RESUMEN
Antibodies are a core element of the immune system's defense against infectious diseases. We hypothesize that antibody titres might therefore be an important predictor of survival in older individuals. This is important because biomarkers that robustly measure survival have proved elusive, despite their potential utility in health care settings. We present evidence supporting the hypothesis that influenza antibody titres are associated with overall survival of older individuals, and indicate a role for biological sex in modulating this association. Since antibody titres can be modulated by vaccination, these results have important implications for public health policy on influenza control in aging populations.
RESUMEN
BACKGROUND: Antibiotics are commonly prescribed for respiratory tract infections (RTIs) among older adults in long-term care facilities (LTCFs), and this contributes to the emergence of antimicrobial resistance. The objective of this study was to determine the antibiotic prescribing rate for RTIs among LTCF residents, and to analyse the antibiotic consumption patterns with the AwaRe monitoring tool, developed by the World Health Organization. METHODS: MEDLINE, EMBASE and CINAHL were searched from inception to March 2022. Original articles reporting antibiotic use for RTIs in LTCFs were included in this review. Study quality was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Prevalence Data. A random-effects meta-analysis was employed to calculate the pooled estimates. Subgroup analysis was conducted by type of RTI, country, and study start year. RESULTS: In total, 47 articles consisting of 50 studies were included. The antibiotic prescribing rate ranged from 21.5% to 100% (pooled estimate 69.8%, 95% confidence interval 55.2-82.6%). The antibiotic prescribing rate for lower respiratory tract infections (LRTIs) was higher than the rates for viral and general RTIs. Compared with Italy, France and the USA, the Netherlands had lower antibiotic use for LRTIs. A proportion of viral RTIs were treated with antibiotics, and all the antibiotics were from the Watch group. Use of antibiotics in the Access group was higher in the Netherlands, Norway, Switzerland and Slovenia compared with the USA and Australia. CONCLUSION: The antibiotic prescribing rate for RTIs in LTCFs was high, and AWaRe antibiotic use patterns varied by type of RTI and country. Improving antibiotic use may require coordination efforts.
Asunto(s)
Antibacterianos , Infecciones del Sistema Respiratorio , Humanos , Anciano , Antibacterianos/uso terapéutico , Cuidados a Largo Plazo , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/epidemiología , Instituciones de Salud , Instituciones de Cuidados Especializados de EnfermeríaAsunto(s)
Infecciones por Coronavirus/prevención & control , Internacionalidad , Pandemias/prevención & control , Neumonía Viral/prevención & control , Guías de Práctica Clínica como Asunto , Servicios Preventivos de Salud/estadística & datos numéricos , Servicios Preventivos de Salud/normas , Cuarentena/estadística & datos numéricos , Cuarentena/normas , Betacoronavirus , COVID-19 , Humanos , SARS-CoV-2Asunto(s)
Infecciones por Coronavirus , Pulmón/diagnóstico por imagen , Pandemias , Neumonía Viral , Infecciones del Sistema Respiratorio/diagnóstico , Tomografía Computarizada por Rayos X/métodos , Betacoronavirus/aislamiento & purificación , COVID-19 , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Diagnóstico Diferencial , Humanos , Neumonía Viral/diagnóstico , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/epidemiología , Neumonía Viral/etiología , SARS-CoV-2RESUMEN
Super-spreading events in an outbreak can change the nature of an epidemic. Therefore, it is useful for public health teams to determine whether an ongoing outbreak has any contribution from such events, which may be amenable to interventions. We estimated the basic reproductive number (R0) and the dispersion factor (k) from empirical data on clusters of epidemiologically linked coronavirus disease 2019 (COVID-19) cases in Hong Kong, Japan and Singapore. This allowed us to infer the presence or absence of super-spreading events during the early phase of these outbreaks. The relatively large values of k implied that large cluster sizes, compatible with super-spreading, were unlikely.
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Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Brotes de Enfermedades/prevención & control , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , COVID-19 , Hong Kong/epidemiología , Humanos , Japón/epidemiología , Pandemias , SARS-CoV-2 , Singapur/epidemiologíaAsunto(s)
Gripe Humana/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Hong Kong/epidemiología , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Seroepidemiológicos , Factores de Tiempo , Adulto JovenRESUMEN
This study explored how cultural values affected Health Belief Model (HBM) components and the influenza vaccine uptake among nurses across three Asian populations using a survey conducted in 2017 (N = 3971). The vaccination coverages were 33.5% (Brunei), 35.6% (Hong Kong) and 69.5% (Singapore). Three HBM components (perceived susceptibility, perceived benefits and cues to action) were positively associated with vaccination. A direct negative link and an indirect positive link via HBM were observed between collectivism and vaccination, whereas a negative indirect link via HBM between power distance and vaccination was observed. Cultural values, notably collectivism, advanced HBM to study nurses' vaccination.
Asunto(s)
Cultura , Conocimientos, Actitudes y Práctica en Salud , Gripe Humana/prevención & control , Enfermeras y Enfermeros/psicología , Cobertura de Vacunación , Vacunación/psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brunei , Infección Hospitalaria/prevención & control , Estudios Transversales , Transmisión de Enfermedad Infecciosa/prevención & control , Femenino , Hong Kong , Humanos , Gripe Humana/transmisión , Masculino , Persona de Mediana Edad , Singapur , Adulto JovenRESUMEN
Although new techniques and innovative approaches in hand surgery are increasing in number and popularity, the ultimate aim of achieving improved functions may not be fulfilled. On the other hand, perfect functional results are not achieved, not because of inability to use recent technology, but because of deficient skills, e.g. on basic incisions, tendon repair, or nerve repair.