El desafío de la administración adecuada de antimicrobianos en pediatría.

Background: Antibiotics are among the drugs most commonly prescribed to children in hospitals and communities. Unfortunately, a great number of these prescriptions are unnecessary or inappropriate. Antibiotic abuse and misuse have several negative consequences, including drug-related adverse events, the emergence of multidrug resistant bacterial pathogens, the development of Clostridium difficile infection, the negative impact on microbiota, and undertreatment risks. In this paper, the principle of and strategies for paediatric antimicrobial stewardship (AS) programs, the effects of AS interventions and the common barriers to development and implementation of AS programs are discussed. Discussion: Over the last few years, there have been significant shortages in the development and availability of new antibiotics; therefore, the implementation of strategies to preserve the activity of existing antimicrobial agents has become an urgent public health priority. AS is one such approach. The need for formal AS programs in paediatrics was officially recognized only recently, considering the widespread use of antibiotics in children and the different antimicrobial resistance patterns that these subjects exhibit in comparison to adult and elderly patients. However, not all problems related to the implementation of AS programs among paediatric patients are solved. The most important remaining problems involve educating paediatricians, creating a multidisciplinary interprofessional AS team able to prepare guidelines, monitoring antibiotic prescriptions and defining corrective measures, and the availability of administrative consensuses with adequate financial support. Additionally, the problem of optimizing the duration of AS programs remains unsolved. Further studies are needed to solve the above mentioned problems. Conclusions: In paediatric patients, as in adults, the successful implementation of AS strategies has had a significant impact on reducing targeted- and nontargeted-antimicrobial use by improving the quality of care for hospitalized patients and preventing the emergence of resistance. Considering that rationalization of antibiotic misuse and abuse is the basis for reducing emergence of bacterial resistance and several clinical problems, all efforts must be made to develop multidisciplinary paediatric AS programs in hospital and community settings

From Bureaucracy to Debureaucratization?

Administration, Administrative evil, Bureaucracy, Corruption, Debureaucratization, Democracy, Deregulation, Enlightenment, Etatisme , New public management, Professionalism, Public service ethics, Technology, Weber, Max,

Visual Impairment

The past decade has witnessed a considerable upsurge of clinical and research interest in the problems of developmentally and physically the fields of psychology, disabled persons. Indeed, professionals from special education, rehabilitation, psychiatry, and social work have all directed attention to the development and implementation of evaluation and remedial programs. The heightened activity in this area is in part a result of early assessment research with these populations, which provided preliminary evidence of difficulties in social and emotional adjustment in many disabled individuals. In response to these findings, many intervention efforts have been implemented to deal with these issues and improve the life situation of the disabled. Also, there were indications that developmentally and physically disabled children often were deprived of adequate educations. As a result, legal and legislative initiatives have been enacted in recent years to make public education available to all students irrespective of disability. Central to all therapeutic and psychoeducational endeavors with the disabled is psychological evaluation. Only through careful and com­prehensive psychological evaluation can areas of deficit as well as strengths be identified. Once treatment targets and goals have been ascertained, psychological evaluation is needed to determine the efficacy of intervention strategies. However, the field of psychological evalua­tion, in general, and with disabled persons, in particular, has become highly specialized. This is largely a function of the changing roles of psychological evaluators.https://nsuworks.nova.edu/cps_facbooks/1221/thumbnail.jp