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045).CONCLUSION We discovered an appreciable prevalence of subclinical TB in HIV-infected pregnant women in Soweto, which had not been detected by screening algorithms based solely on symptoms. Infants of HIV-infected mothers with subclinical TB appear to have a higher risk of adverse outcomes than those of TB-negative mothers.BACKGROUND Indonesia has the second highest smoking prevalence among adult males in the world, with over 61.4 million current smokers. However, there is no national regulation on outdoor tobacco advertising.OBJECTIVE >To assess the density of outdoor tobacco advertising around schools in Semarang City, Indonesia.METHODS We conducted geospatial analyses using buffer and hotspot analyses based on advertising and school data in ArcMap 10.6. We statistically tested the significance of different densities, including between 100 m and 100-300-m buffers from schools using Stata 15.1.RESULTS We found a total of 3453 tobacco advertisements, of which 3026 (87%) were at least medium in size (1.3 m x l.9 m), and 2556 (74%) were within 300 m of schools. We also found hotspots with a 45% higher density of adverts within 100 m of schools (compared to within 100-300 m). A total of 378 schools (39%) were in these advertising hotspots.CONCLUSION There was high density of outdoor tobacco advertising, with significant clusters in close proximity to schools in Semarang City. The policy implications of this are discussed.BACKGROUND Systematic screening for TB using automated chest radiography (ACR) with computer-aided detection software (CAD4TB) has been implemented at scale in Karachi, Pakistan. Despite evidence supporting the use of ACR as a pre-screen prior to Xpert® MTB/RIF diagnostic testing in presumptive TB patients, there has been no data published on its use in mass screening in real-world settings.METHOD Screening was undertaken using mobile digital X-ray vehicles at hospital facilities and community camps. Chest X-rays were offered to individuals aged ≥15 years, regardless of symptoms. Those with a CAD4TB score of ≥70 were offered Xpert testing. The association between Xpert positivity and CAD4TB scores was examined using data collected between 1 January and 30 June 2018 using a custom-built data collection tool.RESULTS Of the 127 062 individuals screened, 97.2% had a valid CAD4TB score; 11 184 (9.1%) individuals had a CAD4TB score ≥70. Prevalence of Xpert positivity rose from 0.7% in the 90 category. The strong linear association between CAD4TB score and Xpert positivity was found in both community and hospital settings.CONCLUSION The strong association between CAD4TB scores and Xpert positivity provide evidence that an ACR-based pre-screening performs well when implemented at scale in a high-burden setting.Nursing facilities have suffered the double injury of an immediate reduction in occupancy and the reputational harm of the high number of COVID-19 deaths and infections.INTRODUCTION Inpatient falls continue to have detrimental effects on patient care and recovery. Because controllable and uncontrollable factors impact fall rates, predicting which patients are at the greatest risk can be challenging. One method includes the incorporation of student learners to help identify which patients are at the greatest risk for falls. CONCLUSION This pharmacist-intern-led falls-prevention initiative did not provide a statistically significant reduction in falls. While the scoring metric was helpful in reviewing charts to make recommendations for interventions, the assigned score did not correlate as expected to incidents of falls.The Food and Drug Administration issued several warnings recently regarding the use of fluoroquinolones because of a variety of serious toxicities. Risk for serious adverse reactions increases in older people because of the physiologic changes that come with aging, the increased likelihood of concurrent comorbidities, and the use of multiple medications. Because of these risk-enhancing factors, fluoroquinolone use, particularly in older people, should be scrutinized and used only when no other therapeutic alternatives exist. Pharmacists can have an impact on fluoroquinolone prescribing and use; therefore, they can optimize patient outcomes by reducing the potential for harm caused by fluoroquinolone use in older people.Lefamulin is a novel systemic, semi-synthetic pleuromutilin class of antimicrobials that has been shown to be effective against common respiratory pathogens associated with community-acquired bacterial pneumonia (CABP). CABP, a common infection among older people, leads to an increase in hospitalizations and mortality. Therefore, the use of lefamulin could be beneficial for CABP treatment in patients who are 65 years of age or older. Lefamulin does not require dosage adjustment in renal impairment. However, the drug does requires dosage adjustment in severe hepatic impairment, based on Child-Pugh scores and clinical consideration in patients with severe hepatic impairment based on Child-Pugh scores. Though the benefit of adding lefamulin to a formulary is still in question; its potential to be a beneficial treatment for CABP is encouraging.In 2017, a total of 26,431 beta-blocker exposures were reported to United States poison centers, with 21% of adult exposures attributed to patients 60 years of age and older. Beta-blockers are a major component of therapy in numerous cardiovascular diseases, which have a higher incidence in older people. Along with polypharmacy and neurocognitive decline, potentially limiting reliable medication adherence, older patients may be more sensitive to the hypotensive and bradycardic effects of beta-blockers. Additionally, because of a lack of success of traditional management methods, evidence of newer therapies such as highdose insulin euglycemia therapy and intravenous lipid emulsion has shown success in various patient cases. This review seeks to summarize the mechanisms and effects of beta-blocker toxicity and review management strategies in older people.Digital therapeutics (DTx)-treatment or therapy that uses digital health technologies to spur changes in patient behavior-increasingly are making their way into the health care environment. This evolution is especially apparent as health care moves to valuebased care, silos between settings are breaking down, and data collection/analysis and teamwork play key roles. These technologies, whether they are apps, software programs, or sensors, are helping patients adhere to treatments and lifestyle changes, set and meet viable care goals, and avoid costly emergency department visits and hospitalizations. GCN2iB purchase At the same time, DTx are helping practitioners ensure the best possible outcomes; streamline costs; monitor patient progress; and receive, analyze, and share data.

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