Third-generation cephalosporin-resistant (3GC-R) Enterobacteriaceae represent a major threat to human health. Here, we captured 288 3GC-R Enterobacteriaceae clinical isolates from 264 patients presenting at a regional Australian hospital over a 14-month period. In addition to routine mass spectrometry and antibiotic sensitivity testing, isolates were examined using rapid (∼40-min) real-time PCR assays targeting the most common extended-spectrum β-lactamases (ESBLs; bla CTX-M-1 and bla CTX-M-9 groups, plus bla TEM, bla SHV, and an internal 16S rRNA gene control). AmpC CMY β-lactamase (bla CMY) prevalence was also examined. Escherichia coli (80.2%) and Klebsiella pneumoniae (17.0%) were dominant, with Klebsiella oxytoca, Klebsiella aerogenes, and Enterobacter cloacae infrequently identified. Ceftriaxone and cefoxitin resistance were identified in 97.0% and 24.5% of E. coli and K. pneumoniae isolates, respectively. Consistent with global findings in Enterobacteriaceae, most (98.3%) isolates harbored at least one β-lactamase gene, with 144 (50%) harboring bla CTX-M-1 group, 92 (31.9%) harboring bla CTX-M-9 group, 48 (16.7%) harboring bla SHV, 133 (46.2%) harboring bla TEM, and 34 (11.8%) harboring bla CMY genes. A subset of isolates (n = 98) were subjected to whole-genome sequencing (WGS) to identify the presence of cryptic resistance determinants and to verify genotyping accuracy. WGS of β-lactamase-negative or carbapenem-resistant isolates identified uncommon ESBL and carbapenemase genes, including bla NDM and bla IMP, and confirmed all PCR-positive genotypes. We demonstrate that our PCR assays enable the rapid and cost-effective identification of ESBLs in the hospital setting, which has important infection control and therapeutic implications.Inappropriate use of antibiotics in the community contributes to the development of antibiotic resistance (ABR), one of the most concerning issues in modern medicine. The objectives of the study were to investigate the knowledge and attitudes regarding ABR and dispensing antibiotics without prescription (DAwP) and to assess the extent of the practice of DAwP among Italian community pharmacists (CPs). A nationwide cross-sectional study using an anonymous, structured, validated, and pilot-tested questionnaire was conducted. The five sections gathered data on demographic and professional characteristics, knowledge and attitudes toward ABR and DAwP, practices regarding dispensing antibiotics with or without prescription and their reasons, counselling on the potential antibiotic side effects and the importance of adherence to medication regimen, and the information sources used to update the knowledge about ABR. About 4 in 10 CPs (37.1%) reported being involved in DAwP, although 93.7% knew that it is illegal in Italy. The vast majority affirmed to have always/often asked clients about their drug allergies (95.5%) and about their medication history (82.5%). Two-thirds (66.2%) warned their clients about the potential side effects of the drugs, and 55% informed them about the importance of completing the full course of antibiotics. Complacency with clients who found it difficult to consult the physician was the most significant predictor of DAwP. A considerable proportion of DAwP was described, so it could be easy for patients to misuse these drugs. Future policies need to enhance the enforcement of existing prescription-only regulations and to develop monitoring strategies to ensure their establishment in real-life practices.

Childhood adversity (CA) has previously been linked to various health problems in adulthood. Investigations into the differential impact of distinct types of CA on a wide range of outcomes are scarce. This study aimed to assess the impact of self-reported childhood family conflict and/or financial strain on health and social functioning in adulthood among Europeans, while taking into account the mediating role of adulthood socioeconomic disadvantage (SED) in these associations.

Using the European Social Survey (ESS) collected in 2014, nationally representative cross-sectional data from 35 475 participants aged 15 years and older in 19 European countries were analysed. Logistic regressions were conducted to assess associations of retrospectively reported family conflict and/or financial strain in childhood with physical and mental health as well as health behaviours and social functioning in adulthood.

A quarter of the European population reported having experienced family conflict, financial strain or bo operate as an indirect pathway.

Individuals reporting family conflict or financial strain during childhood are at increased risk of developing a wide range of health and social problems. Those who report financial strain in childhood are more likely to experience SED in adulthood, which in turn increases their risk of experiencing health and social problems. DMX-5084 datasheet Reported family conflict during childhood conferred increased risk of health and social problems, but adulthood SED did not appear to operate as an indirect pathway.

The initial International Conference on Population and Development in 1994 contains the first reference to sexual and reproductive health and reproductive rights (SRHR). It has been considered agreed language on SRHR in future United Nations (UN) documents. However, opposition to SRHR in global forums has increased, including in conjunction with an increase in religious, far-right populist politics. This study provides an empirical analysis of UN documents to discover whether opposition to SRHR has resulted in changes in the language on SRHR between and what these changes are.

This is a qualitative policy analysis in which 14 UN resolutions, 6 outcome documents from the Commission on the Status of Women (CSW) and 522 country and group statements and 5 outcome reports from the Commission on Population and Development were collected from the organisations websites from 2014 to 2019. Framework analysis was used. The text from documents was charted and indexed and themes developed from these.

The results den of SRHR.The COVID-19 is an established threat whose clinical features and epidemiology continues to evolve. In an effort to contain the disease, the National Health Service has adopted a digital first approach in UK general practice resulting in a significant shift away from face-to-face consultations. Consequently, more consultations are being completed without obtaining objective recording of vital signs and face-to-face examination. Some regions have formed hot hubs to facilitate the review of suspected COVID-19 cases and keep their practice site ‘clean’ including the use of doorstep observations in avoiding the risk of face-to-face examination. To support the safe, effective and efficient remote assessment of suspected and confirmed patients with COVID-19, we established a doorstep assessment service to compliment telephone and video consultations. This allows physiological parameters such as temperature, pulse, blood pressure and oxygen saturation to be obtained to guide further triage. Quality improvement methods were used to integrate and optimise the doorstep assessment and measure the improvements made.