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A scoping review of the peer-reviewed and grey literature to identify which public health measures are being used in flood preparedness, response and recovery in the WHO European region.

Background Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used drugs, and have a wide range of uses, including treatment of acute and chronic pain, fever, and inflammations of infectious and non-infectious etiology. NSAIDs include unselective cyclooxygenase (COX) inhibitors (such as ibuprofen, aspirin (acetylsalicylate), diclofenac and naproxen) as well as selective COX 2 inhibitors (such as Celecoxib, Rofecoxib, Etoricoxib, Lumiracoxib, and Valecoxib). Concerns have been raised that NSAIDs may be associated with an increased risk for adverse effects when used in patients with acute viral respiratory infections, including COVID-19 (caused by the virus SARS-CoV-2), Severe Acute Respiratory Syndrome (SARS, caused by SARS-CoV), Middle East Respiratory Syndrome (MERS, caused by MERS-CoV), and other coronavirus infections. These concerns apply both to the use of NSAIDs prior to the infection, and to the use of NSAID during the infection. Objectives To assess the effects of prior and current use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with acute viral respiratory infections on acute severe adverse events (including mortality, acute respiratory distress syndrome (ARDS), acute organ failure and opportunistic infections), on acute healthcare utilization (including hospitalization, intensive care unit (ICU) admission, supplemental oxygen therapy and mechanical ventilation) as well as on quality of life and long-term survival. Setting of the review question and protocol development The overall review question was set by the World Health Organization (WHO), which commissioned this review. At WHO, clinical experts and methodologists were involved in defining the review question. The protocol was developed by PvP and ER drawing on Cochrane Rapid Review guidance [1] and with input from Susan Norris (WHO), Gerald Gartlehner (Cochrane Austria) as well as AM, JB, JMS, KS, LMP and SD. Outcomes were set by WHO and refined by PvP and ER drawing on guidance from the WHO Working Group on the clinical characterization of COVID-19 infection (Annex 1) [2] and Susan Norris.

Scoping review on containing the COVID-19 pandemic in primary or secondary school settings

Objective:To systematically assess Germany’s nutrition policies, to benchmark them against international best practices and to identify priority policy actions to improve population-level nutrition in Germany.Design:We applied the Food Environment Policy Index (Food-EPI), a methodological framework developed by the International Network for Food and Obesity/non-communicable Diseases Research, Monitoring and Action Support (INFORMAS) network. Qualitative content analysis of laws, directives and other documents formed the basis of a multistaged, structured consultation process.Setting:Germany.Participants:The expert consultation process included fifty-five experts from academia, public administration and civil society.Results:Germany lags behind international best practices in several key policy areas. For eighteen policy indicators, the degree of implementation compared with international best practices was rated as very low, for twenty-one as low, for eight as intermediate and for none as high. In particular, indicators on food taxation, regulation of food marketing as well as retail and food service sector policies were rated as very low to low. Identified priority actions included the binding implementation of nutrition standards for schools and kindergartens, a reform of the value added tax on foods and beverages, a sugar-sweetened beverage tax and stricter regulation of food marketing directed at children.Conclusions:The results show that Germany makes insufficient use of the potential of evidence-informed health-promoting nutrition policies. Adopting international best practices in key policy areas could help to reduce the burden of nutrition-related chronic disease and related inequalities in nutrition and health in Germany. Implementation of relevant policies requires political leadership, a broad societal dialogue and evidence-informed advocacy by civil society, including the scientific community.

Fragestellung: Bis zu 70% der Medizinstudierenden führen studienbezogene Auslandsaufenthalte durch, bis zu 60% als internships[ref:1] mit direkter praktischer Erfahrung, viele davon in sogenannten low and middle income countries (LMIC). Die Studierenden sind unterschiedlich [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Eine chronische Infektion mit dem Hepatitis B Virus (HBV) ist ein wichtiges, jedoch vernachlässigtes Problem der globalen Gesundheit. Weltweit sind ungefähr 257 Millionen Personen chronisch mit dem Virus infiziert. Eine Impfung gegen diese Erkrankung ist seit 1982 verfügbar. Impfprogramme haben dort, wo die Impfung ausreichend verfügbar ist, einen durchschlagenden Erfolg in der Reduktion von chronischer Hepatitis B gezeigt. Es gibt jedoch Teile der Welt, in denen die Impfung nicht zu einem ausreichenden Schutz führt, da die Infektion schon vor der Gabe der ersten Impfdosis geschieht oder die Impfung nicht oder nur unvollständig verabreicht wird. In Ländern mit einer hohen Prävalenz von Hepatitis B wird das Virus vor allem von Müttern auf Kinder übertragen. Kinder, die sich innerhalb ihres ersten Lebensjahres infizieren, haben hohes Risiko eine chronische Infektion zu entwickeln. Tansania, mit einer Prävalenz der chronischen Hepatitis B von 7,2% in der Allgemeinbevölkerung, gilt als Hochendemiegebiet der Erkrankung. Die Weltgesundheitsorganisation (WHO) nennt in ihrer globalen Strategie zur Elimination von viralen Hepatitiden die Prävention von Mutter-Kind-Übertragung als eine zentrale Aufgabe. Das beinhaltet unter anderem die Testung von schwangeren Frauen und die Impfung von Neugeborenen gegen HBV innerhalb von 24 Stunden nach der Geburt. Diese Maßnahmen sind jedoch in Tansania nicht implementiert. Zudem lagen zum Durchführungszeitraum der Studie nur wenige Daten zu der Prävalenz von HBV in schwangeren Frauen vor. Aus diesem Grund untersuchte die Studie die Prävalenz von Hepatitis B unter schwangeren Frauen in einem Krankenhaus der tertiären Versorgungsstufe in Mwanza, Tansania, sowie den sozio-ökonomischen Hintergrund und mögliche Risikofaktoren für eine Infektion seitens der Mütter. Ergänzend wurden verschiedene serologische und virologische Analysen des Blutes der Mütter und ihrer Kinder durchgeführt., Chronic hepatitis B virus (HBV) infection is an important but neglected global health problem. Approximately 257 million people worldwide are chronically infected with the virus. Vaccination against this disease has been available since 1982 and vaccination programs have shown resounding success in reducing chronic hepatitis B where vaccination is sufficiently available. However, there are parts of the world where vaccination does not result in adequate protection because infection occurs before the first dose of vaccine is administered or because vaccination is not administered or is incomplete. In countries with a high prevalence of hepatitis B, the virus is transmitted primarily from mothers to their children. Children who become infected within their first year of life are at high risk of developing chronic infection. Tanzania, with a prevalence of chronic hepatitis B of 7.2% in the general population, is considered a high-endemic area for the disease. In its global strategy for the elimination of viral hepatitis, the World Health Organization (WHO) identifies prevention of mother-to-child transmission as a key task. This includes, among others, testing pregnant women and vaccinating newborns against HBV within 24 hours after birth. However, these measures have not been implemented in Tanzania. In addition, few data were available on the actual prevalence of HBV in pregnant women at the time the study was conducted. For this reason, the following study investigated the prevalence of hepatitis B among pregnant women in a tertiary care hospital in Mwanza, Tanzania, as well as the socioeconomic background and possible risk factors for infection on the part of the mothers. In addition, various serological and virological analyses of the blood of the mothers and their children were performed.

Gesundheit betrifft alle Bereiche der GesellschaftDie COVID-19-Pandemie stellt unsere Gesellschaft auf die Probe. Binnen kürzester Zeit mussten zahlreiche Herausforderungen adressiert werden, wie die Kontaktnachverfolgung durch die Gesundheitsämter, die Beschaffung von medizinischen Produkten, die intensivmedizinische und pflegerische Versorgung der Erkrankten und vieles mehr. Alle gesellschaftlichen Bereiche, wie Wirtschaft, Bildung, Kultur und das private Leben sind durch die gesundheitliche Bedrohung und die Maßnahmen zur Eindämmung massiv beeinträchtigt. Besonders stark betroffen sind dabei Kinder, alte Menschen, vulnerable Gruppen, Menschen in sozial bzw. wirtschaftlich prekären Situationen und Menschen mit gesundheitlichen Vorbelastungen. Dies unterstreicht die Erkenntnis, dass

BACKGROUND: In response to the spread of SARS-CoV-2 and the impact of COVID-19, national and subnational governments implemented a variety of measures in order to control the spread of the virus and the associated disease. While these measures were imposed with the intention of controlling the pandemic, they were also associated with severe psychosocial, societal, and economic implications on a societal level. One setting affected heavily by these measures is the school setting. By mid-April 2020, 192 countries had closed schools, affecting more than 90% of the world's student population. In consideration of the adverse consequences of school closures, many countries around the world reopened their schools in the months after the initial closures. To safely reopen schools and keep them open, governments implemented a broad range of measures. The evidence with regards to these measures, however, is heterogeneous, with a multitude of study designs, populations, settings, interventions and outcomes being assessed. To make sense of this heterogeneity, we conducted a rapid scoping review (8 October to 5 November 2020). This rapid scoping review is intended to serve as a precursor to a systematic review of effectiveness, which will inform guidelines issued by the World Health Organization (WHO). This review is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and was registered with the Open Science Framework. OBJECTIVES: To identify and comprehensively map the evidence assessing the impacts of measures implemented in the school setting to reopen schools, or keep schools open, or both, during the SARS-CoV-2/COVID-19 pandemic, with particular focus on the types of measures implemented in different school settings, the outcomes used to measure their impacts and the study types used to assess these. SEARCH METHODS: We searched the Cochrane COVID-19 Study Register, MEDLINE, Embase, the CDC COVID-19 Research Articles Downloadable Database for preprints, and the WHO COVID-19 Global literature on coronavirus disease on 8 October 2020. SELECTION CRITERIA: We included studies that assessed the impact of measures implemented in the school setting. Eligible populations were populations at risk of becoming infected with SARS-CoV-2, or developing COVID-19 disease, or both, and included people both directly and indirectly impacted by interventions, including students, teachers, other school staff, and contacts of these groups, as well as the broader community. We considered all types of empirical studies, which quantitatively assessed impact including epidemiological studies, modelling studies, mixed-methods studies, and diagnostic studies that assessed the impact of relevant interventions beyond diagnostic test accuracy. Broad outcome categories of interest included infectious disease transmission-related outcomes, other harmful or beneficial health-related outcomes, and societal, economic, and ecological implications. DATA COLLECTION AND ANALYSIS: We extracted data from included studies in a standardized manner, and mapped them to categories within our a priori logic model where possible. Where not possible, we inductively developed new categories. In line with standard expectations for scoping reviews, the review provides an overview of the existing evidence regardless of methodological quality or risk of bias, and was not designed to synthesize effectiveness data, assess risk of bias, or characterize strength of evidence (GRADE). MAIN RESULTS: We included 42 studies that assessed measures implemented in the school setting. The majority of studies used mathematical modelling designs (n = 31), while nine studies used observational designs, and two studies used experimental or quasi-experimental designs. Studies conducted in real-world contexts or using real data focused on the WHO European region (EUR; n = 20), the WHO region of the Americas (AMR; n = 13), the West Pacific region (WPR; n = 6), and the WHO Eastern Mediterranean Region (EMR; n = 1). One study conducted a global assessment and one did not report on data from, or that were applicable to, a specific country. Three broad intervention categories emerged from the included studies: organizational measures to reduce transmission of SARS-CoV-2 (n = 36), structural/environmental measures to reduce transmission of SARS-CoV-2 (n = 11), and surveillance and response measures to detect SARS-CoV-2 infections (n = 19). Most studies assessed SARS-CoV-2 transmission-related outcomes (n = 29), while others assessed healthcare utilization (n = 8), other health outcomes (n = 3), and societal, economic, and ecological outcomes (n = 5). Studies assessed both harmful and beneficial outcomes across all outcome categories. AUTHORS' CONCLUSIONS: We identified a heterogeneous and complex evidence base of measures implemented in the school setting. This review is an important first step in understanding the available evidence and will inform the development of rapid reviews on this topic.

Additional file 1: Table S1. Oligonucleotide primers used for the nested PCR amplification of the HBV polymerase gene. Table S2. HBsAg positive participants and laboratory results (n = 22).

Objective: The WHO Commission on Social Determinants of Health (SDH) has called for a health workforce trained in recognising, understanding and acting on the SDH. However, little is known about how current medical education prepares graduates for this challenge. This study analyses the extent to which the German medical education incorporates content on SDH. Design: Following a published protocol, in 2018, we conducted a qualitative and quantitative content analysis of three key document groups, defining and guiding what medical schools are expected to teach and what medical students are expected to know when graduating in Germany. We developed the coding system in a mixed inductive and deductive approach based on key WHO documents. Setting: Medical schools and the medical education system in Germany. Results: Important gaps exist in the representation of SDH in medical education in Germany. Between 3% and 27% of the analysed document-elements made reference to SDH and only 0%-3% of those document elements made explicit references to SDH. While some aspects were covered widely (eg, topics of occupational health, early childhood development and hygiene), other topics such as health inequalities or determinants outside of the healthcare system were not or hardly represented. Conclusions: A stronger and more explicit representation of SDH in German medical education is needed to prepare the new health workforce for current and future challenges in our globalised world and for medical schools to be socially accountable.

Open Heart 8(8), e020696 (2018). doi:10.1136/bmjopen-2017-020696, Published by BMJ, London

Introduction: Every year, natural and other disasters cause significant loss of life around the world. This calls for an improved response from, among others, the health professions to strengthen disaster medicine, whether relating to prevention, emergency response or recovery. It includes both knowledge and competencies, such as planning, coordination, and communication. Simulations can be used to acquire these competencies. Project description: In 2016, the German Medical Students’ Association founded the project “Disaster Medicine” with the goal of educating and connecting medical students interested in the topic. AFTERSHOCK, a board game simulating early disaster response after an earthquake, was utilized for workshops. It highlights the need for interagency cooperation and the challenges of responding to disasters in dynamic and highly complex settings. Seven workshops were facilitated between October 2016 and December 2017. A survey was conducted to assess participant satisfaction and the design of the workshop. Results: 89 German medical students participated and 74 (83 %) responded with written evaluation. Students generally reported moderate to low levels of previous knowledge. The event produced very positive feedback, with participants overwhelmingly finding the simulation to be a useful or very useful way to learn about the challenges of humanitarian assistance and disaster relief. Qualitative feedback included requests for more theoretical background information and highlighted the need for small group sizes. Discussion and Conclusion: Board games such as AFTERSHOCK are well-suited for medical education and enjoy high rates of acceptance among students. To ensure deeper and longer-term learning, they should be accompanied by theoretical coursework., Einleitung: Jedes Jahr verursachen Katastrophen eine signifikante Anzahl von Todesfällen weltweit. Eine Stärkung der Katastrophenmedizin, unter anderem durch Gesundheitsfachkräfte, in den Bereichen Prävention, Notfalleinsätze als auch bei dem Wiederaufbau ist erforderlich. Hierzu zählen Kompetenzen und Wissen in den Feldern Planung, Koordination und Kommunikation. Simulationen können dazu genutzt werden, diese Kompetenzen zu erwerben. Projektbeschreibung: Die Bundesvertretung der Medizinstudierenden in Deutschland e.V. hat 2016 das Projekt „Katastrophenmedizin“ gegründet um interessierte Studierende fortbilden und vernetzen zu können. Für die Workshops wurde das Brettspiel AFTERSHOCK genutzt, welches die Phase der unmittelbaren Katastrophenhilfe nach einem Erdbeben simuliert. Sieben Workshops wurden zwischen Oktober 2016 und Dezember 2017 durchgeführt. Eine Umfrage wurde durchgeführt, um die Zufriedenheit der Teilnehmenden und den Aufbau des Workshops zu evaluieren. Ergebnisse: 89 Medizinstudierende nahmen an den Workshops teil und 73 (83 %) beteiligten sich an der Evaluation. Die Studierenden gaben allgemein ein mittleres bis niedriges Vorwissen an. Die Veranstaltung wurde positiv bewertet und ein Großteil der Studierenden empfand die Simulation als einen hilfreichen oder sehr hilfreichen Weg um die Herausforderungen von humanitärer Hilfe und Katastrophenhilfe kennenzulernen. Qualitatives Feedback umfasste unter anderem die Forderung nach mehr theoretischem Hintergrundwissen und einer kleineren Gruppengröße. Diskussion und Schlussfolgerung: Brettspiele wie AFTERSHOCK sind für die medizinische Ausbildung gut geeignet und bei Studierenden sehr beliebt. Um einen umfassenderen und langanhaltenden Lerneffekt zu erreichen, sollten sie durch theoretische Kurse begleitet werden., GMS Journal for Medical Education; 35(4):Doc46

„Medical Peace Work“ [[link:http://www.medicalpeacework.org*http://www.medicalpeacework.org]] ist eine Disziplin, die die Wechselwirkungen von Frieden und Gesundheit sowie Gewalt und Krankheit untersucht. Das vorgestellte Projekt hat das Ziel,[zum vollständigen Text gelangen Sie über die oben angegebene URL], Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA) und des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ)

Zielsetzung: Sozialen Determinanten von Krankheit und Gesundheit (SDHs) beschreiben gesundheitsrelevante Bedingungen, in die Menschen hineingeboren werden, unter denen sie aufwachsen, leben, arbeiten und altern. Über ökonomische, psychosoziale, soziokulturelle und verhaltensbezogene Mechanismen[zum vollständigen Text gelangen Sie über die oben angegebene URL], Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA) und des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ)