Significant Reduction of Antibiotic Use in the Community after a Nationwide Campaign in France, 2002–2007

Didier Guillemot and colleagues describe the evaluation of a nationwide programme in France aimed at decreasing unnecessary outpatient prescriptions for antibiotics. The campaign was successful, particularly in reducing prescriptions for children

The labour : first approach in Walloon dairy farms

peer reviewedEn 2010, on dénombre 4.819 exploitations laitières en Wallonie, soit une diminution de 70 % depuis 1984. Parmi ces exploitations, il y a 2.133 qui sont spécialisées en lait (OTE 41). Elles disposent, en moyenne, de 56 ha de SAU avec un cheptel de 58 vaches laitières (VL). Le quota pour ce type d'exploitations est de +/- 451.000 l. La taille des fermes moyenne a doublé depuis 1984 or la main-d'oeuvre disponible reste constante. Comment gérer ces structures ? L'étude DiraLait s'intéresse à ce problème en réalisant une analyse globale (économie, sociale, durabilité et performance zootechniques). Le présent article se focalise uniquement sur le temps de travail

Strategies of the Walloon dairy producersfaced to the uncertain dairy future

This study observes the strategies, and their determinants, of the Walloon dairy producersfaced to the post quota perspective through the realisation of 245 surveys, conducted from November 2014 to February 2015. It highlights how dairy production companies plan to evolve to cope with this great change in the sector and so how will move the production of our dairy products. Three kinds of strategical variables were defined and related to the evolution of milk production (MP) [the producerswho increase MP (HighMP) vs. keep constant MP (ConstantMP) vs. stop MP]; the valorisation of MP [alternative (ValMP)vs. classical] and the diversification of activities [with (DivMP) vs. without such activities]. The relationships between the chosen strategies and the quantitative technical variables were studied using generalised linear models. The independence between qualitative technical variables and the strategical variables was tested using Chi Square test. HighMP and ConstantMP producersrepresent 38.4% and 53.9% of respondents, respectively. HighMP producerswere significantly more declared as legal entity (p-value = 0.03), had more family members on the farm (p-value<0.01), larger agricultural area in property (p-value = 0.03) and higher MP quota(p-value = 0.01)compared to ConstantMP producers. Only 9.8% of respondents decide to valorise differently MP. ValMP producerstend to have more employees (p-value = 0.08) and an agricultural area less fragmented (p-value = 0.07)than classical producers. A total of 7.8% of respondents decide to develop other activities. DivMP producerstend to have more employees (p-value = 0.10), more agricultural area in property (p-value = 0.03) and a more recent year of installation (p-value < 0.01). Finally, 44.9% of ConstantMP producersdo not want to start an alternative valorisation of MP and diversify their activities. In conclusion, a relationship exists between, amongst others, the legal status, workforce available, characteristics of the agricultural area, the dairy production and the strategy chosen by the Walloon dairy producers

Differences in Management of Eosinophilic Esophagitis in Europe: An Assessment of Current Practice

OBJECTIVES: The aim of the study was to assess differences in the diagnosis and management of eosinophilic esophagitis (EoE) by European pediatric (PG) and adult gastroenterologists (AG), and their self-reported adherence to guidelines. METHODS: A multiple-choice questionnaire gauged the diagnostic and management strategies of gastroenterologists treating children or adults in 14 European countries and the United Arab Emirates (UAE). RESULTS: Questionnaires were completed by 465 PG and 743 AG. PG were significantly more likely to take biopsies in patients with symptoms of esophageal dysfunction (86.2% PG vs 75.4% AG, P &lt; 0.001) and to perform endoscopic follow-up (86.3% PG vs 80.6% AG, P &lt; 0.001). After failure of proton-pump inhibitors (PPIs), topical steroids were the preferred second-line therapy; however, PG opted more frequently for elimination diets (47.5% PG vs 13.7% AG, P &lt; 0.001). More PG than AG indicated having read recent guidelines (89.4% PG vs 58.2% AG, P &lt; 0.001). Geographic differences in practice were reported, with respondents from the United Kingdom, Portugal, and Spain more often adhering to recommended biopsy protocols. Physicians in the UAE, France, Lithuania, and Poland tended to opt for steroid therapy or elimination diets as first-line therapy, in contrast to most other countries. CONCLUSIONS: Significant differences in general practice between PG and AG were demonstrated with notable divergence from consensus guidelines. International practice variations are also apparent. Among other strategies, educational activities to highlight current recommendations may help harmonize and optimize clinical practice

Differences in Management of Eosinophilic Esophagitis in Europe: An Assessment of Current Practice

OBJECTIVES: The aim of the study was to assess differences in the diagnosis and management of eosinophilic esophagitis (EoE) by European pediatric (PG) and adult gastroenterologists (AG), and their self-reported adherence to guidelines. METHODS: A multiple-choice questionnaire gauged the diagnostic and management strategies of gastroenterologists treating children or adults in 14 European countries and the United Arab Emirates (UAE). RESULTS: Questionnaires were completed by 465 PG and 743 AG. PG were significantly more likely to take biopsies in patients with symptoms of esophageal dysfunction (86.2% PG vs 75.4% AG, P &lt; 0.001) and to perform endoscopic follow-up (86.3% PG vs 80.6% AG, P &lt; 0.001). After failure of proton-pump inhibitors (PPIs), topical steroids were the preferred second-line therapy; however, PG opted more frequently for elimination diets (47.5% PG vs 13.7% AG, P &lt; 0.001). More PG than AG indicated having read recent guidelines (89.4% PG vs 58.2% AG, P &lt; 0.001). Geographic differences in practice were reported, with respondents from the United Kingdom, Portugal, and Spain more often adhering to recommended biopsy protocols. Physicians in the UAE, France, Lithuania, and Poland tended to opt for steroid therapy or elimination diets as first-line therapy, in contrast to most other countries. CONCLUSIONS: Significant differences in general practice between PG and AG were demonstrated with notable divergence from consensus guidelines. International practice variations are also apparent. Among other strategies, educational activities to highlight current recommendations may help harmonize and optimize clinical practice