Systemic antibiotic prescribing to paediatric outpatients in 5 European countries: A population-based cohort study

Background: To describe the utilisation of antibiotics in children and adolescents across 5 European countries based on the same drug utilisation measures and age groups. Special attention was given to age-group-specific distributions of antibiotic subgroups, since comparison in this regard between countries is lacking so far.Methods: Outpatient paediatric prescriptions of systemic antibiotics during the years 2005-2008 were analysed using health care databases from the UK, the Netherlands, Denmark, Italy and Germany. Annual antibiotic prescription rates per 1,000 person years were estimated for each database and stratified by age (≤4, 5-9, 10-14, 15-18 years). Age-group-specific distributions of antibiotic subgroups were calculated for 2008.Results: With 957 prescriptions per 1000 person years, the highest annual prescription rate in the year 2008 was found in the Italian region Emilia Romagna followed by Germany (561), the UK (555), Denmark (481) and the Netherlands (294). Seasonal peaks during winter months were most pronounced in countries with high utilisation. Age-group-specific use varied substantially between countries with regard to total prescribing and distributions of antibiotic subgroups. However, prescription rates were highest among children in the age group ≤4 years in all countries, predominantly due to high use of broad s

抗うつ薬レボキセチンの有効性評価：連続変数（HAM-Dスコア）と2値変数（有効率）に基づくメタアナリシス

博士（医学）神戸大

Debt as a shared responsibility: A present-day application of the debt jubilee

Debts have always been a moral issue. They are laden with norms and values. Being in debt brings value judgments. Creating debt creates responsibility. The question is: are we treating debt properly today? Do debts and the relationships they imply need to be reassessed? Debts have been increasing rapidly, even more so after the warning calls of the financial crisis that started in 2008. Since then debt worldwide increased with an additional 80 percent. This debt mountain is looming as a big threat over the world-economy. In addition, it augurs serious troubles for numerous individuals in debt as well as countries that are in debt. Households, companies and governments take on debts to finance activities and investments. As long as the activities financed by debt are productive and as long as this increases incomes, debts contribute to the development of society and its economy and can be repaid with the newly generated income. When general trends become negative, as now during the corona crisis, debts tend to become unproductive. They can even turn into a lead weight that draws people, companies, organizations and countries down. The question then is: who will take responsibility

Schuld als een gedeelde verantwoordelijkheid: een hedendaagse uitwerking van het jubilee.

Debts have always been a moral issue. They are laden with norms and values. Being in debt brings value judgments. Creating debt creates responsibility. The question is: are we treating debt properly today? Do debts and the relationships they imply need to be reassessed? Debts have been increasing rapidly, even more so after the warning calls of the financial crisis that started in 2008. Since then debt worldwide increased with an additional 80 percent. This debt mountain is looming as a big threat over the world-economy. In addition, it augurs serious troubles for numerous individuals in debt as well as countries that are in debt. Households, companies and governments take on debts to finance activities and investments. As long as the activities financed by debt are productive and as long as this increases incomes, debts contribute to the development of society and its economy and can be repaid with the newly generated income. When general trends become negative, as now during the corona crisis, debts tend to become unproductive. They can even turn into a lead weight that draws people, companies, organizations and countries down. The question then is: who will take responsibility

The Value of Family History as a Risk Indicator for Venous Thrombosis

Background A positive family history of venous thrombosis may reflect the presence of genetic risk factors. Once a risk factor has been identified, it is not known whether family history is of additional value in predicting an individual's risk. We studied the contribution of family history to the risk of venous thrombosis in relation to known risk factors. \ud \ud Methods In the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis, a population-based case-control study, we collected blood samples and information about family history and environmental triggers from 1605 patients with a first venous thrombosis and 2159 control subjects. \ud \ud Results A total of 505 patients (31.5%) and 373 controls (17.3%) reported having 1 or more first-degree relatives with a history of venous thrombosis. A positive family history increased the risk of venous thrombosis more than 2-fold (odds ratio [95% confidence interval], 2.2 [1.9-2.6]) and up to 4-fold (3.9 [2.7-5.7]) when more than 1 relative was affected. Family history corresponded poorly with known genetic risk factors. Both in those with and without genetic or environmental risk factors, family history remained associated with venous thrombosis. The risk increased with the number of factors identified; for those with a genetic and environmental risk factor and a positive family history, the risk was about 64-fold higher than for those with no known risk factor and a negative family history. \ud \ud Conclusions Family history is a risk indicator for a first venous thrombosis, regardless of the other risk factors identified. In clinical practice, family history may be more useful for risk assessment than thrombophilia testing\u