Antibiotic resistance in primary care in Austria - a systematic review of scientific and grey literature

<p>Abstract</p> <p>Background</p> <p>Antibiotic resistance is an increasing challenge for health care services worldwide. While up to 90% of antibiotics are being prescribed in the outpatient sector recommendations for the treatment of community-acquired infections are usually based on resistance findings from hospitalized patients. In context of the EU-project called "APRES - the appropriateness of prescribing antibiotic in primary health care in Europe with respect to antibiotic resistance" it was our aim to gain detailed information about the resistance data from Austria in both the scientific and the grey literature.</p> <p>Methods</p> <p>A systematic review was performed including scientific and grey literature published between 2000 and 2010. Inclusion and exclusion criteria were defined and the review process followed published recommendations.</p> <p>Results</p> <p>Seventeen scientific articles and 23 grey literature documents could be found. In contrast to the grey literature, the scientific publications describe only a small part of the resistance situation in the primary health care sector in Austria. Merely half of these publications contain data from the ambulatory sector exclusively but these data are older than ten years, are very heterogeneous concerning the observed time period, the number and origin of the isolates and the kind of bacteria analysed. The grey literature yields more comprehensive and up-to-date information of the content of interest. These sources are available in German only and are not easily accessible. The resistance situation described in the grey literature can be summarized as rather stable over the last two years. For <it>Escherichia coli </it>e.g. the highest antibiotic resistance rates can be seen with fluorochiniolones (19%) and trimethoprim/sulfamethoxazole (27%).</p> <p>Conclusion</p> <p>Comprehensive and up-to-date antibiotic resistance data of different pathogens isolated from the community level in Austria are presented. They could be found mainly in the grey literature, only few are published in peer-reviewed journals. The grey literature, therefore, is a very valuable source of relevant information. It could be speculated that the situation of published literature is similar in other countries as well.</p

Towards Process-Driven Mobile Data Collection Applications: Requirements, Challenges, Lessons Learned

In application domains like healthcare, psychology and e-learning, data collection is based on specifically tailored paper & pencil questionnaires. Usually, such a paper-based data collection is accomplished by a massive workload regarding the processing, analysis, and evaluation of the data collected. To relieve domain experts from these manual tasks and to increase the efficiency of the data collection process, we developed a generic approach for realizing process-driven smart mobile device applications based on process management technology. According to this approach, the logic of a questionnaire is described in terms of an explicit process model whose enactment is driven by a generic process engine. Our goal is to demonstrate that such a process-aware design of mobile business applications is useful with respect to mobile data collection. Hence, we developed a generic architecture comprising the main components of mobile data collection applications. Furthermore, we used these components for developing mobile electronic questionnaires for psychological studies. The paper presents the challenges identified in this context and discusses the lessons learned. Overall, process management technology offers promising perspectives for developing mobile business applications at a high level of abstraction

The influence of general practitioners on access points to health care in a system without gatekeeping: a crosssectional study in the context of the QUALICOPC project in Austria

Aim To assess the rates of specialist visits and visits to hospital emergency departments (ED) among patients in Austria with and without concurrent general practitioner (GP) consultation and among patients with and without chronic disease. Methods The cross-sectional questionnaire study was conducted in the context of the QUALICOPC project in 2012. Fieldworkers recruited 1596 consecutive patients in 184 GP offices across Austria. The 41-question survey addressed patients’ experiences with regard to access to, coordination, and continuity of primary care, as well demographics and health status. Descriptive statistics as well as univariate and multivariate regression models were applied. Results More than 90% of patients identified a GP as a primary source of care. Among all patients, 85.5% reported having visited a specialist and 26.4% the ED at least once in the previous year. Having a usual GP did not change the rate of specialist visits. Additionally, patients with chronic disease had a higher likelihood of presenting to the ED despite having a GP as a usual source of care. Conclusion Visiting specialists in Austria is quite common, and the simple presence of a GP as a usual source of care is insufficient to regulate pathways within the health care system. This can be particularly difficult for chronic care patients who often require care at different levels of the system and show higher frequency of ED presentations

Magnesium as a biomaterial and its biological interactions

To investigate different magnesium alloys as a biodegradable material for implants it is necessary to understand the degradation process in the biological environment. The following study shows interactions of pure magnesium with various physical and chemical environmental parameters according to the parameters within the application area.DFG/SFB/599DFG/SFB/59

Preserving cultural heritage: Analyzing the antifungal potential of ionic liquids tested in paper restoration

Early industrialization and the development of cheap production processes for paper have led to an exponential accumulation of paper-based documents during the last two centuries. Archives and libraries harbor vast amounts of ancient and modern documents and have to undertake extensive endeavors to protect them from abiotic and biotic deterioration. While services for mechanical preservation such as ex post de-acidification of historic documents are already commercially available, the possibilities for long-term protection of paper-based documents against fungal attack (apart from temperature and humidity control) are very limited. Novel processes for mechanical enhancement of damaged cellulosic documents use Ionic Liquids (IL) as essential process components. With some of these ILs having azolefunctionalities similar to well-known fungicides such as Clotrimazole, the possibility of antifungal activities of these ILs was proposed but has not yet been experimentally confirmed. We evaluated the potency of four ILs with potential application in paper restoration for suppression of fungal growth on five relevant paper-infesting molds. The results revealed a general antifungal activity of all ILs, which increased with the size of the non-polar group. Physiological experiments and ultimate elemental analysis allowed to determine the minimal inhibitory concentration of each IL as well as the residual IL concentration in process-treated paper. These results provide valuable guidelines for IL-applications in paper restoration processes with antifungal activity as an added benefit. With azoles remaining in the paper after the process, simultaneous repair and biotic protection in treated documents could be facilitated

NOT JUST ANOTHER TYPE OF RESISTANCE – TOWARDS A DEEPER UNDERSTANDING OF SUPPORTIVE NON-USE

Research on information system (IS) adoption and resistance has accumulated substantial theoretical and managerial knowledge. Surprisingly, the paradox that end users support and at the same time resist use of an IS has received relatively little attention. The investigation of this puzzle, however, is important to complement our understanding of resistant behaviours and consequently to strengthen the explanatory power of extant theoretical constructs on IS resistance. We investigate an IS project within the healthcare sector in the UK in which end-users, who were heavily involved during the de-sign, implementation and roll out, expressed their support for the system, while simultaneously showing resistance. To examine this behaviour in detail, we applied Q methodology. As a result, we identified three different groups: (1) The convinced connector, waiting for collaborators. (2) The savvy explorer, sceptical about the tools’ benefits. (3) The ambivalent follower, overwhelmed by complexity. While the behaviour is similar across all three groups, the reasons for not using the system differ significantly. Based on these groups, as our main contribution, we explain the paradox of supportive non-use. We further add a fine grained understanding of supportive non-use to the existing types of IS resistance

Сопоставительный анализ эффективности и надежности применения пластинчатых и кожухотрубных теплообменных аппаратов на ЗАО «Томский приборный завод»

Вследствие экономических санкций к России поставка импортного теплоэнергетического оборудования становится затруднительной. Поэтому требуется замена пластинчатых теплообменников на кожухотрубные, что подтверждает практическую значимость этой проблемы.Due to economic sanctions to Russia, the supply of imported heat and power equipment becomes difficult. Therefore, replacement of plate heat exchangers with shell-and-tube heat exchangers is required, which confirms the practical importance of this problem