Ten years in public health 2007-2017 chronicles the evolution of global public health over the decade that Margaret Chan served as Director-General at the World Health Organization. This series of chapters evaluates successes setbacks and enduring challenges during the decade. They show what needs to be done when progress stalls or new threats emerge. The chapters show how WHO technical leadership can get multiple partners working together in tandem under coherent strategies. The importance of country leadership and community engagement is stressed repeatedly throughout the chapters. Together we have made tremendous progress. Health and life expectancy have improved nearly everywhere. Millions of lives have been saved. The number of people dying from malaria and HIV has been cut in half. WHO efforts to stop TB saved 49 million lives since the start of this century. In 2015 the number of child deaths dropped below 6 million for the first time a 50% decrease in annual deaths since 1990. Every day 19 000 fewer children die. We are able to count these numbers because of the culture of measurement and accountability instilled in WHO. These chapters tell a powerful story of global challenges and how they have been overcome. In a world facing considerable uncertainty international health development is a unifying – and uplifting – force for the good of humanity.
This encyclopedia covers the definitions, concepts, methods, theories, and application of evidence-based pharmaceutical public health and health services research. It highlights why and how this field has a significant impact on healthcare. The work aims to synthesize baseline knowledge as well as the latest and cutting-edge research-based information. The encyclopedia collates information on public health, health services research, evidence-based pharmacy practice and its impacts on patients, decision-makers and consumers. This reference work discusses all aspects of policy and practice decisions on medicines use, access and pharmacy services by covering broad aspects related to pharmacy practice, public health and health services research. The aim is to develop high-quality content, which will be a must-read and be used as a reference source at all pharmacy and medical schools in the world. The health services research investigates the impact of social factors, organizational policies, financing systems, medical technologies and personal influence on access, quality and cost of healthcare concerning the quality of life of the patients. This reference work fundamentally promotes the evidence-based evaluation of healthcare services and thus will improve the better access and delivery of healthcare services. Also, pharmacy, medical and health services students and researchers need a broad understanding of pharmaceutical public health, evidence-based approaches to delivering care, changing professional and patient behavior and undertaking research in these areas. In general, there is a need to build research capacity and capability in the pharmacy profession. EDITOR-IN-CHIEF: Professor Zaheer-Ud-Din Babar, University of Huddersfield SECTION EDITORS: Filipa Alves da Costa, University of LisbonZubin Austin, University of TorontoDalia Dawood, National Institute for Health and Care Excellence Andy Gray, University of Kwa Zulu-NatalRachele Hendricks-Sturrup, Duke Margolis Center for Health PolicyJason Hsu, Taiwan Medical UniversityRabia Hussain, Universiti Sains MalaysiaChristine Y. Lu, Harvard Medical School and Harvard Pilgrim Health Care InstituteMohamed Izham Mohamed Ibrahim, Qatar UniversityPrasad Nishtala, University of BathDerek Charles Stewart, College of Pharmacy, Qatar University Fatima Suleman, University of Kwa Zulu-NatalZaheer-Ud-Din Babar, University of Huddersfield
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We are today encountering numerous sustainable health concerns in relation to the existential threats caused by ecological and global changes. This book illustrates the ways in which health is being affected by anthropogenic human impacts on the environment, as well as climate change. It highlights synergistic, interventional approaches towards sustainable healthcare, together with innovative conceptual frameworks and models for facing the changing demands of our health needs under these current epidemiological and health transitions. It also sets out a vision of ecological principles to guide our professional directions with regards to sustainable health developments as legacy-based values across generations.
Given its continent-like diversity, India’s epidemiological, nutritional, and demographic transitions are occurring in a staggered fashion, with high state-level variances. In many parts of the country, high rates of undernutrition co-exist with equally high and increasing rates of overweight and obesity. Further, the incidence of non-communicable diseases (NCDs) as a leading cause of mortality is increasing, even as the communicable, maternal, neonatal and nutritional causes (or the “Millennium Development Goals (MDG) conditions”) are coming down. Indeed, India has witnessed inconsistent progress towards the MDGs, and even in states where absolute levels of “MDG conditions” are still high, the NCD proportion is growing rapidly. The imperative is for a realignment of policy responding to fast-changing subnational realities, through greater integration between health and nutrition policy at every level of governance.
Blood samples are often used to investigate the possible presence of disease and to make treatment decisions. In the interpretation of the results, comparison either with previous values from the same individual or with a set of appropriate group-based reference intervals are used. Current reference intervals for common laboratory analytes are often based on measurements from apparently healthy persons aged 18–65 years. Age is accompanied by a general decline in organ functions and it is difficult to determine whether a change in levels of laboratory analytes in an elderly individual can be attributed to age alone, independent of environmental or disease processes. Frailty can be seen as a consequence of age-related multifactorial deterioration – physical, cognitive and sensory – resulting in vulnerability and lack of adaptability to internal stressors such as infection or new medication and/or external stressors such as fall at home. Consensus about the definition of “frail” and “frailty” is missing, both nationally and internationally, the question arises whether different definitions of “frailty” affect the interpretation of analytes when comparing different groups of elderly. The overarching aim of the thesis was to interpret and assess circulating levels of some clinical laboratory analytes in relation to conventional reference values in ?80-year-old, “apparently healthy”, “moderately healthy”, and “frail” individuals. Data originated from other studies, in which blood samples were collected from individuals ?80-year-old. Comparisons in Paper I of levels of some laboratory analytes, from 138 nursing home residents (NHRs), was made with blood from reference populations, both blood donor and the NORIP study. The results indicated differences for some immunological (complement factor 3 and 4, immunoglobulin G and M) and chemical analytes (alanine aminotransferase (ALT), phosphate, albumin, sodium, creatinine and urea), but no differences in levels occurred for aspartate aminotransferase (AST), gamma-glutamyltransferase (?-GT) or lactate dehydrogenase (LDH). It was unclear whether the differences were due to differences in age between the elderly and the reference populations or whether the elderly individuals had chronic diseases and were on medication. In Paper II, 569 individuals elderly individuals ?80 years old were classified as “healthy”, “moderately healthy”, and “frail”, based on diseases, medications and physical and cognitive abilities. Statistical differences between the groups were found for the investigated analytes; albumin, ALT, AST, creatinine and ?-GT. In Paper IV, individuals from Paper II (n=569) were divided into two groups and thereafter divided into “apparently healthy”, “moderately healthy”, and “frail”. One group was subdivided into “apparently healthy”, “moderately healthy” and “frail” based on physical and cognitive abilities and the other group was divided based on the frailty index (FI). There was no statistical difference found between “apparently healthy” and “moderately healthy" groups, regardless of classification model used. Among “frail” individuals, differences in levels occurred for three out of the five investigated analytes: ALT, creatinine and g-GT, with lower levels occurring when the FI classification model was used. No differences in levels occurred for albumin or AST in “frail” individuals, regardless of classification model used. The aim of Paper III was to study whether 1-year changes in complete blood count (CBC) (including haemoglobin (Hb), red blood cell (RBC), erythrocyte volume fraction (EVF), mean corpuscular volume (MCV), mean corpuscular Hb concentration (MCHC), white blood cell (WBC) and platelet count (PLT)), C-reactive protein (CRP) and interleukin (IL)-1?, IL-1RA, IL-6, IL-8 and IL-10 are associated with survival in elderly NHRs aged >80 years. Elevated levels of CRP and IL-8 during 1-year follow-up were associated with reduced length of survival in elderly NHRs. Based on the present thesis it is clear that there is need for reference intervals that consider both age and health status in elderly individuals. A reasonable conclusion when interpreting levels of analytes in elderly individuals with disease or frailty is that individual evaluation based on the individual’s previous levels, is recommended. Blodprover används ofta för att undersöka ev förekomst av sjukdomar och för att fatta behandlingsbeslut. Vid tolkningen av resultaten används jämförelse antingen med tidigare värden från samma individ eller med en uppsättning lämpliga gruppbaserade referensintervall. Nuvarande referensintervall för vanliga laboratorieanalyter baseras ofta på mätningar från tillsynes friska personer i åldern 18–65 år. Åldern åtföljs av en allmän nedgång i organfunktioner och det är svårt att avgöra om en ev förändring av nivåerna av laboratorieanalyterna kan enbart beror på skillnaden i ålder, oberoende av miljö- eller sjukdomsprocesser. Skörhet kan ses som en konsekvens av åldersrelaterad multifaktoriell försämring - fysisk, kognitiv och sensorisk - vilket resulterar i sårbarhet och brist på anpassningsförmåga till interna stressfaktorer som infektion eller ny medicinering och/eller yttre stressorer, såsom att ramla hemma. Konsensus om definitionen av "skörhet" saknas, både nationellt och internationellt och frågan uppstod om olika definitioner av "skörhet" påverkar tolkningar och referensintervall för laboratorieanalyter, när man jämför olika grupper av äldre individer. Det övergripande syftet med avhandlingen var att tolka och bedöma cirkulerande nivåer för några kliniska laboratorieanalyser i förhållande till gällande referensvärden hos ?80-åriga, ”hälsosamma”, ”måttligt friska” och ”sköra” individer. Data kommer från andra studier, inom vilka blodprov samlades, alla från individer ?80 år. Jämförelser i studie I gjordes mellan blodprover från 138 individer i särskilt boende, med blodprover från referenspopulationer, både blodgivare och från NORIP-studien. Resultaten visade skillnader för vissa immunologiska (komplementfaktor 3 och 4) och kemiska analyser (alaninaminotransferas (Alat), fosfat, albumin, natrium, kreatinin och urea), men inte alla (aspartataminotransferas (Asat), gamma-glytamyltransferas (?-GT) eller laktatdehydrgenas (LD)). Det var oklart om skillnaderna berodde på skillnader i ålder mellan de äldre och referenspopulationerna eller om de äldre individerna hade kroniska sjukdomar och medicinerade. I studie II klassificerades 569 individer >80 år som ”hälsosamma”, ”måttligt friska” och ”sköra”, baserat på sjukdomar, medicinering och fysiska och kognitiva förmågor. Statistiska skillnader mellan grupperna hittades för de undersökta analyterna: albumin, Alat, Asat, kreatinin och y-GT. I studie IV delades individer från papper II (n = 569) in i två grupper och delades därefter upp i "hälsosamma", "måttligt friska" och "sköra". En grupp delades in i ”hälsosamma”, ”måttligt friska” och ”sköra” baserat på fysiska och kognitiva förmågor och den andra gruppen delades in baserat på skörhetsindex. Det fanns ingen statistisk skillnad mellan ”hälsosamma” och ”måttligt friska” grupperna, oavsett vilken klassificeringsmodell som användes. Bland ”sköra” individer inträffade skillnader i nivåer för tre av de fem undersökta analyterna: Alat, kreatinin och ?-GT, med lägre nivåer där skörhetsindex hade använts som klassificeringsmodell jämfört klassificering baserad på fysiska och kognitiva förmågor. Syftet med studie III var att studera om 1-års förändringar i blodstatusparametrar (hemoglobin (Hb), erytrocytpartikelkoncentration (EPK), erytrocytvolymfraktion (EVF), medelcellvolym (MCV), mean corpuscular Hb concentration (MCHC), leukocytpartikelkoncentration (LPK) och trombocytpartikelkoncentration (TPK)), C-reaktivt protein (CRP) och interleukin (IL)-1?, IL-1Ra, IL-6, IL-8 och IL-10 var associerade med överlevnad hos individer från särskilt boende > 80 år. De mest framträdande resultaten var att förhöjda nivåer av CRP och IL-8 under 1-års uppföljning var förknippade med förkortad överlevnadstid hos äldre från särskilt boende. Baserat på den aktuella avhandlingen är det tydligt att det finns behov av referensintervall som beaktar både ålder och hälsostatus hos äldre individer. En rimlig slutsats när man tolkar nivåer av laboratorieanalyter hos äldre individer med sjukdom eller skörhet är att individuell utvärdering baserad på individens tidigare nivåer rekommenderas.
All Human activities produce certain kinds of waste, such waste may be dangerous and it needs safe and proper disposal. It can also be dangerous to human beings and the environment. The improper management of Bio-Medical Waste generated in Health Care Institutions/Hospitals severely affects the health of patients, staff and the public at large and also has an adverse impact on the environment. In addition, pollution from improper treatment of waste directly affects the health of the community, in this affinity the author has selected a specific area and collected necessary research data by personally visiting the selected Health Care Institutions within Bangalore Urban City. Therefore, this book comprises Bio-Medical Waste Management and its impact on the Environment and Human beings, National and International Legal framework on Health Care Waste Management, it is useful for students who are studying Bachelor of Law (LL.B), Master of Law (LL.M) Ph.D scholars, Doctors, Nurses and persons who are handling of Health Care Waste Management at Hospital, Labs, Clinics and all Health Care Institutions
Global Health Watch (GHW), now in its sixth edition, provides the definitive voice for an alternative discourse on health. It integrates rigorous analysis, alternative proposals and stories of struggles and change to present a compelling case for the imperative to work for a radical transformation of the way we approach actions and policies on health. It was conceived in 2003 as a collaborative effort by activists and academics from across the world, and is designed to question present policies on health and to propose alternatives Global Health Watch 6 (GHW6) has been coordinated by eight civil society organizations – the People's Health Movement, ALAMES, Health Poverty Action, Medico International, Third World Network, Medact, Sama and Viva Salud. With contributions from across the globe, GHW6 addresses key issues related to health systems and the range of social, economic, political and environmental determinants of health, locating decisions and choices that impact on health in the structure of global power relations and economic governance.
For those wishing to understand issues of homelessness, social exclusion and health at a local level by framing these issues in a global context. It expands notions of health by drawing on disciplines outside the fields of housing and health to better comprehend the ways that stigma, identity and urban geographies shape and present homelessness.
