Antibiotic use for community-acquired pneumonia in neonates and children: WHO evidence review.

Background Pneumonia is the most common cause of death in children worldwide, accounting for 15% of all deaths of children under 5 years of age. This review summarises the evidence for the empirical antibiotic treatment of community-acquired pneumonia in neonates and children and puts emphasis on publications since the release of the previous WHO Evidence Summary report published in 2014. Methods A systematic search for systematic reviews and meta-analyses of antibiotic therapy for community-acquired pneumonia was conducted between 1 January 2013 and 10 November 2016. Results The optimal dosing recommendation for amoxicillin remains unclear with limited pharmacological and clinical evidence. There is limited evidence from surveillance to indicate whether amoxicillin or broader spectrum antibiotics (e.g. third-generation cephalosporins) are being used most commonly for paediatric CAP in different WHO regions. Data are lacking on clinical efficacy in the context of pneumococcal, staphylococcal and mycoplasma disease and the relative contributions of varying first-line and step-down options to the selection of such resistance. Conclusion Further pragmatic trials are required to optimise management of hospitalised children with severe and very severe pneumonia

Nick McTurk ... [et al.]

Made available by the Northern Territory Library via the Publications (Legal Deposit) Act 2004 (NT).Date:2008-0

NT Child Deaths Review and Prevention Committee.

Made available by the Northern Territory Library via the Publications (Legal Deposit) Act 2004 (NT)."The Committee commisioned Menzies School of Health Research to conduct an exploratory study of recent trends in suicide among NT children and youth. The study focused on providing a concise review of recently published and unpublished literature of this topic within the NT context and as the suicide deaths predominantly involved Indigenous children there was a further focus on Australian and international reviews dealing with Indigenous populations." p. 1 "Due to the level of detail about individual cases in the Menzies study, the Committee determined that it would not be in the families' or the deceased individual's interests to publicy disclose those details of the research. Attached is the report prepared for public release by the Menzies School of Health Research." p. 2Date:201

Implementing a chronic disease strategy in two remote indigenous Australian settings: a multi-method pilot evaluation

Objective: To test an evaluation framework designed to evaluate implementation of the North Queensland Indigenous communities between August and December 2005.\ud \ud Setting: Both communities are located in Cape York, North Queensland. Community A has an estimated population of around 600 people; Community B has an enumerated population of 750, although health centre records indicate a higher number.\ud \ud Participants: Process evaluation involved health centre staff in both communities; clinical audits used random samples from the adult population (each sample n = 30); ethnographic fieldwork was conducted with resident population.\ud \ud Main outcome measures: Health centre scores and qualitative findings using a System Assessment Tool; clinical audits – extent to which scheduled services recorded; selected primary health performance indicators; qualitative ethnographic findings.\ud \ud Results: On almost all indicators, implementation of NQICDS had progressed further in Community A than in Community B; however, some common issues emerged, especially lack of linkages between health centres and other groups, and lack of support for client self-management.\ud \ud Conclusions: The evaluation framework is an effective and acceptable framework for monitoring implementation of the NQICDS at the primary health centre level

Supporting healthy drink choices in remote Aboriginal and Torres Strait Islander communities: a community-led supportive environment approach

Objective: To create supportive environments to reduce sugary drink consumption and increase water consumption by partnering with remote Aboriginal and Torres Strait Islander communities in Cape York. Methods: This paper applied qualitative and quantitative methods to evaluate a co-designed multi-strategy health promotion initiative, implemented over 12 months from 2017 to 2018. Outcome measures included changes in community readiness, awareness of the social marketing campaign and changes in drink availability. Changes in store drink sales were measured in one community and compared to sales in a control store. Results: Community readiness to address sugary drink consumption increased in two of the three communities. Awareness of social marketing campaign messaging was high (56-94%). Availability of drinking water increased in all communities. Water sales as a proportion of total drink volume sales increased by 3.1% (

What Indigenous Australian clients value about primary health care: a systematic review of qualitative evidence

Abstract Objective: To synthesise client perceptions of the unique characteristics and value of care provided in Aboriginal Community Controlled Health Organisations (ACCHOs) compared to mainstream/general practitioner services, and implications for improving access to quality, appropriate primary health care for Indigenous Australians. Method: Standardised systematic review methods with modification informed by ethical and methodological considerations in research involving Indigenous Australians. Results: Perceived unique valued characteristics of ACCHOs were: 1) accessibility, facilitated by ACCHOs welcoming social spaces and additional services; 2) culturally safe care; and 3) appropriate care, responsive to holistic needs. Conclusion: Provider‐client relationships characterised by shared understanding of clients' needs, Indigenous staff, and relationships between clients who share the same culture, are central to ACCHO clients' perceptions of ACCHOs' unique value. The client perceptions provide insights about how ACCHOs address socio‐economic factors that contribute to high levels of chronic disease in Indigenous communities, why mainstream PHC provider care cannot substitute for ACCHO care, and how to improve accessibility and quality of care in mainstream providers. Implications for public health: To increase utilisation of PHC services in Indigenous Australian communities, and help close the gaps between the health status of Indigenous and non‐Indigenous Australians, Indigenous community leaders and Australian governments should prioritise implementing effective initiatives to support quality health care provision by ACCHOs

The effect of nutrition education on nutrition‐related health outcomes of Aboriginal and Torres Strait Islander people: a systematic review

Abstract Objective: To determine the effectiveness of nutrition education on improving nutrition‐related health outcomes in Aboriginal and Torres Strait Islander people. Methods: Databases Medline, Cinahl, Scopus, ProQuest and ATSI Health were searched in September 2013 to identify nutrition education intervention studies in Indigenous Australian populations. Peer‐reviewed and grey literature with nutrition‐related biochemical or anthropometrical health outcomes were included in a qualitative comparative analysis. Results: Of 1,162 studies identified from the search, six met inclusion criteria. Three studies were from a remote setting and three from an urban setting. Four of the six education interventions were shown to improve body mass index (BMI) and/or nutritional biochemical indicators. Components of the nutrition education interventions showing greatest effect included cooking skills workshops, group education sessions and store interventions. Community involvement in the program design was most strongly associated with a positive effect on BMI. Conclusion: Nutrition education had some effect in reducing biochemical and anthropometric risk factors for chronic disease in Indigenous Australians. Implications: Nutrition education can be considered as part of a range of strategies to improve nutrition‐related health for Aboriginal and Torres Strait Islander people. Further evidence is needed to strengthen this recommendation