Improving care pathways for otitis media in First Nations children
Bibliographic record
Abstract
Background: Otitis media (OM) disproportionately impacts First Nations children, affecting speech and language development, social and cognitive development and, in turn, education and life outcomes. Ear and hearing care (EHC) programs are critical to early detection and management of OM. Program sustainability depends on health policy, which secures funding and resources. This thesis aimed to; (i) chart approaches, sustainability factors, and areas of focus across the EHC pathway for First Nations EHC programs in Australia, New Zealand, Canada, and the United States, and (ii) explore utilisation of two tools to appraise Australian EHC policies for Aboriginal children. Method: A scoping review was conducted to identify program core elements in high-income colonial-settler countries. A policy appraisal pilot study was conducted utilising the Aboriginal and Torres Strait Islander Quality Appraisal Tool and Morestin’s Policy Appraisal Tool to evaluate feasibility of utilising these tools to assess Australian EHC policies. Results: The review identified 28 eligible studies. Programs approaches included; (i) connecting patients to specialist services, (ii) ensuring cultural safety of services, and (iii) increasing entry into EHC pathways. The policy pilot indicated that the Aboriginal and Torres Strait Islander Quality Appraisal Tool has dimensions of cultural safety that overlap between research and policy. Morestin’s Policy Appraisal Tool indicated the feasibility of utilising this tool for analysis of Australian EHC policies. Discussion: Programs connected patients to care through outreach, mobile health clinics, and telehealth services. Cultural safety was achieved by employing Indigenous Health Workers (IHWs) or providing cultural awareness training for non-IHWs. Access to EHC pathways was increased with screening or awareness programs. The preliminary findings of the policy appraisal pilot study indicated feasibility of utilising the Aboriginal and Torres Strait Islander Quality Appraisal Tool and Morestin’s Policy Appraisal Tool for appraising two separate culturally-specific EHC policies in Australia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.084 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".