Ratliffkaplan8173

We aim to explore and compare the effect of global travel restrictions and public health countermeasures in response to COVID-19 outbreak.

A data-driven spatio-temporal modelling to simulate the spread of COVID-19 worldwide for 150 days since 1 January 2020 under different scenarios.

Worldwide.

Travel restrictions and public health countermeasures.

The cumulative number of COVID-19 cases.

The cumulative number of COVID-19 cases could reach more than 420 million around the world without any countermeasures taken. Under timely and intensive global interventions, 99.97% of infections could be avoided comparing with non-interventions. The scenario of carrying out domestic travel restriction and public health countermeasures in China only could contribute to a significant decrease of the cumulative number of infected cases worldwide. read more Without global travel restriction in the study setting, 98.62% of COVID-19 cases could be avoided by public health countermeasures in China only compared with non-interventions at all.

Public health countermeasures were generally more effective than travel restrictions in many countries, suggesting multinational collaborations in the public health communities in response to this novel global health challenge.

Public health countermeasures were generally more effective than travel restrictions in many countries, suggesting multinational collaborations in the public health communities in response to this novel global health challenge.

To explore the potential impacts of introducing General Practitioners into Emergency Departments (GPED) from the perspectives of service leaders, health professionals and patients. These 'expectations of impact' can be used to generate hypotheses that will inform future implementations and evaluations of GPED.

Qualitative study consisting of 228 semistructured interviews.

10 acute National Health Service (NHS) hospitals and the wider healthcare system in England. Interviews were undertaken face to face or via telephone. Data were analysed thematically.

124 health professionals and 94 patients and carers. 10 service leaders representing a range of national organisations and government departments across England (eg, NHS England and Department of Health) were also interviewed.

A range of GPED models are being implemented across the NHS due to different interpretations of national policy and variation in local context. This has resulted in stakeholders and organisations interpreting the aims of GPED differently and anticipating a range of potential impacts. Participants expected GPED to affect the following areas ED performance indicators; patient outcome and experience; service access; staffing and workforce experience; and resources. Across these 'domains of influence', arguments for positive, negative and no effect of GPED were proposed.

Evaluating whether GPED has been successful will be challenging. However, despite uncertainty surrounding the direction of effect, there was agreement across all stakeholder groups on the areas that GPED would influence. As a result, we propose eight domains of influence that will inform our subsequent mixed-methods evaluation of GPED.

ISRCTN51780222.

ISRCTN51780222.

To determine the prevalence of pesticide, corrosive, drugs, venom and miscellaneous poisoning in India.

Systematic literature search was done in PubMed Central, Cochrane and Google Scholar databases for studies that satisfied the inclusion criteria. Systematic review and meta-analyses of all observational studies published in the English language from January 2010 to May 2020 were included in this review.

Patients exposed to poisoning reported to hospitals were included.

The prevalence of pesticide poisoning was analysed. The prevalence of poisoning due to corrosives, venom, drugs and miscellaneous agents, along with subgroup analysis based on age and region, was also determined. The percentage of persons with poisoning along with 95% CI was analysed.

Pooled analysis of studies revealed that pesticides were the main cause of poisoning in adults, with an incidence of 63% (95% CI 63% to 64%), while miscellaneous agents were the main cause of poisoning in children, with an incidence of 45.0% (95% CI 43.1% to 46.9%), among those presenting to hospitals. Pesticide poisoning was the most prevalent in North India (79.1%, 95% CI 78.4% to 79.9%), followed by South (65.9%, 95% CI 65.3% to 66.6%), Central (59.2%, 95% CI 57.9% to 60.4%), West (53.1%, 95% CI 51.9% to 54.2%), North East (46.9%, 95% CI 41.5% to 52.4%) and East (38.5%, 95% CI 37.3% to 39.7%). The second most common cause of poisoning was miscellaneous agents (18%, 95% CI 18% to 19%), followed by drugs (10%, 95% CI 10% to 10%), venoms (6%, 95% CI 6% to 6%) and corrosives (2%, 95% CI 1% to 2%).

Pesticide poisoning is the most common type of poisoning in adults, while miscellaneous agents remain the main cause of poisoning in children.

CRD42020199427.

CRD42020199427.

The objective of this study is to explore the association of health financing indicators with the proportion of births by caesarean section (CS) across countries.

Ecological cross-country study.

This study examines CS proportions across 172 countries.

The primary outcome was the percentage excess of CS proportion, defined as CS proportions above the global target of 19%. We also analysed continuous CS proportions, as well as excess proportion with a more restrictive 9% global target. Multivariable linear regressions were performed to test the association of health financing factors with the percentage excess proportions of CS. The health financing factors considered were total available health system resources (as percentage of gross domestic product), total contributions from private households (out-of-pocket, compulsory and voluntary health insurance contributions) and total national income.

We estimate that in 2018 there were a total of 8.8 million unnecessary CS globally, roughly two-thirds of which occurred in upper middle-income countries. Private health financing was positively associated with percentage excess CS proportion. In models adjusted for income and total health resources as well as human resources, each 10 per cent increase in out-of-pocket expenditure was associated with a 0.7 per cent increase in excess CS proportions. A 10 per cent increase in voluntary health insurance was associated with a 4 per cent increase in excess CS proportions.

We have found that health system finance features are associated with CS use across countries. Further monitoring of these indicators, within countries and between countries will be needed to understand the effect of financial arrangements in the provision of CS.

We have found that health system finance features are associated with CS use across countries. Further monitoring of these indicators, within countries and between countries will be needed to understand the effect of financial arrangements in the provision of CS.