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Pregnancy and breastfeeding during an Ebola virus outbreak

Women who are pregnant or breastfeeding in an Ebola outbreak face similar challenges as other population groups, but they have specific health needs which must be met.

As the second largest Ebola outbreak in history continues in the Democratic Republic of Congo, WHO has released new clinical guidelines for healthcare providers supporting pregnant or breastfeeding women in the context of Ebola virus disease.

Improving clinical care and reducing mortality

Clear and coherent guidance is needed to meet the combined needs of women requiring Ebola treatment, pregnancy care and management of complications.

Information on how to protect breastfeeding children and other members in the community from transmission of the disease is also critical.

Limited scientific evidence on how to best manage these needs has previously been a challenge for affected countries. In addition, misconceptions that pregnant women have a higher mortality rate than other populations with Ebola may in some contexts have put pregnant women at risk of not receiving standard care.

WHO’s Guideline on the management of pregnant and breastfeeding women in the context of Ebola virus reviews existing evidence and provides a single set of recommendations on the care continuum for women exposed to, diagnosed with, or recovered from Ebola.

This will enable healthcare providers, emergency response teams and health policy-makers to improve prevention and treatment measures in an Ebola outbreak.

Obstetric care at an Ebola Treatment Centre

Optimal supportive care should be offered to all pregnant women with Ebola. Likewise, they should be offered experimental treatment and vaccination under the same conditions as non-pregnant populations.

Ebola virus disease does increase the risk of miscarriage and early labour, requiring close clinical management at Ebola treatment centres. It is important to engage both obstetric providers and those trained in Ebola response.

This dual expertise is also important because early Ebola and pregnancy-related symptoms can overlap. Pregnant women should be prioritised for testing to confirm an Ebola infection.

Ebola virus can persist in pregnancy related fluids as well as breastmilk. If healthcare providers are not clear on how to manage Ebola infection risk, they may be less willing to provide care. This stigma can be life-threatening for women who experience complications during delivery.

The new WHO guidelines advise healthcare workers on how to protect themselves while caring for pregnant women with Ebola virus disease. This includes induced labour or surgical procedures, which carry greater risk of transmission in cases of acute infection. Any invasive treatments should be carried out in full personal protective equipment.

Breastfeeding recommendations in an Ebola outbreak

WHO recommends that women with suspected or confirmed Ebola immediately stop breastfeeding and are prioritised for diagnostic testing. Any child exposed to Ebola through breast milk should be placed into safe care, closely monitored for symptoms over a 21-day period and fed with an appropriate breast milk substitute.

The guidelines strongly recommend that breastfeeding is only restarted following two consecutive negative tests of breast milk, separated by 24 hours.

A breast milk substitute should be used even if infection is confirmed for both the mother and her child. Exceptions can be made for infants under 6 months of age who are already infected, if breast milk substitutes are not feasible, affordable, sustainable or safe and separation cannot be implemented safely.

Women’s health and rights in a disease outbreak

A disease outbreak does not change women’s and adolescent girls’ fundamental human right to sexual and reproductive healthcare, including evidence-based care during pregnancy and childbirth.

Women need support to make informed reproductive health care choices for themselves and their children. Women living in an Ebola outbreak should have access to all relevant reproductive options, regardless of economic, cultural, racial or religious status, including contraception and safe abortion to the full extent of the law.

Pregnant and breastfeeding women across affected communities need equitable and respectful care that considers the risks they face and supports the choices they make.

Accessing the guidelines and further research

These guidelines are now available online and may be freely downloaded. The executive summary will be available in French.

WHO will closely monitor new data as it emerges, as there is still a pressing need to prioritise ongoing research related to Ebola virus transmission.

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https://www.who.int/news-room/detail/10-02-2020-pregnancy-and-breastfeeding-during-an-ebola-virus-outbreak

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February 27, 2020
US$675 million needed for new coronavirus preparedness and response global plan
To fight further spread of the new coronavirus (2019-nCoV) outbreak in China and globally, and protect states with weaker health systems, the international community has launched a US$675 million preparedness and response plan covering the months of February through to April 2020.

“My biggest worry is that there are countries today who do not have the systems in place to detect people who have contracted with the virus, even if it were to emerge,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Urgent support is needed to bolster weak health systems to detect, diagnose and care for people with the virus, to prevent further human to human transmission and protect health workers.”

The Strategic Preparedness and Response Plan (SPRP) for the new coronavirus lays out activities and resources needed by international health organizations globally, including WHO, to implement priority public health measures in support of countries to prepare and respond to nCoV-2019 for a period February-April 2020. The objectives of the plan are to limit human-to-human transmission of the virus, particularly in countries most vulnerable if they were to face an outbreak; identify, isolate and care for patients early; communicate critical risk and event information; minimize social and economic impact; reduce virus spread from animal sources; and address crucial unknowns.

The plan focuses on:
- Rapidly establishing international coordination and operational support;
- Scaling up country readiness and response operations;
- Accelerating priority research and innovation.
“The effectiveness of outbreak response depends on the preparedness measures put in place before outbreaks strike,” said Dr Mike Ryan, head of WHO’s Health Emergencies Programme. “That is why we are seeking resources to safeguard the most vulnerable countries to protect people from the new coronavirus before it arrives on the doorstep.”

As noted in the SPRP, WHO assesses that the outbreak poses a very high risk in China, and high risk regionally and globally. The risk assessment was based on factors including the likelihood of further spread, the potential impact on human health, and the varying levels of effectiveness in national preparedness and response measures. Accelerated action, as called for in the plan, can address these risks and areas requiring support.

As of 10 a.m. Central European Time on 5 February, 25 countries have reported confirmed cases of the new coronavirus, including China, where 24,363 people had contracted the virus, or over 99% of all cases. In all other countries, 191 cases have contracted the virus.

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https://www.who.int/news-room/detail/05-02-2020-us-675-million-needed-for-new-coronavirus-preparedness-and-response-global-plan

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February 27, 2020
Unleashing Youth Power:A Decade of Accelerating Actions Towards Zero Female Genital Mutilation

Joint statement by UNFPA Executive Director Dr Natalia Kanem, UNICEF Executive Director Henrietta Fore and UN Women Executive Director Phumzile Mlambo-Ngcuka and WHO Director-General Dr Tedros Adhanom Ghebreyesus on the occasion of International Day of Zero Tolerance for Female Genital Mutilation

– “When Tabitha was growing up in rural Kenya, most of her 16-year-old peers were subjected to female genital mutilation – a human rights violation that more than 4 million girls worldwide are at risk of this year. Yet Tabitha remains unharmed, thanks to the unwavering support of her parents, who, in spite of enormous social pressure, saved their daughter from the same fate.

“On the International Day of Zero Tolerance for Female Genital Mutilation, we join with Tabitha and young people around the world who are standing up for their rights with urgency and energy. They are engaging their peers, families, communities and governments with a call to end this harmful act of gender-based violence once and for all, as promised by the international community in the 2030 Agenda for Sustainable Development.

“While significant progress in eliminating the practice has been made in the last 30 years, approximately 200 million girls and women alive today have had their genitals mutilated. This can lead to long-term physical, psychological and social consequences.

“Support for the practice is dwindling. Adolescent girls aged 15 to 19 in countries where female genital mutilation is prevalent are less supportive of continuing the practice than are women aged 45 to 49. And in many countries, young girls are at much lower risk of being subjected to female genital mutilation than their mothers and grandmothers were. However, rapid youth population growth in countries where female genital mutilation is prevalent could lead to a significant rise in the number of girls at risk by 2030.

“Today’s young people can play a critical role in ending the practice. Unleashing the power of youth means investing in youth-led movements to champion gender equality, an end to violence against women and girls and the elimination of harmful practices. This requires including young people as partners when designing and implementing national action plans, building relationships with youth-led organizations and networks that work to end female genital mutilation and recognize it as a form of violence against women and girls, empowering young people to lead community campaigns that challenge social norms and myths, and engaging men and boys as allies.

“But this is not a goal young people can achieve alone, nor can it be addressed in isolation from other forms of violence against women and girls or from gender inequality. It also requires strong political leadership and commitment.

“Last year, at the Nairobi Summit on ICPD25, governments, civil society, faith-based organizations and private companies recommitted to ending gender-based violence and harmful practices – such as female genital mutilation – in 10 years, the same timeframe for achieving the Sustainable Development Goals. In March, we mark 25 years since the Beijing Platform for Action, a global commitment to advance women’s rights across 12 critical areas, including the elimination of all harmful practices against girls and women. This year, we will announce the creation of a new Generation Equality to drive further investment and results for gender equality.

“Now is the time to invest, translating the political commitments already made into concrete action. Now is the time to do more and do it better and faster to end the practice once and for all. Now is the time to keep our promise to Tabitha and all girls of reaching zero female genital mutilation by 2030.”

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https://www.who.int/news-room/detail/06-02-2020-unleashing-youth-power-a-decade-of-accelerating-actions-towards-zero-female-genital-mutilation

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February 27, 2020
Preventing child obesity in the next generation must start before conception

The key to preventing obesity in future generations is to make their parents healthier before they conceive, leading health researchers suggest.

In a series of papers, published in The Lancet Diabetes and Endocrinology, the researchers say that the time before couples conceive represents a missed opportunity to prevent the transmission of obesity risk from one generation to the next. They argue that a new approach is needed to motivate future parents to live a healthier lifestyle.

There is now a wealth of evidence that the risk of obesity and its associated conditions, such as heart disease diabetes and some cancers, could impact the developing baby. In turn, when the child becomes a young adult they may pass the risk of obesity on to their children – it is a vicious cycle.

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February 27, 2020
You Can Stop Feeling Bad About Eating Chocolate

Whether you’re an avid baker, or just love a sweet treat, it’s hard to resist the appeal of chocolate. But increasing evidence shows that resistance may not be necessary. Studies demonstrate myriad benefits of chocolate, from creating a feel-good buzz to boosting cardiovascular health. Read on to learn more, then try some healthy recipes.

The Latest Research

A recent study in the journal Heart shows that habitual chocolate consumption is linked to a lower risk of cardiovascular disease and stroke. Keeping in mind that the study only demonstrated correlation (not causation), it’s nonetheless exciting to see that among participants who consumed a relatively high volume of chocolate every day, 12% developed or died of cardiovascular disease during the 12-year study. Compare that to participants who didn’t eat chocolate at all, among whom 17.4% developed or died of the disease. How much were the chocolate-eaters consuming? About 16 to 100 grams per day, or roughly one half to two typical chocolate bars.

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February 27, 2020
A family-based weight management program improved self-perception among obese children

Battling the childhood obesity epidemic is a priority for many researchers, as obesity during adolescence increases the risk of chronic diseases throughout life. Because obese children have lower quality of life and self-esteem, greater levels of depression and anxiety, and also face more teasing and bullying than normal-weight peers, including mental health in any intervention is necessary. To that end, researchers studied the self-perception of children participating in the Fit Families program.

Fit Families is a program based on Social Cognitive Theory delivered through the New Mexico Cooperative Extension service. The program was developed for areas of southern New Mexico lacking resources to help combat childhood obesity in a positive, culturally appropriate manner by encouraging healthy food and nutrient intake and increased physical activity. For this study, children with a body mass index at least in the 85th percentile were referred by local physicians. The final study included 46 children, ranging from 8 to 17 years of age, 43% of whom were male, and 80% of whom were Hispanic.

“With our emphasis on fun physical activity, children and parents reported enjoying the games at Fit Families. We believe this may have resulted in the children’s increased self-perception related to their athletic ability,” said Martha Archuleta, PhD, RD, lead author of the study. “Children also improved the perception of their physical appearance, possibly due to the way self-acceptance and diversity of body sizes were promoted.”

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February 27, 2020
Changes needed to increase access to colorectal cancer screening

Colorectal cancer is the second highest cause of cancer death in the United States, expected to claim the lives of an estimated 49,190 people in 2016. The Affordable Care Act (ACA) aimed to increase access to CRC screening by not holding patients responsible for all costs of the procedure, yet current Medicare insurance beneficiaries lacking supplemental insurance may not be able to afford colon cancer screening and treatment. This policy disproportionally puts low-income Americans at risk and adds unnecessary strains on overall health care costs, according to a commentary in the May issue of the journal Gastroenterology.

“Study after study shows that screening saves lives,” said Chyke A. Doubeni, MD, MPH, chair and the Presidential Associate Professor of Family Medicine and Community Health at the Perelman School of Medicine at the University of Pennsylvania, and lead author of the commentary. “Yet many of those in the group most affected by this deadly disease are unable to afford the screening they critically need. We must renew efforts to ensure equitable access to and use of disease prevention, detection, and treatment services for colorectal cancer.”

For CRC screening, a full colonoscopy is necessary, where the doctor inspects the rectum and entire colon through a flexible lighted tube, and can remove any abnormal growth. The entire colon has to be cleansed before the colonoscopy, for which the patient is usually sedated

There are currently an estimated 55.5 million Medicare beneficiaries in the U.S. A 2010 Kaiser Family Foundation survey found that 14 percent lacked supplemental coverage. Until recently, colon cancer screening has been viewed as a one-time activity, while in practice, screening is a series of clinical activities to identify and test patients and perform diagnostic confirmation when necessary. This series of tests and steps include a diagnostic workup, which can include a biopsy to obtain a tissue sample or polypectomy, in which polyps are removed to prevent them from becoming cancerous.

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February 27, 2020
Apple and Johnson & Johnson team up on study to reduce stroke risk: How to volunteer

Can the Apple Watch and an app on your iPhone reduce the likelihood you’ll have a stroke?

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February 26, 2020
Lifestyle Changes

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Lifestyle Choices: Learn to Overcome Emotional Overeating

Overcoming emotional overeating can seem overwhelming, and setbacks can be expected. But the good news is, there are lifestyle choices that you can make to help overcome this problem.

The key word is choice – you can choose to follow a healthy lifestyle. Sometimes it helps to break things down into small, specific steps you can take (just trying to lead a “healthier lifestyle” is a bit vague!). Following are some of these specifics. And remember, setbacks and relapses are not unusual. Don’t beat yourself up; just start fresh tomorrow.

It is never too late to start afresh and start feeding your body with the nutrients it needs to sustain itself and function better as a whole.

Under-nourished people usually do not have the time or knowledge to ingest proper food and are thus losing out on a healthy lifestyle and risk putting their lives in jeopardy.

Exercise

Experts are in general agreement that regular exercise three to five days a week is most beneficial. This exercise should consist of at least 20 minutes of cardiovascular exercise (such as vigorous walking, jogging, biking, etc.) followed by some light toning or weight training. Committing to this regimen full-force is not necessarily the best way to go; if you can only exercise once or twice a week, that’s still better than nothing and will hopefully pave the way for more in the future.

Exercise is said to relieve emotional overeating in several ways. For one, exercise produces endorphins which are the body’s natural “feel good” hormones. For another, exercise prevents boredom and mindless eating, which is what you might be doing if you weren’t exercising! And finally, exercise will likely boost your self-image, helping to break the cycle of low self-esteem and poor self-image that “feeds” emotional overeating disorder.

Nature

Never underestimate the healing power of nature! For those with emotional overeating disorder, choosing to spend more time out in nature can be particularly beneficial. After all, in the natural realm there are no media messages to mess with your self-image, and being in nature connects you to your origins and the origins of food.

Some experts theorize that detachment from food and its natural source plays a role in emotional overeating disorder. Getting involved in nature and exploring and appreciating it can go a long way toward reconnecting with our biologically normal view of food. Maybe you can kill two birds with one stone and do your regular exercise outdoors!

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Source by Michael Oscar Pisani

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February 9, 2020
What Is the Best Definition of a Wealth Creator?

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One of the most important personal traits of a wealth creator is that they have integrity, in other words, their words and their actions go hand-in-hand. It is because of this personal trait that they can always be trusted and are trustworthy.

Unfortunately, most people say one thing and do another, that is, their words are not backed up by their actions. It is, therefore, understandable why most people are not creators of wealth. You cannot be a creator of wealth unless you have integrity.

Secondly, their relationships are built on trust and respect and therefore, their relationships are positive, good and long-lasting. This makes perfect sense, as any relationships that lack trust and respect, simply cannot last.

Thirdly, creators of wealth lead solid, stable and progressive lives. They are not living grand, high-flying lives one day, and then down-and-out on the streets the next. The main reason for this, is that wealth creators do not take risks and therefore, do not put themselves in situations where they stand the chance of losing everything.

This goes against the popular conventional belief that the higher the risk, the higher the reward. People who believe this to be true, are not creators of wealth and if they believe this to be true and are wealthy because of taking high risks, they can then be considered, to be gamblers.

Gamblers do stand a chance of becoming wealthy, however, they also stand the chance of losing all of their wealth.

Creators of wealth, on the other hand, grow their wealth.

Fourthly, creators of wealth do not create their wealth by chance, by fortune, or by luck. They each have a formula for building wealth and they simply, steadfastly, stick to the formula. Creators of wealth grow their wealth by following a successful formula that consistently provides positive results; it can, therefore, be said that wealth creators are results-driven people, that is, that they are only interested in the results.

My next point, is that wealth creators know how to build an investment or business. They have taken the time and effort to invest in themselves, so that they have the necessary knowledge and skills, in order to build a business or investment.

Lastly, wealth creators have the ability to make their money work for them – they do not have to work for their money. This is another reason, why most people aren’t wealth creators, as most people are only able to work for their money and are unable to make their money work for them.

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Source by Trevor Warwick Miller

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February 9, 2020