WHO Global Report Research Articles

Physical characteristics of quercetin pulmospheres using combination of alginate-carrageenan: Effect of polymer concentration.

Indonesia is the second country with the highest number of tuberculosis (TB) cases in the world and the first in Southeast Asia, according to WHO Global Report 2020. Quercetin has been tried as an alternative therapy and was found effective. This study aims to optimize quercetin pulmospheres using combination polymers and study its characteristics as an inhalation delivery system. Combination polymers provide the advantages of safe, mucoadhesive, and compact pulmospheres. Pulmospheres were made as formula F1, F2, and F3 (polymer ratios of 1:1, 1:2, and 1:3), respectively. Pulmospheres were made with quercetin 0.2%, alginate-carrageenan (total concentration of 1.8%), and CaCl2 0.5 M. Characterization of particle size, morphology, moisture content (MC), yield, drug loading, and entrapment efficiency (EE) were conducted. The yield range was from 83.89 to 86.30% ± 4.59%. MC range was from 4.23 to 5.12% ± 0.05%. Particle size was <3 µm (between 2.19 and 2.76 ± 0.149 µm), spherical shape and smooth surface. EE range was 60.69% ± 4.45% to 77.86% ± 1.74% and the drug loading range was 1.66-2.09% ± 0.15%. F2 formula with a polymer ratio of 1:2 was the best quercetin pulmospheres. Potential pulmospheres will then be recommended for in vitro release and in vivo study.

Setting a dutch integrative medicine research agenda: Results of a consensus-based strategy

IntroductionThe WHO Traditional Medicine Strategy 2014–2023 emphasises the significance of traditional medicine systems for preventing and treating diseases, worldwide. As a result, many countries have developed national research programmes and research institutes dealing with traditional, complementary and integrative medicine (TCIM) (WHO Global Report on Traditional and Complementary Medicine, Geneva, 2019) or integrative medicine (IM). Despite considerable public interest in IM in the Netherlands, no Dutch programme or research institute has been established, yet. In 2018, a consortium for integrative care and health was founded, and developed a national research agenda with research priorities for the Netherlands. MethodsThe consensus-based strategy for developing the research agenda involved: (1) conducting a literature review, (2) organising an online consensus meeting with a select group of integrative medicine (IM) experts, (3) conducting a survey among IM stakeholders, and (4) organising a second consensus meeting with the same group of IM experts to discuss the survey results and further refine the research agenda. Snowball sampling was used to recruit IM stakeholders, starting from a list of those interested in or connected to IM. ResultsNinety-two stakeholders completed the survey. The most promising research areas were oncology, pain management and palliative care. Respondents awarded the highest priority to research on the effectiveness, cost-effectiveness and safety of IM interventions. Directions for research included mind–body interventions, biological interventions and whole medical systems. Moreover, respondents strongly recommended developing reliable patient information tools. Facilitators for IM implementation were increasing attention on prevention, the rising incidence of chronic diseases and the shift from disease-focused to health-focused approaches. The identified barriers included a lack of knowledge about IM, the absence of health insurance reimbursement for complementary medicine, and governance structures of healthcare organisations. ConclusionsThe first Dutch IM research agenda was developed based on consensus among Dutch healthcare professionals, along with input from a smaller group of patients and researchers. This agenda provides clear research directions and distinguishes both positive developments and barriers for IM in the Netherlands.

Monkeypox virus infections in low-risk groups during the 2022-23 global outbreak: An analysis of the WHO global report

Monkeypox virus infections in low-risk groups during the 2022-23 global outbreak: An analysis of the WHO global report

Monoresistance to Rifampicin: An Uncharted Territory in The Management of Drug-Resistant Tuberculosis

Tuberculosis (TB) disease caused by the bacilli Mycobacterium tuberculosis (MTB) is a chronic disease, mostly involving the lungs but can also involve other parts of the body, which if left untreated may lead to severe illness which can be fatal. Worldwide, TB is the 13th leading cause of death. TB occurs in every part of the world but its distribution is heterogenous. As per WHO global TB report, the biggest quantum of cases occurs in the South and South-Eastern Asian region (46%). Africa contributes to 23% with Western pacific taking 18% of the burden of TB [1].

Person-centred long-term care for older persons: a new Lancet Commission

The UN declared 2021–30 to be the Decade of Healthy Ageing, and efforts are being made to maximise the functional ability of people over their life course. 1 Beard JR Officer A de Carvalho IA et al. The World report on ageing and health: a policy framework for healthy ageing. Lancet. 2016; 387: 2145-2154 Summary Full Text Full Text PDF PubMed Scopus (1088) Google Scholar , 2 WHODecade of healthy ageing: baseline report. World Health Organization, Geneva2021https://www.who.int/publications/i/item/9789240017900Date accessed: May 5, 2023 Google Scholar Yet older people are marginalised and perceived as a burden, particularly those with ongoing loss in capacity. 3 WHOGlobal report on ageism. World Health Organization, Geneva2021https://www.who.int/teams/social-determinants-of-health/demographic-change-and-healthy-ageing/combatting-ageism/global-report-on-ageismDate accessed: May 5, 2023 Google Scholar Nowhere is this more conspicuous than in the context of long-term care (LTC) worldwide, where older people in some settings encounter a loss of independence and other violations of their human rights. Such experiences can range from deprivation of liberty and loss of legal capacity and consent to coerced institutionalisation, exposure to abuse, neglect, and disrespect, and persistent use of restraints. 4 Office of the United Nations High Commissioner for Human RightsA/HRC/51/27: older persons deprived of liberty—report of the Independent Expert on the enjoyment of all human rights by older persons, Claudia Mahler. United Nation Human Rights Council, Geneva2022https://www.ohchr.org/en/documents/thematic-reports/ahrc5127-older-persons-deprived-liberty-report-independent-expertDate accessed: May 5, 2023 Google Scholar These circumstances create inequity, injustice, and indignity for older people. 3 WHOGlobal report on ageism. World Health Organization, Geneva2021https://www.who.int/teams/social-determinants-of-health/demographic-change-and-healthy-ageing/combatting-ageism/global-report-on-ageismDate accessed: May 5, 2023 Google Scholar

Diabetes Prediction with the Help of Machine Learning

“The first WHO Global Report on Diabetes was launched on World Health Day 7th April 2016 and was dedicated to Diabetes” (Roglic G. WHO Global report on diabetes, 2016). Diabetes was recognized as a serious medical condition even in ancient times, but it does not appear that clinicians or other physicians dealt with it frequently. Increases in the prevalence of this disease over the past few decades have had a chilling effect on human health and development. This research is all about diabetic patients and how diabetes can be detected early using data science and machine learning algorithms. Based on diagnostic measurements, the purpose of the research is to make a diagnostic determination as to whether a patient suffers from diabetes.

A study of analysis on prevalence, serological marker and prognosis of tuberculosis in tertiary care hospital

BackgroundTuberculosis is an infectious disease responsible for a significant cause of ill health. According to the WHO global tuberculosis report 2021. 9.9 million cases fell sick with TB in 2020. Significantly, the prevalence of tuberculosis in India is 25%. ObjectiveTo analyze the prevalence of tuberculosis in the suburban areas of the metropolitan city in South India. To analyze the serological marker and prognosis of tuberculosis among males and females. To determine the importance of molecular testing - PCR confirmation on TB after AFB smear. MethodsA retrospective study to analyze 462 patients enrolled by the respiratory medicine department on suspecting pulmonary- 356 (M−264 & F-92) and extra-pulmonary-106 (M-73&F-33) patients and diagnosed Zhiel-Neelsen staining, Mantoux test, Chip-based RT-PCR test, Erythrocyte sedimentation rate, and analyzed serological test such as C-Reactive Protein, Chemiluminescence immune assay. Results23 patients were positive in Ziehl-Neelsen staining, 65 were positive in molecular True-Nat PCR test, Mantoux skin test induration in 10 patients, 98 TB Positive patients examined in the serological analysis, 1 & 3 patients reacted in HIV/HBsAg, and HBsAg test respectively, by chemiluminescence immunoassay, 8 PTB and 4 EPTB and 47 non-TB patients were positive in C-reactive protein, 46 TB and 94 non-TB patients detected abnormal values out of these 160 patients in ESR test. ConclusionThe Prevalence of tuberculosis is significantly rising, especially in the middle-aged population. The rapid molecular diagnostics to detect TB are highly sensitive and specific. Serological markers are essential for the analysis of disease prognosis and need to focus on the guidance of DOTS and RNTCP to End TB.

Airport smoking zones: a prospective public health hazard.

Airport smoking zones: a prospective public health hazard.

Assessing data availability of NCD prevention and control in six ASEAN countries based on WHO global monitoring framework and the progress monitor indicators

BackgroundTo tackle noncommunicable disease (NCD) burden globally, two sets of NCD surveillance indicators were established by the World Health Organization: 25 Global Monitoring Framework (GMF) indicators and 10 Progress Monitoring Indicators (PMI). This study aims to assess the data availability of these two sets of indicators in six ASEAN countries: Cambodia, Lao PDR, Malaysia, Myanmar, Thailand, and Vietnam.MethodsAs data on policy indicators were straightforward and fully available, we focused on studying 25 non-policy indicators: 23 GMFs and 2 PMIs. Gathering data availability of the target indicators was conducted among NCD surveillance experts from the six selected countries during May-June 2020. Our research team found information regarding whether the country had no data at all, was using WHO estimates, was providing ‘expert judgement’ for the data, or had actual data available for each target indicator. We triangulated their answers with several WHO data sources, including the WHO Health Observatory Database and various WHO Global Reports on health behaviours (tobacco, alcohol, diet, and physical activity) and NCDs. We calculated the percentages of the indicators that need improvement by both indicator category and country.ResultsFor all six studied countries, the health-service indicators, based on responses to the facility survey, are the most lacking in data availability (100% of this category’s indicators), followed by the health-service indicators, based on the population survey responses (57%), the mortality and morbidity indicators (50%), the behavioural risk indicators (30%), and the biological risk indicators (7%). The countries that need to improve their NCD surveillance data availability the most are Cambodia (56% of all indicators) and Lao PDR (56%), followed by Malaysia (36%), Vietnam (36%), Myanmar (32%), and Thailand (28%).ConclusionSome of the non-policy GMF and PMI indicators lacked data among the six studied countries. To achieve the global NCDs targets, in the long run, the six countries should collect their own data for all indicators and begin to invest in and implement the facility survey and the population survey to track NCDs-related health services improvements once they have implemented the behavioural and biological Health Risks Population Survey in their countries.

Falls assessment and prevention in the nursing home and community

British Journal of Community NursingVol. 28, No. 2 Care of the Older PersonFalls assessment and prevention in the nursing home and communityTiago Horta Reis da SilvaTiago Horta Reis da SilvaE-mail Address: [email protected]Lecturer in Nursing Education AEP, Department of Adult Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College LondonSearch for more papers by this authorTiago Horta Reis da SilvaPublished Online:3 Feb 2023https://doi.org/10.12968/bjcn.2023.28.2.68AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Almeida LMDS, Meucci RD, Dumith SC. Prevalence of falls in elderly people: a population based study. Rev Assoc Med Bras (1992). 2019;65(11):1397-1403. https://doi.org/10.1590/1806-9282.65.11.1397 Crossref, Medline, Google ScholarCare Inspectorate and NHS Scotland. managing fall and fractures in care homes for older people - good practise resource. 2016. http://www.careinspectorate.com/index.php/publications-statistics/76-professionals-registration/resources/2712-managing-falls-and-fractures-in-care-homes-for-older-people (accessed 9 January 2023) Google ScholarCooper R. Reducing falls in a care home. BMJ Open Quality. 2017;6:u214186.w5626. https://doi.org/10.1136/bmjquality.u214186.w5626 Google ScholarCraig J, Murray A, Mitchell S, Clark S, Saunders L, Burleigh L. The high cost to health and social care of managing falls in older adults living in the community in Scotland. Scott Med J. 2013;58(4):198-203. https://doi.org/10.1177/0036933013507848 Crossref, Medline, Google ScholarDemura S, Yamada T, Kasuga K. Severity of injuries associated with falls in the community dwelling elderly are not affected by fall characteristics and physical function level. Arch Gerontol Geriatr. 2012;55(1):186-189. https://doi.org/10.1016/j.archger.2011.06.033 Crossref, Medline, Google ScholarDepartment of Health. Best Practise Guidance. Falls and fractures - effective interventions in health and social care. 2009. http://www.laterlifetraining.co.uk/wp-content/uploads/2011/12/FF_Effective-Interventions-in-health-and-social-care.pdf (accessed 9 January 2023) Google ScholarDhargave P, Sendhilkumar R. Prevalence of risk factors for falls among older people people living in long-term care homes. J Clin Gerontol Geriatr. 2016;7(3):99–103. https://doi.org/10.1016/j.jcgg.2016.03.004 Crossref, Google ScholarJohansson J, Nordström A, Nordström P. Greater Fall Risk in Elderly Women Than in Men Is Associated With Increased Gait Variability During Multitasking. 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Cochrane Database Syst Rev. 2019;1(1):CD012424. https://doi.org/10.1002/14651858.cd012424.pub2 Medline, Google ScholarTinetti ME, Williams CS. The effect of falls and fall injuries on functioning in community-dwelling older persons. J Gerontol A Biol Sci Med Sci. 1998;53(2):M112-119. https://doi.org/10.1093/gerona/53a.2.m112 Crossref, Medline, Google ScholarUdell JE, Drahota A, Mackenzie H. Psychological and educational interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019;2019(11):CD013480. https://doi.org/10.1002%2F14651858.CD013480 Google ScholarWorld Health Organization. WHO global report on falls prevention in older age. 2008. https://extranet.who.int/agefriendlyworld/wp-content/uploads/2014/06/WHo-Global-report-on-falls-prevention-in-older-age.pdf (accessed 9 January 2023) Google Scholar FiguresReferencesRelatedDetails 2 February 2023Volume 28Issue 2ISSN (print): 1462-4753ISSN (online): 2052-2215 Metrics History Published online 3 February 2023 Published in print 2 February 2023 Information© MA Healthcare LimitedPDF download

Effectiveness and determinants of smoking cessation in the Saudi Arabian Region of Jazan: A cross-sectional study.

Smoking cessation has significant health benefits. The purpose of this study is to assess the efficacy and related factors of smoking cessation therapies in the Jazan Region of Saudi Arabia. This is a cross-sectional study that took place at smoking cessation clinics in primary healthcare centers between January 2019 and January 2020. This study enrolled a total of 103 people. The success rate for quitting smoking was 36% at three months, with a 13% relapse rate at six months. Age (p=0.017), occupation (p=0.046), daily cigarette intake (p=0.015), and number of visits (p=0.001) were all found to be significant determinants of smoking cessation. In the multivariate analysis, only the number of visits increased the likelihood to quit smoking (AOR=0.31; 95% CI: 0.15-0.63). Self-efficacy was cited as the primary reason for quitting smoking by 71% of the participants, whereas family support, smoking cessation therapies, and friends' support were cited as predictive variables by 18%, 10%, and 1% of the participants, respectively. Smokers who received the smoking cessation intervention package were three times more likely to succeed in giving up smoking when compared to those who received the routine service. Regular follow-up during smoking cessation interventions significantly enhanced the quit rate. It is recommended that pharmacotherapy strategies and intense therapy performed face-to-face with a cessation counselor be combined to improve the quit rate.

Integrative medicine: The future of Indian health care

Integrative medicine is a patient-focused healing-oriented medicine selectively incorporating elements of complementary (chiropractic therapy, yoga, and meditation) medicine and alternative medicine (drugs, surgery, and lifestyle changes) evidence-based and experience-based therapy into comprehensive treatment methods. It is a form of health care that seeks to understand the individual as a whole (body, mind, and spirit) including all aspects of lifestyle, and use all appropriate therapeutic approaches within a framework that focuses on health, the therapeutic relationship, and the whole person. In recent years, integrative medicine has developed into a distinct medical specialty as more and more health-care professionals have embraced it as an approach to patient care and the public has also become more educated and conscious enough about its foundational concepts. As defined by the National Center for Complementary and Alternative Medicine at the National Institutes of Health, integrative medicine combines mainstream medical therapies and complementary therapies for which there is some high-quality scientific evidence of safety and effectiveness. The term integration is used to express the formalization and official incorporation of traditional medicine into the National Health Services.[1] India is a reservoir of the antiquity of health practices supported by a strong foundation of indigenous traditional knowledge. The health needs of modern society are enormous and no single established and approved health-care system can address all the needs. Hence, became evident the need for a new collaborative regimen to guide health interventions and programs. India is backed with a rich heritage of indigenous knowledge coupled with a robust infrastructure and skilled workforce in modern medicine serving as a fertile land for medical pluralism to bloom. The integrative approach has thus proved effective in formulating strategies for healthy senescence, promoting self-management, and managing health-care expenditures. The Government of India has also promoted the integrative approach by mainstreaming Ayurveda and Yoga (AYUSH) with the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke in 2015 by the Ministry of AYUSH and Central Council of Research in Ayurvedic Sciences in collaboration with the Directorate General of Health Services with the objective to reduce drug dependency in chronic cases through yoga practices and Ayurveda and lifestyle changes. The application of Ayurveda as an adjuvant therapy has been used to reduce morbidities and associated ailments, to incorporate yoga sessions among admitted patients during their stay at the hospital for enhancing metabolism and positive physical and mental health. The National Health Policy 2017 advocates the improvement of health status through coordinated policy implementation in all sectors. The WHO Global Report on Traditional and Complementary Medicine 2019 reiterates the need for integrating the best of traditional and complementary medicine and that of conventional medicine to tackle the unique health challenges posed in the 21st century.[23] Scope of Integrative Medicine and Ways Forward Integrative health recognizes that modern systems and AYUSH systems have their own strengths and limitations in a way that they complement each other. The strengths of modern medicine include emergency management, anesthesia, surgical management, antimicrobial therapy, and management of communicable and noncommunicable diseases. In contrast, the conventional systems of traditional Indian health practices have strengths in preventive and promotive health, dietetics, advocacy of moral conduct, yoga, etc., An integrative approach incorporating the strengths of different systems of medicine provides scope for holistic and comprehensive care. Integrative Medicine is Not… Unfortunately, integrative medicine has often been mislabeled as mixopathy necessitating the need for the professions and consumers to distinguish between the two. Understanding the reason for integration is a pivotal step in preserving, protecting, and rejuvenating health along with effective, ethical, and safe management of different ailments. Integration aims to bring together the best practices of each system without losing their identity. In contrast, mixopathy is the unethical practice of self-perpetuated and self-convenient methods by unqualified people, which is not supported by any evidence. A system of integrative medicine can thus avoid the ballooning of health-care expenditure and provide a continuum of care and help us realize the Sustainable Development Goal 3 of universal health care.[3]

COVID-19 and TB. Review

The COVID-19 coronavirus pandemic has caused millions of casualties and led to enormous health and socio-economic consequences. Numerous studies show that as a result of the COVID-19 pandemic, significant disruptions to the health care system have occurred, which was reflected on the one hand in a decrease in the detection of tuberculosis, but also in an increase in cases of severe disease and acute progression of this disease. The 2020 WHO global report showed that for the first time in 10 years, mortality from tuberculosis has increased. According to many studies, COVID-19 and tuberculosis have a synergistic relationship, enhancing each other’s harmful effects. Both pathogens cause a general dysregulation of immune responses, leading to an increased risk of severity and progression of both diseases, including the possibility of cytokine storm and lethal outcomes. Given the synergistic impact of these two respiratory diseases, it is critical to treat both diseases simultaneously to control TB syndrome and COVID-19. The effects of the past pandemic will inevitably have an impact in the future, especially since COVID-19, which has not disappeared, has been added to the usual flu, ARVI and other seasonal diseases. In this regard, there is a need to include measures to integrate COVID-19 safety awareness in various national programs, and there is a need for coordinated global health activities aimed at combating emerging pandemics while ensuring continued provision of health services to people requiring treatment for ongo-ing diseases.

Identification of smoking cessation phenotypes as a basis for individualized counseling: An explorative real-world cohort study.

INTRODUCTIONThe rate of relapse in smokers attempting to quit is generally high. In order to maximize the chances of success, it is of interest to better understand the dynamic of lapse and relapse during smoking cessation. We hypothesized that specific behavioral patterns in tobacco consumption could predict the probability of quitting success and could open the possibility for a more targeted approach. The aim of the current study was to characterize clusters of quitting trajectories among participants involved in a smoking cessation program.METHODSIn a retrospective real-world cohort study, data from 843 consecutive participants between March 2012 and December 2014 were collected. Data consisted of baseline information on demographics, smoking history and dependence level, as well as longitudinal data about tobacco consumption. The correlations among time series were characterized using principal coordinates analysis. Clusters were identified using k-means clustering and the average profile associated with each cluster was computed. The association between the participant’s baseline characteristics and clusters of tobacco consumption was assessed.RESULTSFour distinct clusters of transition phenotypes were identified based on tobacco consumption during the cessation phase: the long-term quitters (30%), the persistent smokers/reducers (44%), the short-term returners (16%) and the repeated try and failers (10%). Significant between-cluster differences were found in terms of baseline characteristics and smoking behavior during follow-up.CONCLUSIONSMeaningful clusters of quitting trajectories could be identified. Such specific behavioral patterns were useful for the application of personalized assistance needed to achieve successful and long-term cessation.

Congenital Infections: Priorities and Possibilities for Resource-limited Settings.

Congenital Infections: Priorities and Possibilities for Resource-limited Settings.

Opinions and experiences of physicians regarding complementary and alternative medicine (CAM). A research report from Poland

Background: The term CAM denotes complementary and alternative medicine. However, CAM is practiced by individuals without academic medical education and formal eligibility for treating people. The extent of interest in CAM is considerable. The WHO global report on traditional and complementary medicine has demonstrated that 87% of all WHO Member States legally recognise individual forms of CAM, and 100 Member States have national policies regarding such practices. In Poland, performing medical activities without appropriate qualifications is prohibited.&#x0D; Material and Methods: Diagnostic survey distributed as Google Forms was used as the basic research method with the research technique of a questionnaire. The questionnaire starting with a metrics part consisted of several questions regarding popularity and tendency of CAM, causes of CAM popularity, approach to those types of practices and patients as well as role of CAM during the pandemic. Sixty-one responses were obtained from physicians of different age, experience and speciality.&#x0D; Results: Ninety-five percent (95%) of doctors believe that alternative medicine can be dangerous; 67.2% think that the phenomenon of alternative medicine should be combated; almost half of the physicians surveyed believe that there is a fundamental contradiction between evidence-based medicine (EBM) and alternative medicine. Furthermore, according to 48% of respondents, physicians in Poland should be able to recommend and combine methods of traditional and alternative medicine.&#x0D; Conclusion: Doctors point to the increasing popularity of CAM among patients in Poland, the consequences of which cannot be determined because there is still a lack of research on the safety of alternative methods. The most frequently cited reasons for interest in CAM suggest that there is a need for a better tailored biomedical approach to individual patient needs.

National tuberculosis spending efficiency and its associated factors in 121 low-income and middle-income countries, 2010–19: a data envelopment and stochastic frontier analysis

SummaryBackgroundMaximising the efficiency of national tuberculosis programmes is key to improving service coverage, outcomes, and progress towards End TB targets. We aimed to determine the overall efficiency of tuberculosis spending and investigate associated factors in 121 low-income and middle-income countries between 2010 and 2019.MethodsIn this data envelopment and stochastic frontier analysis, we used data from the WHO Global TB report series on tuberculosis spending as the input and treatment coverage as the output to estimate tuberculosis spending efficiency. We investigated associations between 25 independent variables and overall efficiency.FindingsWe estimated global tuberculosis spending efficiency to be between 73·8% (95% CI 71·2–76·3) and 87·7% (84·9–90·6) in 2019, depending on the analytical method used. This estimate suggests that existing global tuberculosis treatment coverage could be increased by between 12·3% (95% CI 9·4–15·1) and 26·2% (23·7–28·8) for the same amount of spending. Efficiency has improved over the study period, mainly since 2015, but a substantial difference of 70·7–72·1 percentage points between the most and least efficient countries still exists. We found a consistent significant association between efficiency and current health expenditure as a share of gross domestic product, out-of-pocket spending on health, and some Sustainable Development Goal (SDG) indicators such as universal health coverage.InterpretationTo improve efficiency, treatment coverage will need to be increased, particularly in the least efficient contexts where this might require additional spending. However, progress towards global End TB targets is slow even in the most efficient countries. Variables associated with TB spending efficiency suggest efficiency is complimented by commitments to improving health-care access that is free at the point of use and wider progress towards the SDGs. These findings support calls for additional investment in tuberculosis care.FundingNone.

The WHO Global Tuberculosis 2021 Report – not so good news and turning the tide back to End TB

ObjectiveTo review the data presented in the 2021 WHO global TB report and discuss the current constraints in the global response. Introduction and methodsThe WHO global TB reports, consolidate TB data from countries and provide up to date assessment of the global TB epidemic. We reviewed the data presented in the 2021 report. ResultsWe noted that the 2021 WHO global TB report presents a rather grim picture on the trajectory of the global epidemic of TB including a stagnation in the annual decline in TB incidence, a decline in TB notifications and an increase in estimated TB deaths. All the targets set at the 2018 United Nations High Level Meeting on TB were off track. Interpretation and conclusionThe sub-optimal global performance on achieving TB control targets in 2020 is attributed to the on-going COVID-19 pandemic, however, TB programs were already off track well before the onset of the pandemic, suggesting that the pandemic amplified an already fragile global TB response. We emphasize that ending the global TB epidemic will require bold leadership, optimization of existing interventions, widespread coverage, addressing social determinants of TB and importantly mobilization of adequate funding required for TB care and prevention.

LEGAL DIMENSION OF TRADITIONAL AND COMPLEMENTARY MEDICINE PRACTICES IN TURKEY

Context and Aim: The World Health Organization defines traditional and complementary medicine (TCM) practices as “the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness”. This study aims to analyse the main legal regulations on TCM practices in Turkey.&#x0D; Methodology: The study is based on a systematic review and analysis of desk research and data in the literature. TCM practices were analysed by reviewing the literature screening in particular data of the Ministry of Health, the CAMbrella study which had been conducted by the European Union and the WHO Global Report On Traditional And Complementary Medicine 2019. The literature review was carried out in “Ulakbim Turkish Academic Network and Information Center”, “Google Scholar“. The research was made between September 2021 and October 2021, and 5 keywords were used: “traditional medicine”, “complementary medicine”, "integrative medicine", "alternative medicine" and "functional medicine".&#x0D; Findings: TCM practices in Turkey are based on the Supplementary Article 13 of the Law No. 1219 on the Practice of Medicine and Medical Arts, Article 9/c and Annex 11 of the Health Services Basic Law No. 3359, and the Presidential Decree No. 1. Traditional and Complementary Medicine Practices Regulation (“Regulation”), dated 2014, stipulates the TCM practices in 15 areas, including acupuncture, apitherapy, phytotherapy, hypnosis, leech, homeopathy, chiropractic, cupping, larva, mesotherapy, prolotherapy, osteopathy, ozone, reflexology and music therapy. Although the regulation basically specified the qualifications of TCM practitioners, the minimum requirements of the practice centres, and in which cases TCM practice can be imply or not, the issues such as the obligation to informed consent regarding TCM practices, medical malpractice regarding TCM practices is not fully regulated. In this respect, it is required to make comprehensive and detailed regulations on these issues.&#x0D; Conclusion: TCM practices fill an important gap in terms of human health in areas that modern medicine cannot deal with. It is important to make the necessary legal regulations, especially to regulate informed consent; to define the care standards for medical malpractices regarding TCM practices, to strengthen the evidence base of TCM practices just like the conventional medicine practices.

Design of gourmet menus high in fiber for diabetic patients of the French sanatorium: evaluation of the nutritional content, acceptability, organoleptic characteristics and glycemic control

Rationale: The first WHO global report on diabetes, shows that the number of adults with diabetes has quadrupled since 1980 to 422 million. However, there is scientific evidence that diabetes can be treated with diet, physical activity and medications. Therefore, given the increase in diabetic patients admitted to hospitals, the higher economic costs generated by their treatment and the growing demand for gourmet gastronomy in hospital settings for susceptible populations.