World Health Organization - Australia

Coleoptera is the most diverse group of insects with over 360,000 described species divided into four suborders: Adephaga, Archostemata, Myxophaga, and Polyphaga. In this study, we present six new complete mitochondrial genome (mtgenome) descriptions, including a representative of each suborder, and analyze the evolution of mtgenomes from a comparative framework using all available coleopteran mtgenomes. We propose a modification of atypical cox1 start codons based on sequence alignment to better reflect the conservation observed across species as well as findings of TTG start codons in other genes. We also analyze tRNA-Ser(AGN) anticodons, usually GCU in arthropods, and report a conserved UCU anticodon as a possible synapomorphy across Polyphaga. We further analyze the secondary structure of tRNA-Ser(AGN) and present a consensus structure and an updated covariance model that allows tRNAscan-SE (via the COVE software package) to locate and fold these atypical tRNAs with much greater consistency. We also report secondary structure predictions for both rRNA genes based on conserved stems. All six species of beetle have the same gene order as the ancestral insect. We report noncoding DNA regions, including a small gap region of about 20 bp between tRNA-Ser(UCN) and nad1 that is present in all six genomes, and present results of a base composition analysis.

We describe the enhanced rumor surveillance during the avian influenza H5N1 outbreak in 2004. The World Health Organization's Western Pacific Regional Office identified 40 rumors; 9 were verified to be true. Rumor surveillance informed immediate public health action and prevented unnecessary and costly responses.

Abstract The growing number of actors involved in China's international activities has led to fractured authority in foreign policy decision‐making. Actors vie for the attention of senior officials to promote their interests on any specific issue. As a result, decision making is often a slow process; there are multiple channels of information, and actors appeal to public opinion to support their claims. Since 2012, Xi Jinping has taken charge of all foreign policy related decision‐making bodies in what appears to be an attempt to improve coordination of interest groups. A slight shift to a more personified foreign policy than during the Hu or Jiang eras has also taken place. In this paper, we describe how foreign policy decisions should be made in China according to formal rules; next, we take into account the reality of how the Chinese political system deals with China's evolving international role. We conclude by assessing the risks of fragmentation, on the one hand, and Xi's efforts to recentralise foreign policy, on the other hand.

In many parts of the world, particularly in the developing countries, street food vending also makes an important contribution to employment, household revenue and food security. While street foods are an important source of ready-to-eat nutrition and provides low cost meal for the urban poor population, the health risks possessed by such foods may outweigh their benefits. Dhaka city is the capital of Bangladesh and is one of the most densely populated cities of the world. At present Dhaka is the residence of approximately 14 million people and it has been estimated that there are around 2 million street food vendors currently engaged in food vending in the city. A few published reports on street food vendors in Dhaka suggests poor microbial quality of street food and bear the risk of transmitting enteric disease in the communities. Therefore the aim of this study is to explore the challenges faced by the street food vendors to maintain food hygiene while vending in Dhaka city. Semi structured interview approach was chosen for its suitability for exploring attitudes, values, beliefs and motives. The street food vendors were first categorized into four categories based on the food item they sell. All 26 interviews were tape-recorded, transcribed and content analysis with inductive coding was used to code the transcribed interview data. Qualitative, inductive coding methods were used to explore the challenges faced by the street food vendors to maintain street food safety while vending in Dhaka city. The study revealed that lack of education, training and experience and lack of infrastructural support all together acts as major challenges for these street food vendors to ensure food safety while vending in Dhaka city. The interviewed street food vendors gave their opinion that proper training about safe food handling and proper financial and infrastructural support like loans for starting a business, fixing a site for the street food vendors in different places of the city with all sorts of support available like supply of purified water, proper toilet facility and proper garbage disposal might be helpful to overcome the challenges faced by them to maintain hygiene of the food sold by them.

Frailty is a highly prevalent geriatric condition, affecting between 12-24% of older adults globally. It remains a major cause of morbidity and mortality in older adults. Incorporating frailty measurement into clinical decision making can guide optimal patient care. This updated review presents an outline of current frailty definitions and measurement approaches in both research and clinical practice, including: Fried's frailty phenotype; Rockwood and Mitnitski's Frailty Index (FI) of cumulative deficits; Clinical Frailty Scale (CFS); Fatigue, Resistance, Ambulation, Illness and Loss of weight (FRAIL) scale; Edmonton Frail Scale (EFS); electronic Frailty Index (eFI); Hospital Frailty Risk Score (HFRS); Study of Osteoporotic Fractures (SOF) Index; Tilburg Frailty Indicator (TFI); Groningen Frailty Indictor (GFI); Multidimensional Prognostic Index (MPI); the Kihon Checklist (KCL); Geriatric 8 (G8) for oncology; the Essential Frailty Toolset (EFT) for cardiology; plus gait speed and grip strength. The main strengths and limitations of existing frailty measurements are summarised, including how well these measurements operationalise frailty in terms of their accuracy in identifying frailty, their basis on biological causative theory, and their ability to reliably predict patient outcomes and response to potential therapies.

The role of gastrointestinal endoscopy in the developed world has seen an amazing expansion that has resulted in it becoming a crucial diagnostic and therapeutic tool to replace radiology, as well as surgery to an increasing extent. Areas of Africa have seen a similar development, but in large areas of Sub-Saharan Africa (SSA), the situation is far from ideal, with very limited access to endoscopic competence. This is related to financial, organizational, and educational factors, which have hampered the development of badly needed endoscopy services. Presence and involvement from relevant industry partners is also variable and often incomplete. General political and logistic challenges specific to each country add to the complexity; however, with a goal-oriented approach, improvement can be achieved within those limitations. Along with the process of improving the overall situation, there is a need to optimize the use of currently available resources. To accomplish this, a comprehensive understanding of local and regional dynamics is essential.

BACKGROUND: Uncorrected refractive error is a leading cause of vision impairment which, in most cases, can be managed with the appropriate spectacle correction. In 2021, the World Health Assembly endorsed a global target of a 40-percentage-point increase in effective coverage of refractive error by 2030. To achieve this global target, equitable access to refractive and optical services within community and primary care settings needs to be strengthened. This review will inform the development of technical guidance to support improvements in the testing and correction of refractive error among World Health Organization (WHO) member states. OBJECTIVES: To determine the range of approaches for delivery of refractive and optical care services in community and primary care settings, and the methods employed for their evaluation. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase and Global Health databases, grey literature, and annual reports and websites of relevant organizations involved in eye-care delivery from January 2002 to November 2022 to identify approaches for refractive and optical service delivery. SELECTION CRITERIA: We included observational and interventional studies, reviews, and reports from relevant organizations related to delivering refractive services and optical services for preschool and school-aged children and adults in community and primary care settings published between January 2002 and November 2022. We searched for studies and reports published within the last 20 years because vision impairment due to uncorrected refractive error has only recently become a public health and eye health priority, therefore we did not expect to find much relevant literature until after 2002. DATA COLLECTION AND ANALYSIS: Two review authors screened titles, abstracts and full texts, and extracted data. We resolved any discrepancies through discussion. We synthesized data, and presented results as tables, figures, and case studies. This project was led by the World Health Organization (WHO) Vision and Eye Care Programme. MAIN RESULTS: We identified 175 studies from searches of databases and grey literature, 146 records from company reports, and 81 records from website searches of relevant organizations that matched our inclusion criteria. Delivery approaches for refractive and optical services in community care included school-based, pharmacy, and outreach models, whereas primary care approaches comprised vision centre, health centre, and a combination of vision or health centre and door-to-door delivery. In community care, school-based and outreach approaches were predominant, while in primary care, a vision-centre approach was mainly used. In the WHO African region, the school-based and outreach approaches were mainly reported while, in the Americas, the outreach approach was mostly used. Very few approaches for service delivery were reported in the WHO Eastern Mediterranean region. Prominent gaps exist in the evaluation of the approaches, and few studies attempted to evaluate the approaches for delivery of refractive and optical care services. AUTHORS' CONCLUSIONS: We comprehensively describe a range of approaches for delivery of refractive and optical services in community and primary care. Further evaluation of their effectiveness will better inform the application of these service-delivery approaches. The study outcomes will help guide WHO member states in strengthening refractive and optical services at community and primary care levels. FUNDING: This scoping review was supported by the Vision and Eye care Programme, World Health Organization and ATscale Global Partnership. REGISTRATION: The protocol of this scoping review was published in the Open Source Framework.

There is growing attention to the influence of commercial milk formula (CMF) marketing on health professionals and their professional associations, with ongoing controversies about the conflicts of interest created by the CMF industry and how health professionals and their associations can avoid them. Australian guidelines state that health workers should implement the International Code of Marketing of Breast-milk Substitutes (the Code), and a recent regulatory review considered whether health professional association (HPA) ethical codes and standards require compliance with the Code. However, evidence was lacking. This study aimed to assess the extent to which Australian HPAs' codes and standards require compliance with the Code. Sampled were national associations of regulated health professionals likely to provide health care to mothers and infants. Online searches of websites of these Australian HPAs were conducted in 2021 and repeated in 2024, to identify documents on professional ethics on the Code and breastfeeding. To assess the documents, we developed a simple scoring system and tool using the eight critical elements of the Code and World Health Organisation guidance for health workers. Searches identified 19 within-scope associations. Most (15/19) had no provisions relating to the Code or Guidance in their ethics or standards documents in 2024. Only one comprehensively covered the Code components and just five scored above 50 per cent. Professional association codes of ethics and standards in Australia do not prevent health professionals being influenced by CMF company marketing or ensure breastfeeding is protected, promoted and supported in line with health worker responsibilities under Australian guidelines and the Code. Future research could apply this scoring system in other country settings, and for other HPAs.

Background Asthma is a chronic respiratory disorder that requires long-term pharmacotherapy and patient empowerment to manage the condition and recognize and respond to asthma exacerbations. Mobile health (mHealth) apps represent a potential medium through which patients can improve their ability to self-manage their asthma. Few studies have conducted a systematic evaluation of asthma mobile apps for quality and functionality using a validated tool. None of these reviews have systematically assessed these apps for their content and evaluated them against the available international best practice guidelines. Objective The objective of this study is to conduct a systematic search and evaluation of adult-targeted asthma mHealth apps. As part of this review, the potential of an mHealth app to improve asthma self-management and the overall quality of the app will be evaluated using the Mobile App Rating Scale framework, and the quality of the information within an app will be evaluated using the current Global Initiative for Asthma guidelines as a reference. Methods A stepwise methodological approach was taken in creating this review. First, the most recent Global Initiative for Asthma guidelines were independently reviewed by 2 authors to identify key recommendations that could be feasibly incorporated into an mHealth app. A previously developed asthma assessment framework was identified and was modified to suit our research and ensure that all of these identified recommendations were included. In total, 2 popular app stores were reviewed to identify potential mHealth apps. These apps were screened based on predefined inclusion and exclusion criteria. Suitable apps were then evaluated. Technical information was obtained from publicly available information. The next step was to perform an app quality assessment using the validated Mobile App Rating Scale framework to objectively determine the quality of an app. App functionality was assessed using the Intercontinental Medical Statistics Institute for Health Informatics Functionality Scoring System. Finally, the mHealth apps were assessed using our developed checklist. Results Funding has been received for the project from the Respiratory Department at Northern Health, Victoria. Three reviewers have been recruited to systematically evaluate the apps. The results of this study are expected in 2022. Conclusions To our knowledge, this review represents the first study to examine all mHealth apps available in Australia that are targeted to adults with asthma for their functionality, quality, and consistency with international best practice guidelines. Although this review will only be conducted on mHealth apps available in Australia, many apps are available worldwide; thus, this study should be largely generalizable to other English-speaking regions and users. The results of this review will help to fill gaps in the literature and assist clinicians in providing evidence-based advice to patients wishing to use mHealth apps as part of their asthma self-management. Trial Registration PROSPERO 269894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269894 International Registered Report Identifier (IRRID) PRR1-10.2196/33103

The purpose of this study is nutrient resources recovery by achieving the optimal chemical oxygen demand (COD) and carbon to nitrogen ratio (C/N) in co-composting wastewater treatment plant sludge with Municipal Solid Wastes (MSW). In this effort, the co-composting has been conducted in form of a case study in the southern region of Caspian Sea. In this research, 192 tests were carried out on four series of samples examined in terms of waste to sludge ratio, different aeration period, the percent of porous materials and the moisture content. This study was carried out at a temperature of 65 °C for a 15 day period by application of the in-vessel system and shows that the best ratio for waste to sludge is 2:1, while the 8 hour period is the best aeration period. The porous material which can be added to the composting process is limited to 15% in weight. In other words, any more or less amount of this material will adversely impact the process. Moreover, this research suggests that the sludge dewatering is not required in such processes. In Addition, the efficiency of both COD and C/N reductions equals to about 40%.

Immediate aid to survivors of a natural disaster is the keynote to crisis management. Providing temporary access is one of the most important principles of immediate relief. However, in the postdisaster conditions, it is not possible to use road construction machinery, especially in rural areas. Therefore, in this study, the feasibility of using a Rapid Assembly Building (RAB) system for the temporary pavement with the possibility of rapid construction, which follows the natural topography of the place, is investigated. The introduced system consists of a high-density polyurethane (PUR) foam core as well as two continuous layers of high-density polyethylene (HDPE) facings. For this purpose, the mechanical properties of the materials and composite pavement were determined by a series of laboratory tests. Then, the mechanical performance and bearing behaviour of an element of the presented pavement system was numerically modelled under AASHTO loading. Since in the post-disaster situation, it is not possible to establish the subgrade, an un-compacted subgrade is used for modelling. The results show that this system can be used well in post-disaster situations to provide a rapid, safe, yet robust road without any permanent deformation.

Urinary bladder carcinoma is the most frequently occurring cancer of the urinary tract. Like any other types of cancer the diagnosis, treatment and overall management of urinary bladder cancer is not only expensive but also time consuming. During all these procedures, patients face several barriers while accessing care. The physicians and healthcare administrative or policy makers have the opportunity to closely observe patients' situation or their view towards existing policy and support system. Objective of this study is to explore professionals' perspective on access to care for patients with urinary bladder carcinoma in Scotland in order to identify recent progresses and difficulties faced by patients at different stages of management of the disease. Semi structured interview approach was chosen for its suitability for exploring attitudes, values, beliefs and motives. A total of twelve participants were interviewed. All the twelve participants were chosen through purposive sampling. A phenomenological approach was used to explore perspectives of these twelve professionals having experience of treating patients with urinary bladder carcinoma. All the participants despite of the differences in their views have identified backlog and/or long standing waiting list, lack of patient centered care and shortage of infrastructure, as major barriers in access to care for urinary bladder carcinoma patients. The major gaps identified were inefficiencies of the system and lack of focus on bladder cancer. According to the participants' financial deficiency, systemic complication, age group and socio-economic status of patients are the biggest challenges to overcome these barriers. Professionals gave their opinion for increasing the capacity of the service by establishing bladder cancer care centers and also employing skilled workforce in accordance to the patient number in these centers.

<sec> <title>BACKGROUND</title> Asthma is a chronic respiratory disorder that requires long-term pharmacotherapy and patient empowerment to manage the condition and recognize and respond to asthma exacerbations. Mobile health (mHealth) apps represent a potential medium through which patients can improve their ability to self-manage their asthma. Few studies have conducted a systematic evaluation of asthma mobile apps for quality and functionality using a validated tool. None of these reviews have systematically assessed these apps for their content and evaluated them against the available international best practice guidelines. </sec> <sec> <title>OBJECTIVE</title> The objective of this study is to conduct a systematic search and evaluation of adult-targeted asthma mHealth apps. As part of this review, the potential of an mHealth app to improve asthma self-management and the overall quality of the app will be evaluated using the Mobile App Rating Scale framework, and the quality of the information within an app will be evaluated using the current Global Initiative for Asthma guidelines as a reference. </sec> <sec> <title>METHODS</title> A stepwise methodological approach was taken in creating this review. First, the most recent Global Initiative for Asthma guidelines were independently reviewed by 2 authors to identify key recommendations that could be feasibly incorporated into an mHealth app. A previously developed asthma assessment framework was identified and was modified to suit our research and ensure that all of these identified recommendations were included. In total, 2 popular app stores were reviewed to identify potential mHealth apps. These apps were screened based on predefined inclusion and exclusion criteria. Suitable apps were then evaluated. Technical information was obtained from publicly available information. The next step was to perform an app quality assessment using the validated Mobile App Rating Scale framework to objectively determine the quality of an app. App functionality was assessed using the Intercontinental Medical Statistics Institute for Health Informatics Functionality Scoring System. Finally, the mHealth apps were assessed using our developed checklist. </sec> <sec> <title>RESULTS</title> Funding has been received for the project from the Respiratory Department at Northern Health, Victoria. Three reviewers have been recruited to systematically evaluate the apps. The results of this study are expected in 2022. </sec> <sec> <title>CONCLUSIONS</title> To our knowledge, this review represents the first study to examine all mHealth apps available in Australia that are targeted to adults with asthma for their functionality, quality, and consistency with international best practice guidelines. Although this review will only be conducted on mHealth apps available in Australia, many apps are available worldwide; thus, this study should be largely generalizable to other English-speaking regions and users. The results of this review will help to fill gaps in the literature and assist clinicians in providing evidence-based advice to patients wishing to use mHealth apps as part of their asthma self-management. </sec> <sec> <title>CLINICALTRIAL</title> PROSPERO 269894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269894 </sec> <sec> <title>INTERNATIONAL REGISTERED REPORT</title> PRR1-10.2196/33103 </sec>

Understanding the spatiotemporal patterns of emergence and circulation of new human seasonal influenza virus variants is a key scientific and public health challenge. The global circulation patterns of influenza A/H3N2 viruses are well characterized1, 2, 3, 4, 5, 6, 7, but the patterns of A/H1N1 and B viruses have remained largely unexplored. Here we show that the global circulation patterns of A/H1N1 (up to 2009), B/Victoria, and B/Yamagata viruses differ substantially from those of A/H3N2 viruses, on the basis of analyses of 9,604 haemagglutinin sequences of human seasonal influenza viruses from 2000 to 2012. Whereas genetic variants of A/H3N2 viruses did not persist locally between epidemics and were reseeded from East and Southeast Asia, genetic variants of A/H1N1 and B viruses persisted across several seasons and exhibited complex global dynamics with East and Southeast Asia playing a limited role in disseminating new variants. The less frequent global movement of influenza A/H1N1 and B viruses coincided with slower rates of antigenic evolution, lower ages of infection, and smaller, less frequent epidemics compared to A/H3N2 viruses. Detailed epidemic models support differences in age of infection, combined with the less frequent travel of children, as probable drivers of the differences in the patterns of global circulation, suggesting a complex interaction between virus evolution, epidemiology, and human behaviour.