Delivering environmental sustainability in healthcare for future generations: Time to clean up our own cubby house.

Children and future generations will be those most affected by climate change, and paediatricians have a moral responsibility to preserve a secure and habitable world for them. Despite our pledge to 'first do no harm', the health-care sector itself is a major contributor to global warming and environmental degradation. These contributions are projected to rise unless urgent measures are undertaken to decarbonise.

No jab, no record: Catch-up vaccination of children in immigration detention.

International Health and Medical Services (IHMS) are contracted to provide health services, including catch-up vaccination, for individuals in immigration detention. Our audit of catch-up vaccination in asylum seeker children who spent time in held detention demonstrates inadequate and suboptimal vaccine delivery in this setting, and no evidence that IHMS recorded vaccines on the Australian Childhood Immunisation Register at the time. We also found substantial shortfalls in vaccination for these children after they were released from detention.

The treatment of imported malaria in children: an update.

Since the 2010 publication in this journal of a review of the management of imported malaria for U.K. children, new evidence for the treatment of both severe and uncomplicated malaria has been published.

Outbreak of osteomyelitis/septic arthritis caused by Kingella kingae among child care center attendees.

Objective: Kingella kingae often colonizes the oropharyngeal and respiratory tracts of children but infrequently causes invasive disease. In mid-October 2003, 2 confirmed and 1 probable case of K kingae osteomyelitis/septic arthritis occurred among children in the same 16- to 24-month-old toddler classroom of a child care center. The objective of this study was to investigate the epidemiology of K kingae colonization and invasive disease among child care attendees.

Clinician knowledge and beliefs after statewide program to promote appropriate antimicrobial drug use.

In 1999, Wisconsin initiated an educational campaign for primary care clinicians and the public to promote judicious antimicrobial drug use. We evaluated its impact on clinician knowledge and beliefs; Minnesota served as a control state. Results of pre- (1999) and post- (2002) campaign questionnaires indicated that Wisconsin clinicians perceived a significant decline in the proportion of patients requesting antimicrobial drugs (50% in 1999 to 30% in 2002; p<0.

Rates and risks of transmission of smallpox and mechanisms of prevention.

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak.