As many of you know today is World Mental Health Day. The theme this year is psychological first aid. Intrigued by this we thought it would be great to share with you a fascinating interview with Dr Mark van Ommeren, Public Mental Health Adviser, Department of Mental Health and Substance Abuse, World Health Organization. Well it’s more a press conference but you get our drift!
Psychological first aid is a practical approach that can be provided by first-line responders such as police and fire officers, health staff in emergency units and humanitarian aid workers following a short course of training.
The approach has been used with success in countries around the world, including Guinea, Liberia and Sierra Leone during the recent Ebola epidemic. It is also being offered widely in Syria and for thousands of displaced persons in Greece and Nigeria.
Despite its name, psychological first aid covers both psychological and social support. Just like general health care never consists of physical first aid alone, similarly no mental health care system should consist of psychological first aid alone. Indeed, the investment in psychological first aid is part of a longer-term effort to ensure that anyone in acute distress due to a crisis is able to receive basic support, and that those who need more than psychological first aid will receive additional advanced support from health, mental health and social services.
Sunbeds give out ultraviolet (UV) rays that increase your risk of developing skin cancer (both malignant melanoma and non-melanoma). Many sunbeds give out greater doses of UV rays than the midday tropical sun.
The risks are greater for young people. Evidence shows that:
people who are frequently exposed to UV rays before the age of 25 are at greater risk of developing skin cancer later in life
sunburn in childhood can greatly increase the risk of developing skin cancer later in life
It’s illegal for people who are under the age of 18 to use sunbeds. The Sunbeds (Regulation) Act 2010 makes it an offence for someone operating a sunbed business to permit those under 18 to:
use a sunbed at the business premises, including beauty salons, leisure centres, gyms and hotels
be offered the use of a sunbed at the business premises
be allowed in an area reserved for sunbed users (unless they’re working as an employee of the business)
Sunbeds, sunlamps and tanning booths give out the same type of harmful radiation as sunlight. UVA rays make up about 95% of sunlight. They can cause your skin to age prematurely, making it look coarse, leathery and wrinkled. UVB rays make up about 5% of sunlight and burn your skin.
A tan is your body’s attempt to protect itself from the damaging effect of UV rays. Using a sunbed to get a tan isn’t safer than tanning in the sun. It may even be more harmful, depending on factors such as:
the strength of UV rays from the sunbed
how often you use a sunbed
the length of your sunbed sessions
your skin type – for example, whether you have fair or dark skin
In 2006, the Scientific Committee on Consumer Products concluded the maximum ultraviolet radiation (UVR) from sunbeds should not exceed 0.3W/m2, or 11 standard erythema doses per hour (erythema means reddening of the skin caused by sunburn). These 11 standard doses are the same as exposure to the tropical sun, which the World Health Organization (WHO) describes as extreme.
Damage from UV rays
Prolonged exposure to UV rays increases your risk of developing malignant melanoma, the most serious form of skin cancer.
UV rays can also damage your eyes, causing problems such as irritation, conjunctivitis or cataracts, particularly if you don’t wear goggles.
Advice about using sunbeds
The Health and Safety Executive (HSE) issued advice on the health risks associated with UV tanning equipment, such as sunbeds, sunlamps and tanning booths. They recommend you should not use UV tanning equipment if you:
have fair, sensitive skin that burns easily or tans slowly or poorly
have a history of sunburn, particularly in childhood
are taking medicines or using creams that make your skin sensitive to sunlight
have a medical condition made worse by sunlight, such as vitiligo (a long-term skin condition caused by a lack of a chemical in the skin called melanin)
have had skin cancer or someone in your family has had it
already have badly sun-damaged skin
The HSE advice also includes important points to consider before deciding to use a sunbed. For example, if you decide to use a sunbed, the operator should advise you about your skin type and how long you should limit your session to.
The World Health Organization has recently published “Projections of mortality and causes of death, 2015 and 2030”. The report provides information about all deaths in 2015 by cause and has made some predictions for 20130. Thus giving us impression of how global health will develop over the next 14 years. Also featured is data showing how life expectancy will change between now and 2030.
It also looks at which diseases are the worst killers. And which medical conditions are slowly being eradicated.
Our friends at Medigo have put together a rather interesting and useful infographic. So what do you think? Are things really getting better? Have your say in the comments section below.
23 FEBRUARY 2015 ¦ GENEVA – Use of the same syringe or needle to give injections to more than one person is driving the spread of a number of deadly infectious diseases worldwide. Millions of people could be protected from infections acquired through unsafe injections if all healthcare programmes switched to syringes that cannot be used more than once. For these reasons, the World Health Organization (WHO) is launching a new policy on injection safety to help all countries tackle the pervasive issue of unsafe injections.
A 2014 study sponsored by WHO, which focused on the most recent available data, estimated that in 2010, up to 1.7 million people were infected with hepatitis B virus, up to 315 000 with hepatitis C virus and as many as 33 800 with HIV through an unsafe injection. New WHO injection safety guidelines and policy released today provide detailed recommendations highlighting the value of safety features for syringes, including devices that protect health workers against accidental needle injury and consequent exposure to infection.
WHO also stresses the need to reduce the number of unnecessary injections as a critical way of reducing risk. There are 16 billion injections administered every year. Around 5% of these injections are for immunizing children and adults, and 5% are for other procedures like blood transfusions and injectable contraceptives. . The remaining 90% of injections are given into muscle (intramuscular route) or skin (subcutaneous or intradermal route) to administer medicines. In many cases these injections are unnecessary or could be replaced by oral medication.
“We know the reasons why this is happening,” says Dr Edward Kelley, Director of the WHO Service Delivery and Safety Department. One reason is that people in many countries expect to receive injections, believing they represent the most effective treatment. Another is that for many health workers in developing countries, giving injections in private practice supplements salaries that may be inadequate to support their families.”
Transmission of infection through an unsafe injection occurs all over the world. For example, a 2007 hepatitis C outbreak in the state of Nevada, United States of America, was traced to the practices of a single physician who injected an anaesthetic to a patient who had hepatitis C. The doctor then used the same syringe to withdraw additional doses of the anaesthetic from the same vial – which had become contaminated with hepatitis C virus – and gave injections to a number of other patients. In Cambodia, a group of more than 200 children and adults living near the country’s second largest city, Battambang, tested positive for HIV in December 2014. The outbreak has been since been attributed to unsafe injection practices.
“Adoption of safety-engineered syringes is absolutely critical to protecting people worldwide from becoming infected with HIV, hepatitis and other diseases. This should be an urgent priority for all countries,” says Dr Gottfried Hirnschall, Director of the WHO HIV/AIDS Department.
The new “smart” syringes WHO recommends for injections into the muscle or skin have features that prevent re-use. Some models include a weak spot in the plunger that causes it to break if the user attempts to pull back on the plunger after the injection. Others have a metal clip that blocks the plunger so it cannot be moved back, while in others the needle retracts into the syringe barrel at the end of the injection
Syringes are also being engineered with features to protect health workers from “needle stick” injuries and resulting infections. A sheath or hood slides over the needle after the injection is completed to protect the user from being injured accidentally by the needle and potentially exposed to an infection.
WHO is urging countries to transition, by 2020, to the exclusive use of the new “smart” syringes, except in a few circumstances in which a syringe that blocks after a single use would interfere with the procedure. One example is when a person is on an intravenous pump that uses a syringe .
The Organization is also calling for policies and standards for procurement, safe use and safe disposal of syringes that have the potential for re-use in situations where they remain necessary, including in syringe programmes for people who inject drugs. Continued training of health workers on injection safety – which has been supported by WHO for decades – is another key recommended strategy. WHO is calling on manufacturers to begin or expand production as soon as possible of ”smart” syringes that meet the Organization’s standards for performance, quality and safety.
“The new policy represents a decisive step in a long-term strategy to improve injection safety by working with countries worldwide. We have already seen considerable progress,” Dr Kelley says. Between 2000 and 2010, as injection safety campaigns picked up speed, re-use of injection devices in developing countries decreased by a factor of 7. Over the same period, unnecessary injections also fell: the average number of injections per person in developing countries decreased from 3.4 to 2.9. In addition, since 1999, when WHO and its partner organizations urged developing countries to vaccinate children only using syringes that are automatically disabled after a single use, the vast majority have switched to this method.
Syringes without safety features cost US$ 0.03 to 0.04 when procured by a UN agency for a developing country. The new “smart” syringes cost at least twice that much. WHO is calling on donors to support the transition to these devices, anticipating that prices will decline over time as demand increases.
Urgent government action is needed to meet global targets to reduce the burden of noncommunicable diseases (NCDs), and prevent the annual toll of 16 million people dying prematurely—before the age of 70 – from heart and lung diseases, stroke, cancer and diabetes, according to a new World Health Organization report.
“The global community has the chance to change the course of the NCD epidemic,” says WHO Director-General Dr Margaret Chan, who today launched the Global status report on noncommunicable diseases 2014. “By investing just US$1-3 dollars per person per year, countries can dramatically reduce illness and death from NCDs. In 2015, every country needs to set national targets and implement cost-effective actions. If they do not, millions of lives will continue to be lost too soon.”
The report states that most premature NCD deaths are preventable. Of the 38 million lives lost to NCDs in 2012, 16 million or 42% were premature and avoidable – up from 14.6 million in 2000.
Nearly five years into the global effort to reduce premature deaths from NCDs by 25% by 2025, the report provides a fresh perspective on key lessons learned.
Premature NCD deaths can be significantly reduced through government policies reducing tobacco use, harmful use of alcohol, unhealthy diets and physical inactivity, and delivering universal health care. For example, in Brazil the NCD mortality rate is dropping 1.8% per year due in part to the expansion of primary health care.
But the report calls for more action to be taken to curb the epidemic, particularly in low- and middle-income countries, where deaths due to NCDs are overtaking those from infectious diseases. Almost three quarters of all NCD deaths (28 million), and 82% of the 16 million premature deaths, occur in low- and middle-income countries.
“Best buys” to reduce the burden
The WHO report provides the baseline for monitoring implementation of the Global action plan for NCDs 2013-2020, aimed at reducing the number of premature deaths from NCDs by 25% by 2025. Outlined in the action plan are nine voluntary global targets that address key NCD risk factors including tobacco use, salt intake, physical inactivity, high blood pressure and harmful use of alcohol.
“Our world possesses the knowledge and resources to achieve the nine global NCD targets by 2025,” says Dr Oleg Chestnov, WHO’s Assistant Director-General for Noncommunicable Diseases and Mental Health. “Falling short of the targets would be unacceptable. If we miss this opportunity to set national targets in 2015 and work towards attaining our promises in 2025, we will have failed to address one of the major challenges for development in the 21st century.”
The report provides “best buy” or cost-effective, high-impact interventions recommended by WHO, including banning all forms of tobacco advertising, replacing trans fats with polyunsaturated fats, restricting or banning alcohol advertising, preventing heart attacks and strokes, promoting
breastfeeding, implementing public awareness programmes on diet and physical activity, and preventing cervical cancer through screening. Many countries have already had success in implementing these interventions to meet global targets.
Examples of regional and country “best buy” successes listed in the report:
• Turkey was the first country to implement all the “best-buy” measures for tobacco reduction. In 2012, the country increased the size of health-warning labels to cover 65% of the total surface area of each tobacco product. Tobacco taxes now make up 80% of the total retail price, and there is currently a total ban on tobacco advertising, promotion and sponsorship nationwide. As a result, the country saw a 13.4% relative decline in smoking rates from 2008 to 2012.
• Hungary passed a law to tax food and drink components with a high risk for health, such as sugar, salt and caffeine. A year later, 40% of manufacturers changed their product formula to reduce the taxable ingredients, sales decreased 27% and people consumed 25-35% fewer products.
• Argentina, Brazil, Chile, Canada, Mexico and the USA have promoted salt reduction in packaged foods and bread. Argentina has already achieved a 25% reduction in the salt content of bread.
Working on the ground in more than 150 countries, WHO is helping develop and share “best buy” solutions so that they can be implemented more widely. WHO is also helping countries understand the dimensions that influence NCDs outside the health sector, including public policies in agriculture, education, food production, trade, taxation and urban development.
Meeting global targets
Though some countries are making progress towards the global NCD targets, the majority are off course to meet the 2025 targets. While 167 countries have operational NCD units in the ministry of health, progress on other indicators has been slow, especially in low- and middle-income countries.
As of December 2013 only:
• 70 countries had at least one operational national NCD plan in line with the Global NCD action plan
• 56 countries had a plan to reduce physical inactivity
• 60 countries had national plans to reduce unhealthy diets
• 69 countries had a plan to reduce the burden of tobacco use
• 66 countries had a plan to reduce the harmful use of alcohol
• 42 countries had monitoring systems to report on the nine global targets
NCDs impede efforts to alleviate poverty and threaten the achievement of international development goals. When people fall sick and die in the prime of their lives, productivity suffers. And the cost of treating diseases can be devastating – both to the individual and to the country’s health system.
From 2011-2025, cumulative economic losses due to NCDs under a “business as usual” scenario in low- and middle-income countries is estimated at US$ 7 trillion. WHO estimates the cost of reducing the global NCD burden is US$ 11.2 billion a year: an annual investment of US$ 1-3 per capita.
High rates of death and disease, particularly in low- and middle-income countries, are a reflection of inadequate investment in cost-effective NCD interventions. WHO recommends all countries move from commitment to action, by setting national targets and implementing the “best buy” interventions starting in 2015.