Kate Lycett, Hannah Lane, Georgie Frykberg, Susan Maury, Carolyn Wallace, Luisa Taafua, Bernie Morris, Anne Hollonds, Pasi Sahlberg, Kevin Kapeke, Ngiare Brown, Jordan Cory, Peter D Sly, Craig A Olsson, Fiona J Stanley, Anna M H Price, Planning Saw, Khalid Muse, Peter S Azzopardi, Susan M Sawyer, Rebecca Glauert, Marketa Reeves, Roslyn Dundas, Sandro Demaio, Rosemary Calder, Sharon R Goldfeld
Introduction: This consensus statement recommends eight high-level trackable policy actions most likely to significantly improve health and wellbeing for children and young people by 2030. These policy actions include an overarching policy action and span seven interconnected domains that need to be adequately resourced for every young person to thrive: Material basics; Valued, loved and safe; Positive sense of identity and culture; Learning and employment pathways; Healthy; Participating; and Environments and sustainable futures.
Main recommendations: Provide financial support to invest in families with young children and address poverty and material deprivation in the first 2000 days of life. Establish a national investment fund to provide sustained, culturally relevant, maternal and child health and development home visiting services for the first 2000 days of life for all children facing structural disadvantage and/or adversity. Implement a dedicated funding model for Aboriginal and Torres Strait Islander community-controlled early years services across the country to ensure these services are fully resourced to provide quality early learning and integrated services grounded in culture and community. Properly fund public schools, starting by providing full and accountable Schooling Resource Standard funding for all schools, with immediate effect for schools in communities facing structural disadvantage. Establish legislation and regulation to protect children and young people aged under 18 years from the marketing of unhealthy and harmful products. Amend the electoral act to extend the compulsory voting age to 16 years. Legislate an immediate end to all new fossil fuel projects in Australia. Establish a federal Future Generations Commission with legislated powers to protect the interests of future generations.
Changes in approach as a result of this statement: Together, these achievable evidence-based policies would significantly improve children and young people's health and wellbeing by 2030, build a strong foundation for future generations, and provide co-benefits for all generations and society.
{"title":"The Future Healthy Countdown 2030 consensus statement: core policy actions and measures to achieve improvements in the health and wellbeing of children, young people and future generations.","authors":"Kate Lycett, Hannah Lane, Georgie Frykberg, Susan Maury, Carolyn Wallace, Luisa Taafua, Bernie Morris, Anne Hollonds, Pasi Sahlberg, Kevin Kapeke, Ngiare Brown, Jordan Cory, Peter D Sly, Craig A Olsson, Fiona J Stanley, Anna M H Price, Planning Saw, Khalid Muse, Peter S Azzopardi, Susan M Sawyer, Rebecca Glauert, Marketa Reeves, Roslyn Dundas, Sandro Demaio, Rosemary Calder, Sharon R Goldfeld","doi":"10.5694/mja2.52494","DOIUrl":"10.5694/mja2.52494","url":null,"abstract":"<p><strong>Introduction: </strong>This consensus statement recommends eight high-level trackable policy actions most likely to significantly improve health and wellbeing for children and young people by 2030. These policy actions include an overarching policy action and span seven interconnected domains that need to be adequately resourced for every young person to thrive: Material basics; Valued, loved and safe; Positive sense of identity and culture; Learning and employment pathways; Healthy; Participating; and Environments and sustainable futures.</p><p><strong>Main recommendations: </strong>Provide financial support to invest in families with young children and address poverty and material deprivation in the first 2000 days of life. Establish a national investment fund to provide sustained, culturally relevant, maternal and child health and development home visiting services for the first 2000 days of life for all children facing structural disadvantage and/or adversity. Implement a dedicated funding model for Aboriginal and Torres Strait Islander community-controlled early years services across the country to ensure these services are fully resourced to provide quality early learning and integrated services grounded in culture and community. Properly fund public schools, starting by providing full and accountable Schooling Resource Standard funding for all schools, with immediate effect for schools in communities facing structural disadvantage. Establish legislation and regulation to protect children and young people aged under 18 years from the marketing of unhealthy and harmful products. Amend the electoral act to extend the compulsory voting age to 16 years. Legislate an immediate end to all new fossil fuel projects in Australia. Establish a federal Future Generations Commission with legislated powers to protect the interests of future generations.</p><p><strong>Changes in approach as a result of this statement: </strong>Together, these achievable evidence-based policies would significantly improve children and young people's health and wellbeing by 2030, build a strong foundation for future generations, and provide co-benefits for all generations and society.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"221 Suppl 10 ","pages":"S6-S17"},"PeriodicalIF":6.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emily Nehme, David Anderson, Ross Salathiel, Anthony Carlyon, Dion Stub, Peter A Cameron, Andrew Wilson, Sile Smith, John J McNeil, Ziad Nehme
Objectives: To examine changes in out-of-hospital cardiac arrest (OHCA) characteristics and outcomes during 2003-2022, and 12-month outcomes for people who experienced OHCA during 1 January 2010 - 30 June 2022.
Study design: Retrospective observational study; analysis of Victorian Ambulance Cardiac Arrest Registry (VACAR) data.
Setting, participants: OHCA events in Victoria not witnessed by emergency medical services personnel, 1 January 2003 - 31 December 2022.
Main outcome measures: Crude and age-standardised annual OHCA incidence rates; survival to hospital discharge.
Results: Of 102 592 OHCA events included in our analysis, 67 756 were in men (66.3%). The age-standardised incidence did not change significantly across the study period (2003: 89.1 cases, 2022: 91.2 cases per 100 000 population; for trend: P = 0.50). The proportion of OHCA cases with attempted resuscitation by emergency medical services in which bystanders attempted cardio-pulmonary resuscitation increased from 40.3% in 2003/2004 to 72.2% in 2021/2022, and that of public access defibrillation from 0.9% to 16.1%. In the Utstein comparator group (witnessed OHCA events in which the initial cardiac rhythm was ventricular fibrillation or ventricular tachycardia, with attempted resuscitation by emergency medical services), the odds of survival to hospital discharge increased during 2003-2022 (adjusted odds ratio (aOR), 3.08; 95% confidence interval [CI], 2.22-4.27); however, the odds of survival was greater than in 2012 only in 2018 (aOR, 1.37; 95% CI, 1.04-1.80) and 2019 (aOR, 1.68; 95% CI, 1.28-2.21). The COVID-19 pandemic was associated with reduced odds of survival (aOR, 0.63; 95% CI, 0.54-0.74). Of 3161 people who survived OHCA and participated in 12-month follow-up, 1218 (38.5%) reported full health according to the EQ-5D.
Conclusion: Utstein survival to hospital discharge increased threefold during 2003-2022, and the proportions of cases in which bystanders provided cardio-pulmonary resuscitation or public access defibrillation increased. The COVID-19 pandemic was associated with a substantial reduction in survival, and new strategies are needed to improve outcomes.
{"title":"Out-of-hospital cardiac arrests in Victoria, 2003-2022: retrospective analysis of Victorian Ambulance Cardiac Arrest Registry data.","authors":"Emily Nehme, David Anderson, Ross Salathiel, Anthony Carlyon, Dion Stub, Peter A Cameron, Andrew Wilson, Sile Smith, John J McNeil, Ziad Nehme","doi":"10.5694/mja2.52532","DOIUrl":"10.5694/mja2.52532","url":null,"abstract":"<p><strong>Objectives: </strong>To examine changes in out-of-hospital cardiac arrest (OHCA) characteristics and outcomes during 2003-2022, and 12-month outcomes for people who experienced OHCA during 1 January 2010 - 30 June 2022.</p><p><strong>Study design: </strong>Retrospective observational study; analysis of Victorian Ambulance Cardiac Arrest Registry (VACAR) data.</p><p><strong>Setting, participants: </strong>OHCA events in Victoria not witnessed by emergency medical services personnel, 1 January 2003 - 31 December 2022.</p><p><strong>Main outcome measures: </strong>Crude and age-standardised annual OHCA incidence rates; survival to hospital discharge.</p><p><strong>Results: </strong>Of 102 592 OHCA events included in our analysis, 67 756 were in men (66.3%). The age-standardised incidence did not change significantly across the study period (2003: 89.1 cases, 2022: 91.2 cases per 100 000 population; for trend: P = 0.50). The proportion of OHCA cases with attempted resuscitation by emergency medical services in which bystanders attempted cardio-pulmonary resuscitation increased from 40.3% in 2003/2004 to 72.2% in 2021/2022, and that of public access defibrillation from 0.9% to 16.1%. In the Utstein comparator group (witnessed OHCA events in which the initial cardiac rhythm was ventricular fibrillation or ventricular tachycardia, with attempted resuscitation by emergency medical services), the odds of survival to hospital discharge increased during 2003-2022 (adjusted odds ratio (aOR), 3.08; 95% confidence interval [CI], 2.22-4.27); however, the odds of survival was greater than in 2012 only in 2018 (aOR, 1.37; 95% CI, 1.04-1.80) and 2019 (aOR, 1.68; 95% CI, 1.28-2.21). The COVID-19 pandemic was associated with reduced odds of survival (aOR, 0.63; 95% CI, 0.54-0.74). Of 3161 people who survived OHCA and participated in 12-month follow-up, 1218 (38.5%) reported full health according to the EQ-5D.</p><p><strong>Conclusion: </strong>Utstein survival to hospital discharge increased threefold during 2003-2022, and the proportions of cases in which bystanders provided cardio-pulmonary resuscitation or public access defibrillation increased. The COVID-19 pandemic was associated with a substantial reduction in survival, and new strategies are needed to improve outcomes.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-18Epub Date: 2024-10-25DOI: 10.5694/mja2.52505
Laxmi Iyengar, Alvin H Chong, Andrew C Steer
Scabies is the most common neglected tropical disease with cutaneous manifestations, disproportionately affecting socially disadvantaged populations living in overcrowded settings. Scabies infestation is characterised by a generalised intractable pruritus, and is often complicated by secondary bacterial infection, which can lead to a range of complications. Scabies is a clinical diagnosis and requires an adequate degree of suspicion. The use of dermoscopy may improve diagnostic accuracy. In Australia, the first-line treatment recommended for scabies is topical permethrin 5% cream, applied to the whole body and repeated in one week. Oral ivermectin is subsidised by the Pharmaceutical Benefits Scheme with streamlined authority for patients who have completed and failed treatment with topical therapy, have a contraindication to topical treatment or have crusted scabies. Early identification and prompt initiation of treatment is key to minimise the disease burden of scabies.
{"title":"Scabies: a clinical update.","authors":"Laxmi Iyengar, Alvin H Chong, Andrew C Steer","doi":"10.5694/mja2.52505","DOIUrl":"10.5694/mja2.52505","url":null,"abstract":"<p><p>Scabies is the most common neglected tropical disease with cutaneous manifestations, disproportionately affecting socially disadvantaged populations living in overcrowded settings. Scabies infestation is characterised by a generalised intractable pruritus, and is often complicated by secondary bacterial infection, which can lead to a range of complications. Scabies is a clinical diagnosis and requires an adequate degree of suspicion. The use of dermoscopy may improve diagnostic accuracy. In Australia, the first-line treatment recommended for scabies is topical permethrin 5% cream, applied to the whole body and repeated in one week. Oral ivermectin is subsidised by the Pharmaceutical Benefits Scheme with streamlined authority for patients who have completed and failed treatment with topical therapy, have a contraindication to topical treatment or have crusted scabies. Early identification and prompt initiation of treatment is key to minimise the disease burden of scabies.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":" ","pages":"558-563"},"PeriodicalIF":6.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The equitable challenges to quality use of modulators for cystic fibrosis in Australia.","authors":"Laura K Fawcett, Shafagh A Waters, Adam Jaffe","doi":"10.5694/mja2.52527","DOIUrl":"https://doi.org/10.5694/mja2.52527","url":null,"abstract":"","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Participation is widely recognised as a determinant of children and young people's health.<span><sup>1</sup></span> Both the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) (Article 18) and the Convention on the Rights of the Child (Article 12) enshrine participation as an inalienable right.<span><sup>2, 3</sup></span> Despite this, the exclusion and non-participation of Indigenous children, adolescents and young people persists.<span><sup>4</sup></span></p><p>Indigenous children and young people experience worse health outcomes than their non-Indigenous peers and are starkly over-represented in the contact with youth justice and in out-of-home care.<span><sup>5-7</sup></span> We propose this is in part due to their exclusion and non-participation — both as children and as Indigenous people.<span><sup>4, 5, 7</sup></span> These children and young people's stories are often told for them, if at all.<span><sup>4</sup></span> “It didn't matter what I screamed at (Child Protection Services), they wanted to tell my story for me, decide for me, know what was best for me. That's easier than listening, isn't it?”, said one Indigenous young person in contact with the youth justice system.<span><sup>6</sup></span></p><p>Indigenous young people are less likely to access primary health services despite having more health needs than non-Indigenous counterparts.<span><sup>8</sup></span> Most children and young people in the youth justice system have severe neurodevelopmental disorders — nearly all previously undiagnosed and untreated.<span><sup>9</sup></span> Current mainstream health and youth services are failing to provide culturally safe rudimentary services and meet Indigenous children and young people's unique needs.<span><sup>5, 7, 8, 10</sup></span> They have not been designed with meaningful participation of Indigenous people, let alone children and young people.<span><sup>5, 8</sup></span> There is an urgency for meaningful participation of Indigenous children and young people in reform.<span><sup>4, 7, 8</sup></span> There is an urgency for decision makers to listen and act.<span><sup>4, 5, 7, 8</sup></span></p><p>Best-practice mechanisms like the case study provided in this article, the Victorian based youth-led, Indigenous-led Koorie Youth Council, which centres self-determination, can ensure that Indigenous children and young people are empowered.<span><sup>4</sup></span> This article is part of the 2024 <i>MJA</i> supplement for the Future Healthy Countdown 2030, which examines how participating affects the health and wellbeing of children, young people and future generations. Society must not only uphold Indigenous children and young people's rights, but also value their strengths and the expertise they hold about their own lives.<span><sup>4, 5, 7, 8, 11</sup></span></p><p>Participation is not a binary, it exists on a spectrum indicating the degree of agency afforded to individuals or groups to relationally determine
{"title":"Participation of Indigenous children and young people to improve health and wellbeing","authors":"Jordan Cory (Kamilaroi), Hope Kuchel (Barkindji), Bonnie Dukakis (Gunditjmara), Rhian Dicker (Palawa), Sandra Eades (Noongar)","doi":"10.5694/mja2.52490","DOIUrl":"10.5694/mja2.52490","url":null,"abstract":"<p>Participation is widely recognised as a determinant of children and young people's health.<span><sup>1</sup></span> Both the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) (Article 18) and the Convention on the Rights of the Child (Article 12) enshrine participation as an inalienable right.<span><sup>2, 3</sup></span> Despite this, the exclusion and non-participation of Indigenous children, adolescents and young people persists.<span><sup>4</sup></span></p><p>Indigenous children and young people experience worse health outcomes than their non-Indigenous peers and are starkly over-represented in the contact with youth justice and in out-of-home care.<span><sup>5-7</sup></span> We propose this is in part due to their exclusion and non-participation — both as children and as Indigenous people.<span><sup>4, 5, 7</sup></span> These children and young people's stories are often told for them, if at all.<span><sup>4</sup></span> “It didn't matter what I screamed at (Child Protection Services), they wanted to tell my story for me, decide for me, know what was best for me. That's easier than listening, isn't it?”, said one Indigenous young person in contact with the youth justice system.<span><sup>6</sup></span></p><p>Indigenous young people are less likely to access primary health services despite having more health needs than non-Indigenous counterparts.<span><sup>8</sup></span> Most children and young people in the youth justice system have severe neurodevelopmental disorders — nearly all previously undiagnosed and untreated.<span><sup>9</sup></span> Current mainstream health and youth services are failing to provide culturally safe rudimentary services and meet Indigenous children and young people's unique needs.<span><sup>5, 7, 8, 10</sup></span> They have not been designed with meaningful participation of Indigenous people, let alone children and young people.<span><sup>5, 8</sup></span> There is an urgency for meaningful participation of Indigenous children and young people in reform.<span><sup>4, 7, 8</sup></span> There is an urgency for decision makers to listen and act.<span><sup>4, 5, 7, 8</sup></span></p><p>Best-practice mechanisms like the case study provided in this article, the Victorian based youth-led, Indigenous-led Koorie Youth Council, which centres self-determination, can ensure that Indigenous children and young people are empowered.<span><sup>4</sup></span> This article is part of the 2024 <i>MJA</i> supplement for the Future Healthy Countdown 2030, which examines how participating affects the health and wellbeing of children, young people and future generations. Society must not only uphold Indigenous children and young people's rights, but also value their strengths and the expertise they hold about their own lives.<span><sup>4, 5, 7, 8, 11</sup></span></p><p>Participation is not a binary, it exists on a spectrum indicating the degree of agency afforded to individuals or groups to relationally determine","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"221 S10","pages":"S26-S33"},"PeriodicalIF":6.7,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muideen T Olaiya, Joosup Kim, Christopher Pearce, Kiran Bam, Dominique A Cadilhac, Nadine E Andrew, Lauren M Sanders, Amanda G Thrift, Mark R Nelson, Seana Gall, Monique F Kilkenny