Articles: community-health-services.
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Community paramedicine (CP) leverages trained emergency medical services personnel outside of emergency response as an innovative model of health care delivery. Often used to bridge local gaps in healthcare delivery, the CP model has existed for decades. Recently, the number of programs has increased. However, the level of robust data to support this model is less well known. ⋯ Initial studies suggest benefits of the CP model; however, notable evidence gaps remain.
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Cochrane Db Syst Rev · Apr 2019
Meta AnalysisCommunity-based antibiotic delivery for possible serious bacterial infections in neonates in low- and middle-income countries.
The recommended management for neonates with a possible serious bacterial infection (PSBI) is hospitalisation and treatment with intravenous antibiotics, such as ampicillin plus gentamicin. However, hospitalisation is often not feasible for neonates in low- and middle-income countries (LMICs). Therefore, alternative options for the management of neonatal PSBI in LMICs needs to be evaluated. ⋯ Low-quality data demonstrated that community-based antibiotics reduced neonatal mortality when compared to the standard hospital referral for neonatal PSBI in resource-limited settings. The use of co-interventions, however, prevent disentanglement of the contribution from community-based antibiotics. Moderate-quality evidence showed that simplified, community-based treatment of PSBI using regimens which rely on the combination of oral and injectable antibiotics did not result in increased neonatal mortality when compared to the standard treatment of using only injectable antibiotics. Overall, the evidence suggests that simplified, community-based antibiotics may be efficacious to treat neonatal PSBI when hospitalisation is not feasible. However, implementation research is recommended to study the effectiveness and scale-up of simplified, community-based antibiotics in resource-limited settings.
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Randomized Controlled Trial Multicenter Study
Cultural respect in general practice: a cluster randomised controlled trial.
To examine whether the Ways of Thinking and Ways of Doing (WoTWoD) cultural respect framework improves clinically appropriate anticipatory care in general practice and the cultural respect levels of medical practice staff. ⋯ The WoTWoD program did not increase the rate of Indigenous health checks or improve cultural respect scores in general practice. Conceptual, methodologic, and contextual factors that influence cultural mentorship, culturally respectful clinical practice, and Indigenous health care require further investigation.
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Eur J Public Health · Apr 2019
Effects of a community-based exercise and motivational intervention on physical fitness of subjects with type 2 diabetes.
This study aimed to analyze the effects of a long-term community-based combined exercise program consisting of aerobic, resistance, flexibility and agility/balance training associated with motivational interviewing on physical fitness, physiological parameters and Physical Activity (PA) levels in middle-aged and older patients with Type 2 Diabetes (T2D). ⋯ A long-term motivational exercise-based intervention may be more effective than PA recommendations only in improving physical fitness and PA levels in individuals with T2D and produce similar health improvements.