RESUMEN
Despite the acknowledged injustice and widespread existence of parachute research studies conducted in low- or middle-income countries by researchers from institutions in high-income countries, there is currently no pragmatic guidance for how academic journals should evaluate manuscript submissions and challenge this practice. We assembled a multidisciplinary group of editors and researchers with expertise in international health research to develop this consensus statement. We reviewed relevant existing literature and held three workshops to present research data and holistically discuss the concept of equitable authorship and the role of academic journals in the context of international health research partnerships. We subsequently developed statements to guide prospective authors and journal editors as to how they should address this issue. We recommend that for manuscripts that report research conducted in low- or middle-income countries by collaborations including partners from one or more high-income countries, authors should submit accompanying structured reflexivity statements. We provide specific questions that these statements should address and suggest that journals should transparently publish reflexivity statements with accepted manuscripts. We also provide guidance to journal editors about how they should assess the structured statements when making decisions on whether to accept or reject submitted manuscripts. We urge journals across disciplines to adopt these recommendations to accelerate the changes needed to halt the practice of parachute research.
Asunto(s)
Autoria/normas , Investigación Biomédica/normas , Políticas Editoriales , Salud Global/normas , Publicaciones Periódicas como Asunto/normas , África , Australia , Investigación Biomédica/tendencias , Salud Global/tendencias , Humanos , Publicaciones Periódicas como Asunto/tendencias , Literatura de Revisión como Asunto , Reino UnidoRESUMEN
INTRODUCTION: Widespread misuse of short-acting beta-agonists (SABAs) may contribute to asthma-related morbidity and mortality. Recognizing this, the Global Initiative for Asthma neither recommends SABA monotherapy nor regards this formulation as a preferred reliever. Many health systems and healthcare professionals (HCPs) experience practical issues in implementing guidelines. Clear quality standards can drive improvements in asthma care and encourage implementation of global and national medical guidelines. METHODS: A steering group of global asthma experts came together between May and September 2019 to develop quality statements codifying the minimum elements of good quality asthma care. These statements were either evidence based (when robust evidence was available) or reflected a consensus based on clinical expertise and experience of the group. RESULTS: The quality statements (and associated essential criteria) developed emphasize key elements concerning (1) objective diagnosis specific to individual symptoms, (2) treatment appropriate to the long-term management of asthma as an inflammatory disease, consistent with evidence-based recommendations, (3) controlled dispensing of SABA canisters and monitoring to prevent overuse, (4) regular review of patients after treatment initiation or change, and (5) follow-up of patients in primary care after treatment for an exacerbation in a hospital or an emergency department. CONCLUSIONS: The steering group proposes quality statements that national and local clinical groups can implement as quantitative quality standards that are appropriate to their local circumstances, including during the coronavirus disease 2019 (Covid-19) pandemic. By translating these statements into locally relevant quality standards, primary care physicians and HCPs can encourage optimal management and reduce preventable healthcare interactions. The evidence-based evolution of care encapsulated in these statements will further engender high-quality, patient-centered holistic management that addresses asthma as an inflammatory disease. In particular, the statements empower self-management by patients and encourage health-promoting behaviors, which are essential to reduce exacerbations, the primary goal of asthma management.
Asunto(s)
Agonistas Adrenérgicos beta/farmacología , Asma , COVID-19 , Abuso de Medicamentos/prevención & control , Administración del Tratamiento Farmacológico/normas , Mejoramiento de la Calidad/organización & administración , Adulto , Antiasmáticos/farmacología , Asma/diagnóstico , Asma/tratamiento farmacológico , COVID-19/epidemiología , COVID-19/prevención & control , Niño , Femenino , Salud Global/normas , Adhesión a Directriz , Humanos , Masculino , Inhaladores de Dosis Medida , Guías de Práctica Clínica como Asunto , SARS-CoV-2RESUMEN
INTRODUCTION: globally, by 2020 the paralytic poliomyelitis disease burden decreased to over 99% of the reported cases in 1988 when resolution 41.8 was endorsed by the World Health Assembly (WHA) for global polio eradication. It is clearly understood that, if there is Wild Poliovirus (WPV) and circulating Vaccines Derived Poliovirus (cVDPV) in the world, no country is safe from polio outbreaks. All countries remain at high risk of re-importation depending on the level of the containment of the types vaccine withdrawn, the laboratory poliovirus isolates, and the population immunity induced by the vaccination program. In this regard, countries to have polio outbreak preparedness and response plans, and conducting the polio outbreak simulation exercises for these plans remain important. METHODS: we conducted a cross-section qualitative study to review to 8 countries conducted polio outbreak simulation exercises in the East and Southern Africa from 2016 to 2018. The findings were categorized into 5 outbreak response thematic areas analyzed qualitatively and summarized them on their strengths and weaknesses. RESULTS: we found out that, most countries have the overall technical capacities and expertise to deal with outbreaks to a certain extent. Nevertheless, we noted that the national polio outbreak preparedness and response plans were not comprehensive enough to provide proper guidance in responding to outbreaks. The guidelines were inadequately aligned with the WHO POSOPs, and IHR 2005. Additionally, most participants who participated in the simulation exercises were less familiar with their preparedness and response plans, the WHO POSOPs, and therefore reported to be sensitized. CONCLUSION: we also realized that, in all countries where the polio simulation exercise conducted, their national polio outbreak preparedness and response plan was revised to be improved in line with the WHO POSOPs and IHR 2005. we, therefore, recommend the polio outbreak simulation exercises to be done in every country with an interval of 3-5 years.
Asunto(s)
Defensa Civil/métodos , Poliomielitis/epidemiología , Poliomielitis/terapia , Entrenamiento Simulado/métodos , África del Sur del Sahara/epidemiología , Defensa Civil/organización & administración , Simulación por Computador , Estudios Transversales , Erradicación de la Enfermedad , Brotes de Enfermedades , Estudios de Evaluación como Asunto , Salud Global/normas , Implementación de Plan de Salud/organización & administración , Implementación de Plan de Salud/normas , Historia del Siglo XXI , Humanos , Programas de Inmunización/métodos , Programas de Inmunización/organización & administración , Programas de Inmunización/normas , Programas Nacionales de Salud/organización & administración , Programas Nacionales de Salud/normas , Vacunas contra Poliovirus/provisión & distribución , Vacunas contra Poliovirus/uso terapéutico , Vigilancia de la Población , Estudios Retrospectivos , Medición de Riesgo , Entrenamiento Simulado/organización & administración , Entrenamiento Simulado/normas , Reserva Estratégica/métodos , Reserva Estratégica/organización & administraciónAsunto(s)
Atención a la Salud/organización & administración , Política Nutricional , Terapia Nutricional/normas , Medicina Basada en la Evidencia/métodos , Salud Global/normas , Programas de Gobierno , Promoción de la Salud/métodos , Promoción de la Salud/organización & administración , Humanos , Desnutrición/terapia , Terapia Nutricional/métodos , Estado Nutricional , Atención de Salud UniversalRESUMEN
OBJECTIVE: To compile the lessons learned in the Greater Maghreb, during the first six months of the fight against the COVID-19 pandemic, in the field of "capacity building" of community resilience. METHODS: An expert consultation was conducted during the first week of May 2020, using the "Delphi" technique. An email was sent requesting the formulation of a lesson, in the form of a "Public Health" good practice recommendation. The final text of the lessons was finalized by the group coordinator and validated by the signatories of the manuscript. RESULTS: A list of five lessons of resilience has been deduced and approved : 1. Elaboration of "white plans" for epidemic management; 2. Training in epidemic management; 3. Uniqueness of the health system command; 4. Mobilization of retirees and volunteers; 5. Revision of the map sanitary. CONCLUSION: Based on the evaluation of the performance of the Maghreb fight against COVID-19, characterized by low resilience, this list of lessons could constitute a roadmap for the reform of Maghreb health systems, towards more performance to manage possible waves of COVID-19 or new emerging diseases with epidemic tendency.
Asunto(s)
COVID-19/epidemiología , COVID-19/terapia , Atención a la Salud/organización & administración , Atención a la Salud/normas , Reforma de la Atención de Salud , África del Norte/epidemiología , Argelia/epidemiología , Actitud del Personal de Salud , Defensa Civil/métodos , Defensa Civil/organización & administración , Defensa Civil/normas , Participación de la Comunidad/métodos , Conflicto de Intereses , Atención a la Salud/estadística & datos numéricos , Técnica Delphi , Testimonio de Experto , Salud Global/normas , Reforma de la Atención de Salud/organización & administración , Reforma de la Atención de Salud/normas , Capacidad de Camas en Hospitales/normas , Capacidad de Camas en Hospitales/estadística & datos numéricos , Humanos , Mauritania/epidemiología , Programas Nacionales de Salud/organización & administración , Programas Nacionales de Salud/normas , Pandemias , Salud Pública/métodos , Salud Pública/normas , SARS-CoV-2/fisiología , Túnez/epidemiologíaRESUMEN
Since its establishment the World Federation of Neurology (WFN) has manifested a keen interest in the environment and its relation to neurological diseases. Thus, in 2007 the WFN renamed the "Neurotoxicological Research Group" to "Environmental Neurology Research Group". In this short article, we review some recent events which illustrate the WFN involvement in Environmental Neurology as well its concerns about global health matters involving environmental issues.
Asunto(s)
Medicina Ambiental , Salud Global , Neurología , Enfermedades Ambientales/epidemiología , Enfermedades Ambientales/terapia , Medicina Ambiental/organización & administración , Medicina Ambiental/normas , Medicina Ambiental/tendencias , Salud Global/normas , Salud Global/tendencias , Humanos , Cooperación Internacional , Enfermedades del Sistema Nervioso/epidemiología , Enfermedades del Sistema Nervioso/terapia , Neurología/organización & administración , Neurología/normas , Neurología/tendencias , Síndromes de Neurotoxicidad/epidemiología , Síndromes de Neurotoxicidad/etiología , Síndromes de Neurotoxicidad/terapia , Sociedades Médicas/organización & administración , Sociedades Médicas/normasAsunto(s)
Salud Global/normas , Prioridades en Salud/legislación & jurisprudencia , Partería/legislación & jurisprudencia , Comités Consultivos , Femenino , Equidad en Salud , Humanos , Atención Dirigida al Paciente/estadística & datos numéricos , Embarazo , Recursos Humanos , Organización Mundial de la Salud/organización & administraciónRESUMEN
BACKGROUND: Global concern about vitamin D deficiency has fuelled debates on photoprotection and the importance of solar exposure to meet vitamin D requirements. OBJECTIVES: To review the published evidence to reach a consensus on the influence of photoprotection by sunscreens on vitamin D status, considering other relevant factors. METHODS: An international panel of 13 experts in endocrinology, dermatology, photobiology, epidemiology and biological anthropology reviewed the literature prior to a 1-day meeting in June 2017, during which the evidence was discussed. Methods of assessment and determining factors of vitamin D status, and public health perspectives were examined and consequences of sun exposure and the effects of photoprotection were assessed. RESULTS: A serum level of ≥ 50 nmol L-1 25(OH)D is a target for all individuals. Broad-spectrum sunscreens that prevent erythema are unlikely to compromise vitamin D status in healthy populations. Vitamin D screening should be restricted to those at risk of hypovitaminosis, such as patients with photosensitivity disorders, who require rigorous photoprotection. Screening and supplementation are advised for this group. CONCLUSIONS: Sunscreen use for daily and recreational photoprotection does not compromise vitamin D synthesis, even when applied under optimal conditions. What's already known about this topic? Knowledge of the relationship between solar exposure behaviour, sunscreen use and vitamin D is important for public health but there is confusion about optimal vitamin D status and the safest way to achieve this. Practical recommendations on the potential impact of daily and/or recreational sunscreens on vitamin D status are lacking for healthy people. What does this study add? Judicious use of daily broad-spectrum sunscreens with high ultraviolet (UV) A protection will not compromise vitamin D status in healthy people. However, photoprotection strategies for patients with photosensitivity disorders that include high sun-protection factor sunscreens with high UVA protection, along with protective clothing and shade-seeking behaviour are likely to compromise vitamin D status. Screening for vitamin D status and supplementation are recommended in patients with photosensitivity disorders.
Asunto(s)
Medicina Basada en la Evidencia/normas , Neoplasias Cutáneas/prevención & control , Luz Solar/efectos adversos , Protectores Solares/efectos adversos , Deficiencia de Vitamina D/prevención & control , Vitamina D/sangre , Consenso , Salud Global/normas , Humanos , Tamizaje Masivo/normas , Recreación , Valores de Referencia , Piel/efectos de los fármacos , Piel/metabolismo , Piel/efectos de la radiación , Neoplasias Cutáneas/etiología , Factor de Protección Solar , Protectores Solares/administración & dosificación , Protectores Solares/química , Rayos Ultravioleta/efectos adversos , Vitamina D/administración & dosificación , Vitamina D/metabolismo , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/diagnóstico , Deficiencia de Vitamina D/epidemiologíaRESUMEN
After the declaration of the Millennium Development Goals in 2000 by the United Nations, many stakeholders allocated financial resources to "global maternal health." Research to expand care and improve delivery of maternal health services has exponentially increased. The present article highlights an overview, namely 10 of the health system, clinical, and technology-based advancements that have occurred in the past three decades in the field of global maternal health. The list of topics has been selected through the cumulative clinical and public health expertise of the authors and is certainly not exhaustive. Rather, the list is intended to provide a mapping of key topics arranged from broad to specific that span from the global policy level to the level of individual care. The list of health system, clinical, and technology-based advancements include: (10) Millennium Development Goals and Sustainable Development Goals; (9) Development of clinical training programs, including the potential for subspecialty development; (8) Prenatal care expansion and potential; (7) Decentralized health systems, including the use of skilled birth attendants; (6) Antiretroviral therapy for HIV; (5) Essential medicines; (4) Vaccines; (3) mHealth/eHealth; (2) Ultrasonography; and (1) Obstetric hemorrhage management. With the Sustainable Development Goals now underway, the field must build upon past successes to sustain maternal and neonatal well-being in the future global health agenda.
Asunto(s)
Salud Global/normas , Salud Materna/normas , Atención Prenatal/organización & administración , Femenino , Humanos , Mortalidad Materna , Partería/organización & administración , Mortalidad Perinatal , Embarazo , Desarrollo Sostenible , Naciones UnidasRESUMEN
An important series of papers have been published in the Lancet. These papers provide a comprehensive update for the major global problem of low back pain, and the challenges that low back pain presents to healthcare practitioners and policy makers. Chiropractors are well placed to reduce the burden of low back pain, but not all that chiropractors do is supported by robust, contemporary evidence. This commentary summarises the Lancet articles. We also make suggestions for how the chiropractic profession should most effectively help people with low back pain by implementing practices supported by high quality evidence.
Asunto(s)
Dolor de la Región Lumbar/terapia , Manipulación Quiropráctica/normas , Salud Global/normas , Humanos , Manipulación Quiropráctica/instrumentación , Manipulación Quiropráctica/métodos , Médicos , Guías de Práctica Clínica como AsuntoRESUMEN
The World Federation of Chiropractic supports the involvement of chiropractors in public health initiatives, particularly as it relates to musculoskeletal health. Three topics within public health have been identified that call for a renewed professional focus. These include healthy ageing; opioid misuse; and women's, children's, and adolescents' health. The World Federation of Chiropractic aims to enable chiropractors to proactively participate in health promotion and prevention activities in these areas, through information dissemination and coordinated partnerships. Importantly, this work will align the chiropractic profession with the priorities of the World Health Organization. Successful engagement will support the role of chiropractors as valued partners within the broader healthcare system and contribute to the health and wellbeing of the communities they serve.
Asunto(s)
Quiropráctica/organización & administración , Salud Global/normas , Promoción de la Salud/organización & administración , Salud Pública/normas , Quiropráctica/normas , Personal de Salud/psicología , Promoción de la Salud/normas , Humanos , Organización Mundial de la SaludRESUMEN
In 2001, the World Health Assembly (WHA) passed the landmark WHA 54.19 resolution for global scale-up of mass administration of anthelmintic drugs for morbidity control of schistosomiasis and soil-transmitted helminthiasis, which affect more than 1·5 billion of the world's poorest people. Since then, more than a decade of research and experience has yielded crucial knowledge on the control and elimination of these helminthiases. However, the global strategy has remained largely unchanged since the original 2001 WHA resolution and associated WHO guidelines on preventive chemotherapy. In this Personal View, we highlight recent advances that, taken together, support a call to revise the global strategy and guidelines for preventive chemotherapy and complementary interventions against schistosomiasis and soil-transmitted helminthiasis. These advances include the development of guidance that is specific to goals of morbidity control and elimination of transmission. We quantify the result of forgoing this opportunity by computing the yearly disease burden, mortality, and lost economic productivity associated with maintaining the status quo. Without change, we estimate that the population of sub-Saharan Africa will probably lose 2·3 million disability-adjusted life-years and US$3·5 billion of economic productivity every year, which is comparable to recent acute epidemics, including the 2014 Ebola and 2015 Zika epidemics. We propose that the time is now to strengthen the global strategy to address the substantial disease burden of schistosomiasis and soil-transmitted helminthiasis.
Asunto(s)
Antihelmínticos/uso terapéutico , Salud Global/economía , Guías como Asunto , Helmintiasis/tratamiento farmacológico , Esquistosomiasis/epidemiología , África del Sur del Sahara/epidemiología , Salud Global/normas , Helmintiasis/prevención & control , Helmintiasis/transmisión , Humanos , Morbilidad , Años de Vida Ajustados por Calidad de Vida , Esquistosomiasis/tratamiento farmacológico , Esquistosomiasis/economía , Esquistosomiasis/prevención & control , SueloRESUMEN
The World Health Organization (WHO) Global Strategic Directions for Strengthening Nursing and Midwifery 2016-2020 provide a framework to ensure nursing and midwifery interventions are developed, implemented, and evaluated at global, regional, and country levels and in partnership with key stakeholders. The Global Strategic Directions for Strengthening Nursing and Midwifery 2016-2020 supports the WHO's Global Strategy on Human Resources for Health: Workforce 2030. The WHO Global Strategic Directions for Strengthening Nursing and Midwifery 2016-2020 presents a vision, guiding principles, and four themes to maximize nursing and midwifery workforce contributions to improve global health. Implementation of the strategy is articulated in the context of country and regional needs, areas for expedited action, partnerships and alliances, and accountability for ongoing monitoring and evaluation. As a framework, the 2016-2020 Global Strategic Directions for Nursing and Midwifery can help countries achieve the United Nations' Sustainable Development Goals and universal health coverage.
Asunto(s)
Salud Global/normas , Cooperación Internacional , Partería/normas , Atención de Enfermería/normas , Organización Mundial de la Salud , Femenino , Humanos , EmbarazoRESUMEN
Considerando a existência de uma nova arquitetura em Saúde Global que agrega uma visão holística dos determinantes em saúde, com um maior palco de ação para atores do Sul influenciarem a Governança em Saúde Global este trabalho se propõe a apresentar a inserção do Brasil nessa arquitetura. Ressaltando o caráter dual dessa dinâmica, que se desenrola tanto em uma atuação como doador para os países africanos de língua portuguesa em áreas nas quais o Brasil possui expertise, como receptor de cooperação cubana, via arranjo de triangulação com a Organização Pan-Americana de Saúde, no fortalecimento das ações em atenção primária em saúde.
Considering the existence of a new architecture in Global Health - which joins up a holistic vision on the determining factors on health with a greater policy space for the actors from the South to influence the Global Health Governance - this work aims to present the Brazilian insertion in this architecture . It Highlighting the dual character of its dynamics, which takes place both in an action as donor for Portuguese-speaking African countries in areas where Brazil has expertise, and as a recipient of cooperation from Cuban, through an triangulation with the Pan American Health Organization , In strengthening the actions on primary health care.
Asunto(s)
Salud Global/normas , Política de Innovación y Desarrollo , Planes Estatales de Salud , Cooperación Técnica , África , Brasil , Cuba , Médicos Graduados Extranjeros/normas , Cooperación Internacional , Determinantes Sociales de la Salud/normas , Organización Mundial de la SaludRESUMEN
Infrastructures, such as roads, mines, and hydroelectric dams, are proliferating explosively. Often, this has serious direct and indirect environmental impacts. We highlight nine issues that should be considered by project proponents to better evaluate and limit the environmental risks of such developments.
Asunto(s)
Ambiente , Medicina Ambiental/normas , Salud Global/normas , Medicina Ambiental/tendencias , Monitoreo del Ambiente , Salud Global/tendencias , Humanos , Centrales Eléctricas , Factores de Riesgo , Factores SocioeconómicosRESUMEN
In this paper, the authors consider the idea of the public biobank governance framework with respect to the innovative paradigm of One Health. The One Health initiative has been defined as an integrative and interdisciplinary effort to improve the lives and well-being of human beings and non-human animals, as well as to preserve the environment. Here, we use this approach as a starting presumption with respect to institutional design. We examine the theoretical and legal framework underlying the concept of biobanking that, being public orientated, is for the public good. We suggest that this account of research practice does not ethically correlate with One Health principles. Instead, we argue that One Health requires a model of biobanking that is based on universal goods, that is, goods that serve human beings as well as non-human animals and the environment, and which we define in detail. Our purpose is to begin a discussion on how One Health principles might be implemented in health initiatives.
Asunto(s)
Bancos de Muestras Biológicas , Bioterrorismo/prevención & control , Brotes de Enfermedades/prevención & control , Salud Global , Salud Pública , Zoonosis/prevención & control , África , Terapia Asistida por Animales , Animales , Bancos de Muestras Biológicas/normas , Bancos de Muestras Biológicas/tendencias , Canadá , Europa (Continente) , Salud Global/ética , Salud Global/normas , Salud Global/tendencias , Fiebre Hemorrágica Ebola/prevención & control , Humanos , Salud Pública/ética , Salud Pública/normas , Salud Pública/tendencias , Reino Unido , Estados UnidosRESUMEN
After 8 years the Global Initiative for Asthma (GINA) presented a fully revised report. In May 2014 the new GINA was published online [www.ginasthma.org]. On a live GINA Session at the European Respiratory Society (ERS) conference 2014 in Munich members of the board of directors and of the science committee presented the new contents, e.g. the GINA statement from page one, that GINA is "Not a guideline, but a practical approach to managing asthma in clinical practice"--was explicitly emphasized on the ERS. This may reflect a changing claim towards a more pragmatic attempt (but probably also the fear of liability).