximum daily 8-h ozone average and NO2 followed a lognormal distribution with an inflection point at 20 µg m-3 of NO2, suggesting that Wuhu should conduct joint control of VOC and NOx with a focus on VOC reduction before the inflection point. Alkenes and aromatics were suggested to be preferentially controlled due to their higher ozone formation potentials. Using random forest meteorological normalization method, meteorology had a positive effect on O3 concentration in 2018, 2019 and 2022, but a negative effect in 2020 and 2021. The meteorology could explain 44.0 ± 19.1% of the O3 variation during 2018-2022. High temperature favors O3 production and O3 pollution occurred more easily when temperature was over 25 °C, while high relative humidity inhibits O3 generation and no O3 pollution was found at relative humidity above 70%. This study unveils some new insights into the trend of urban O3 pollution in Yangtze River Delta region since Clean Air Action Plan Phase II and the findings provide important references for formulating control strategies against O3 pollution.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Ozônio , Compostos Orgânicos Voláteis , Ozônio/análise , Poluentes Atmosféricos/análise , Dióxido de Nitrogênio/análise , Compostos Orgânicos Voláteis/análise , Monitoramento Ambiental/métodos , Poluição do Ar/prevenção & controle , China
16.
Antibiotics (Basel) ; 13(3)2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38534641

RESUMO

The agriculture and food (agrifood) sectors play key roles in the emergence, spread, and containment of antimicrobial resistance (AMR). Pakistan's first National Action Plan (NAP) on AMR was developed to guide One Health interventions to combat AMR through 2017-2022. To improve subsequent iterations, we assessed the implementation of Pakistan's NAP in the agrifood sectors (NAPag) in October 2022, using the Progressive Management Pathway on AMR tool developed by the Food and Agriculture Organization of the United Nations (FAO). The assessment tool addressed four crucial focus areas of the NAPag: governance, awareness, evidence, and practices. Each focus area contains multiple topics, which involve four sequential stages of activities to progressively achieve systematic management of AMR risk in the agrifood sectors. High-level representatives of the NAPag stakeholders provided information for the assessment through pre-event documentary review and workshop discussions. The assessment results showed that Pakistan's NAPag had an overall moderate coverage (59%) of the anticipated activities. Gaps were particularly notable in strengthening governance, good practices, and interventions in non-livestock sectors. Furthermore, only 12% of the evaluated activities were fully executed and documented, consistently remaining at the planning and piloting stages in the livestock sector across all the examined topics. Insufficient attention to non-livestock sectors, inadequate regulation and enforcement capacity, and resource constraints have hindered scalable and sustainable interventions under the current plan. This assessment provides valuable insights to strengthen the inclusiveness and contribution of the agrifood sectors in the next NAP iteration. In the short-to-medium term, strategic prioritization is necessary to optimize the use of limited resources and target the most critical gaps, such as improving awareness among key stakeholders and fortifying regulations for prudent antimicrobial use. In the long term, integration of AMR into the country's broader health, development, and agricultural transformation agendas will be needed to generate sustainable benefits.

18.
Health Sci Rep ; 7(2): e1854, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38332931

RESUMO

Background and Aims: Implementing diagnosis-related groups (DRGs) in different countries increases the efficiency of healthcare services, improves treatment quality, and reduces treatment costs. Due to the lack of a coherent model for its implementation, the present study aimed to develop a DRGs-based implementation action plan Model for Iran. Methods: The present study was an applied, descriptive cross-sectional study conducted in three stages. In the first stage, a review of studies conducted in different countries was carried out. In the second stage, a model was designed for an action plan to implement the DRGs in Iran. In the third stage, the model was validated based on the Delphi technique. Results: The DRGs-based implementation action plan model in Iran was designed in three primary axes, including the strategic approach of the DRGs-based implementation action plan, technical dimensions, and executive institutions involved in the DRGs-based implementation action plan. Validation of the designed model showed the agreement of experts (94%) for the mentioned axes. Conclusion: The significance of tailoring a DRGs-based implementation action plan to each country's unique context is well-established. Given the intricacies of the Iranian healthcare system, we recommend an initial pilot implementation of DRGs at the hospital level, followed by a gradual national rollout.

20.
Health Policy Plan ; 39(2): 188-197, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38179856

RESUMO

In 2015, the World Health Assembly adopted a global action plan (GAP) on antimicrobial resistance (AMR). Member states were encouraged to develop their own national action plans (NAPs) in alignment with the GAP. To-date, in systematic assessments of NAPs, the Latin American specific context has not been previously analysed. Here we examined 11 Latin American NAPs published between 2015 and 2021 using content analysis. We focused on two approaches: (1) alignment between the strategic objectives and actions defined in the GAP, and those outlined in the NAPs via a content indicator; and (2) assessment of the NAPs via a governance framework covering 'policy design', 'implementation tools' and 'monitoring and evaluation' areas. We observed a high alignment with the strategic objectives of the GAP; however, the opposite was observed for the corresponding actions. Our results showed that the governance aspects contained within coordination and participation domains were addressed by every Latin American NAP, whereas monitoring and assessment areas, as well as incorporating the environment, would need more attention in subsequent NAPs. Given that AMR is a global health threat and collective efforts across regions are necessary to combat it, our findings can benefit member states by highlighting how to strengthen the AMR strategies in Latin America, while also supporting global policy formulation.


Assuntos
Antibacterianos , Farmacorresistência Bacteriana , Humanos , Antibacterianos/uso terapêutico , América Latina , Política de Saúde , Saúde Global
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