Borghild Løyland

Residents in nursing homes are fragile and at high risk of serious illness or death from healthcare-associated infections. The COVID-19 pandemic posed a significant risk of suffering and mortality for residents of nursing homes. Surveillance of infections is essential for infection prevention and is missing in many countries. The aim of this study is to explore infection rates and antibiotic use in nursing homes during the COVID-19 pandemic. Data collection was conducted from February to September 2021. Each week, healthcare workers at 21 nursing home wards answered a questionnaire on infections, antibiotic use, deaths, and hospital admissions related to infections. A total of 495 infections were reported, and 97.6% were treated with antibiotics. The total infection rate was 5.37 per 1000 bed days, and there were reported 53 hospital admissions and 11 deaths related to or caused by infections. The infection rate and high use of antibiotics found in this study indicated that it is difficult to treat infections in residents in nursing homes and make it difficult to achieve the global goal of reducing infections and antibiotic resistance rates. This emphasizes the need for stricter infection control programs to reduce antibiotic use and patient suffering.

Breast cancer affected more than 2.3 million women in 2022 and is the most diagnosed cancer among women worldwide. The incidence rates are greater in developed regions and are significantly higher among women with higher education and socioeconomic status. Therefore, it is reasonable to assume that the way women live their lives may impact their risk of being diagnosed with breast cancer. This systematic review aimed to identify what is known about the causes and risk factors of breast cancer, excluding genetic causes. A comprehensive systematic search identified 2387 systematic reviews, 122 were included and six overall themes identified. In our “top list” with the 36 most important findings, a study of breast density had the highest effect size for increasing the risk of breast cancer, and a high sex-hormone-binding globulin level was the most protective factor. Many of the included studies investigating the same topics had conflicting results. The conclusion from this evidence synthesis reveals a lack of consensus of factors associated with the causes and risk of breast cancer. These findings suggest that recommendations about lifestyle and breast cancer should be made with caution.