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Background: Antimicrobial stewardship programmes (ASPs) include strategies that enable sustainable management of rational anti-infective treatment in the clinical setting. The successful introduction of ASPs requires close interdisciplinary collaboration among various health professionals, including the hospital management. So far, ASPs have been evaluated mainly from a clinical-pharmacological and infectious disease perspective.Aim: To identify and evaluate parameters with decisive significance for the economic impact of ASPs.Methods: A systematic literature search for peer-reviewed health-economic studies associated with antimicrobial stewardship programmes was performed. Primary outcomes included savings in drug costs and lower revenue losses for hospitals.Findings and Conclusions: A total of 16 studies met all inclusion criteria. Most of the evidence from published clinical trials demonstrated savings through reduced direct cost of antibiotics. However, there are also studies that prove revenue effects of ASPs through decreases in length of stay and readmission rates. [ABSTRACT FROM AUTHOR]

Purpose: This study examined factors related to young children's distress during preventive oral health visits. Additionally, associations between parent-reported child behaviour during the dental visit and during previous medical visits were tested. Methods: One hundred twenty-two children under 3 years of age enrolled in a government insurance programme for low-income children were seen for examination, prophylaxis, and fluoride application at a university-based dental clinic. Child distress was rated by parents on a numerical rating scale. Results: The average age of children enrolled was 23.5 ± 7.3 months. The majority (55.7 %) were judged to have little or no distress pre-examination. Mild or no distress during the examination was reported for 42.6 % of the children and severe distress was reported for 39.4 %. Intensity of distress during the examination was not associated with the child's age, gender, dental health, or previous experience with dental care. Distress was also unrelated to the caregiver's education level or own dental health. Intensity of distress was associated with the child's pre-dental examination distress and distress during prior medical examinations and injections. Conclusions: Dental professionals can better anticipate child distress by assessing children before a dental examination and enquiring about previous medical experiences. Strategies to prepare parents and alleviate distress may help children cope with the preventive dental visit. [ABSTRACT FROM AUTHOR]

Abstract: Background: Human Paneth cell α-defensins, especially DEFA5, are involved in maintaining homeostasis of the human microbial microflora. Since breakdown of normal mucosal antibacterial defence occurs in inflammatory bowel disease (IBD), variants in the DEFA5 gene could be associated with IBD risk. Subjects: A cohort of 25 patients with indeterminate colitis (IC), 405 with ulcerative colitis (UC), and 385 with Crohn''s disease (CD), were compared with 201 control individuals from the Canterbury region in New Zealand. Methods: A 15kb haplotype block surrounding DEFA5 contained 35 HapMap markers which were polymorphic in Caucasians. Four markers (A–D) were selected to tag 27 of the 35 markers at r 2 >0.68, and were genotyped in DNA samples. Results: Minor allele frequencies for all single nucleotide polymorphisms (SNPs) were somewhat elevated in patients. Subgroup analysis showed SNP A had odds ratio 1.44 in UC patients with pancolitis (95% C.I. 1.07–1.94), SNP B odds ratio 2.37 in CD patients with onset prior to 17 years age (95% C.I. 1.12–5.03), SNP C odds ratio 1.68 in UC patients with left colonic localisation (95% C.I. 1.12–2.52), and SNP D had odds ratio 1.56 in CD patients with one or more relatives with IBD (95% C.I. 1.03–2.35). Two two-marker haplotypes and one three-marker haplotype were associated with UC (p-values 0.025–0.05). Conclusions: The SNPs genotyped in our study were surrogates for common variants, and observed associations between these and IBD status are likely due to linkage disequilibrium with a functional common DEFA5 variant. Identifying such functional variants will be prioritised in subsequent work. [Copyright &y& Elsevier]