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Objective: The coronavirus disease 2019 (COVID-19) vaccination response in primary health care provides important learnings for strengthening health systems and preparing for surge response. The aim of this study was to examine the contributions of service providers to the COVID-19 vaccination program in Victoria, Australia, to gain insight into the role of primary health care during surge response and determine if this differs with rurality. Methods: A descriptive quantitative study design using existing COVID-19 vaccination data extracted from the Australian Immunisation Record via the Department of Health and Aged Care, Health Data Portal, de-identified for primary health networks, was used. Vaccination administrations were categorised by provider type for the first year of the Australian COVID-19 vaccination program in Victoria, Australia from February 2021 to December 2021. Descriptive analyses describe the total and proportional vaccinations administered by provider type and patient rurality. Results: Overall, primary care providers delivered half (50.58%) of total vaccinations for the population, and the number and proportion of vaccinations increased with patient rurality. The largest difference was observed in remote communities where 70.15% of COVID-19 vaccinations were administered by primary care providers. Primary care providers administered fewer COVID-19 vaccines in regional centres at 42.70%, compared to 46.45% administered by state government (and 10.85% administered by other). Conclusion: The contribution of primary health care to the COVID-19 vaccine program highlights the importance of rural primary care providers and settings, primarily general practice, to the delivery of population health interventions in rural communities especially during times of crisis. What is known about the topic? Research on pandemic response provides important insights for future surge planning and preparedness. What does this paper add? The contribution of primary care to the COVID-19 vaccine program highlights the importance of rural general practice to the delivery of population health interventions during times of crisis. What are the implications for practitioners? Policymakers must tailor reforms towards strengthening rural primary health care in preparation for future surge response. [ABSTRACT FROM AUTHOR]

Health inequalities between metropolitan and rural areas persist despite a range of interventions over recent years. Social inclusion is often linked to health outcomes, yet few studies examine social inclusion across different geographic areas. In this study, a set of indicators of social inclusion were drawn together and sourced data were aligned to these indicators, which are readily available to primary health practitioners and population health planners. Through this process, a useful framework that provides a nuanced understanding to guide primary health policy and practice has been produced. Using Victoria as an example, 11 domains of social inclusion were explored using population data across 79 local government areas. Analysis highlighted significant differences in several indicators, with rural and regional local government areas ranking higher on measures of social participation, trust and social resources. The use of a diversity of data sources provided information on the social, economic, and education issues of an area, along with relational factors such as safety, trust, community resources and civic participation. A social inclusion lens can inform action to address the rural–urban primary health divide by determining and exploring the social inclusion characteristics of communities. [ABSTRACT FROM AUTHOR]

Abstract: A number of N 6-substituted adenosine-5′-N-methylcarboxamides were synthesised and their pharmacology, in terms of their receptor affinity, selectivity and cardioprotective effects, were explored. The first series of compounds, 4a–4f and 5a–5f, showed modest receptor affinity for the A3AR with K i values in the low to mid μM range. However, the incorporation of a 4-(2-aminoethyl)-2,6-di-tert-butylphenol group in the N 6-position (in compounds 4g and 5g) significantly improved the affinity with K i values of 30 and 9nM, respectively. Improvements in affinity, as well as selectivity were seen when a functionalised linker was introduced. The N 6-phenyl series, compounds 7a–7d, demonstrated low to mid nanomolar receptor affinities (K i =2.3–45.0nM), with 7b displaying 109-fold selectivity for the A3AR (vs A1). The N 6-benzyl series 9a–9c also proved to be potent and selective A3AR agonists and the longer chain length linker 13 was tolerated at the A3AR without abrogation of affinity or selectivity. Cardioprotection was demonstrated by a simulated ischaemia cell culture assay, whereby 7b, 7c, 9a, 9b and 9c all showed cardioprotective effects at 100nM comparable or better than the benchmark A3AR agonist IB-MECA, but which were indistinguishable by statistical analysis. For example, compound 9c reduced cell death by 68.0±3.6%. [Copyright &y& Elsevier]