The appropriateness of prescribing antibiotics in the community in Europe: study design

Contains fulltext : 97417.pdf (publisher's version ) (Open Access)ABSTRACT: BACKGROUND: Over 90% of all antibiotics in Europe are prescribed in primary care. It is important that antibiotics are prescribed that are likely to be effective; however, information about antibiotic resistance in the community is incomplete. The aim of our study is to investigate the appropriateness of antibiotic prescribing in primary care in Europe by collecting and combining patterns of antibiotic resistance patterns and antibiotic prescription patterns in primary care. We will also evaluate the appropriateness of national antibiotic prescription guidelines in relation to resistance patterns. METHODS/DESIGN: Antibiotic resistance will be studied in an opportunistic sample from the community in nine European countries. Resistance data will be collected by taking a nose swab of persons (N = 4,000 per country) visiting a primary care practice for a non-infectious disease. Staphylococcus aureus and Streptococcus pneumoniae will be isolated and tested for resistance to a range of antibiotics in one central laboratory. Data on antibiotic prescriptions over the past 5 years will be extracted from the electronic medical records of General Practitioners (GPs). The results of the study will include the prevalence and resistance data of the two species and 5 years of antibiotic prescription data in nine European countries.The odds of receiving an effective antibiotic in each country will be calculated as a measure for the appropriateness of prescribing. Multilevel analysis will be used to assess the appropriateness of prescribing. Relevant treatment guidelines of the nine participating countries will be evaluated using a standardized instrument and related to the resistance patterns in that country. DISCUSSION: This study will provide valuable and unique data concerning resistance patterns and prescription behaviour in primary care in nine European countries. It will provide evidence-based recommendations for antibiotic treatment guidelines that take resistance patterns into account which will be useful for both clinicians and policy makers. By improving antibiotic use we can move towards controlling the resistance problem globally

Attitudes van leerkrachten tegenover meertalige studenten bekeken vanuit een logopedisch standpunt

Het hanteren van een aangepast taalaanbod in een multiculturele klas is een uitdaging voor vele leerkrachten. Aangezien leerkrachten vaak ook het eerste aanspreekpunt zijn voor ouders, hebben ze tevens een niet te onderschatten impact op het taalaanbod dat hun leerlingen thuis ontvangen en dus ook op de ontwikkeling van de moedertaal. Om de attitudes van Vlaamse leerkrachten ten opzichte van meertalige kinderen en hun taalontwikkeling in kaart te brengen werd een vragenlijst opgesteld die peilt naar zowel de cognitieve, emotionele als gedragsmatige attitudes. Uit de antwoorden van 710 respondenten bleek hoofdzakelijk dat de Vlaamse leerkrachten zich positief verhouden tegenover meertaligheid en het behoud van de moedertaal, maar dat zij voor zichzelf hierin geen actieve functie zien. Leerkrachten zijn vragende partij op vlak van extra vorming en advies. Daarom wordt tijdens deze lezing ook dieper ingegaan op welke manier logopedisten hieraan kunnen bijdragen

Attitudes of teachers toward multilingualism, heritage language maintenance and second language learning at school

Introduction: Providing an adapted language input in a multicultural classroom is often challenging to educators. Teachers are frequently the parents' first contacts for language counselling and educational support, and therefore, they may influence the language exposure not only in the classroom but at home as well. This study aims to investigate the cognitive, emotional and behavioral attitudes of teachers toward multilingualism in Flanders. The effects of contextual teacher- and school-related properties on the attitudes of teachers are also considered. Methods: An online survey questioning the cognitive, emotional and behavioral attitudes of teachers was developed and distributed to all schools in Flanders. 710 preschool, primary and secondary teachers completed the questionnaire.Results: The results showed rather positive attitudes toward heritage language maintenance and multilingualism. However, there are still some misconceptions about multilingual language learning strategies. Teachers are interested in extra training, as they find it hard to use the languages of their pupils as a resource in their teaching practice. Discussion/Conclusion: Teachers mostly consider multilingualism as an added value. Supplementary training and extra advice given by speech-language therapists could be helpful to inform teachers about the importance of their students' proficiency in the heritage language and could give teachers insight in the principles of second-language acquisition

A phenotypic screen in zebrafish identifies a novel small-molecule inducer of ectopic tail formation suggestive of alterations in non-canonical Wnt/PCP signaling

Zebrafish have recently emerged as an attractive model for the in vivo bioassay-guided isolation and characterization of pharmacologically active small molecules of natural origin. We carried out a zebrafish-based phenotypic screen of over 3000 plant-derived secondary metabolite extracts with the goal of identifying novel small-molecule modulators of the BMP and Wnt signaling pathways. One of the bioactive plant extracts identified in this screen - Jasminum gilgianum, an Oleaceae species native to Papua New Guinea - induced ectopic tails during zebrafish embryonic development. As ectopic tail formation occurs when BMP or non-canonical Wnt signaling is inhibited during the tail protrusion process, we suspected a constituent of this extract to act as a modulator of these pathways. A bioassay-guided isolation was carried out on the basis of this zebrafish phenotype, identifying para-coumaric acid methyl ester (pCAME) as the active compound. We then performed an in-depth phenotypic analysis of pCAME-treated zebrafish embryos, including a tissue-specific marker analysis of the secondary tails. We found pCAME to synergize with the BMP-inhibitors dorsomorphin and LDN-193189 in inducing ectopic tails, and causing convergence-extension defects in compound-treated embryos. These results indicate that pCAME may interfere with non-canonical Wnt signaling. Inhibition of Jnk, a downstream target of Wnt/PCP signaling (via morpholino antisense knockdown and pharmacological inhibition with the kinase inhibitor SP600125) phenocopied pCAME-treated embryos. However, immunoblotting experiments revealed pCAME to not directly inhibit Jnk-mediated phosphorylation of c-Jun, suggesting additional targets of SP600125, and/or other pathways, as possibly being involved in the ectopic tail formation activity of pCAME. Further investigation of pCAME's mechanism of action will help determine this compound's pharmacological utility

Recognition of COVID-19 with occupational origin: a comparison between European countries

Objectives: This study aims to present an overview of the formal recognition of COVID-19 as occupational disease (OD) or injury (OI) across Europe. Methods: A COVID-19 questionnaire was designed by a task group within COST-funded OMEGA-NET and sent to occupational health experts of 37 countries in WHO European region, with a last update in April 2022. Results: The questionnaire was filled out by experts from 35 countries. There are large differences between national systems regarding the recognition of OD and OI: 40% of countries have a list system, 57% a mixed system and one country an open system. In most countries, COVID-19 can be recognised as an OD (57%). In four countries, COVID-19 can be recognised as OI (11%) and in seven countries as either OD or OI (20%). In two countries, there is no recognition possible to date. Thirty-two countries (91%) recognise COVID-19 as OD/OI among healthcare workers. Working in certain jobs is considered proof of occupational exposure in 25 countries, contact with a colleague with confirmed infection in 19 countries, and contact with clients with confirmed infection in 21 countries. In most countries (57%), a positive PCR test is considered proof of disease. The three most common compensation benefits for COVID-19 as OI/OD are disability pension, treatment and rehabilitation. Long COVID is included in 26 countries. Conclusions: COVID-19 can be recognised as OD or OI in 94% of the European countries completing this survey, across different social security and embedded occupational health systems