198 resultados para prescribing patterns
STOPP & START criteria: A new approach to detecting potentially inappropriate prescribing in old age
Resumo:
Using a combination of experimental and computational techniques, changes in the domain structures seen infreestanding single-crystal platelets of BaTiO3 have been described in terms of a second-order phase transition.The transition is driven by the change in the length-to-width ratio of the platelet sidewalls and results in a symmetrybreaking of a complex, quadrant domain pattern. The phenomenon can be described by a Landau formalism inwhich (1) the order parameter is not the polarization but rather is the degree to which the domain pattern becomesoff-centered, and (2) the shape anisotropy of the platelet substitutes for temperature in the conventional Landauexpansion as the controlling thermodynamic variable. Bistability, in terms of the direction in which the domainpattern moves off center, coupled with the spontaneous macroscopic polarization and toroidal moment that resultfrom this off-centering, prompt the possibility of a new form of memory storage.
Resumo:
BACKGROUND: In 2005, the European Commission recommended that all member states should establish or strengthen surveillance systems for monitoring the use of antimicrobial agents. There is no evidence in the literature of any surveillance studies having been specifically conducted in nursing homes (NHs) in Northern Ireland (NI).
OBJECTIVE: The aim of this study was to determine the prevalence of antimicrobial prescribing and its relationship with certain factors (e.g. indwelling urinary catheterization, urinary incontinence, disorientation, etc.) in NH residents in NI.
METHODS: This project was carried out in NI as part of a wider European study under the protocols of the European Surveillance of Antimicrobial Consumption group. Two point-prevalence surveys (PPSs) were conducted in 30 NHs in April and November 2009. Data were obtained from nursing notes, medication administration records and staff in relation to antimicrobial prescribing, facility and resident characteristics and were analysed descriptively.
RESULTS: The point prevalence of antimicrobial prescribing was 13.2% in April 2009 and 10.7% in November 2009, with a 10-fold difference existing between the NHs with the highest and lowest antimicrobial prescribing prevalence during both PPSs. The same NH had the highest rate of antimicrobial prescribing during both April (30.6%) and November (26.0%). The group of antimicrobials most commonly prescribed was the penicillins (April 28.6%, November 27.5%) whilst the most prevalent individual antimicrobial prescribed was trimethoprim (April 21.3%, November 24.3%). The majority of antimicrobials were prescribed for the purpose of preventing urinary tract infections (UTIs) in both April (37.8%) and in November (46.7%), with 5% of all participating residents being prescribed an antimicrobial for this reason. Some (20%) antimicrobials were prescribed at inappropriate doses, particularly those which were used for the purpose of preventing UTIs. Indwelling urinary catheterization and wounds were significant risk factors for antimicrobial use in April [odds ratio {OR} (95% CI) 2.0 (1.1, 3.5) and 1.8 (1.1, 3.0), respectively] but not in November 2009 [OR (95% CI) 1.6 (0.8, 3.2) and 1.2 (0.7, 2.2), respectively]. Other resident factors, e.g. disorientation, immobility and incontinence, were not associated with antimicrobial use. Furthermore, none of the NH characteristics investigated (e.g. number of beds, hospitalization episodes, number of general practitioners, etc.) were found to be associated with antimicrobial use in either April or November 2009.
CONCLUSIONS: This study has identified a high overall rate of antimicrobial use in NHs in NI, with variability evident both within and between homes. More research is needed to understand which factors influence antimicrobial use and to determine the appropriateness of antimicrobial prescribing in this population in general and more specifically in the management of recurrent UTIs.
Resumo:
Objectives: To explore the views and perspectives of children on the unlicensed/off-label use of medicines in children and on the participation of children in clinical trials. Methods: Focus-group discussions, involving school children, were carried out in a range of primary and secondary schools in Northern Ireland. A purposeful sample was chosen to facilitate representation of various socioeconomic groupings. Results: A total of 123 pupils, aged from 10 to 16 years, from six schools, participated in 16 focus groups. In general, pupils viewed the unlicensed/off-label use of medicines in children as unsafe and unethical and felt it is necessary to test medicines in children to improve the availability of licensed products. The majority felt that older children should be told, and that parents should be told, about the unlicensed/off-label use of medicines in children, yet they recognised some implications of this, such as potential medication non-adherence. Conclusions: This is the first study to explore the views of healthy children on unlicensed medicine use in children. Children were able to recognise potential risks associated with the unlicensed use of medicines and felt it is necessary to test and license more medicines in children. Practice implications Health care professionals should consider the views of children in decisions that affect their health.
Resumo:
The gametogenic and spat settlement patterns of two Mytihis edulis beds were studied in Dundrum Inner Bay, Northern Ireland. There was evidence of gonad development throughout the year with the main development period between November and March. Spawning was protracted, lasting from May to November. Slight inter-annual and inter-population differences in the riming of the phases were observed but the cycles at both beds were broadly similar to each other and to those of other British and Irish sites. Settlement occurred throughout the year and there was evidence of both primary and secondary spat settlement at both sites. Although the reproductive cycles were similar, distinct seasonal and inter-site differences in spatfall were apparent. At the Downshire Bridge bed, settlement peaked during summer and was dominated by spat in the 0•;5-1•0 mm size range. At Ballykinler, settlement levels were highest in the winter months and larger (>1 mm) spat dominated the samples. The orientation of spat collection pads also significantly affected numbers of the larger (>1 mm) spat. Collectors facing the flood tide attracted significantly more secondary settlers than ebb-facing collectors. This effect varied seasonally and was greater at the Ballykinler bed. It is suggested that hydrodynamic regimes may be an important factor in the differences in settlement patterns of M. edulis.
Resumo:
This audit of prescribing practices explores recent trends at Kitovu Hospital, Uganda. The average number of drugs prescribed per patient was 2.89 ± 0.11, of which 1.79±0.09 were generics and 0.69±0.06 antibiotics. No injections were prescribed. Patient essential drug knowledge was 100% while the adequacy of labelling was 0%. The number of drugs prescribed correlated positively with patient age, was greater for female patients, similar for doctors and clinical officers but greater in medical (3.30±0.15, n=50) than surgical (2.48±0.13, n=50) outpatient clinics. The mean consultation time was 6.56 min and 10.25 min per patient in medical and surgical outpatient clinics respectively. The patient essential knowledge indicators were greatly improved but only modest reduction in polypharmacy was evident compared to the Ugandan Pharmaceutical Sector national survey of 2002. Antibiotic prescription was high and generic prescribing was found to be low. Policy changes are required to enhance rational drug use in the health sector in Uganda.
Dietary patterns and bone mineral status in young adults: the Young Hearts Project, Northern Ireland