Prevalence, awareness, treatment, and control of hypertension in community-dwelling older adults with chronic kidney disease: the Irish longitudinal study on ageing.

Background: Hypertension is highly prevalent in chronic kidney disease (CKD), posing a significant but modifiable risk for adverse clinical outcomes. This study explored the prevalence, awareness, treatment, and control of hypertension in older Irish adults with CKD.

Methods: Data were analysed from participants in Wave 1 of The Irish Longitudinal Study on Ageing (TILDA) who were aged 50 years and older.

Antibiotic dispensing practices among informal healthcare providers in low-income and middle-income countries: a scoping review protocol.

Introduction: The rise of antimicrobial resistance represents a critical threat to global health, exacerbated by the excessive and inappropriate dispensing and use of antimicrobial drugs, notably antibiotics, which specifically target bacterial infections. The surge in antibiotic consumption globally is particularly concerning in low-income and middle-income countries (LMICs), where informal healthcare providers (IPs) play a vital role in the healthcare landscape. Often the initial point of contact for healthcare-seeking individuals, IPs play a crucial role in delivering primary care services in these regions.

Teamwork and its impact on chronic disease clinical outcomes in primary care: a systematic review and meta-analysis.

Objective: Teamwork positively affects staff performance and patient outcomes in chronic disease management. However, there is limited research on the impact of specific team components on clinical outcomes. This review aims to explore the impact of teamwork components on key clinical outcomes of chronic diseases in primary care.

Hepatitis C Infection and Treatment among Injecting Drug Users Attending General Practice: A Systematic Review and Meta-Analysis.

Background: The care provided in general practice to intravenous drug users (IDUs) with hepatitis C (HCV) extends beyond opioid substitution therapy. An aggregated analysis of HCV service utilization within general practice specifically related to diagnosis and treatment outcomes remains unknown from previous literature.

Aims: This study aims to estimate the prevalence of HCV and analyze data related to the diagnosis and treatment-related outcomes of HCV patients with a history of intravenous drug use in the general practice setting.

The relationship between person-centered care in nursing homes and COVID-19 infection, hospitalization, and mortality rates.

Objectives: This cohort study compared rates of COVID-19 infections, admissions/readmissions, and mortality among a statewide person-centered model known as PEAK and non-PEAK NHs.

Methods: Rates per 1000 resident days were derived for COVID-19 cases and admissions/readmissions, and per 100 positive cases for mortality. A log-rank test compared rates between PEAK (n = 109) and non-PEAK NHs (n = 112).

National Chronic Disease Management Programmes in Irish General Practice-Preparedness and Challenges.

Information on the readiness of Irish general practice to participate in structured chronic disease management (CDM) care is limited. This study explores the logistic, staffing, and organizational preparedness of Irish general practice to do so, stratified by their size, location, and training status; implementation challenges were also explored. An anonymous, paper-based random survey was performed.

Impact of antimicrobial stewardship program on antimicrobial-resistance and prescribing in nursing homes: a systematic review and meta-analysis.

Objectives: The success of the antimicrobial stewardship program (ASP) is more often measured in antimicrobial use in the literature; however, there is limited evidence regarding antimicrobial resistance (AMR). This study aims to systematically review the impact of urinary tract infection-targeted ASP on overall AMR, antimicrobial use, and specific to fluoroquinolone (FQ) use in nursing homes (NHs).

Methods: This systematic review and meta-analysis included studies published in EMBASE, PubMed, Scopus, Medline, and Cochrane Central Register of Controlled Trials.

Discovering symptom patterns of COVID-19 patients using association rule mining.

Background: The COVID-19 pandemic is a significant public health crisis that is hitting hard on people's health, well-being, and freedom of movement, and affecting the global economy. Scientists worldwide are competing to develop therapeutics and vaccines; currently, three drugs and two vaccine candidates have been given emergency authorization use. However, there are still questions of efficacy with regard to specific subgroups of patients and the vaccine's scalability to the general public.

Nontraditional Small House Nursing Homes Have Fewer COVID-19 Cases and Deaths.

Objectives: Green House and other small nursing home (NH) models are considered "nontraditional" due to their size (10-12 beds), universal caregivers, and other home-like features. They have garnered great interest regarding their potential benefit to limit Coronavirus Disease 2019 (COVID-19) infections due to fewer people living, working, visiting, and being admitted to Green House/small NHs, and private rooms and bathrooms, but this assumption has not been tested. If they prove advantageous compared with other NHs, they may constitute an especially promising model as policy makers and providers reinvent NHs post-COVID.

Treatment of uncomplicated UTI in males: a systematic review of the literature.

Background: Urinary tract infections (UTIs) affect around 20% of the male population in their lifetime. The incidence of UTIs in men in the community is 0.9-2.

Gender Disaggregation in COVID-19 and Increased Male Susceptibility.

Novel coronavirus disease 2019 (COVID-19) is a growing public health crisis. Despite initial focus on the elderly population with comorbidities, it seems that large studies from the worst affected countries follow a sex-disaggregation pattern. Analysis of available data showed marked variations in reported cases between males and females among different countries with higher mortality in males.

Which Nursing Home Residents With Pneumonia Are Managed On-Site and Which Are Hospitalized? Results from 2 Years' Surveillance in 14 US Homes.

Objectives: Pneumonia is a frequent cause of hospitalization among nursing home (NH) residents, but little information is available as to how clinical presentation and other characteristics relate to hospitalization, and the differential use of antimicrobials based on hospitalization status. This study examined how hospitalized and nonhospitalized NH residents with pneumonia differ.

Design: Data from a 2-year prospective study of residents who participated in a randomized controlled trial.

Preventive Antibiotic Use in Nursing Homes: A Not Uncommon Reason for Antibiotic Overprescribing.

A substantial portion of "potentially inappropriate" systemic antibiotics in nursing homes are prescribed with the intention of preventing the development of bacterial infections. In the past, such practices were generally considered acceptable; however, they now are being increasingly scrutinized due to concerns about limited benefits and the potential for adverse effects, including contributing to antimicrobial resistance. As a result of these issues and because of the frequency of these practices, unnecessary prophylactic antibiotic use is an appropriate target for antibiotic stewardship practices.

Fidelity and sustainability of Mouth Care Without a Battle and lessons for other innovations in care.

There are countless efficacious interventions that improve outcomes when conducted in controlled situations. Many fewer are effective when implemented in real-world situations, largely because they are not implemented with fidelity. Still fewer are sustained over time, for reasons including lack of institutional support and fit with existing values, among others.

Discovering Links Between Side Effects and Drugs Using a Diffusion Based Method.

Identifying the unintended effects of drugs (side effects) is a very important issue in pharmacological studies. The laboratory verification of associations between drugs and side effects requires costly, time-intensive research. Thus, an approach to predicting drug side effects based on known side effects, using a computational model, is highly desirable.

Role of patient descriptors in predicting antimicrobial resistance in urinary tract infections using a decision tree approach: A retrospective cohort study.

Background: In general practice, many infections are treated empirically prior to or without microbiological confirmation. Prediction of antimicrobial susceptibility could optimise prescribing thus improving patient outcomes. Decision tree models are a novel idea to predict AMR at the time of clinical presentation.

Antimicrobial resistance patterns of urine culture specimens from 27 nursing homes: Impact of a two-year antimicrobial stewardship intervention.

Objective: Identify changes in the prevalence and antimicrobial resistance patterns of potentially pathogenic bacteria in urine cultures during a 2-year antimicrobial stewardship intervention program in nursing homes (NHs).

Design: Before-and-after intervention study.

Setting: The study included 27 NHs in North Carolina.

A comparative analysis of prophylactic antimicrobial use in long-term care facilities in Ireland, 2013 and 2016.

BackgroundLong-term care facilities (LTCFs) are important locations of antimicrobial consumption. Of particular concern is inappropriate prescribing of prophylactic antimicrobials. AimWe aimed to explore factors related to antimicrobial prophylaxis in LTCFs in Ireland.

Improving Antimicrobial Prescribing: A Multinomial Model Identifying Factors Associated With First- and Second-Line Prescribing.

Background/objectives: Broad-spectrum, second-line antimicrobials may be prescribed when initial first-line options prove ineffective. This study compares prescribing practices and identifies potential influencing factors for first- and second-line antimicrobials in long-term care facilities.

Design: Point prevalence survey of health care-associated infections and antimicrobial use in long-term care facilities (HALT), expanded by additional data collection.

Out-of-hospital cardiac arrest survival in international airports.

Background: The highest achievable survival rate following out-of-hospital cardiac arrest is unknown. Data from airports serving international destinations (international airports) provide the opportunity to evaluate the success of pre-hospital resuscitation in a relatively controlled but real-life environment.

Methods: This retrospective cohort study included all cases of out-of-hospital cardiac arrest at international airports with resuscitation attempted between January 1st, 2013 and December 31st, 2015.

Adverse Effects of Amoxicillin for Acute Lower Respiratory Tract Infection in Primary Care: Secondary and Subgroup Analysis of a Randomised Clinical Trial.

A European placebo-controlled trial of antibiotic treatment for lower respiratory tract infection (LRTI) conducted in 16 primary care practices networks recruited participants between November 2007 and April 2010, and found adverse events (AEs) occurred more often in patients prescribed amoxicillin compared to placebo. This secondary analysis explores the causal relationship and estimates specific AEs (diarrhoea, nausea, rash) due to amoxicillin treatment for LRTI, and if any subgroup is at increased risk of any or a specific AE. A total of 2061 patients were randomly assigned to amoxicillin (1038) and placebo (1023); 595 (28%) were 60 and older.

Using Mobile Phones to Collect Patient Data: Lessons Learned From the SIMPle Study.

Background: Mobile phones offer new opportunities to efficiently and interactively collect real-time data from patients with acute illnesses, such as urinary tract infections (UTIs). One of the main benefits of using mobile data collection methods is automated data upload, which can reduce the chance of data loss, an issue when using other data collection methods such as paper-based surveys.

Objective: The aim was to explore differences in collecting data from patients with UTI using text messaging, a mobile phone app (UTI diary), and an online survey.

Reconsultation and Antimicrobial Treatment of Urinary Tract Infection in Male and Female Patients in General Practice.

Current antimicrobial prescribing guidelines indicate that male and female patients with urinary tract infections (UTIs) should be treated with same antimicrobials but for different durations. The aim of this study was to explore the differences in reconsultations and antimicrobial prescribing for UTI for both males and females. A total of 2557 adult suspected UTI patients participating in the Supporting the Improvement and Management of Prescribing for urinary tract infection (SIMPle) study from 30 general practices were analyzed.

Do general practitioners prescribe more antimicrobials when the weekend comes?

Inappropriate antimicrobial prescribing contributes to the global spread of antimicrobial resistance. The pending weekend with changed availability of general practitioners (GP) and increased patient concern may increase the intention to prescribe antimicrobials. The aim of this study is to analyse variation in antimicrobial prescribing between weekdays and weekend in Irish general practice.