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Unnecessary antibiotic prescribing in a Canadian primary care setting: a descriptive analysis using routinely collected electronic medical record data

Background:

Unnecessary antibiotic use in the community in Canada is not well defined. Our objective was to quantify unnecessary antibiotic prescribing in a Canadian primary care setting.

Methods:

We performed a descriptive analysis in Ontario from April 2011 to March 2016 using the Electronic Medical Records Primary Care database linked to other health administrative data sets at ICES. We determined antibiotic prescribing rates (per 100 patient–physician encounters) for 23 common conditions and estimated rates of unnecessary prescribing using predefined expected prescribing rates, both stratified by condition and patient age group.

Results:

The study included 341 physicians, 204 313 patients and 499 570 encounters. The rate of unnecessary antibiotic prescribing for included conditions was 15.4% overall and was 17.6% for those less than 2 years of age, 18.6% for those aged 2–18, 14.5% for those aged 19–64 and 13.0% for those aged 65 or more. The highest unnecessary prescribing rates were observed for acute bronchitis (52.6%), acute sinusitis (48.4%) and acute otitis media (39.3%). The common cold, acute bronchitis, acute sinusitis and miscellaneous nonbacterial infections were responsible for 80% of the unnecessary antibiotic prescriptions. Of all antibiotics prescribed, 12.0% were for conditions for which they are never indicated, and 12.3% for conditions for which they are rarely indicated. In children, 25% of antibiotics were for conditions for which they are never indicated (e.g., common cold).

Interpretation:

Antibiotics were prescribed unnecessarily for 15.4% of included encounters in a Canadian primary care setting. Almost one-quarter of antibiotics were prescribed for conditions for which they are rarely or never indicated. These findings should guide safe reductions in the use of antibiotics for the common cold, bronchitis and sinusitis.




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Activity of Plazomicin Tested against Enterobacterales Isolates Collected from U.S. Hospitals in 2016-2017: Effect of Different Breakpoint Criteria on Susceptibility Rates among Aminoglycosides [Susceptibility]

Plazomicin was active against 97.0% of 8,783 Enterobacterales isolates collected in the United States (2016 and 2017), and only 6 isolates carried 16S rRNA methyltransferases conferring resistance to virtually all aminoglycosides. Plazomicin (89.2% to 95.9% susceptible) displayed greater activity than amikacin (72.5% to 78.6%), gentamicin (30.4% to 45.9%), and tobramycin (7.8% to 22.4%) against carbapenem-resistant and extensively drug-resistant isolates. The discrepancies among the susceptibility rates for these agents was greater when applying breakpoints generated using the same stringent contemporary methods applied to determine plazomicin breakpoints.




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Establishment of the T1D Exchange Quality Improvement Collaborative (T1DX-QI)

The T1D Exchange established a learning platform by evaluating the current state of care and engaging 10 diabetes clinics in collaborative quality improvement (QI) activities. Participating clinics are sharing data and best practices to improve care delivery for people with type 1 diabetes. This article describes the design and initial implementation of this platform, known as the T1D Exchange Quality Improvement Collaborative. This effort has laid a foundation for learning from variation in type 1 diabetes care delivery via QI methodology and has demonstrated success in improving processes through iterative testing cycles and transparent sharing of data.




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Li-Fraumeni Exploration Consortium Data Coordinating Center: Building an Interactive Web-Based Resource for Collaborative International Cancer Epidemiology Research for a Rare Condition

Background:

The success of multisite collaborative research relies on effective data collection, harmonization, and aggregation strategies. Data Coordination Centers (DCC) serve to facilitate the implementation of these strategies. The utility of a DCC can be particularly relevant for research on rare diseases where collaboration from multiple sites to amass large aggregate datasets is essential. However, approaches to building a DCC have been scarcely documented.

Methods:

The Li-Fraumeni Exploration (LiFE) Consortium's DCC was created using multiple open source packages, including LAM/G Application (Linux, Apache, MySQL, Grails), Extraction-Transformation-Loading (ETL) Pentaho Data Integration Tool, and the Saiku-Mondrian client. This document serves as a resource for building a rare disease DCC for multi-institutional collaborative research.

Results:

The primary scientific and technological objective to create an online central repository into which data from all participating sites could be deposited, harmonized, aggregated, disseminated, and analyzed was completed. The cohort now include 2,193 participants from six contributing sites, including 1,354 individuals from families with a pathogenic or likely variant in TP53. Data on cancer diagnoses are also available. Challenges and lessons learned are summarized.

Conclusions:

The methods leveraged mitigate challenges associated with successfully developing a DCC's technical infrastructure, data harmonization efforts, communications, and software development and applications.

Impact:

These methods can serve as a framework in establishing other collaborative research efforts. Data from the consortium will serve as a great resource for collaborative research to improve knowledge on, and the ability to care for, individuals and families with Li-Fraumeni syndrome.




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College Town II

Phố Thương mại tri thức College Town II nằm ở vị trí trung tâm của dự án khu đô thị sinh thái dịch vụ du lịch Thới Hòa quy mô 956ha, với vị trí vô cùng đắc địa, hứa hẹn đem lại cho cư dân nơi đây những điều kiện thuận lợi về giao thông cũng như tiện ích to lớn về cơ sở hạ tầng.





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Halo 2: Anniversary for Halo: The Master Chief Collection for PC Launches May 12

Publisher Microsoft and developer 343 Industries announced Halo 2: Anniversary will launch for the Windows PC version of Halo: The Master Chief Collection via Steam and Microsoft Store on Tuesday, May 12.

Earth will never be the same.

Halo 2: Anniversary arrives on PC as part of Halo: The Master Chief Collection on May 12! https://t.co/y5NHDTiQ1E pic.twitter.com/HVzgxIuY8V

— Halo (@Halo) May 5, 2020

Here is an overview of the game:

Halo 2: Anniversary comes to PC as the next installment in Halo: The Master Chief Collection. Now optimized for PC, experience the impeccably remastered edition of the original Halo 2 game. Following the destruction of Halo, humankind experiences a short-lived victory. Eager for revenge, the Covenant launches a surprise attack on Earth, but they find themselves ill-prepared to defeat the UNSC’s home fleet and are forced to flee into slipspace. When the Master Chief pursues his overzealous enemies, they discover yet another Halo ring, uncovering long-buried secrets, including an unlikely ally, that will dramatically alter the course of the Human-Covenant Conflict forever.

Key Features:

  • PC Settings/Optimizations: Halo 2: Anniversary is now optimized for PC and looking better than ever at up to 4k UHD and at 60+ FPS.* Other PC native settings include customizable mouse and keyboard support, ultrawide support, FOV customization, and more.
  • Campaign: Experience the next chapter in the Halo saga and fight your way through 15 unforgettable missions. Play as both Spartan-117, the Master Chief, and for the first time, the Covenant Elite, known as the Arbiter, and experience the Human-Covenant Conflict in a whole new way.
  • Anniversary Edition/Update: Toggle between the remastered graphics in the Anniversary edition and the graphics from the original Halo 2 campaign. In the Anniversary edition, view Blur Studio’s spectacularly remastered cutscenes from the original Halo 2 game.
  • Multiplayer: Continue your Halo adventure with 7 remastered multiplayer maps from Halo 2: Anniversary and 25 multiplayer maps from the original Halo 2, featuring a completely updated progression system.

A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel dedicated to gaming Let's Plays and tutorials. You can contact the author at wdangelo@vgchartz.com or on Twitter @TrunksWD.

Full Article - https://www.vgchartz.com/article/443396/halo-2-anniversary-for-halo-the-master-chief-collection-for-pc-launches-may-12/




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Two stars colliding in 2083 will outshine all the others in the sky

Two stars in the constellation Sagitta are predicted to smash together in the year 2083, producing an explosion that will outshine every star in the sky




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Oxygen in lunar rocks suggests the moon formed in huge collision

A leading theory for the formation of the moon is that a planet called Theia smashed into the early Earth, but doubts remain. Now a new analysis of lunar rock supports this idea




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Volunteers Are Collecting Tablets for COVID-19 Patients So They Don’t Have to Suffer Alone

Groups across the country are putting tablets in the hands of COVID patients so their families can see them, sometimes for the last time




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Lori Loughlin, other parents lose bid to dismiss U.S. college scam charges

A federal judge on Friday declined to dismiss the charges against "Full House" actress Lori Loughlin and other wealthy parents awaiting trial in the U.S. college admissions scandal after they accused investigators of fabricating evidence.




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Senior Living: Consider a collateral charge

There are benefits to getting a collateral charge for long-term estate and financial planning. As an adviser to high-net-worth clients, I have always recommended setting up a collateral charge for every client regardless of their debt or savings situation. A collateral charge is a financial planning tool secured against your primary residence for 100 per […]






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Sanders' bid to collect delegates takes blow as New York cancels its Democratic presidential primary

Bernie Sanders' bid to collect convention delegates hits snag as New York cancels Democratic presidential primary




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Whirlwind leaves Steegmans with broken collarbone

Team RadioShack rider Gert Steegmans broke his left collarbone when a whirlwind caused him to crash during the prologue of the Paris-Nice race on Sunday.




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Compton crash: Cyclist in his 40s killed in collision with van

A cyclist has died after being involved in a collision with a van.




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From the frontline: Chaos, confusion but we will not collapse under challenge

Follow our live coronavirus updates here Coronavirus: the symptoms




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Oasis and Warehouse collapse into administration hitting 2,300 jobs

Fashion chains Oasis and Warehouse have fallen into administration, affecting some 2,300 workers.




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Colleagues remember Lyra Mckee on first anniversary of Northern Ireland journalist's murder

The National Union of Journalists gathered for a special virtual tribute




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Motorcylist, 37, dies after collision with lamppost in east London

A motorcyclist has died after colliding with a lamppost in east London.




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Prince Philip hails everyone from healthcare workers to rubbish collectors as they help nation battle coronavirus

The Duke of Edinburgh's tribute about the 'vital and urgent work being done by so many' is his first major statement since his retirement in 2017




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First RAF plane collecting PPE from Turkey finally takes off

An RAF flight has left to collect a consignment of protective gowns for healthcare workers on the coronavirus frontline.




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Richard Branson warns Virgin Atlantic will collapse without Government support as he defends himself over bailout backlash

Billionaire Sir Richard Branson today warned Virgin Atlantic will need financial aid from the Government in order to survive the coronavirus crisis as he defended himself amid backlash over a bailout request.




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Police motorcyclist dies after collision with a car while on duty

A police motorcyclist has died after a collision with a car while responding to an incident in Sheffield, South Yorkshire Police said.




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RAF plane returns to UK from Turkey after being dispatched to collect PPE

An RAF plane believed to be carrying a delayed consignment of personal protective equipment (PPE) for NHS staff has landed in the UK.




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Welsh health minister Vaughan Gething apologises for Zoom blunder after swearing about colleague with mic still on

A Zoom blunder from Wales's health minister left fellow politicians with their heads in their hands as he was heard swearing about a colleague with his microphone still on.




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Crash near Harry Dunn collision site being probed by US airbase

The US military base near to where the crash which claimed Harry Dunn's life is "looking into" claims a staff member also drove on the wrong side of the road before hitting into a stone wall.




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Brent crash: Motorcyclist dies after collision in north London

A man has died after his motorbike crashed into the central reservation of a major London road.




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University College London medics don 'lockdown costumes' for online graduation ceremony

Medical students from University College London who were fast-tracked onto the NHS coronavirus frontline donned "lockdown costumes" for an online graduation ceremony.




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Car sales almost wiped out as registrations collapse to lowest level for 74 years amid coronavirus crisis

New car sales were almost wiped out last month as the the number of registrations collapsed to their lowest level for 74 years.




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Thousands of London restaurants and bars 'on brink of collapse as they do not qualify for Government's emergency grants'

Campaign launched to increase threshold on rateable value to help struggling businesses





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NOAA makes a pact with Vulcan to deepen collaboration on ocean science

The National Oceanic and Atmospheric Administration says it has forged a new agreement with Vulcan Inc., the Seattle-based holding company created by the late Microsoft co-founder Paul Allen, to share data on ocean science and exploration. The memorandum of understanding builds on an existing relationship between NOAA and Vulcan. “The future of ocean science and exploration is partnerships,” retired Navy Rear Admiral Tim Gallaudet, assistant secretary of commerce for oceans and atmosphere and deputy NOAA administrator, said today in a news release. “NOAA is forging new collaborations, such as the one with Vulcan, to accelerate our mission to map, explore… Read More






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Coronavirus: NHS doctor returning to help during pandemic cheers up colleagues by singing opera

Dr Alex Aldren has returned to the NHS after leaving to become an opera singer




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N.L. archive collecting stories, art from ongoing coronavirus outbreak and past pandemics

The Rooms is eager to document how people are coping with the current pandemic to build a record for the future.




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Should colleges give refunds over coronavirus?

With higher education forced online amid the coronavirus pandemic, students say the quality of their education has decreased. Do colleges owe them a refund?





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Disney+ curates collection of Simpsons episodes that predict the future

Fans think The Simpsons predicted everything from Trump's presidency to coronavirus




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Felicity Huffman's daughter admitted to university after college admissions scandal

Huffman served 11 days in jail in 2019 for paying to have her daughter's SAT results doctored





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GRUBHUB Collected Record Fees From Restaurants Struggling To Stay Alive...


GRUBHUB Collected Record Fees From Restaurants Struggling To Stay Alive...


(Second column, 13th story, link)


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Gemma Collins breaks down as dream house purchase falls through in Diva on Lockdown

The episode also saw the star close her shop as the pandemic took hold




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Gemma Collins and James Argent's relationship timeline in full

The course of true love never did run smooth, after all




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Justin Bieber and Ariana Grande announce collaboration to raise money for children of frontline workers

Stuck With U will be released later this month




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ReBurberry Edit: Burberry launches eco capsule collection and new green eco clothing tags for Earth Day

To celebrate World Earth Day, the British brand has created an edit of its SS20 collection made from recycled and bio-based materials




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Sustainable luxury fashion label Mother of Pearl creates first high street collection with John Lewis

Hardworking wardrobe staples from one of luxury fashion's coolest sustainability stars




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Princess Charlotte rocks the oversized collar trend in fifth birthday pictures

Happy Birthday Princess Charlotte!




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Phil Collins helps Jimmy Greaves with 'substantial donation', reveals agent

Phil Collins has made a 'substantial donation' to help Jimmy Greaves, according to the Tottenham legend's agent.




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Sixth form college funded by Tottenham making protective equipment for north London hospitals

A sixth-form college sponsored by Tottenham is helping to produce protective equipment for NHS workers.