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COVID-19 remains a significant public health problem in New South Wales, Australia. Although the NSW government is employing various control policies, more specific and compelling interventions are needed to control the spread of COVID-19. This paper presents a modified SEIR-X model based on a nonlinear ordinary differential equations system that considers the transmission routes from asymptomatic (Exposed) and symptomatic (Mild and Critical) individuals. The model is fitted to the corresponding cumulative number of cases in metropolitan and rural health districts of NSW reported by the Health Department and parameterised using the least-squares method. The basic reproduction number (R 0) , which measures the possible spread of COVID-19 in a population, is computed using the next generation operator method. Sensitivity analysis of the model parameters reveals that the transmission rate had an enormous influence on R 0 , which may be an option for controlling this disease. Two time-dependent control strategies, namely preventive (it refers to effort at inhibiting the virus transmission and prevention of case development from Exposed, Mild, Critical, Non-hospitalised and Hospitalised population) and management (it refers to enhance the management of Non-hospitalised and Hospitalised individuals who are infected by COVID-19) measures, are considered to mitigate this disease's dynamics using Pontryagin's maximum principle. The most sensible control strategy is determined through the cost-effectiveness analysis for the metropolitan and rural health districts of NSW. Our findings suggest that of the single intervention strategies, enhanced preventive strategy is more cost-effective than management control strategy, as it promptly reduces COVID-19 cases in NSW. In addition, combining preventive and management interventions simultaneously is found to be the most cost-effective. Alternative policies can be implemented to control COVID-19 depending on the policymakers' decisions. Numerical simulations of the overall system are performed to demonstrate the theoretical outcomes. [ABSTRACT FROM AUTHOR]

Abstract The objective of this paper is to share our experiences of participating in an action research project designed to improve the care of older people at risk of delirium. The setting for the study and the subject of this paper was a busy medical ward in a 550 bed regional tertiary referral hospital located in New South Wales, Australia. The participants for the project and the authors of this paper include clinical nursing and allied health staff based on the ward at the time of the study. In the discussion that follows we outline details of the study, participatory action research (PAR), what we were asked to do to participate, our reasons for agreeing to participate, our expectations of the project, the group process, the PAR cycles: look, think and act, and the benefits and challenges of participating in the project. In conclusion we highlight the gains of participating in PAR and we make recommendations for the future. [ABSTRACT FROM AUTHOR]

Background: A substantial increase in substance treatment episodes for methamphetamine problems suggests characteristics of the treatment population could have changed and that targeted treatment programs are required. To determine who methamphetamine treatment should be designed for this study has two aims. First, to empirically describe changes in amphetamine treatment presentations to a rural NSW drug and alcohol treatment agency over time. Second, to examine how these characteristics may affect the likelihood of being treated for amphetamines compared to other drugs. Method: The Australian Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS-NMDS) containing closed treatment episodes from a single agency from three time periods was used. Characteristics of people receiving amphetamine treatments in these three periods were compared and the effects of these characteristics on the odds of being treated for amphetamine were estimated using a logistic regression model. The characteristics utilised in the analysis include age, sex, Indigenous status, usual accommodation, living arrangement, source of referral and source of income. Results: The proportion of amphetamine treatment episodes doubled from 2006/2007 to 2015/2016 and overtook alcohol as the most commonly treated principal drug of concern. The estimated proportion of amphetamine treatments showed an increment across all ages and for men and women. It was found that younger people, women, people in temporary accommodation or homeless, people who were self-referred and people whose main source of income was not through employment are more likely to be treated for amphetamine use. Conclusion: Significant changes over time in the age, sex and Indigenous status of people receiving treatment for amphetamine as the principal drug of concern requires service delivery to match demand from younger people, particularly women; and Indigenous people. The needs and preferences for treatment of younger women who use amphetamine will be important factors in treatment planning service providers who are more used to providing treatment for young men who use cannabis and older men who use alcohol. Further research on women's experiences in treatment and outcomes would be useful for informing treatment practices. [ABSTRACT FROM AUTHOR]

Introduction: The Active Kids voucher is a universal, state-wide voucher program, provided by the New South Wales (NSW) Government, Office of Sport. All school-aged children in NSW are eligible to receive a voucher to reduce registration costs of structured physical activity programs. This study explores reasons behind lower uptake among children who are overweight or obese, from cultural and linguistically diverse families and those living in low socio-economic areas., Methods: Participants were recruited through a convenience sample of parent/carers who participated in the NSW Health Go4Fun program. Qualitative data were collected using focus groups. The Framework method was adapted for the analysis, taking an interpretive phenomenological approach., Results: Study participants (n = 54) were all parents of children who were overweight or obese from both low and high socio-economic status (SES). Most reported speaking a primary language other than English at home (65%). Parents were mostly aware of the Active Kids program (91%) and reported that the voucher had a positive impact on their children's participation in structured physical activity. A range of socio-ecological factors, in addition to activity cost, influenced whether parents were able to use an Active Kids voucher and participate in structured physical activity., Conclusions: The Active Kids voucher does not alleviate all barriers, particularly for families living in low socio-economic areas. Engagement of this population in structured physical activities using the Active Kids vouchers could be strengthened through the implementation of effective interventions which comprehensively address the remaining barriers, such as access and flexibility of programs with local stakeholders and activity providers., (© 2021 Australian Health Promotion Association.)

At the end of December 2019, an outbreak of COVID-19 occurred in Wuhan city, China. Modelling plays a crucial role in developing a strategy to prevent a disease outbreak from spreading around the globe. Models have contributed to the perspicacity of epidemiological variations between and within nations and the planning of desired control strategies. In this paper, a literature review was conducted to summarise knowledge about COVID-19 disease modelling in three countries-China, the UK and Australia-to develop a robust research framework for the regional areas that are urban and rural health districts of New South Wales, Australia. In different aspects of modelling, summarising disease and intervention strategies can help policymakers control the outbreak of COVID-19 and may motivate modelling disease-related research at a finer level of regional geospatial scales in the future.

Issue addressed Anecdotal evidence from teachers in Western Sydney Local Health District (WSLHD) indicated that many primary school children are regularly unable to participate in the Crunch&Sip ® (C&S) program (breaks during class time to eat fruit and/or vegetables and drink water) as they do not bring produce from home. Actual reach of the program may therefore be currently overestimated, and inequitable. This study examined the feasibility, acceptability and efficacy of providing school children supplementary, fresh free produce in supporting equitable participation in C&S. Methods Free fruit and vegetables were provided for 10 weeks to four schools in a socioeconomically-disadvantaged area in Western Sydney. WSLHD sourced the produce at a discounted rate and storage and distribution was arranged in partnership with industry. Schools determined methods of allocation to children who did not have fruit or vegetables for the C&S break. Pre- and late-intervention (Week 9) classroom surveys provided quantitative data of intervention efficacy. Qualitative methods were used with key school persons to explore barriers and enablers to implementation. Results Participation of children in C&S increased significantly from 46.7% pre-intervention to 92.0% in Week 9. The proportion of children bringing fruit or vegetables from home also increased significantly, from 46.7% to 54.0%. Schools perceived the supplementary strategy to be highly feasible and acceptable. Conclusion Expansion of this equity strategy warrants consideration, although issues of sustainability would need to be addressed. The criteria for 'full implementation' should include high proportional participation by students in participating classes. So what? Establishing a system by which schools in disadvantaged areas can supplement their C&S program would effectively increase access to fruit and vegetables among those children most at need.