Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.243
Filtrar
4.
Lancet Psychiatry ; 6(9): 778-785, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31296444

RESUMO

Developed in collaboration with WHO Department of Mental Health and Substance Abuse, this study (conducted in India, the UK, and the USA) integrated feedback from mental health service users into the development of the chapter on mental, behavioural, and neurodevelopmental disorders for ICD-11. The ICD-11 will be used for health reporting from January, 2022. As a reporting standard and diagnostic classification system, ICD-11 will be highly influential by informing policy, clinical practice, and research that affect mental health service users. We report here the first study to systematically seek and collate service user perspectives on a major classification and diagnostic guideline. Focus groups were used to collect feedback on five diagnoses: depressive episode, generalised anxiety disorder, schizophrenia, bipolar type 1 disorder, and personality disorder. Participants were given the official draft diagnostic guidelines and a parallel lay translation. Data were then thematically analysed, forming the basis of co-produced recommendations for WHO, which included features that could be added or revised to better reflect lived experience and changes to language that was confusing or objectionable to service users. The findings indicated that an accessible lay language version of the ICD-11 could be beneficial for service users and their supporters.


Assuntos
Grupos Focais/métodos , Classificação Internacional de Doenças/normas , Transtornos Mentais/diagnóstico , Serviços de Saúde Mental/organização & administração , Organização Mundial da Saúde/organização & administração , Transtornos de Ansiedade/classificação , Transtornos de Ansiedade/diagnóstico , Transtorno Bipolar/classificação , Transtorno Bipolar/diagnóstico , Transtorno Depressivo/classificação , Transtorno Depressivo/diagnóstico , Estudos de Avaliação como Assunto , Feminino , Guias como Assunto , Humanos , Índia/epidemiologia , Masculino , Transtornos Mentais/classificação , Transtornos Mentais/psicologia , Serviços de Saúde Mental/normas , Transtornos da Personalidade/classificação , Transtornos da Personalidade/diagnóstico , Esquizofrenia/classificação , Esquizofrenia/diagnóstico , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
7.
BMC Public Health ; 19(1): 858, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266477

RESUMO

BACKGROUND: When microorganisms (such as bacteria or viruses) are highly exposed to antimicrobial drugs, they can develop the capacity to defeat the drugs designed to eradicate them. Long-term accumulation of adaptations to survive drug exposure can lead to the development of antimicrobial resistance (AMR). The success of antibiotics has led to their widespread overuse and misuse in humans, animals and plants. MAIN TEXT: AMR is a global concern and solutions are not vertical actions in a single buy business model. Even if a transectoral approach is key, there is a lack of multi-disciplinary partnerships that allow for strategic cooperation between different sectors such as the pharmaceutical industry, agro-alimentary complex, patient care and education, NGOs and research and development. Global public health voices should lead this integration to align the progress of existing AMR successes. Maintaining the public's trust in preventive medicine, health systems and food production safety, together with public health driven, non-profit drug development, is a key factor. In its "Call for integrated action on AMR", signed by about 70 national and international organizations the World Federation of Public Health Associations (WFPHA) called "on all governments, the private sector, non-governmental organizations, health professionals, public and private research organizations, and all stakeholders to ensure that public health remains at the centre of all policy and scientific endeavours in the field of antimicrobial resistance". CONCLUSIONS: The "Global Charter for the Public's Health", developed by the WFPHA in association with WHO, is proposed in this article as a tool for implementation of complex public health actions such as AMR.


Assuntos
Resistência Microbiana a Medicamentos , Saúde Global , Saúde Pública , Sociedades/organização & administração , Organização Mundial da Saúde/organização & administração , Humanos
13.
BMC Health Serv Res ; 19(1): 295, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31068183

RESUMO

BACKGROUND: A variety of antenatal care models have been implemented in low and middle-income countries over the past decades, as proposed by the World Health Organisation (WHO). One such model is the 2001 Focused Antenatal Care (FANC) programme. FANC recommended a minimum of four visits for women with uncomplicated pregnancies and emphasised quality of care to improve both maternal and neonatal outcomes. Malawi adopted FANC in 2003, however, up to now no study has been done to analyse the model's performance with regards to antenatal care service quality and utilisation patterns. METHODS: The paper is based on data pooled from three comparable nationally representative Malawi Demographic and Health Survey (MDHS) datasets (2000, 2004 and 2010). The DHS collects data on demographics, socio-economic indicators, antenatal care, and the fertility history of reproductive women aged between 15 and 49. We pooled a sample of 8545 women who had a live birth in the last 5 years prior to each survey. We measure the impact of FANC on early access to care, underutilisation of care and quality of care with interrupted time series analysis. This method enables us to track changes in both levels and the trends of our outcome variables. RESULTS: We find that FANC is associated with earlier access to care. However, it has also been associated with unintended increases in underutilisation. We see no change in the quality of ANC services. CONCLUSION: In light of the WHO 2016 ANC guidelines, which recommend an increase of visits to eight, these results are important. Given that we find underutilisation when the benchmark is set at four visits, eight visits are unlikely to be feasible in low-resource settings.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Mau Uso de Serviços de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Organização Mundial da Saúde/organização & administração , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde/organização & administração , Inquéritos Epidemiológicos , Humanos , Malaui , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gravidez , Estudos Retrospectivos
15.
Medicina (Kaunas) ; 55(5)2019 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-31117297

RESUMO

Chronic pain is a global health concern. This special issue on matters related to chronic pain aims to draw on research and scholarly discourse from an eclectic mix of areas and perspectives. The purpose of this non-systematic topical review is to précis an assortment of contemporary topics related to chronic pain and its management to nurture debate about research, practice and health care policy. The review discusses the phenomenon of pain, the struggle that patients have trying to legitimize their pain to others, the utility of the acute-chronic dichotomy, and the burden of chronic pain on society. The review describes the introduction of chronic primary pain in the World Health Organization's International Classification of Disease, 11th Revision and discusses the importance of biopsychosocial approaches to manage pain, the consequences of overprescribing and shifts in service delivery in primary care settings. The second half of the review explores pain perception as a multisensory perceptual inference discussing how contexts, predictions and expectations contribute to the malleability of somatosensations including pain, and how this knowledge can inform the development of therapies and strategies to alleviate pain. Finally, the review explores chronic pain through an evolutionary lens by comparing modern urban lifestyles with genetic heritage that encodes physiology adapted to live in the Paleolithic era. I speculate that modern urban lifestyles may be painogenic in nature, worsening chronic pain in individuals and burdening society at the population level.


Assuntos
Dor Crônica/classificação , Classificação Internacional de Doenças/tendências , Dor Crônica/tratamento farmacológico , Humanos , Sobremedicalização/prevenção & controle , Organização Mundial da Saúde/organização & administração
16.
Artigo em Inglês | MEDLINE | ID: mdl-30950423

RESUMO

"Leaving no one behind" is at the heart of the agenda of the Sustainable Development Goals, requiring that health systems be vigilant to how interventions can be accessed equitably by all, including population subgroups that face exclusion. In the World Health Organization (WHO) South-East Asia Region, inequalities can be found across and within countries but there has been a growing commitment to examining and starting to tackle them. Over the past decade in particular, WHO has been developing an armamentarium of tools to enable analysis of health inequalities and action on health equity. Tools include the Health Equity Assessment Toolkit in built-in database and upload database editions, as well as the Innov8 tool for reorientation of national health programmes. Countries across the region have engaged meaningfully in the development and application of these tools, in many cases aligning them with, or including them as part of, ongoing efforts to examine inequities in population subgroups domestically. This paper reflects on these experiences in Bangladesh, India, Indonesia, Nepal, Sri Lanka and Thailand, where efforts have ranged from workshops to programme reorientation; the creation of assemblies and conferences; and collation of evidence through collaborative research, reviews/synthesis and conferences. This promising start must be maintained and expanded, with greater emphasis on building capacity for interpretation and use of evidence on inequalities in policy-making. This may be further enhanced by the use of innovative mixed methodologies and interdisciplinary approaches to refine and contextualize evidence, with a concomitant shift in attention, developing solutions to redress inequities and anchor health reform within communities. There are many lessons to be learnt in this region, as well as mounting political and popular will for change.


Assuntos
Fortalecimento Institucional/métodos , Equidade em Saúde/normas , Política de Saúde/tendências , Bangladesh , Fortalecimento Institucional/tendências , Equidade em Saúde/tendências , Disparidades em Assistência à Saúde/tendências , Humanos , Índia , Indonésia , Nepal , Sri Lanka , Tailândia , Organização Mundial da Saúde/organização & administração
20.
Artigo em Inglês | MEDLINE | ID: mdl-30832448

RESUMO

In October 2018, at Asia Pacific Conference for Disaster Medicine (APCDM), an expert meeting to identify key research needs was organized by the World Health Organization (WHO) Centre for Health Development (WHO Kobe Centre (WKC)), convening the leading experts from Asia Pacific region, WHO, WHO Thematic Platform for Health Emergency and Disaster Risk Management (Health-EDRM) Research Network (TPRN), World Association for Disaster and Emergency Medicine (WADEM), in collaboration with Asia Pacific Conference for Disaster Medicine (APCDM) and Japan International Cooperation Agency (JICA). International experts, who were pre-informed about the meeting, contributed experience-based priority issues in Health-EDRM research, ethics, and scientific publication. Two moderators, experienced in multi-disciplinary research interacted with discussants to transcribe practical issues into related methodological and ethical issues. Each issue was addressed in order to progress research and scientific evidence in Health-EDRM. Further analysis of interactive dialogues revealed priorities for action, proposed mechanism to address these and identified recommendations. Thematic discussion uncovered five priority areas: (1) the need to harmonize Health-EDRM research with universal terms and, definitions via a glossary; (2) mechanisms to facilitate and speed up ethical review process; (3) increased community participation and stakeholder involvement in generating research ideas and in assessing impact evaluation; (4) development of reference materials such as possible consensus statements; and (5) the urgent need for a research methods resource textbook for Health-EDRM addressing these issues.


Assuntos
Medicina de Desastres/normas , Planejamento em Desastres/normas , Medicina de Emergência/normas , Projetos de Pesquisa/normas , Medicina de Desastres/ética , Medicina de Desastres/organização & administração , Planejamento em Desastres/organização & administração , Medicina de Emergência/ética , Medicina de Emergência/organização & administração , Guias como Assunto , Humanos , Agências Internacionais/organização & administração , Cooperação Internacional , Japão , Organização Mundial da Saúde/organização & administração
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA