Antipsychotic prescribing in GMS paediatric and young adult population in Ireland 2005-2015: repeated cross-sectional study.

OBJECTIVES: To examine the rates of antipsychotic prescribing in the Irish paediatric and young adult population enrolled in the Irish General Medical Services Scheme pharmacy claims database from the Health Service Executive Primary Care Reimbursement Services database, with a focus on age and sex differences. To examine concomitant prescribing of certain other related medicines in this population. METHODS: Data were obtained from the Irish General Medical Services (GMS) scheme pharmacy claims database from the Health Service Executive (HSE) - Primary Care Reimbursement Services (PCRS). Participants included children aged <16 years and youth aged 16-24 years availing of medicines under the HSE-PCRS GMS scheme between January 2005 and December 2015. Outcome measures included prescribing rates of antipsychotics from 2005 to 2015, differences in prescribing rates between different ages and sexes, and percentage of concomitant prescriptions for antidepressants, psychostimulants, anxiolytics and hypnosedatives. RESULTS: Overall the trend in prescribing rates of antipsychotic medications was stable at 3.94/1000 in 2005 compared with 3.97/1000 in 2015 for children <16 years, and 48.37/1000 eligible population in 2005 compared to 39.64/1000 in 2015 for those aged 16-24. There was a significant decrease in prescribing rates for males in the 16-24 age group. CONCLUSIONS: While rates of antipsychotic prescribing have decreased or remained stable over the timeframe of the study, we did find a significant proportion of this population were prescribed antipsychotics. This study also shows that co-prescribing of antidepressants increased and highlights the need for guidelines for antipsychotic prescribing in children and youth in terms of clinical indication, monitoring, co-prescribing and treatment duration.

Benthic changes at McMurdo Station, Antarctica following local sewage treatment and regional iceberg-mediated productivity decline.

McMurdo Station, the largest research station in Antarctica, ceased on-site garbage dumping in 1988 and initiated sewage treatment in 2003. In 2003-2004 its sea-ice regime was altered by the massive B-15A and C-19 iceberg groundings in the Ross Sea, approximately 100km distant. Here we follow macrofaunal response to these changes relative to a baseline sampled since 1988. In the submarine garbage dump, surface contaminants levels have declined but associated macrofaunal recolonization is not yet evident. Although sewage-associated macrofauna were still abundant around the outfall nearly 2yr after initiation of treatment, small changes downcurrent as far as 434m from the outfall suggest some community recovery. Widespread community changes in 2003-2004, not seen in the decade previously, suggests that the benthos collectively responded to major changes in sea-ice regime and phytoplankton production caused by the iceberg groundings.

Coverage of smoking cessation treatment by union health and welfare funds.

OBJECTIVES: This study determined the level of insurance coverage for smoking cessation treatment and factors associated with coverage among health and welfare funds affiliated with a large labor union. METHODS: A self-administered written survey was mailed to fund and union officials. Analyses were conducted by chi2 tests. RESULTS: Twenty-nine percent of funds provided coverage for some type of smoking cessation treatment, with the odds of coverage significantly increased among funds whose administrators reported having received members' requests for smoking cessation treatment in the past year (odds ratio = 4.9, P = .05). CONCLUSIONS: Coverage for smoking cessation services is low, comparable to coverage offered by other health insurers. Interventions with union members and fund officials are needed to provide union members with access to affordable and effective smoking cessation treatments.