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Non-conventional in Chinese | WHOIRIS, Grey literature | ID: grc-754452
Non-conventional in Spanish | WHOIRIS, Grey literature | ID: grc-754450
Non-conventional in French | WHOIRIS, Grey literature | ID: grc-754449
Non-conventional in English | WHOIRIS, Grey literature | ID: grc-754448
Med J Aust ; 216(4): 194-198, 2022 Mar 07.
Article in English | MEDLINE | ID: covidwho-1753885


OBJECTIVES: To determine the characteristics and population rates of barbiturate-related hospitalisations, treatment episodes, and deaths in Australia, 2000-2018. DESIGN, SETTING: Analysis of national data on barbiturate-related hospitalisations (National Hospital Morbidity Database, 1999-2000 to 2017-18), drug treatment episodes (Alcohol and Other Drug Treatment Services National Minimum Data Set, 2002-03 to 2017-18), and deaths (National Coronial Information System, 2000-01 to 2016-17). MAIN OUTCOME MEASURES: Population rates directly age-standardised to the 2001 Australian standard population; average annual percentage change (AAPC) in rates estimated by Joinpoint regression. RESULTS: We identified 1250 barbiturate-related hospitalisations (791 cases of deliberate self-harm [63%]), 993 drug treatment episodes (195 cases with barbiturates as the principal drug of concern [20%]), and 511 deaths during the respective analysis periods. The barbiturate-related hospitalisation rate declined from 0.56 in 1999-2000 to 0.14 per 100 000 population in 2017-18 (AAPC, -6.0%; 95% CI, -7.2% to -4.8%); the declines in hospitalisations related to accidental poisoning (AAPC, -5.8%; 95% CI, -9.1% to -2.4%) and intentional self-harm (AAPC, -5.6%; 95% CI, -6.9% to -4.2%) were each statistically significant. Despite a drop from 0.67 in 2002-03 to 0.23 per 100 000 in 2003-04, the drug treatment episode rate did not decline significantly (AAPC, -6.7%; 95% CI, -16% to +4.0%). The population rate of barbiturate-related deaths increased from 0.07 in 2000-01 to 0.19 per 100 000 population in 2016-17 (AAPC, +9.3%; 95% CI, +6.2-12%); the rate of intentional self-harm deaths increased (AAPC, +11%; 95% CI, +7.4-15%), but not that of accidental deaths (AAPC, -0.3%; 95% CI, -4.1% to +3.8%). CONCLUSIONS: While prescribing and community use of barbiturates has declined, the population rate of intentional self-harm using barbiturates has increased. The major harm associated with these drugs is now suicide.

Barbiturates , Suicide , Australia/epidemiology , Barbiturates/therapeutic use , Hospitalization , Humans
Med J Aust ; 215(9): 427-432, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1389702


OBJECTIVES: To analyse the outcomes of COVID-19 vaccination by vaccine type, age group eligibility, vaccination strategy, and population coverage. DESIGN: Epidemiologic modelling to assess the final size of a COVID-19 epidemic in Australia, with vaccination program (Pfizer, AstraZeneca, mixed), vaccination strategy (vulnerable first, transmitters first, untargeted), age group eligibility threshold (5 or 15 years), population coverage, and pre-vaccination effective reproduction number ( R eff v ¯ ) for the SARS-CoV-2 Delta variant as factors. MAIN OUTCOME MEASURES: Numbers of SARS-CoV-2 infections; cumulative hospitalisations, deaths, and years of life lost. RESULTS: Assuming R eff v ¯ = 5, the current mixed vaccination program (vaccinating people aged 60 or more with the AstraZeneca vaccine and people under 60 with the Pfizer vaccine) will not achieve herd protection unless population vaccination coverage reaches 85% by lowering the vaccination eligibility age to 5 years. At R eff v ¯ = 3, the mixed program could achieve herd protection at 60-70% population coverage and without vaccinating 5-15-year-old children. At R eff v ¯ = 7, herd protection is unlikely to be achieved with currently available vaccines, but they would still reduce the number of COVID-19-related deaths by 85%. CONCLUSION: Vaccinating vulnerable people first is the optimal policy when population vaccination coverage is low, but vaccinating more socially active people becomes more important as the R eff v ¯ declines and vaccination coverage increases. Assuming the most plausible R eff v ¯ of 5, vaccinating more than 85% of the population, including children, would be needed to achieve herd protection. Even without herd protection, vaccines are highly effective in reducing the number of deaths.

COVID-19 Vaccines/immunology , COVID-19/prevention & control , Immunity, Herd , Mass Vaccination/organization & administration , SARS-CoV-2/pathogenicity , Adolescent , Adult , Age Factors , Australia/epidemiology , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , COVID-19 Vaccines/administration & dosage , Child , Child, Preschool , Computer Simulation , Humans , Immunogenicity, Vaccine , Mass Vaccination/statistics & numerical data , Middle Aged , Models, Immunological , SARS-CoV-2/genetics , SARS-CoV-2/immunology , Vaccination Coverage/organization & administration , Vaccination Coverage/statistics & numerical data , Young Adult
Fam Med Community Health ; 8(4)2020 12.
Article in English | MEDLINE | ID: covidwho-961107


OBJECTIVES: We aimed to describe the quality improvement measures made by Norwegian general practice (GP) during the COVID-19 pandemic, evaluate the differences in quality improvements based on region and assess the combinations of actions taken. DESIGN: Descriptive study. SETTING: Participants were included after taking part in an online quality improvement COVID-19 course for Norwegian GPs in April 2020. The participants reported whether internal and external measures were in place: COVID-19 sign on entrance, updated home page, access to video consultations and/or electronic written consultations, home office solutions, separate working teams, preparedness for home visits, isolation rooms, knowledge on decontamination, access to sufficient supplies of personal protective equipment (PPE) and COVID-19 clinics. PARTICIPANTS: One hundred GP offices were included. The mean number of general practitioners per office was 5.63. RESULTS: More than 80% of practices had the following preparedness measures: COVID-19 sign on entrance, updated home page, COVID-19 clinic in the municipality, video and written electronic consultations, knowledge on how to use PPE, and home office solutions for general practitioners. Less than 50% had both PPE and knowledge of decontamination. Lack of PPE was reported by 37%, and 34% reported neither sufficient PPE nor a dedicated COVID-19 clinic. 15% reported that they had an isolation room, but not enough PPE. There were no geographical differences. CONCLUSIONS: Norwegian GPs in this study implemented many quality improvements to adapt to the COVID-19 pandemic. Overall, the largest potentials for improvement seem to be securing sufficient supply of PPE and establishing an isolation room at their practices.

COVID-19 , General Practice , COVID-19/prevention & control , COVID-19/therapy , Delivery of Health Care , General Practice/methods , General Practice/standards , General Practice/statistics & numerical data , General Practitioners , Humans , Norway , Pandemics , Quality Improvement , Remote Consultation , SARS-CoV-2