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1.
Reprod Health ; 19(Suppl 1): 123, 2022 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-35698143

RESUMO

Over the last two decades, improvements in Ethiopia's socio-economic context, the prioritization of health and development in the national agenda, and ambitious national health and development policies and programmes have contributed to improvements in the living standards and well-being of the population as a whole including adolescents. Improvements have occurred in a number of health outcomes, for example reduction in levels of harmful practices i.e., in child marriage and female genital mutilation/cutting (FGM/C), reduction in adolescent childbearing, increase in positive health behaviours, for example adolescent contraceptive use, and maternal health care service use. However, this progress has been uneven. As we look to the next 10 years, Ethiopia must build on the progress made, and move ahead understanding and overcoming challenges and making full use of opportunities by (i) recommitting to strong political support for ASRHR policies and programmes and to sustaining this support in the next stage of policy and strategy development (ii) strengthening investment in and financing of interventions to meet the SRH needs of adolescents (iii) ensuring laws and policies are appropriately communicated, applied and monitored (iv) ensuring strategies are evidence-based and extend the availability of age-disaggregated data on SRHR, and that implementation of these strategies is managed well (v) enabling meaningful youth engagement by institutionalizing adolescent participation as an essential element of all programmes intended to benefit adolescents, and (vi) consolidating gains in the area of SRH while strategically broadening other areas without diluting the ASRHR focus.


Assuntos
Política de Saúde/tendências , Prioridades em Saúde/tendências , Classe Social , Fatores Socioeconômicos , Adolescente , Serviços de Saúde do Adolescente/normas , Serviços de Saúde do Adolescente/tendências , Criança , Circuncisão Feminina/estatística & dados numéricos , Circuncisão Feminina/tendências , Etiópia , Feminino , Humanos , Casamento/estatística & dados numéricos , Casamento/tendências , Serviços de Saúde Materna/normas , Serviços de Saúde Materna/tendências
3.
PLoS One ; 16(12): e0261236, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34936650

RESUMO

In the past year, the global epidemic situation is still not optimistic, showing a trend of continuous expansion. With the research and application of vaccines, there is an urgent need to develop some optimal vaccination strategies. How to make a reasonable vaccination strategy to determine the priority of vaccination under the limited vaccine resources to control the epidemic and reduce human casualties? We build a dynamic model with vaccination which is extended the classical SEIR model. By fitting the epidemic data of three countries-China, Brazil, Indonesia, we have evaluated age-specific vaccination strategy for the number of infections and deaths. Furthermore, we have evaluated the impact of age-specific vaccination strategies on the number of the basic reproduction number. At last, we also have evaluated the different age structure of the vaccination priority. It shows that giving priority to vaccination of young people can control the number of infections, while giving priority to vaccination of the elderly can greatly reduce the number of deaths in most cases. Furthermore, we have found that young people should be mainly vaccinated to reduce the number of infections. When the emphasis is on reducing the number of deaths, it is important to focus vaccination on the elderly. Simulations suggest that appropriate age-specific vaccination strategies can effectively control the epidemic, both in terms of the number of infections and deaths.


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Prioridades em Saúde/tendências , Fatores Etários , Brasil/epidemiologia , COVID-19/epidemiologia , COVID-19/imunologia , China/epidemiologia , Humanos , Indonésia/epidemiologia , Modelos Teóricos , SARS-CoV-2/imunologia , SARS-CoV-2/patogenicidade , Vacinação/métodos , Vacinação/psicologia , Vacinação/tendências , Vacinas/administração & dosagem , Vacinas/uso terapêutico
9.
Anaesthesia ; 76(5): 608-616, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33572007

RESUMO

National (and global) vaccination provides an opportunity to control the COVID-19 pandemic, which disease suppression by societal lockdown and individual behavioural changes will not. We modelled how vaccination through the UK's vaccine priority groups impacts deaths, hospital and ICU admissions from COVID-19. We used the UK COVID-19 vaccines delivery plan and publicly available data to estimate UK population by age group and vaccination priority group, including frontline health and social care workers and individuals deemed 'extreme clinical vulnerable' or 'high risk'. Using published data on numbers and distributions of COVID-19-related hospital and ICU admissions and deaths, we modelled the impact of vaccination by age group. We then modified the model to account for hospital and ICU admission, and death among health and social care workers and the population with extreme clinical vulnerability and high risk. Our model closely matches the government's estimates for mortality after vaccination of priority groups 1-4 and groups 1-9. The model shows vaccination will have a much slower impact on hospital and ICU admissions than on deaths. The early prioritisation of healthcare staff and clinically vulnerable patients increases the impact of vaccination on admissions and also protects the healthcare service. An inflection point, when 50% of the adult population has been vaccinated - with deaths reduced by 95% and hospital admissions by 80% - may be a useful point for re-evaluating vaccine prioritisation. Our model suggests substantial reductions in hospital and ICU admissions will not occur until late March and into April 2021.


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Cuidados Críticos/tendências , Pessoal de Saúde/tendências , Admissão do Paciente/tendências , Vacinação/tendências , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Feminino , Prioridades em Saúde/tendências , Hospitalização/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Instituições Residenciais/tendências , Reino Unido/epidemiologia , Adulto Jovem
11.
JMIR Public Health Surveill ; 7(6): e26267, 2021 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-33592576

RESUMO

In March 2020, the World Health Organization declared COVID-19 as a global pandemic. The COVID-19 pandemic has affected various public health functions and essential services in different ways and magnitudes. Although all countries have witnessed the effect of COVID-19, the impact differed based on many factors including the integrity and resiliency of the countries' health systems. This paper presents opinions and expectations of the authors about the anticipated changes in the future of public health at the global, regional, and national levels. The viewpoint is based on the current efforts and challenges that various stakeholders have carried out to control COVID-19 and the contribution from the literature on the future of public health. Numerous agencies and actors are involved in the fight against COVID-19 with variations in their effectiveness. The public health services showed weaknesses in most of the countries, in addition to the lack of adequate curative medicine settings. The pandemic highlighted the need for better governance and stronger and more resilient health systems and capacities. The COVID-19 experience has also emphasized the importance of coordination and collaboration among the countries and stakeholders. The COVID-19 pandemic might lead to a wide discussion to improve international and national approaches to prepare for and respond to similar events in terms of preparedness and response mechanisms and tools. Public health will not be the same as before COVID-19. New health priorities, approaches, and new agendas will be on the table of the global platforms and initiatives. More investment in research and technology to meet the demand for new vaccines and medicines, innovative methods like distance learning and working, more respect and remuneration to health professionals, and normalization of the public health and social measures that were induced during the COVID-19 pandemic are expected to be seen in future.


Assuntos
COVID-19 , Previsões , Saúde Global/tendências , Saúde Pública/tendências , Prioridades em Saúde/tendências , Humanos , SARS-CoV-2
12.
Health Aff (Millwood) ; 40(2): 197-203, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33476192

RESUMO

In 2016, in anticipation of the US presidential election and forthcoming new administration, the National Academy of Medicine launched a strategic initiative to marshal expert guidance on pressing health and health care priorities. Published as Vital Directions for Health and Health Care, the products of the initiative provide trusted, nonpartisan, evidence-based analysis of critical issues in health, health care, and biomedical science. The current collection of articles published in Health Affairs builds on the initial Vital Directions series by addressing a set of issues that have a particularly compelling need for attention from the next administration: health costs and financing, early childhood and maternal health, mental health and addiction, better health and health care for older adults, and infectious disease threats. The articles also reflect the current experience with both the coronavirus disease 2019 (COVID-19) pandemic and the health inequities that have been drawn out sharply by COVID-19, as well as the implications going forward for action.


Assuntos
COVID-19 , Atenção à Saúde/organização & administração , Medicina Baseada em Evidências , Prioridades em Saúde/tendências , Disparidades nos Níveis de Saúde , Saúde Mental/tendências , Pesquisa Biomédica , Geriatria , Custos de Cuidados de Saúde , Humanos , Transtornos Relacionados ao Uso de Substâncias
14.
Nurs Outlook ; 69(3): 265-275, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33386144

RESUMO

BACKGROUND: The U.S. health care system faces increasing pressures for reform. The importance of nurses in addressing health care delivery challenges cannot be overstated. PURPOSE: To present a Nursing Health Services Research (NHSR) agenda for the 2020s. METHOD: A meeting of an interdisciplinary group of 38 health services researchers to discuss five key challenges facing health care delivery (behavioral health, primary care, maternal/neonatal outcomes, the aging population, health care spending) and identify the most pressing and feasible research questions for NHSR in the coming decade. FINDINGS: Guided by a list of inputs affecting health care delivery (health information technology, workforce, delivery systems, payment, social determinants of health), meeting participants identified 5 to 6 research questions for each challenge. Also, eight cross-cutting themes illuminating the opportunities and barriers facing NHSR emerged. DISCUSSION: The Agenda can act as a foundation for new NHSR - which is more important than ever - in the 2020s.


Assuntos
Atenção à Saúde/estatística & dados numéricos , Atenção à Saúde/tendências , Política de Saúde/tendências , Prioridades em Saúde/estatística & dados numéricos , Prioridades em Saúde/tendências , Pesquisa sobre Serviços de Saúde/estatística & dados numéricos , Pesquisa sobre Serviços de Saúde/tendências , Previsões , Humanos , Estados Unidos
15.
Endocrine ; 71(1): 20-25, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33284396

RESUMO

PURPOSE: Nowadays, the clinical management of thyroid nodules needs to be multi-disciplinary. In particular, the crosstalk between endocrinologists and cytopathologists is key. When FNAs are properly requested by endocrinologists for nodules characterised by relevant clinical and ultrasound features, cytopathologists play a pivotal role in the diagnostic work-up. Conversely, improper FNA requests can lead to questionable diagnostic efficiency. Recently, recommendations to delay all non-urgent diagnostic procedures, such as thyroid FNAs, to contain the spread of COVID-19 infection, have made the interplay between endocrinologists and cytopathologists even more essential. The objective of this study was to assess the impact of COVID-19 pandemic on our practice by evaluating the total number of FNAs performed and the distribution of the Bethesda Categories before, during, and after the lockdown. METHODS: We analysed the FNA trends before (1st January 2019 to March 13th 2020), during (March 14th to May 15th), and after (May 16th to July 7th) the lockdown. RESULTS: Although the total number of weekly FNAs dropped from 62.1 to 23.1, our referring endocrinologists managed to prioritise patients with high-risk nodules. In fact, in the post-lockdown, the weekly proportion of benign diagnoses dropped on average by 12% and that of high-risk diagnoses increased by 6%. CONCLUSIONS: The lesson we have learned so far from this pandemic is that by applying safety protocols to avoid contagion and by increasing the threshold for FNA requests for thyroid nodules, we can continue to guarantee our services to high-risk patients even in times of a health crisis.


Assuntos
COVID-19/epidemiologia , Acesso aos Serviços de Saúde , Pandemias , Quarentena , Nódulo da Glândula Tireoide/diagnóstico , Adulto , Idoso , Atitude Frente a Saúde , Biópsia por Agulha Fina/estatística & dados numéricos , Biópsia por Agulha Fina/tendências , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Controle de Doenças Transmissíveis/normas , Feminino , Fidelidade a Diretrizes/normas , Fidelidade a Diretrizes/estatística & dados numéricos , Fidelidade a Diretrizes/tendências , Prioridades em Saúde/normas , Prioridades em Saúde/estatística & dados numéricos , Prioridades em Saúde/tendências , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/tendências , História do Século XXI , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricos , Padrões de Prática Médica/tendências , Quarentena/organização & administração , Quarentena/normas , Encaminhamento e Consulta/estatística & dados numéricos , Encaminhamento e Consulta/tendências , Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/epidemiologia , Fatores de Tempo , Ultrassonografia de Intervenção
17.
Rehabilitación (Madr., Ed. impr.) ; 54(4): 276-283, oct.-dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-192491

RESUMO

La pandemia de COVID-19 es un desafío para el manejo de las patologías no COVID como la enfermedad linfática y el lipedema. La telemedicina puede evitar la propagación del coronavirus. Se necesita un sistema que nos ayude a determinar la prioridad clínica y la selección de la asistencia presencial o telemática para cada paciente y la forma de realizarlas durante la pandemia. El Grupo Español de Linfología ha realizado un documento de consenso con recomendaciones basadas en la bibliografía y experiencia clínica, como guía de práctica clínica en el manejo de anomalías linfáticas y lipedema durante la pandemia de COVID-19. Estas recomendaciones deben adaptarse a las características del paciente, las condiciones locales de los centros y las decisiones de los profesionales de la salud. Es un documento de criterios mínimos, sujeto a modificaciones según evolucione la pandemia, los conocimientos científicos y las instrucciones de las autoridades sanitarias


The COVID-19 pandemic poses a challenge to the management of non-COVID pathologies such as lymphatic diseases and lipoedema. The use of telemedicine can prevent the spread of the disease. A system is needed to help determine the clinical priority and selection of face-to-face or telemedicine options for each patient and how to carry them out during the pandemic. The Spanish Lymphology Group has drafted a consensus document with recommendations based on the literature and clinical experience, as clinical practice guidelines for the management of lymphatic abnormalities and lipoedema during the COVID-19 pandemic. These recommendations must be adapted to the characteristics of each patient, the local conditions of the centres, and the decisions of health care professionals. The document contains minimum criteria, subject to modifications according to the evolution of the pandemic, scientific knowledge and instructions from health authorities


Assuntos
Humanos , Infecções por Coronavirus/reabilitação , Lipedema/reabilitação , Anormalidades Linfáticas/reabilitação , Linfedema/reabilitação , Malformações Vasculares/reabilitação , Telerreabilitação/organização & administração , Pandemias , Centros de Reabilitação/organização & administração , Continuidade da Assistência ao Paciente/organização & administração , Prioridades em Saúde/tendências
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