scholarly journals Primary care management of group A streptococcal pharyngitis in Northland

2014 ◽  
Vol 6 (3) ◽  
pp. 189 ◽  
Author(s):  
Anil Shetty ◽  
Clair Mills ◽  
Kyle Eggleton
Keyword(s):  
General Practice ◽  
Young People ◽  
Rheumatic Fever ◽  
Sore Throat ◽  
Health Board ◽  
Prescription Data ◽  
National Guidelines ◽  
Children And Young People ◽  
School Based ◽  
Group A

INTRODUCTION: Reducing the rate of acute rheumatic fever nationally by two-thirds by 2017 is a New Zealand Ministry of Health priority. Northland District Health Board (DHB) has high rates of rheumatic fever, disproportionately impacting on Maori children and young people. School-based programmes and general practice both contribute to rheumatic fever prevention in detecting and appropriately treating group A streptococcal (GAS) pharyngitis. AIM: The aim of this study was to assess adherence by general practitioners and school-based sore throat programmes to national guidelines for the management of GAS pharyngitis in Northland. METHODS: Laboratory and pharmaceutical data were obtained for children and young people aged 3–20 years who had GAS positive throat swabs in Northland laboratory services between 1 April and 31 July 2012. Data were analysed separately for general practice and the school programmes for rheumatic fever prevention. RESULTS: One in five of those children presenting to general practice with a positive throat swab and complete prescription data did not receive treatment according to national guidelines, while appropriate treatment was offered to more than 98% of children accessing school-based programmes. A significant proportion of those seen in general practice received antibiotics not recommended by guidelines, an inadequate length of treatment or no prescription. There were no significant differences in the management of Maori and non-Maori children. DISCUSSION: There is room for improvement in general practice management of GAS pharyngitis in Northland. School-based management of sore throat provides high-quality management for children at high risk of rheumatic fever. KEYWORDS: Pharyngitis; prevention and control; primary health care; rheumatic fever; school health services; Streptococcus pyogenes

scholarly journals A repeat audit of primary care management of group A streptococcal pharyngitis in Northland, New Zealand 2016

2018 ◽  
Vol 10 (1) ◽  
pp. 18 ◽  
Author(s):  
Anil Shetty ◽  
Clair Mills ◽  
Kyle Eggleton
Keyword(s):  
General Practice ◽  
New Zealand ◽  
Young People ◽  
Rheumatic Fever ◽  
Streptococcal Pharyngitis ◽  
Health Board ◽  
National Guidelines ◽  
District Health ◽  
Children And Young People ◽  
Group A

ABSTRACT INTRODUCTION One of the New Zealand Government’s Better Public Services targets was to reduce the rate of acute rheumatic fever (ARF) nationally by two-thirds by 2017. Māori children and young people are disproportionately affected by ARF in the Northland District Health Board region. General practice contributes to ARF prevention in detecting and appropriately treating group A streptococcal (GAS) pharyngitis. An audit in 2012 suggested improvements in adherence to national guidelines were needed. AIM The aim was to reassess general practice adherence to national guidelines for the management of GAS pharyngitis in Northland, New Zealand, following implementation of the national Rheumatic Fever Prevention Programme. METHODS Throat swab and dispensing data were obtained and analysed for children and young people aged 3–20 years who attended general practice in Northland between 1 April and 31 July 2016 and had laboratory-proven GAS pharyngitis. RESULTS Between 2012 and 2016, the number of throat swabs carried out in general practice more than doubled, and amoxicillin was more commonly prescribed. The proportion of GAS pharyngitis patients in general practice not receiving recommended antibiotics, or receiving an inadequate length of treatment or no prescription, has not reduced. There are significant differences in the management of care for Māori and non-Māori patients, with much higher risk of ARF for Māori. Discussion The management of GAS pharyngitis by general practice in Northland remains substandard. Implicit bias may contribute to inequity. Focused engagement with identified subgroups of general practices and practitioners who disproportionately contribute to non-guideline prescribing should be further investigated.

scholarly journals Some thoughts on curriculum in music education

2019 ◽  
Vol 36 (1) ◽  
pp. 1-4
Author(s):  
MARTIN FAUTLEY ◽  
ALISON DAUBNEY
Keyword(s):  
Young People ◽  
Music Education ◽  
Search Engine ◽  
Music Curriculum ◽  
Educational Settings ◽  
Children And Young People ◽  
Selective Sampling ◽  
School Based ◽  
School Music ◽  
Good Learning

Curriculum is currently a big issue in England. What a school-based music curriculum should entail, what sorts of things should be taught and learned, and what makes for good learning experiences are all under consideration. One of the issues that crops up in England, and possibly in other jurisdictions too, when these sorts of discussions take place, involves considerations of what sorts of music children and young people should be involved with, what should they learn, and what is important for schools to be teaching. This immediately places discussions beyond what might be termed the strictly musical, and into the area of values. What music is valued by education systems, and what music should be foregrounded in educational settings become a significant arena of contention. This is especially the case when politicians become involved, as they will often have fixed or politically-motivated views about what they think should be taught and learned in school music classes. As ever, the pages of the BJME provide some interesting views on this matter, and so it is worth a brief trawl through the archives. The BJME home page search engine on the website produces 168 results for the term “curriculum”, so clearly this will be a highly selective sampling from these rich pickings in this editorial.

scholarly journals Preventing domestic abuse for children and young people: A review of school-based interventions

2015 ◽  
Vol 59 ◽  
pp. 120-131 ◽  
Author(s):  
Nicky Stanley ◽  
Jane Ellis ◽  
Nicola Farrelly ◽  
Sandra Hollinghurst ◽  
Soo Downe
Keyword(s):  
Young People ◽  
Domestic Abuse ◽  
Children And Young People ◽  
School Based ◽  
School Based Interventions

Childhood cancer in general practice: Is it really that rare?

2017 ◽  
Vol 10 (4) ◽  
pp. 209-217
Author(s):  
Jennifer Kelly
Keyword(s):  
General Practice ◽  
Young People ◽  
Early Diagnosis ◽  
Childhood Cancer ◽  
Signs And Symptoms ◽  
Childhood Cancers ◽  
Children And Young People ◽  
Number Of Children ◽  
The Uk

Childhood cancer is something most GPs think to be rare, yet it is the biggest medical cause of death in children aged between 1 and 14 years. Its incidence is increasing, with just under 4000 children and young people diagnosed with cancer every year in the UK (11 a day). It is important for GPs to know the signs and symptoms suggestive of childhood cancers, in order to help early diagnosis. This, in turn, can save lives and reduce disability in survivors. The number of children surviving cancer is increasing, with over 35 000 survivors now thought to be living in the UK and in need of particular expertise and care. This article aims to provide GPs with the tools and knowledge to diagnose childhood cancer, and a framework to support children with cancer and their families long-term in the community.

scholarly journals The incidence of sore throat and group A streptococcal pharyngitis in children at high risk of developing acute rheumatic fever: A systematic review and meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242107
Author(s):  
Sarah Pearce ◽  
Asha C. Bowen ◽  
Mark E. Engel ◽  
Maya de la Lande ◽  
Dylan D. Barth
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Rheumatic Fever ◽  
Sore Throat ◽  
Acute Rheumatic Fever ◽  
Meta Analysis ◽  
Incidence Rates ◽  
Children At Risk ◽  
Indigenous Children ◽  
Group A

Background Group A streptococcal (GAS) pharyngitis has traditionally been considered the sole precursor of acute rheumatic fever (ARF). Evidence from Australia, however, suggests that GAS skin infections may contribute to the pathogenesis of ARF. A missing piece of evidence is the incidence of sore throat and GAS pharyngitis in this setting. We conducted a systematic review and meta-analysis of the incidence of sore throat and GAS pharyngitis in all children at risk of developing ARF. Methods Databases were systematically searched for studies reporting on the incidence of pharyngitis among children from low to upper-middle income countries, and Indigenous children living in high-income countries. Studies were subjected to data extraction by two independent reviewers. Following an assessment of the methodological quality of the studies, we extracted incidence rates (IRs) and conducted a meta-analysis. This systematic review is registered on PROSPERO (CRD42019113019). Results From 607 titles identified by the search, 11 articles met the predetermined inclusion criteria; ten studies reported IRs while for the remaining study, the incidence was calculated. The pooled incidence estimated for sore throat was 82.5 per 100 child-years (95% confidence interval [CI], 6.5 to 1044.4 per 100 child-years, I2 = 100%) and GAS pharyngitis was 10.8 per 100 child-years (95% CI, 2.3 to 50.0 per 100 child-years, I2 = 99.9%). Conclusions The pooled IRs for sore throat in children at risk of developing ARF were higher than rates reported in developed nations (32.70–40 per 100 child-years) and similar for GAS pharyngitis (12.8–14 per 100 years). The limited Australian data lend support to the need for further studies to inform the role of GAS pharyngitis in the development of ARF in Australian Indigenous children, so as to inform local primary prevention strategies for ARF and Rheumatic Heart Disease (RHD).

scholarly journals A systematic review of effectiveness and cost-effectiveness of school-based identification of children and young people at risk of, or currently experiencing mental health difficulties

2018 ◽  
Vol 49 (1) ◽  
pp. 9-19 ◽  
Author(s):  
Joanna K. Anderson ◽  
Tamsin Ford ◽  
Emma Soneson ◽  
Jo Thompson Coon ◽  
Ayla Humphrey ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Cost Effectiveness ◽  
Young People ◽  
Evidence Base ◽  
Bibliographic Databases ◽  
Children And Young People ◽  
Presenting Symptoms ◽  
School Based ◽  
Mental Health Difficulties

AbstractBackgroundAlthough school-based programmes for the identification of children and young people (CYP) with mental health difficulties (MHD) have the potential to improve short- and long-term outcomes across a range of mental disorders, the evidence-base on the effectiveness of these programmes is underdeveloped. In this systematic review, we sought to identify and synthesise evidence on the effectiveness and cost-effectiveness of school-based methods to identify students experiencing MHD, as measured by accurate identification, referral rates, and service uptake.MethodElectronic bibliographic databases: MEDLINE, Embase, PsycINFO, ERIC, British Education Index and ASSIA were searched. Comparative studies were included if they assessed the effectiveness or cost-effectiveness of strategies to identify students in formal education aged 3–18 years with MHD, presenting symptoms of mental ill health, or exposed to psychosocial risks that increase the likelihood of developing a MHD.ResultsWe identified 27 studies describing 44 unique identification programmes. Only one study was a randomised controlled trial. Most studies evaluated the utility of universal screening programmes; where comparison of identification rates was made, the comparator test varied across studies. The heterogeneity of studies, the absence of randomised studies and poor outcome reporting make for a weak evidence-base that only generate tentative conclusions about the effectiveness of school-based identification programmes.ConclusionsWell-designed pragmatic trials that include the evaluation of cost-effectiveness and detailed process evaluations are necessary to establish the accuracy of different identification models, as well as their effectiveness in connecting students to appropriate support in real-world settings.

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