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1

Asia, World Health Organization Regional Office for South-East. Priority areas for research in communicable diseases. New Delhi: World Health Organization, Regional Office for South-East Asia, 2009.

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2

Lohsoonthorn, Paibool, Sukon Kanchanaraksa, Thailand. Khana Kammakān Rabātwitthayā hǣng Chāt. Fact Finding Commission. e Rockefeller Foundation, a cura di. Review of the health situation in Thailand: Priority ranking of diseases. Bangkok, Thailand: The Board, 1987.

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3

Ryan, Colleen. Operational definitions for year 2000 objectives: Priority area 20, immunization and infectious diseases. [Hyattsville, Md.] (6525 Belcrest Rd., Hyattsville 20782): [U.S. Dept. of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Health Statistics, 1997.

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4

Messele, Tsehaynesh. Identifying HIV/AIDS, sexually transmitted infections, and tuberculosis research gaps, and priority setting agenda in Ethiopia. Addis Ababa, Ethiopia: Ethiopian Public Health Association, 2005.

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5

Karen, Adams, Corrigan Janet M e Institute of Medicine (U.S.), a cura di. Priority areas for national action: Transforming health care quality. Washington, D.C: National Academies Press, 2003.

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6

Puja, Thakker, World Economic Forum e World Health Organization. Country Office for India, a cura di. Employee wellness as a strategic priority in India: Preventing the burden of non-communicable diseases through workplace wellness programmes. Geneva, Switzerland: World Economic Forum, 2009.

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7

World Health Organization. Regional Office for the Western Pacific. Priority HIV and sexual health interventions in the health sector for men who have sex with men and transgender people in the Asia-Pacific Region. Manila: World Health Organization, Western Pacific Region, 2010.

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8

Workshop, on Enhancing Interactions to Reduce Cancer Health Disparities (2005 Bethesda Md ). Proceedings from enhancing interactions to reduce cancer health disparities, an NCI-wide workshop: Including a proposed action plan to achieve the NCI strategic priority, overcome cancer health disparities. [Bethesda, MD]: U.S. Department of Health and Human Services, National Institutes of Health, 2006.

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9

Brazeau, Stéphanie, e Nicholas H. Ogden, a cura di. Earth observation, public health and one health: activities, challenges and opportunities. Wallingford: CABI, 2022. http://dx.doi.org/10.1079/9781800621183.0000.

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Abstract This book contains 4 chapters that discuss in the context of both the One Health concept and the SDG initiative, remote sensing can provide solutions to the priority of assessing and monitoring public health risks, and it can play an important role in supporting decision making to reduce health risks within our shared ecosystems. The growing awareness of complex but causal interactions among these realms has motivated professionals in a wide range of sectors to adopt the One Health approach, which promotes intersectoral collaboration to address health issues at the human-animal-environment interface. In its 2030 Agenda for Sustainable Development, the United Nations specifically identifies "strengthening the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks" as part of their Good Health and Well-being Sustainable Development Goal (SDG). As examples presented in this book reveal, the risk of infectious disease emergence increases with a wide range of conditions and variables, including those associated with humans, animals, climate, and the environment. This book examines several priority themes to which EO and geomatics can make important contributions: mosquito-borne and tick-borne diseases; water-borne diseases; air quality and extreme heat effects; geospatial indicators of vulnerable human populations.
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10

Lyon-Caen, Olivier. Priorité cerveau: Des découvertes aux traitements. Paris: Jacob, 2010.

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11

Nthia, Njeru Enos Hudson, a cura di. Combating HIV/AIDS in Kenya: Priority setting and resource allocation. Nairobi, Kenya: Institute of Policy Analysis and Research, 2004.

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12

Commission, Uganda AIDS. National HIV and AIDS priority action plan, 2018/2019-2019/2020. Kampala, Uganda: Uganda AIDS Commission, 2018.

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13

Legesse, Berhanu, e YaʼItyop̣yā ṭénā ʼaṭabābaq māhbar, a cura di. HIV/AIDS/STI/TB training needs identification and priority agenda setting: Study. Addis Ababa, Ethiopia: Ethiopian Public Health Association, 2008.

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14

Simbaya, Joseph. How HIV/AIDS scale-up has impacted on non- HIV priority services in Zambia. Zambia: s.n., 2009.

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15

Jacques, Roux. Sang contaminé: Priorités de l'état et décisions politiques. Montpellier: Espaces 34, 1995.

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16

World Health Organization (WHO). Dementia: A Public Health Priority. World Health Organization, 2012.

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17

U. S. Government Accountability Offi Gao. National Institutes of Health: Research Priority Setting, and Funding Allocations Across Selected Diseases and Conditions. Independently Published, 2019.

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18

Adams, Karen, Institute of Medicine, Board on Health Care Services, Committee on Identifying Priority Areas for Quality Improvement e Janet M. Corrigan. Priority Areas for National Action: Transforming Health Care Quality. National Academies Press, 2003.

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19

Adams, Karen, Institute of Medicine, Board on Health Care Services, Committee on Identifying Priority Areas for Quality Improvement e Janet M. Corrigan. Priority Areas for National Action: Transforming Health Care Quality. National Academies Press, 2003.

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20

Adams, Karen, Institute of Medicine, Board on Health Care Services, Committee on Identifying Priority Areas for Quality Improvement e Janet M. Corrigan. Priority Areas for National Action: Transforming Health Care Quality. National Academies Press, 2003.

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21

Kenney, Doreen. Natural Aging Rejuvenation: Giving Priority to Both Natural Treatments and Prevention of Chronic Diseases Which Will Make You Younger. Independently Published, 2018.

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22

U. S. Government Accountability Offi Gao. National Institutes of Health: Kidney Disease Research Funding and Priority Setting. Independently Published, 2019.

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23

San Francisco HIV Prevention Planning Council priority-setting, 1995/1996. [San Francisco, Calif: The Council], 1996.

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24

Jaworska, Agnieszka. Ethical dilemmas in neurodegenerative disease: Respecting patients at the twilight of agency. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198786832.003.0015.

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This chapter focuses on dilemmas faced by caregivers of Alzheimer’s patients in cases in which current preferences of such patients come into conflict with the attitudes and values the person held during better health. To which set of preferences should conscientious caregivers give priority? The chapter argues that many Alzheimer’s patients, at least up to the middle stages of the disease, are still capable of rudimentary autonomy and that they still have authority concerning their well-being. The capacity to value is often not completely lost in dementia, and insofar as it is not, respect for the immediate interests of a demented person compromises neither their well-being nor the respect for their autonomy. In the postscript, emerging neuroscience evidence is discussed that may suggest that, for a time, the capacity to value is not only preserved but even enhanced in the progression of Alzheimer’s disease.
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25

Webber, David M. Morals and Medicines. Edinburgh University Press, 2018. http://dx.doi.org/10.3366/edinburgh/9781474423564.003.0006.

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The second case study, explored here in chapter 6, addresses the commitment of the New Labour government to increase the availability of antiretroviral (ARV) drugs needed to combat HIV and AIDS in the developing world. This chapter extends the analysis that appears in chapter 3 concerning New Labour’s claim to be the ‘party of business’ and its special relationship with the UK pharmaceutical industry. In doing so, it reveals a clear tension between the priority that New Labour afforded to these drug companies, and the commitment that Brown and other government officials made concerning the delivery of ARV medicines. Despite the urgent need to roll-out these drugs to stem the rising tide of AIDS-related deaths in the global South, New Labour’s policies – again designed principally by Brown – appeared to prioritise the preferences of these firms and their shareholders. Although Brown was amongst a number of government officials concerned at the prohibitively high price of these drugs, this chapter finds that he was also instrumental in introducing a number of measures that incentivised rather than forced the industry into meeting its wider obligations towards addressing HIV and AIDS, and the other so-called ‘diseases of poverty’ in the global South.
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26

Reichel, Philip, e Ryan Randa, a cura di. Transnational Crime and Global Security. Praeger, 2018. http://dx.doi.org/10.5040/9798216989707.

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Abstract (sommario):
This two-volume work offers a comprehensive examination of the distressing topics of transnational crime and the implications for global security. National security is a key concern for individual nations, regions, and the global community, yet globalism has led to the perfusion of transnational crime such that it now poses a serious threat to the national security of governments around the world. Whether attention is concentrated on a particular type of transnational crime or on broader concerns of transnational crime generally, the security issues related to preventing and combatting transnational crime remain of top-priority concern for many governments. Transnational Crime and Global Securityhas been carefully curated to provide students, scholars, professionals, and consultants of criminal justice and security studies with comprehensive information about and in-depth analysis of contemporary issues in transnational crime and global security. The first volume covers such core topics as cybercrime, human trafficking, and money laundering and also contains infrequently covered but nevertheless important topics including environmental crime, the weaponization of infectious diseases, and outlaw motorcycle gangs. The second volume is unique in its coverage of security issues related to such topics as the return of foreign terrorist fighters, using big data to reinforce security, and how to focus efforts that encourage security cooperation.
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27

Reichel, Philip, e Ryan Randa, a cura di. Transnational Crime and Global Security. ABC-CLIO, LLC, 2018. http://dx.doi.org/10.5040/9798216989714.

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Abstract (sommario):
This two-volume work offers a comprehensive examination of the distressing topics of transnational crime and the implications for global security. National security is a key concern for individual nations, regions, and the global community, yet globalism has led to the perfusion of transnational crime such that it now poses a serious threat to the national security of governments around the world. Whether attention is concentrated on a particular type of transnational crime or on broader concerns of transnational crime generally, the security issues related to preventing and combatting transnational crime remain of top-priority concern for many governments. Transnational Crime and Global Securityhas been carefully curated to provide students, scholars, professionals, and consultants of criminal justice and security studies with comprehensive information about and in-depth analysis of contemporary issues in transnational crime and global security. The first volume covers such core topics as cybercrime, human trafficking, and money laundering and also contains infrequently covered but nevertheless important topics including environmental crime, the weaponization of infectious diseases, and outlaw motorcycle gangs. The second volume is unique in its coverage of security issues related to such topics as the return of foreign terrorist fighters, using big data to reinforce security, and how to focus efforts that encourage security cooperation.
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28

Pisinger, Charlotta, e Serena Tonstad. Smoking. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656653.003.0010.

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Abstract (sommario):
Smoking causes all forms of cardiovascular disease (CVD): there is no safe level of smoking. The health benefits of quitting smoking are immediate. In patients with coronary heart disease smoking cessation results in a dramatic decline in future cardiovascular events and reduces cardiovascular death; it is the most effective and cheapest treatment for preventing new or recurrent CVD. Tobacco dependence should be regarded as a chronic disease with a lifelong risk of relapse. Making treatment readily available and reducing barriers to treatment increase the likelihood that smokers will accept treatment. Medication and follow-up should be arranged for all smokers upon hospital discharge and in outpatient settings. High priority should be given to identification and documentation of the smoking status of all patients, and systematic provision of cessation support. Clinicians should also ask about exposure to second-hand smoke and should play an active role in advocating for stronger tobacco controls.
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29

Pisinger, Charlotta, e Serena Tonstad. Smoking. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199656653.003.0010_update_001.

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Abstract (sommario):
Smoking causes all forms of cardiovascular disease (CVD): there is no safe level of smoking. The health benefits of quitting smoking are immediate. In patients with coronary heart disease smoking cessation results in a dramatic decline in future cardiovascular events and reduces cardiovascular death; it is the most effective and cheapest treatment for preventing new or recurrent CVD. Tobacco dependence should be regarded as a chronic disease with a lifelong risk of relapse. Making treatment readily available and reducing barriers to treatment increase the likelihood that smokers will accept treatment. Medication and follow-up should be arranged for all smokers upon hospital discharge and in outpatient settings. High priority should be given to identification and documentation of the smoking status of all patients, and systematic provision of cessation support. Clinicians should also ask about exposure to second-hand smoke and should play an active role in advocating for stronger tobacco controls.
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30

de Bie, Robertus M. A. An Iatrogenic Catatonia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190607555.003.0030.

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Neuroleptic malignant syndrome is an iatrogenic movement disorders emergency characterized by rigidity, altered consciousness, and autonomic instability of varying degrees of severity. In severe cases this can be a fatal syndrome, so recognition and withdrawal of potentially causative medications is the priority. Management is otherwise supportive, and some patients will require admission to an intensive care unit. Creatine phosphokinase can be used to monitor the disease course; a decreasing creatine phosphokinase level with an increasing temperature may indicate an infection. The incidence of neuroleptic malignant syndrome has declined considerably with the increased use of atypical neuroleptics with greater D2 receptor blockade compared to older agents.
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31

Shein, Steven L., e Robert S. B. Clark. Neurocritical Care. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0009.

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Brain injury is the most common proximate cause of death in pediatric intensive care units. For children who survive critical illness, long-standing brain damage and residual brain dysfunction can affect quality of life significantly. Therefore, minimizing neurological injury to improve patient outcomes is a priority of neurocritical care. This may be accomplished by implementing specific targeted therapies, avoiding pathophysiological conditions that exacerbate neurological injury, and using a multidisciplinary team that focuses on contemporary care of children with neurological injury and disease. This chapter reviews pertinent anatomy and physiology; general principles of pediatric neurocritical care; and specifics for caring for children with traumatic brain injury, hypoxic–ischemic encephalopathy, status epilepticus, meningitis/encephalitis, stroke, and acute hydrocephalus.
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32

Johnstone, R. William. Bioterror. Greenwood Publishing Group, Inc., 2008. http://dx.doi.org/10.5040/9798400619212.

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Abstract (sommario):
This book uses the 2001 anthrax attacks as its point of departure for an analysis of the past, present, and future of America's preparedness to deal with major challenges to public health, including bioterrorism and pandemic flu. The study identified the strength and weaknesses of the system while making recommendations for improvements. This allows the U.S. to be better prepared if faced with a larger or different biological threat. This book looks for linkages not only between bioterrorists and pandemic defenses, but also between public health security and the wider field of homeland security. Johnstone highlights some key foundation plans and strategies that are to serve as a basis for public health security. Failure to address these crucial issues not only creates unfounded mandates but also inhibits priority setting, leadership, and accountablity. Bioterror: Anthrax, Influenza, and the Future of Public Health Security utilizes a large number of sources from within both the public health and public policy communities to document how each sector responded to the anthrax attacks and re-emergent infectious diseases, and how those responses have evolved to the present day, As with other areas of homeland security, sustained progress in public health security is not likely until basic questions about funding priorities and leadership are successfully addressed. In the response to the only mass casualty event in the United States since 2001, Hurricane Katrina, and in various emergency simulation exercises such as TOPOFF series, major performance deficiencies have been observed. This book brings together a variety of sources, the best available evidence on the status of the public health security system at three distinct points: before 2001; during and immediately after the anthrax attacks; and in the period from 2004 to the present.
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33

Godson, Jenny, e Diane Seymour. Primary prevention and health promotion in oral health. A cura di Alan Emond. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198788850.003.0013.

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Abstract (sommario):
Tooth decay, although preventable, is the most common oral disease affecting children and young people. This chapter outlines why child oral health is a priority, the impact of poor oral health on children and families, and what causes poor oral health. It looks at the evidence of what works to improve oral health at an individual level, how we can support children and families to reduce their intake of free sugars, and increase access to fluoride. In addition, it highlights population-based programmes that have evidence that they can improve the oral health of children and what the local return on investment of such a programme would be at 5 and 10 years after commencement. Practitioners, managers, and commissioners all have an important role to play and the chapter concludes with recommendations for action.
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34

Ramos, Khara M., e Walter J. Koroshetz. Integrating ethics into neurotechnology research and development: The US National Institutes of Health BRAIN Initiative®. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198786832.003.0008.

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Abstract (sommario):
The US-based Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative® is focused on developing new tools and neurotechnologies to revolutionize the understanding of how the brain functions in health and disease. Powerful technological advances will enable unprecedented studies of the nervous system that pose new ethical questions. In response, and building on existing neuroethics scholarship and analysis, the National Institutes of Health (NIH) has created a Neuroethics Division as part of its BRAIN Multi-Council Working Group. The division members are delivering guidance documents for pertinent topics, recommendations for high-priority neuroethics research questions, providing neuroethics expertise to BRAIN Initiative® investigators, and holding workshops on some of the most pressing issues. This chapter discusses this major initiative and its implications for the future of neuroethics and new opportunities for action and collaboration.
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35

Talley, Colin L. A History of Multiple Sclerosis. Praeger, 2008. http://dx.doi.org/10.5040/9798400665097.

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Abstract (sommario):
While we now recognize that MS is a common neurological disease, as late as the early twentieth century it was considered a relatively rare condition in Europe and the United States. It was only in the late 1860s that MS came to be generally recognized as a distinct disease apart from other paraplegic maladies. One of the important historical questions about MS is whether it was a new disease of the nineteenth century or one that had simply gone unrecognized for a long time. Answering this question is complicated by the different frames or ways physicians understood and explained disease in previous centuries. The way we now conceive, categorize, and explain disease is a relatively recent formulation in the long view of medical history. This work aims to answer some of the fundamental questions of the history of MS. How and why did MS emerge when and where it did, first in a book of pathological anatomy in early nineteenth-century France, then as a distinct disease category in France by 1868? How and why did the perception of MS as a rare disease in the early twentieth century change so that by the middle of that century it was considered a common affliction of the nervous system? How did local conditions shape research on MS? Why did MS emerge as a popular crusade and research priority, rather suddenly, in the late 1940s and early 1950s? How has the experience of people with MS changed from the nineteenth to the twentieth centuries? Since there was no consensus about the merits of any treatment until very recently, how does one explain the sometimes aggressive treatment of disease from the late nineteenth century to the mid-twentieth century? This book focuses in part on how sociocultural factors allowed MS to emerge into medical awareness and later popular consciousness and how the different scientific and sociocultural frames of disease affected the experience of people with MS. These factors were important in particular ways because of the peculiar disease process of MS, especially its tendency to wax and wane in many patients and in clinical symptoms.
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36

Feigin, Kimberly, e Donna D’Alessio. Communication in cancer radiology. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198736134.003.0046.

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Abstract (sommario):
Diagnostic radiologists are often the first to know of a patient’s medical diagnosis, disease progression, or response to treatment. Communicating this information to both the referring physician and often directly to the patient has become increasingly important as the role of radiologists in patient care has evolved. As technology advances, and the field of radiology extends beyond the interpretation of diagnostic imaging into that of intervention and treatment, timely and clear communication of imaging results, limitations of radiology examinations, and the risks associated with image-guided interventional and therapeutic procedures is a priority. Instituting structured reporting, reporting lexicons, and formal communication skills training for radiologists are a few measures that radiologists can take to improve communication in the field. Such efforts to improve communication in radiology are integral components to enhancing and expanding the role of radiologists in patient care.
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Afza, Musarrat, Marko Petrovic e Sam Ghebrehewet. Tuberculosis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198745471.003.0012.

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Abstract (sommario):
This chapter covers two case studies and scenarios: a case of pulmonary tuberculosis (TB) in a college student; and a case of laboratory-confirmed Mycobacterium bovis in an adult with inflammatory bowel disease. The pulmonary TB case resulted in a wider investigation and contact tracing as the case attended college while symptomatic. The Mycobacterium bovis resulted in wider workplace and hospital contact tracing through convening an Incident Control Team. Background information on the epidemiology and clinical features of TB and the public health response to TB in educational, healthcare, and occupational settings are discussed. Case definitions, and a detailed risk assessment, with clear description of close contacts, priority groups, and the required public health actions, are described. ‘Top tips’ are given, to provide practical tips for the reader to think through the public health management of TB, and ‘tools of the trade’ list the laboratory and epidemiological components of the investigation.
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38

Vandenbulcke, Mathieu, Rose-Marie Dröes e Erik Schokkaert, a cura di. Dementia and Society. Cambridge University Press, 2022. http://dx.doi.org/10.1017/9781108918954.

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Abstract (sommario):
Dementia is increasingly being recognised as a public health priority and poses one of the largest challenges we face as a society. At the same time, there is a growing awareness that the quest for a cure for Alzheimer's disease and other causes of dementia needs to be complemented by efforts to improve the lives of people with dementia. To gain a better understanding of dementia and of how to organize dementia care, there is a need to bring together insights from many different disciplines. Filling this knowledge gap, this book provides an integrated view on dementia resulting from extensive discussions between world experts from different fields, including medicine, social psychology, nursing, economics and literary studies. Working towards a development of integrative policies focused on social inclusion and quality of life, Dementia and Society reminds the reader that a better future for persons with dementia is a collective responsibility.
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HEARTS in the Americas Regulatory Pathway to the Exclusive Use of Validated Blood Pressure Measuring Devices. Pan American Health Organization, 2021. http://dx.doi.org/10.37774/9789275124864.

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Abstract (sommario):
Cardiovascular disease (CVD) is the leading cause of disease burden globally. According to the 2017 Global Burden of Disease estimates, there were 14 million new cases of CVD, 80 million people living with this condition, and nearly 1 million deaths attributed to CVD in the Americas. Hypertension is the major risk factor for CVD, causing half of the cases, and is highly prevalent, affecting one in four adults, including 40% of those over age 25 years.To appropriately detect hypertension, accurate measurement of blood pressure is critical, and inaccurate measurement of BP has important consequences for policies to address hypertension, as well as for patient safety and quality of care. The Fourth World Health Organization (WHO) Global Forum on Medical Devices identified several critical issues related to medical devices. Among those issues were recommendations for increased regulation of medical devices in low- and middle-income countries and development of technical specifications to optimize procurement of priority medical devices. World Health Assembly Resolution 67.20 (Regulatory system strengthening for medical products) stresses the importance of regulation of medical devices for better public health outcomes and to increase access to safe, effective, and quality medical products. This publication seeks to contribute to meeting these recommendations by providing a practical tool for governments to improve their national regulatory frameworks to improve accuracy of blood pressure measuring devices (BPMDs), in turn contributing to the exclusive use of accuracy validated automated BPMDs in primary health care (PHC) facilities by 2025. This publication can also guide the development of procurement mechanisms that will ensure exclusive availability of BPMDs in PHC facilities. Specifically, this publication will provide a brief background on the importance of using validated BPMDs and highlight key elements of regulations related to pre-market approvals to promote accurate BPMDs.
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40

Deaton, Christi, Margaret Cupples e Kornelia Kotseva. Settings and stakeholders. A cura di Massimo Piepoli. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0786.

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Abstract (sommario):
Cardiovascular disease remains a leading cause of death and disability globally, and cardiovascular prevention should take place everywhere. Reducing the burden of cardiovascular disease requires a concerted effort in multiple settings (primary care, acute care, community, and home), and from multiple stakeholders such as government, public health, non-governmental organizations, healthcare, industry, and individuals. Primary care provides the majority of healthcare to populations, and is in an optimal position to screen and assess patients for cardiovascular risk and deliver cardiovascular prevention. Improving screening, risk assessment, and use of evidence-based guidelines requires collaboration between specialist cardiology services and primary care. Nurse-led and multiprofessional teams are effective in delivering prevention across a variety of settings. Prevention should be a priority prior to patient discharge from hospital following an acute cardiovascular event, and should encompass both medications and advice regarding lifestyle behaviours. Secondary prevention through specialized prevention programmes is needed by patients in order to reduce the risk of subsequent events. Cardiac rehabilitation is one of the most effective methods of delivering prevention and improving patient well-being following an acute event or procedure. There is a need to get more patients participating by using alternative methods of delivery and ensuring that women, older patients, and those with low fitness are encouraged and supported to attend. Stakeholders such as government, non-governmental organizations, and industry have important roles to play in improving public health. Healthcare providers should disseminate their research in lay language, and play a role in advising on and supporting public health measures.
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41

AlJaroudi, Wael. Risk Assessment Before Noncardiac Surgery. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0014.

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Abstract (sommario):
Perioperative risk assessment is essential in screening patients before noncardiac surgery. Cardiovascular complications such as fatal and non-fatal myocardial infarction (MI), ventricular arrhythmia, pulmonary edema, and stroke are important in-hospital causes of morbidity and mortality intra and post-operatively. The optimal approach is to identify patients at increased risk so that appropriate testing and therapeutic interventions are undertaken a priori to minimize such risk. The initial preoperative evaluation includes identification of surgery-specific risk, patient exercise functional capacity and clinical risk profile. Patients with major predictors of events such as acute coronary syndromes, recent MI, unstable arrhythmia, and severe valvular disease warrant further management and optimization that often lead to delaying surgery. Those with three or more predictors (history of ischemic heart disease, compensated heart failure, diabetes, renal insufficiency, or history of cerebrovascular disease) undergoing high- risk surgery often require stress testing. Although data from randomized prospective trials are lacking, numerous studies have demonstrated the utility of myocardial perfusion imaging (MPI) for determination of perioperative cardiac risk. The goal of this chapter is to review the use of MPI for preoperative risk assessment and the recommendations from the current guidelines. The focus will be on short-term and long-term prognosis including special groups such as after coronary stenting and before vascular surgery, liver and renal transplantation.
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42

Hospitals in Integrated Health Service Delivery Networks: Strategic Recommendations. Pan American Health Organization, 2021. http://dx.doi.org/10.37774/9789275120040.

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In 2007, PAHO launched the Integrated Health Service Delivery Network (IHSDN) initiative to address the problems derived from the fragmentation of health services and to overcome the structural problems stemming from the widespread segmentation of health systems in the countries of the Region. In the IHSDN initiative, hospitals are an aggregate of specialized institutions that support a highly effective first level of care. Hospitals themselves are defragmented, which is theoretically correct, innovative, and even visionary. However, the IHSDN initiative does not seek to diminish the influence of hospitals in the health system or the importance of their role, but to integrate these institutions so that all their efforts are aligned with the needs of the people and communities they serve through the development of IHSDNs. It is obvious that without hospitals there can be no IHSDNs; however, it should also be recognized that without effective networks, hospitals cannot do their job. The IHSDN initiative presents a change in the role assigned to hospitals, in which they are no longer considered the apex of a pyramid in which the hierarchy is based on specialization to successfully treat disease. Instead, the hospital becomes a very important participant in a service organized as a network, performing specific tasks in a series of processes that cut repeatedly across the health service delivery network and include the participation of individuals and communities. The product of an intense debate and joint effort, this work contains a series of proposals in the six areas considered a priority for developing the new role of hospitals in IHSDNs: governance, resource allocation and incentives, the model of care, technology and infrastructure, human resources, and organization and management.
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Aguilera-Cobos, Lorena, Rebeca Isabel-Gómez e Juan Antonio Blasco-Amaro. Efectividad de la limitación de la movilidad en la evolución de la pandemia por Covid-19. AETSA Área de Evaluación de Tecnologías Sanitarias de Andalucía, Fundación Progreso y salud. Consejería de Salud y Familias. Junta de Andalucía, 2022. http://dx.doi.org/10.52766/pyui7071.

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Introduction During the Covid-19 pandemic, non-pharmacological interventions (NPIs) aimed to minimise the spread of the virus as much as possible to avoid the most severe cases and the collapse of health systems. These measures included mobility restrictions in several countries, including Spain. Objective To assess the impact of mobility constraints on incidence, transmission, severe cases and mortality in the evolution of the Covid-19 pandemic. These constraints include: • Mandatory home confinement. • - Recommendation to stay at home. • - Perimeter closures for entry and/or exit from established areas. • - Restriction of night-time mobility (curfew). Methodology Systematic literature review, including documents from official bodies, systematic reviews and meta-analyses. The following reference databases were consulted until October 2021 (free and controlled language): Medline, EMBASE, Cochrane Library, TripDB, Epistemonikos, Royal college of London, COVID-end, COVID-19 Evidence Reviews, WHO, ECDC and CDC. Study selection and quality analysis were performed by two independent researchers. References were filtered firstly by title and abstract and secondly by full text in the Covidence tool using a priori inclusion and exclusion criteria. Synthesis of the results was done qualitatively. The quality of the included studies was assessed using the AMSTAR-II tool. Results The literature search identified 642 studies, of which 38 were excluded as duplicates. Of the 604 potentially relevant studies, 12 studies (10 systematic reviews and 2 official agency papers) were included in the analysis after filtering. One of the official agency papers was from the European Centre for Disease Prevention and Control (ECDC) and the other paper was from the Ontario Agency for Health Promotion and Protection (OHP). The result of the quality assessment with the AMSTAR-II tool of the included systematic reviews was: 3 reviews of moderate quality, 6 reviews of low quality and 1 review of critically low quality. The interventions analysed in the included studies were divided into 2 categories: the first category comprised mandatory home confinement, recommendation to stay at home and curfew, and the second category comprised perimeter blocking of entry and/or exit (local, cross-community, national or international). This division is because the included reviews analysed the measures of mandatory home confinement, advice to stay at home and curfew together without being able to carry out a disaggregated analysis. The included systematic reviews for the evaluation of home confinement, stay-at-home advice and curfew express a decrease in incidence levels, transmission and severe cases following the implementation of mobility limitation interventions compared to the no measure comparator. These conclusions are supported by the quantitative or qualitative results of the studies they include. All reviews also emphasise that to increase the effectiveness of these restrictions it is necessary to combine them with other public health measures. In the systematic reviews included for the assessment of entry and/or exit perimeter closure, most of the studies included in the reviews were found to be modelling studies based on mathematical models. All systematic reviews report a decrease in incidence, transmission and severe case levels following the implementation of travel restriction interventions. The great heterogeneity of travel restrictions applied, such as travel bans, border closures, passenger testing or screening, mandatory quarantine of travellers or optional recommendations for travellers to stay at home, makes data analysis and evaluation of interventions difficult. Conclusions Mobility restrictions in the development of the Covid-19 pandemic were one of the main NPI measures implemented. It can be concluded from the review that there is evidence for a positive impact of NPIs on the development of the COVID-19 pandemic. The heterogeneity of the data from the included studies and their low quality make it difficult to assess the effectiveness of mobility limitations in a disaggregated manner. Despite this, all the included reviews show a decrease in incidence, transmission, hospitalisations and deaths following the application of the measures under study. These measures are more effective when the restrictions were implemented earlier in the pandemic, were applied for a longer period and were more rigorous in their application.
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