Impact of the COVID-19 pandemic on the utilisation and quality of antibiotic use in the Scottish primary care setting: a population-based segmented interrupted time-series analysis.

BACKGROUND: Inappropriate use of antibiotics is expected to increase during the COVID-19 pandemic, but there are limited data on COVID-19's long-term impact. We assessed the impact of COVID-19 on the quantity and quality of antibiotic use in Scotland. RESEARCH DESIGN AND METHODS: A segmented interrupted time series was applied to monthly dispensed antibiotics using prescription cost analysis data from March/2019 to March/2023. Antibiotic use was quantified using the number of items dispensed/1000 inhabitants (TIDs) and defined daily dose/1000 inhabitants/day (DIDs). The quality of antibiotic use was assessed using key quality indicators including the WHO AWaRe classification, proportion of broad-spectrum and "4C"-antibiotics. RESULTS: Overall, for all antibiotics, there was a non-significant increase in TIDs and DIDs before the first lockdown (March/2020) (ß1), but a decline in the level immediately after the first (ß2) and second lockdowns (ß4) (November/2020), albeit non-significant. However, a significant increase in the time trend after the second lockdown (ß5) for all antibiotic classes was observed. COVID-19 had no negative impact on AWaRe utilisation, with the proportion of all antibiotics from the Access group increasing from 76% in March/2019 to 90% in March/2023. The proportion of "4C" antibiotic reduced significantly after the second lockdown. CONCLUSIONS: Neither the utilisation nor the quality of total antibiotic use appeared to have been significantly affected by COVID-19.

The Impact of COVID-19 Related Lockdown on the Prevalence of Spousal Violence Against Women in Kurdistan Region of Iraq.

There is increasing concern about the impact of the COVID-19 pandemic and the lockdown's social and economic consequences on gender-based violence. This study aimed to assess the impact of the COVID-19 pandemic on gender-based violence by comparing the prevalence of spousal violence against women before and during the COVID-19 related lockdown periods. This study was conducted in the Kurdistan Region of Iraq using a self-administered online questionnaire survey after the COVID-19 lockdown period in June 2020. Data were collected from a sample of 346 married women about the occurrence, frequency, and forms of spousal violence before and during the lockdown period. Significant increases in violence were observed from the pre-lockdown period to the lockdown period for any violence (32.1% to 38.7%, p = .001), emotional abuse (29.5% to 35.0%, p = .005), and physical violence (12.7% to 17.6%, p = .002). Regarding emotional abuse, humiliation (24.6% to 28.3%, p = .041) and scaring or intimidation (14.2% to 21.4%, p < .001) significantly increased during the lockdown. For physical violence, twisting the arm or pulling hair (9.0% to 13.0%, p = .004) and hitting (5.2% to 9.2%, p = .003) significantly increased during the lockdown. Forcing to have sexual intercourse also significantly increased during lockdown (6.6% to 9.5%., p = .021). The concerned authorities and women's rights organizations should collaborate to enhance the prevention of violence against women. An effective prevention strategy should emphasize recognizing and acknowledging the extent of the problem, raising awareness about the problem and the available resources to address it, and ensuring social and economic stability. Lessons learned about the increased prevalence of spousal violence against women during the COVID-19 pandemic and the need to adopt appropriate strategies to prevent and address it will be valuable for similar future crises.

Combined chemo-magnetic field-photothermal breast cancer therapy based on porous magnetite nanospheres.

The efficacy of different modalities of treating breast cancer is inhibited by several limitations such as off-targeted drug distribution, rapid drug clearance, and drug resistance. To overcome these limitations, we developed Lf-Doxo-PMNSs for combined chemo-MF-PTT. The PMNSs were synthesized by hydrothermal method and their physicochemical properties were examined by FE-SEM, TEM, DLS, TGA, XRD investigations. The cytotoxicity of as-synthesized NPs against 4T1 cells was carried out by MTT and flow cytometry assays. Afterwards, the anti-cancer activities of as-synthesized Lf-Doxo-PMNSs on the tumor status, drug distribution and apoptosis mechanism were evaluated. The anti-cancer assays showed that Lf-Doxo-PMNSs significantly suppressed the cancer cell proliferation and tumor weight by prolonging drug availability and potential drug loading in tumor cells; whereas they showed a minimum cytotoxicity against non-cancerous cells. Likewise, combined chemo-MF-PTT using Lf-Doxo-PMNSs displayed the highest anti-cancer activity followed by combined chemo-PTT and combined chemo-MF therapy based on altering the apoptosis mechanism. Therefore, these results showed that combined chemo-MF-PTT based on Lf-Doxo-PMNSs can be used as a promising therapeutic platform with potential targeted drug delivery and high loading capacity features as well as reducing cancer drug resistance.

Plasmonic and chiroplasmonic nanobiosensors based on gold nanoparticles.

Development of optical nanobiosensors has emerged as one of the most important bioresearch areas of interest over the past decades especially in the modern innovations in the design and utilization of sensing platforms. The application of nanobiosensors has been accelerated with the introduction of plasmonic NPs, which overcome the most of the limitations in the case of conventional optical nanobiosensors. Since the plasmonic AuNPs-based nanobiosensors provide high potential achievements to develop promising platforms in fully integrated multiplex assays, some well-developed investigations are clearly required to improve the current technologies and integration of multiple signal inputs. Therefore, in this literature, we summarized the performance and achievements of optical nanobiosensors according to plasmonic rules of AuNPs, including SPR, LSPR, SERS and chiroptical phenomena. Also, we investigated the effects of the physicochemical properties of AuNPs such as size, shape, composition, and assembly on the plasmonic signal propagation in AuNPs-based nanobiosensors. Moreover, we presented an overview on the current state of plasmonic AuNPs-based nanobiosensors in the biomedical activities. Besides, this paper looks at the current and future challenges and opportunities of ongoing efforts to achieve the potential applications of AuNPs-based optical plasmonic nanobiosensors in integration with other nanomaterials. Taken together, the main focus of this paper is to provide some applicable information to develop current methodologies in fabrication of potential AuNPs-based nanobiosensors for detection of a wide range of analytes.

The advance care planning experiences of people with dementia, family caregivers and professionals: a synthesis of the qualitative literature.

There exists compelling evidence that advance care planning (ACP) remains a key factor in the delivery of appropriate end of life care and facilitates the timely transition to palliative care for people with dementia. Take up of ACP within the dementia population is low, especially when compared with other conditions. Quantitative research has helped in identifying some of the key factors in enabling or inhibiting the use of ACP within the dementia population. Qualitative research can, however, shed further light upon the experiences of all. We carried out a search of the qualitative literature addressing the ACP experiences of people with dementia, family caregivers and professionals. An approach to qualitative synthesis involving coding of original text, developing descriptive themes and generating analytical themes was utilized. We identified five papers and subsequently five analytical themes: breadth and scope of future planning; challenges to ACP; postponing ACP; confidence in systems and making ACP happen for people with dementia. The synthesized findings shed light on the ongoing challenges of the use and further development of ACP in the population of people with dementia. In particular attention is drawn to the difficulties in the timing of ACP and the preference for informal approaches to planning within the families of people affected by dementia. The ACP capacity of the workforce is also addressed. The paper reveals considerable complexity in undertaking ACP in a context of dementia. It is suggested that the preference for informal approaches and the timing of initial conversations be considered and that the skills of those involved in initiating discussions should be given primacy.