Sexual and reproductive health(SRH)services are crucial for women especially during disasters,to reduce maternal mortality and morbidity from miscarriages,unsafe abortions,and post-abortion complications.This study ex...Sexual and reproductive health(SRH)services are crucial for women especially during disasters,to reduce maternal mortality and morbidity from miscarriages,unsafe abortions,and post-abortion complications.This study explored the SRH interventions provided during disaster response.A systematic review was conducted to identify what menstrual regulation(MR),safe abortion(SA),and post-abortion care(PAC)approaches/interventions exist to promote resilience in the health system in disaster settings;what intervention components were most eff ective;and challenges and opportunities to meeting SRH rights.Five electronic databases were searched,resulting in 4194 records.Following the screening process,seven publications were included.The intervention-related information in each publication was assessed based on availability,accessibility,acceptability,and quality.Two SRH approaches/interventions were found.The eff ectiveness of intervention components could not be conducted due to the limited number of relevant studies.Challenges were found at facility and community levels,and opportunities included overcoming them,making MR,SA,and PAC integral to the mitigation phase,and policy change to overcome barriers related to unaff ordability and inaccessibility.Recommendations are provided to encourage research and policy towards improving neglected SRH in disaster settings to realize Sustainable Development Goal 3 and the Global Strategy and Sendai Framework's priority to promote disaster-resilient health systems.展开更多
Importance:During the coronavirus disease 2019(COVID-19)lockdown,changes in the visiting rules in neonatal units might have affected the initiation and continuation of breastfeeding.Objective:To investigate the effect...Importance:During the coronavirus disease 2019(COVID-19)lockdown,changes in the visiting rules in neonatal units might have affected the initiation and continuation of breastfeeding.Objective:To investigate the effects of the implementation of the COVID-19 lockdown in the UK on mother’s own milk(MOM)feeding in hospital and at the time of discharge in two UK neonatal units.Methods:Retrospective cohort study using routinely recorded data from electronic patient records.Data were retrieved from two neonatal services in the UK East Midlands region.Adjusted logistic regression was used to compare the odds of MOM feeding before,and after the implementation of the UK lockdown.Results:Among 2073 infants,after adjusting for maternal and infant characteristics and underlying trends over time,there were no differences in the odds of infants receiving any MOM during admission;any MOM at discharge or exclusive MOM at discharge before and after the imposition of the lockdown.Infants with birthweight<1000 g were three times less likely to receive any MOM at discharge compared to those with birthweight>2500 g(adjusted odds ratio[OR]0.33,95%confidence interval[CI]:0.22–0.50).Younger mothers were less likely,and Black British mothers more likely,to be feeding MOM to their infants at discharge,while women in the least deprived Index of Multiple Deprivation(IMD)quintiles were 2–4 times more likely to do so,compared to those in the most deprived IMD quintile(adjusted OR 2.78,95%CI:1.97–3.90).Interpretation:Despite the difficulties faced during COVID-19 pandemic-induced restrictions,infants in the participating neonatal units continued to receive MOM in similar proportions as before the pandemic.展开更多
Background:Helicobacter pylori(H.pylori)infection is an infectious disease with a prevalence rate of up to 50%worldwide.It can cause indigestion,gastritis,peptic ulcer,and gastric cancer.H.pylori eradication treatment...Background:Helicobacter pylori(H.pylori)infection is an infectious disease with a prevalence rate of up to 50%worldwide.It can cause indigestion,gastritis,peptic ulcer,and gastric cancer.H.pylori eradication treatment can effectively control disease progression and reduce the risk of the above conditions.However,the escalating trend of antibiotic resistance presents a global challenge for H.pylori eradication.We aim to provide guidance on pharmacological treatment of H.pylori infection.Methods:This clinical practice guideline is developed following the World Health Organization’s recommended process,adopting Grading of Recommendations Assessment,Development and Evaluation in assessing evidence quality,and utilizing Evidence to Decision framework to formulate clinical recommendations,minimizing bias and increasing transparency of the clinical practice guideline development process.We used the Reporting Items for practice Guidelines in HealThcare(RIGHT)statement and The Appraisal of Guidelines for Research and Evaluation Ⅱ(AGREE Ⅱ)as reporting and conduct guides to ensure the guideline’s completeness and transparency.Results:Though decreasing in developed countries,the prevalence of H.pylori remains high in developing countries,causing a major public health burden.This clinical practice guideline contains 12 recommendations concerning pharmacological treatment for H.pylori eradication.Among them,it is worth highlighting that bismuth preparations are inexpensive,safe,and effective,consequently making bismuth quadruple therapy a preferred choice for initial and rescue treatment.In empirical treatment,high-dose dual therapy is equally effective compared with bismuth quadruple therapy.Conclusions:The 12 recommendations in this clinical practice guideline are formed with consideration for stakeholders’values and preferences,resource use,feasibility,and acceptability.Recommendations are generalizable to resource limited settings with similar antibiotic resistance pattern as China,and lower middle-income countries facing comparable sociological and technical challenges.Registration:Guidelines International Network(GIN)website,https://guidelines.ebmportal.com/node/69996.展开更多
文摘Sexual and reproductive health(SRH)services are crucial for women especially during disasters,to reduce maternal mortality and morbidity from miscarriages,unsafe abortions,and post-abortion complications.This study explored the SRH interventions provided during disaster response.A systematic review was conducted to identify what menstrual regulation(MR),safe abortion(SA),and post-abortion care(PAC)approaches/interventions exist to promote resilience in the health system in disaster settings;what intervention components were most eff ective;and challenges and opportunities to meeting SRH rights.Five electronic databases were searched,resulting in 4194 records.Following the screening process,seven publications were included.The intervention-related information in each publication was assessed based on availability,accessibility,acceptability,and quality.Two SRH approaches/interventions were found.The eff ectiveness of intervention components could not be conducted due to the limited number of relevant studies.Challenges were found at facility and community levels,and opportunities included overcoming them,making MR,SA,and PAC integral to the mitigation phase,and policy change to overcome barriers related to unaff ordability and inaccessibility.Recommendations are provided to encourage research and policy towards improving neglected SRH in disaster settings to realize Sustainable Development Goal 3 and the Global Strategy and Sendai Framework's priority to promote disaster-resilient health systems.
文摘Importance:During the coronavirus disease 2019(COVID-19)lockdown,changes in the visiting rules in neonatal units might have affected the initiation and continuation of breastfeeding.Objective:To investigate the effects of the implementation of the COVID-19 lockdown in the UK on mother’s own milk(MOM)feeding in hospital and at the time of discharge in two UK neonatal units.Methods:Retrospective cohort study using routinely recorded data from electronic patient records.Data were retrieved from two neonatal services in the UK East Midlands region.Adjusted logistic regression was used to compare the odds of MOM feeding before,and after the implementation of the UK lockdown.Results:Among 2073 infants,after adjusting for maternal and infant characteristics and underlying trends over time,there were no differences in the odds of infants receiving any MOM during admission;any MOM at discharge or exclusive MOM at discharge before and after the imposition of the lockdown.Infants with birthweight<1000 g were three times less likely to receive any MOM at discharge compared to those with birthweight>2500 g(adjusted odds ratio[OR]0.33,95%confidence interval[CI]:0.22–0.50).Younger mothers were less likely,and Black British mothers more likely,to be feeding MOM to their infants at discharge,while women in the least deprived Index of Multiple Deprivation(IMD)quintiles were 2–4 times more likely to do so,compared to those in the most deprived IMD quintile(adjusted OR 2.78,95%CI:1.97–3.90).Interpretation:Despite the difficulties faced during COVID-19 pandemic-induced restrictions,infants in the participating neonatal units continued to receive MOM in similar proportions as before the pandemic.
基金The development of this CPG was funded by the China Primary Health Care Foundation.The funder had no involvement in the formulation of the CPG.
文摘Background:Helicobacter pylori(H.pylori)infection is an infectious disease with a prevalence rate of up to 50%worldwide.It can cause indigestion,gastritis,peptic ulcer,and gastric cancer.H.pylori eradication treatment can effectively control disease progression and reduce the risk of the above conditions.However,the escalating trend of antibiotic resistance presents a global challenge for H.pylori eradication.We aim to provide guidance on pharmacological treatment of H.pylori infection.Methods:This clinical practice guideline is developed following the World Health Organization’s recommended process,adopting Grading of Recommendations Assessment,Development and Evaluation in assessing evidence quality,and utilizing Evidence to Decision framework to formulate clinical recommendations,minimizing bias and increasing transparency of the clinical practice guideline development process.We used the Reporting Items for practice Guidelines in HealThcare(RIGHT)statement and The Appraisal of Guidelines for Research and Evaluation Ⅱ(AGREE Ⅱ)as reporting and conduct guides to ensure the guideline’s completeness and transparency.Results:Though decreasing in developed countries,the prevalence of H.pylori remains high in developing countries,causing a major public health burden.This clinical practice guideline contains 12 recommendations concerning pharmacological treatment for H.pylori eradication.Among them,it is worth highlighting that bismuth preparations are inexpensive,safe,and effective,consequently making bismuth quadruple therapy a preferred choice for initial and rescue treatment.In empirical treatment,high-dose dual therapy is equally effective compared with bismuth quadruple therapy.Conclusions:The 12 recommendations in this clinical practice guideline are formed with consideration for stakeholders’values and preferences,resource use,feasibility,and acceptability.Recommendations are generalizable to resource limited settings with similar antibiotic resistance pattern as China,and lower middle-income countries facing comparable sociological and technical challenges.Registration:Guidelines International Network(GIN)website,https://guidelines.ebmportal.com/node/69996.
