Health Organization International Research Articles

Verification of the Integrative Model of Adjustment to Chronic Conditions by Mapping it Onto the World Health Organization's International Classification of Function, Disability and Health.

Purpose:Literature regarding the WHO’s International Classification of Function, Disability and Health (ICF) has called for research into psychosocial adjustment processes. This project aims to establish the relevance of the Integrative Model of Adjustment to Chronic Conditions (IMACC) as a framework for research and a clinical tool in rehabilitation by linking it with the ICF.Methods:The study employed secondary analysis of data from the original IMACC grounded theory study, where 8 women and 2 men with type 2 diabetes mellitus participated. IMACC consists of 3 interconnected parts comprising a total of 13 components. Datasets used for the study consisted of the qualitative data underpinning each IMACC component. Meaningful concepts from each dataset were linked to ICF categories using the updated ICF linking rules.Results:Results showed that all 13 IMACC components accommodate ICF category codes from all health and health related ICF components in patterns consistent with the theoretical conceptualisation of each separate IMACC component.Conclusion:IMACC maps comprehensively to the ICF framework and provides a framework that may be useful for future ICF related research into biopsychosocial processes in psychosocial adjustment. IMACC provides a clinically applicable intervention for people with psychosocial adjustment difficulties consistent with the ICF framework.

Optimizing pathological assessment of breast cancer in Brazil: recommendations from a multidisciplinary working group on the tumor-tissue journey

Timely and correct assessment of histopathological, immunohistochemical and molecular features of biopsy and surgical specimens is of paramount importance in the provision of care to patients with breast cancer, particularly in the current era of precision oncology. In order to ensure that tissue samples are obtained, processed, analyzed and reported in an optimal way, a concerted effort is required by institutions and individuals, taking into account state-of-the-art scientific and technical knowledge and circumventing logistic and operational constraints. This may be particularly challenging in some settings due to several sources of economic, structural, organizational and communication inefficiencies. In the current article, we present a brief review of breast cancer epidemiology and challenges in the disease diagnosis, especially in Brazil, and report the results of a multidisciplinary working group convened in May 2020 in an expert panel to identify and discuss the barriers and challenges related to the journey of breast cancer samples in Brazil. Following the identification of the issues, the working group also discussed and proposed recommendations for improving the journey and quality of breast cancer samples based on their professional experience and the current scientific literature, including guidelines of national and international health organizations (e.g. World Health Organization), consensus of medical societies and other published literature on the topic. We outline the most salient issues related to that journey in Brazilian public and private medical institutions, based on the experts’ clinical experience, since all of them are actively working at both sectors, and discuss current recommendations to address these issues aiming at mitigating and preventing preanalytical and analytical issues affecting diagnostic and therapeutic decisions. Such issues are grouped under four headings pertaining to education, communication, procedures in the operating room and sample transportation, and procedures in the pathology laboratory. Selected recommendations based on the current literature and discussed by the group of Brazilian experts are reviewed, which may mitigate the issues identified and optimize diagnostic and therapeutic decisions for patients with breast cancer, currently the most frequent malignant tumor worldwide and in Brazil. This paper has been submitted and published jointly, upon invitation and consent, in both the Surgical and Experimental Pathology and the Mastology journals.

COVID-19 Vaccine Acceptance and Uptake among Healthcare Workers in Trinidad and Tobago.

Background COVID-19 vaccine acceptance is important in ensuring the widespread vaccination of the population to achieve herd immunity. Establishing the acceptance of vaccines among healthcare workers, who play a vital role in an immunization program's success, is important. The aim of this study was to assess the influence of social trust and demographic factors on COVID-19 vaccine acceptance among healthcare workers. Methods A cross-sectional survey utilizing an electronic questionnaire inquiring about COVID-19 vaccine uptake, preferences, and concerns was distributed via e-mail to 1,351 North Central Regional Health Authority (NCRHA) healthcare workers of the following categories: medical practitioners, nursing personnel, veterinary surgeons, medical interns, dental interns, paramedics, and pharmacists. These professions were selected as they were granted power to administer COVID-19 vaccines during the period of public emergency by the President of Trinidad and Tobago and were therefore likely to be NCRHA healthcare workers directly involved in vaccine administration services. Bivariate analysis using Chi-squared analysis of association was used to determine the association between the respondents' characteristics and the acceptance of the vaccine and the association between vaccine acceptance among healthcare workers and trust. The association between the acceptance of the COVID-19 vaccines and healthcare workers' characteristics and trust was established using multinomial logistic regression. Results A total of 584 healthcare workers took part in the study, and 1.4% showed unwillingness to receive the COVID-19 vaccine. The study indicates that age, profession, trust in international public health organizations, and trust in other healthcare providers predict the uptake of COVID-19 vaccines among healthcare workers, with younger age groups and the nursing profession associated with an unwillingness to accept the vaccine. Gender of the healthcare workers does not predict vaccine acceptance. Conclusions and relevance: efforts towards enhanced vaccine acceptance among healthcare workers should take into consideration age, profession, and the trust in international organizations and other healthcare providers. Sensitization programs aimed at informing and creating awareness among healthcare workers about the COVID-19 vaccines should be age-specific as well as occupation-based.

Black Clouds and Silver Linings: Exploring the Psychosocial Consequences of the COVID-19 Pandemic on Expatriates Living in Hong Kong

Background: While global media, international and local health organisations, epidemiologists, and opinion makers disseminate regular updates on the spread and mortality of COVID-19, the psychosocial effect of the pandemic is often neglected. This is amplified for expatriates living outside their native country as stringent quarantine measures make travelling to their home countries prohibitive, if not impossible, in terms of time and money. Objective: The aim of this study was to understand the psychosocial consequences of the COVID-19 pandemic on expatriates living in Hong Kong. Method: An exploratory qualitative research design was employed. Qualitative data from semi-structured interviews and surveys were analysed using template analysis. Findings: Data revealed that COVID-19 adversely affected the mental and social wellbeing of most of the respondents. There were silver linings in finding new ways to connect, appreciating a slower pace of life and the opportunity to reassess priorities, although the black clouds of separation from family, concern for youth, missing milestones and mental & financial concerns dominated most of the data. These negative consequences were exacerbated by the lack of reasonableness, inclusivity, openness and transparency of the COVID-19 restrictions and regulations. Conclusion: As the psychosocial consequences of the pandemic are expected to continue for some time, this study has implications for public health policy and practice in HK, and internationally, in planning how to mitigate the negative effects of the pandemic.

Impact of Breast Cancer Campaigns in the Last 5 Years: A Global Assessment with Google Trends

All this panorama revealed by the study highlights the importance of campaigns against breast cancer, as well as the commitment of international health organizations in the fight against this public health problem, but at the same time it also motivates a reflection based on the following hypothesis: the implementation of campaigns against breast cancer on additional dates to those already established would generate greater interest in the world population and therefore greater knowledge, awareness and sensitization about it, which would probably allow accelerating the decrease in annual mortality, which would allow completing in less time the objectives proposed with this type of campaigns.

Overview of Epidemiology of Malaria Associated with Pregnancy in Northwestern Colombia, 1985-2020

Background: Knowledge about malaria associated with pregnancy (MAP) is scarce in Latin America and Colombia. Methodology: This paper presents an overview of studies captained in Pubmed, Lilacs, GoogleScholar and thesis repositories from six Colombian universities and bibliographic references of manuscripts. Results: The following topics have been described: study sites, infectious agents, genetic variation of Plasmodium in MAP, vector resistance to insecticides, incubation period, natural susceptibility and resistance to infection, immunity in MAP, frequency, coexistence of gestational (GM) and placental (PM) malaria, associated factors, efficacy of antimalarial treatment, material living conditions in MAP. The MAP has a high prevalence, with a high frequency of submicroscopic infections. There are cases of MAP due to P. falciparum, P. vivax, or both. Monotherapy with chloroquine or amodiaquine for MAP for P. vivax has efficacy greater than 95% and artemether-lumefantrine or artesunate-mefloquine 100% for P. falciparum. There are high rates of anemia in pregnancies (30-70%). In “The Region,” there is no problem of resistance of vectors to insecticides. MAP occurs in poor territories, with interaction of food insecurity, chronic malnutrition, dissatisfaction of basic needs, intestinal parasites, violence and abuse of human rights. Conclusions: MAP study is just beginning in Colombia; there are no programmes that effectively operate to detect and solve this problem; Government agencies, international health organizations, and private companies should finance the multidisciplinary and comprehensive research (natural and social) of the MAP, in order to know its main characteristics throughout the country and use that knowledge as a basis to seek solutions.

PENYEBAB DILAKUKANNYA PEMBERHENTIAN SEMENTARA DONOR DANA YANG DILAKUKAN AMERIKA SERIKAT DAN DAMPAKNYA TERHADAP KEBERLANGSUNGAN WHO

The existence of superpowers in the world is inevitable. The positive or negative impact of the influence of the forces resulting from the policies of these superpowers often has a large impact on the economic, political, social, and security conditions of other countries. The impact is not only in the domestic sphere but also in the international sphere. One of them is influencing international organizations. In the midst of the outbreak of the Covid-19 pandemic, the superpowers, the United States and China, are still competing to conduct a trade war through policies taken to maintain the strength of their countries. One of the perceived threats from the trade war carried out by the two countries has made the United States suspicious of an international health organization, namely the World Health Organization (WHO). In the midst of a global pandemic, the United States decided to no longer provide injections of funds to the World Health Organization. The United States considers that WHO has failed in dealing with the virus and there is a tendency for alignments between WHO and China. So that it can threaten the stability of the United States in terms of economy, politics, social and national security. The magnitude of the impact on this policy decision was due to the large influence of the superpowers, namely the United States and China.

Preconception exposures and adverse pregnancy, birth and postpartum outcomes: Umbrella review of systematic reviews.

Preconception exposures have been associated with adverse pregnancy, birth and postpartum outcomes. However, the reports, statements and guidelines of national and international health organisations vary in what they recommend individuals should monitor, avoid, reduce or practise in the preconception period. To synthesise and evaluate the evidence across systematic reviews for associations between exposures before conception and adverse pregnancy, birth and postpartum outcomes. MEDLINE, Embase, Epistemonikos (to May 2020) and reference lists of included reviews, without language or date restrictions. Systematic literature reviews of observational and/or interventional studies reporting associations between preconception exposures in women and/or men of reproductive age and pregnancy, birth or postpartum health outcomes were included. The methodological quality of reviews and the certainty of the evidence underlying each exposure-outcome association were assessed using AMSTAR 2 and the GRADE approach. We identified 53 eligible reviews reporting 205 unique exposure-outcome associations. Methodological quality was generally low with only two reviews rated as 'high' quality and two as 'moderate'. We found high-certainty, randomised trial evidence that maternal folate supplementation reduces the risk of neural tube defects and anomaly-related terminations. Moderate-certainty, observational evidence was found that maternal physical activity is associated with reduced risk of pre-eclampsia and gestational diabetes, and that paternal age of ≥40years and maternal body mass index (BMI) and interpregnancy weight gain are associated with increased risk of various adverse pregnancy and birth outcomes. Low- and very low-certainty evidence was found for other associations. Clinicians and policymakers can be confident that maternal folate supplementation should be encouraged during the preconception period. There is moderate certainty in the evidence base that maternal physical activity, BMI and interpregnancy weight gain and advanced paternal age are important preconception considerations. High-quality research is required to better understand other exposure-outcome associations.

From Speech Acoustics to Communicative Participation in Dysarthria: Toward a Causal Framework.

We proposed and tested a causal instantiation of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework, linking acoustics, intelligibility, and communicative participation in the context of dysarthria. Speech samples and communicative participation scores were collected from individuals with dysarthria (n = 32). Speech was analyzed for two acoustic metrics (i.e., articulatory precision and speech rate), and an objective measure of intelligibility was generated from listener transcripts. Mediation analysis was used to evaluate pathways of effect between acoustics, intelligibility, and communicative participation. We observed a strong relationship between articulatory precision and intelligibility and a moderate relationship between intelligibility and communicative participation. Collectively, data supported a significant relationship between articulatory precision and communicative participation, which was almost entirely mediated through intelligibility. These relationships were not significant when speech rate was specified as the acoustic variable of interest. The statistical corroboration of our causal instantiation of the ICF framework with articulatory acoustics affords important support toward the development of a comprehensive causal framework to understand and, ultimately, address restricted communicative participation in dysarthria.

COVID-19 and the emotional culture of pandemics: a retrospective and prospective view

ABSTRACT Taking fear as the core emotion in the experience of major disasters and echoing French historian Jean Delumeau’s classic thesis on the social and cultural construction of coping strategies against it, this article outlines some lessons and prospects from the (complex but also distinctive) regime of experiences and behaviours historically configured in the West when facing severe epidemic outbreaks. The analysis of observations and testimonials reported in various sources (literary works, chronicles, medical treatises, autobiographical records, etc.) on the devastations of plague from the fourteenth century onwards, the different cholera waves in nineteenth-century Europe, or the influenza pandemic of 1918–1919, allows indeed identifying the most conspicuous elements of this regime. This set of experiences and behaviours includes – sometimes following a certain chronological order but also coexisting over several weeks, months, or even years – a particular succession and blend of denial, panic, insecurity, uncertainty, mistrust, loneliness, heroism (as well as cowardice), feelings of punishment, scapegoating, hedonistic excesses, discouragement, and even madness and mental derangement. Given the strong emotional and psycho(patho)logical impact of the COVID-19 pandemic according to all major international health organisations and the remarkable recurrence (at least in Western countries) of similar reaction patterns at both the individual and the collective level, it seems reasonable to expect that this traumatic and sudden recovery of the cultural memory of epidemic diseases will have important consequences for our self-understanding as secular risk-managing societies involved in a peculiar and surely growing relationship with fear.

Investigating the Quality and Efficiency of Biosolid Produced in Qatar as a Fertilizer in Tomato Production

This study evaluated biosolid quality over time and the efficiency of using amounts (5 and 7 kg/m2) of municipal class A biosolids in Qatar to fertilize tomato plants (Solanum lycopersicum). Random samples were subjected to physical and chemical analysis, which revealed excellent particle uniformity and stability with minor odor defects. The analysis confirmed the product was nutrient-rich while pollutant levels were below the international standards. The nominated rates were used to fertilize tomato plants in pots grown in a greenhouse for four months with a control treatment of manure and Peat-Moss, before measuring the plant biological characteristics. Plants were examined via chemical analysis of nutrients and pollutants both for the whole plant and for stems, fruits, and leaves. Results indicated that both experimental treatments enhanced plant growth and development as compared to the control treatment. However, the chemical analyses also revealed levels of zinc, copper, and manganese in the plant fruits that were well in excess of the maximum acceptable levels, as defined by international health organizations. This study found that while the application of class A biosolids as organic fertilizer for tomato plants greatly enhanced the overall plant growth, the plant fruits contained toxic levels of trace heavy metals.

Post-traumatic Stress Disorder Following COVID-19 Pandemic: A Review

COVID-19 pandemic has an impact on the quality of life (QoL) of the young people by affecting their psychological stress and suspicion of diagnosis with post-traumatic stress disorder PTSD. In response to this global health crisis, quarantine and lock down measures were implemented by international and government health organizations to contain the rapid spread of the virus. Such a period of health crisis has significant repercussions on human health and welling, accompanied by psychological distress and related symptoms such as stress, panic and anxiety in the general population specifically students. Therefore, this study aimed to study association between COVID-19 pandemic and lock down with post-traumatic stress disorder.

Supporting Peer Interactions for Students with Complex Communication Needs in Inclusive Settings: Paraeducator Roles.

This clinical focus article presents a review of literature supporting the importance of fostering positive peer interactions for students with complex communication needs. A resulting template is included to help guide educational teams, including speech-language pathologists (SLPs), in planning for paraeducator training specific to supporting peer interactions for children with CCN. This article summarizes the current literature available on inclusion and peer relationships for students with CCN in general education classrooms, and paraeducator roles and training. The World Health Organization (WHO) International Classification for Functioning, Disability and Health Children and Youth (ICF-CY) framework was consulted to help establish considerations relevant to paraeducator training. With many demands on the time of SLPs throughout the school day, paraeducators may offer an often untapped resource to help support positive peer relationships for students with CCN. This article provides an overview of challenges that may impede positive peer relationships from developing in inclusive classroom settings, including ones related to: (1) the student with CCN, (2) the peers, (3) the AAC systems, or (4) the environment. The readers will be provided with a template to guide educational teams and SLPs in collaborating with paraeducators to foster positive peer interactions, including the following steps: (1) define goals for the student with CCN and determine supports required from paraeducators; (2) determine content of training for paraeducators; (3) choose an effective instructional approach; (4) establish a feasible training format; (5) implement the paraeducator training and evaluate outcomes to ensure benefits for students with CCN and their peers.

Increased personal protective equipment litter as a result of COVID-19 measures

Use of personal protective equipment (PPE) increased during the COVID-19 pandemic to reduce virus transmission. Here, we quantitatively analyse emergence of PPE and COVID-19-related litter over 14 months for 11 countries using the litter collection application Litterati. The proportion of masks in litter increased by >80-fold as a result of COVID-19 legislation, from <0.01% to >0.8%. Gloves and wipes, more prevalent at ~0.2% of litter before the pandemic, doubled to 0.4%, but this has since fallen. Glove litter increased in the initial stages of the pandemic but fell after the introduction of facemask policies, whereupon there was an increase of facemask litter. National COVID-19 policy responses and international World Health Organization announcements and recommendations are a probable driver of PPE litter dynamics, especially the implementation of facemask policies. Waste management should be incorporated in designing future pandemic policies to avoid negative environmental legacies of mismanaged PPE. The COVID-19 pandemic substantially altered consumption patterns, especially for health supplies such as personal protective equipment, including masks and gloves. This study of 11 countries examines both the rate and types of litter being discarded as a result of changing policies and recommendations during the first 14 months of the pandemic.

Serum metabolomic profiling reveals potential biomarkers in assessing the management of women with polycystic ovary syndrome: a randomized controlled trial.

Background:As one of the most common endocrinal disorders for women at childbearing age, the diagnostic criteria of polycystic ovary syndrome (PCOS) have been defined differently among different international health organizations. Phenotypic heterogeneity of PCOS also brings about difficulties for its diagnosis and management assessment. Therefore, more efficient biomarkers representing the progression of PCOS are expected to be integrated into the monitoring of management process using metabolomic approaches.Methods:In this prospective randomized controlled trial, 117 PCOS patients were enrolled from December 2016 to September 2017. Classical diagnostic parameters, blood glucose, and metabolome were measured in these patients before and at 2 months and 3 months of different medical interventions. The receiver operating characteristic (ROC) curves were built based on multivariate statistical analysis using data at baseline and 3 months’ management, and combinational biomarkers with appreciable sensitivity and specificity were selected, which then validated with data collected at 2 months.Results:A set of metabolites including glutamic acid, aspartic acid, 1-methylnicotinamide, acetylcarnitine, glycerophosphocholine, and oleamide were filtered out with high performance in representing the improvement through 3-month management of PCOS with high sensitivity and specificity in ROC analysis and validation with other two groups showed an appreciable area under the curve over 0.96.Conclusions:The six metabolites were representative of the remission of PCOS through medical intervention, making them a set of potential biomarkers for assessing the outcome of PCOS management.Trial Registration:ClinicalTrials.gov, NCT03264638.

A Psychiatrist’s Journey Through Community Suicide Contagion: How Media Can Make A Difference

A Psychiatrist’s Journey Through Community Suicide Contagion: How Media Can Make A Difference

Potential for health economics to influence policies on tobacco use during pregnancy in low-income and middle-income countries: a qualitative case study

IntroductionTobacco control during pregnancy is a policy priority in high-income countries (HICs) because of the significant health and inequality consequences. However, little evidence exists on interventions to reduce tobacco use...

Immunosuppressant Drugs and Covid-19: Associated Risks, Drug-Drug Interactions and Contraindications

: Immunosuppressant drugs like Etanercept, Mycophenolate mofetil, Sirolimus, Cyclosporine, and Rituximab can weaken the immune system and make patients susceptible to SARS nCoV-2 virus. These drugs make immunocompromised persons more vulnerable to complications associated with COVID-19. Moreover, it can also increase mortality and morbidity, as a weakened immune system can lead to a longer duration of infection. This study discusses the guidelines on immunosuppressant drugs and their associated risk factors with COVID-19, issued by the U.S CDC (Centers for Disease Control and Prevention), WHO (World Health Organization), U.S FDA (Food and Drug Administration), and other accredited global health organizations. Moreover, it also includes information about pharmaceutical properties, mechanism of action, COVID-19 associated risk factors, adverse drug reactions, contraindications, and drug-drug interactions. Our study will help government partners and international health organizations to understand COVID-19 health risks associated with immunosuppressants. Increased public awareness about effective drug therapy for autoimmune diseases, cancer treatment, immunocompromised, and organ transplant patients will help lower the mortality and morbidity associated with the disease amid the COVID-19 pandemic.

Barriers in psychiatrists’ mind to active smoking cessation promotion in severe psychiatric disorders

BackgroundPromoting the cessation of smoking in mental healthcare is a priority of international health organizations as it is the most cost-effective intervention in psychiatry. AimTo explore the representations of psychiatrists on their role in active smoking cessation prevention in severe psychiatric disorders. MethodsPsychiatrists and residents in psychiatry were recruited at a national level by professional mailings. ResultsOne thousand four hundred and sixty participants were included in the study, and only 46% reported actively promoting smoking cessation. In multivariate analyses, participants aged<35years were more likely to promote cessation of tobacco smoking, as well as the two thirds who believe that psychiatry is a systemic discipline with complex interactions between brain, body and mind. Almost two thirds of those promoting tobacco cessation reported lacking time to combine psychiatric and physical examination during one session. The psychiatrists who reported not promoting tobacco smoking cessation also reported never dealing with physical health in case of the absence of a general practitioner and thinking that physical examination may have a negative impact on the therapeutic relationship. Almost all (96%) reported promoting the need for a general practitioner for their patients. We found no significant difference between the public and private sectors (P>0.05). InterpretationYoung psychiatrists are more prone than their elders to promote smoking cessation but report lacking time to include it in their daily practice. Promotion of tobacco smoking cessation should be included in the components for quality evaluation for mental health services and specific sessions dedicated to this intervention.

Knowledge of and preparedness for COVID-19 among Somali healthcare professionals: A cross-sectional study.

Somalia is considered severely underprepared to contain an outbreak of COVID-19, with critical shortages in healthcare personnel and treatment resources. In limited-resource settings such as Somalia, providing healthcare workers with adequate information on COVID-19 is crucial to improve patient outcomes and mitigate the spread of the SARS-CoV-2 virus. This study assessed the knowledge of, preparedness for, and perceptions toward COVID-19 prevention and treatment among Somali healthcare workers. A descriptive, cross-sectional survey was completed by 364 Somali healthcare workers in summer of 2020 utilizing a convenience sampling method. Participants' most accessed sources of COVID-19 information were from social media (64.8%), official government and international health organization websites (51.1%,), and traditional media sources such as radio, TV, and newspapers (48.1%). A majority of participants demonstrated strong knowledge of treatment of COVID-19, the severity of COVID-19, and the possible outcomes of COVID-19, but only 5 out of 10 symptoms listed were correctly identified by more than 75% of participants. Although participants indicated seeing a median number of 10 patients per week with COVID-19 related symptoms, access to essential medical resources, such as N95 masks (30.2%), facial protective shields (24.5%), and disposable gowns (21.4%), were limited. Moreover, 31.3% agreed that Somalia was in a good position to contain an emerging outbreak of COVID-19. In addition, 40.4% of participants agreed that the Somali government's response to the pandemic was sufficient to protect Somali healthcare professionals. This study provides evidence for the need to equip Somali healthcare providers with more information, personal protective equipment, and treatment resources such that they can safely and adequately care for COVID-19 patients and contain the spread of the virus. Social media and traditional news outlets may be effective outlets to communicate information regarding COVID-19 and the Somali government's response to frontline healthcare workers.