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.
"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.
Since 1967, the centennial of Confederation, numerous political crises, economic challenges, and international events have helped to transform Canadian society, and will continue to shape its future. Taking these various challenges and opportunities of the past into account, how does the future look for Canada? In Reflecting on Our Past and Embracing Our Future diplomats, politicians, scientists, and human rights leaders including Phil Fontaine, Michaëlle Jean, Ellen Gabriel, Paul Heinbecker, Bob Rae, Jean Charest, and David Suzuki have come together to share their wisdom and experience of events that have marked the country over the last fifty years. Reflecting on the role of the Senate in Canada as complementary to the House of Commons, they consider central issues such as the condition of indigenous peoples, the obligations of the Charter of Rights and Freedoms, the recognition of two official languages, and the national unity referendums. Contributors also discuss the transformation of the economy in a globalized and digital world, the role of Canada on the world stage at a time of growing tension and an increasing flow of refugees, climate change and the uncertain future of the Arctic, scientific and cultural competitions on the international market, and the future of parliamentary democracy. Correcting misconceptions about the contemporary role of the Senate, and providing a counterargument for radical Senate reform, Reflecting on Our Past and Embracing Our Future offers rich perspectives and fascinating insights about Canada's likely development in the coming years.
International Academic Conferences: Teaching, Learning and E-learning (VIAC-TLEl) Management, Economics and Marketing (VIAC-MEM) Transport, Logistics, Tourism and Sport Science (VIAC-TLTS) Engineering, Robotics, IT and Nanotechnology (VIAC-ERITN)
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
Since the publication of the first volume of Contemporary Developments and Perspectives in International Health Security, a lot has happened in this rapidly evolving area. Perhaps the most dominant global event of the past eighteen months is the COVID-19 pandemic. Within this general context, the importance of the multiple and diverse international health security (IHS) subdomains is becoming evident, especially when one begins to appreciate the interconnectedness of the modern world and the interdependence of various existing societal systems. Moreover, this complexity presents our civilization with both dangers and opportunities, and among the most pronounced opportunities is our ability to effectively “work together and coordinate” as humanity. With a goal to summarize and synthesize our collective experiences from the COVID-19 pandemic, this second tome of Contemporary Developments and Perspectives in International Health Security is a repository of knowledge and a practical resource for those who seek to learn about the current pandemic as well as for those who may already be preparing for the “next pandemic” or as yet unforeseen IHS threats. In addition to the COVID-19 global response, topics discussed in this book include climate change, mental health, supply chain management, and clinical diagnostics, among others.
Nurses are positioned on healthcare's front line, intimately connected to individuals, families, and communities. How can they leverage this position to work for the common good? In Toward a Better World, Mark Lazenby, a philosopher and a nurse, presents a plan of action. He argues that nurses advance the good society when they fulfill fundamental obligations. Promoting equality, peace and respect, providing assistance and safety, and safeguarding the health of our planet are among these obligations. By acting upon them, nurses become a force for social change in their communities. But through the collective power of more than 20 million nurses worldwide, nurses become a global force for making the world a better place--in the present and for the future. A companion to Caring Matters Most, Lazenby's ethics book, Toward a Better World challenges readers to lead good lives of service to others. This book will invigorate all, nurses and non-nurses alike, who wish to spend their lives making the world a better place.
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.
