Improving appropriateness of antibiotic therapy: randomized trial of an intervention to foster reassessment of prescription after 3 days.

OBJECTIVES: Reassessment of ongoing antibiotic therapy is an important step towards appropriate use of antibiotics. This study was conducted to evaluate the impact of a short questionnaire designed to encourage reassessment of intravenous antibiotic therapy after 3 days. PATIENTS AND METHODS: Patients hospitalized on the surgical and medical wards of a university hospital and treated with an intravenous antibiotic for 3-4 days were randomly allocated to either an intervention or control group. The intervention consisted of mailing to the physician in charge of the patient a three-item questionnaire referring to possible adaptation of the antibiotic therapy. The primary outcome was the time elapsed from randomization until a first modification of the initial intravenous antibiotic therapy. It was compared within both groups using Cox proportional-hazard modelling. RESULTS: One hundred and twenty-six eligible patients were randomized in the intervention group and 125 in the control group. Time to modification of intravenous antibiotic therapy was 14% shorter in the intervention group (adjusted hazard ratio for modification 1.28, 95% CI 0.99-1.67, P = 0.06). It was significantly shorter in the intervention group compared with a similar group of 151 patients observed during a 2 month period preceding the study (adjusted hazard ratio 1.17, 95% CI 1.03-1.32, P = 0.02). CONCLUSION: The results suggest that a short questionnaire, easily adaptable to automatization, has the potential to foster reassessment of antibiotic therapy.

National Youth Work Development Plan 2003-2007

Irish society today is dramatically different from the one in which youth work services were first provided on a spontaneous and philanthropic basis more than one hundred years ago. At no time has the process of change been more striking than in the last ten to fifteen years. At least four major types of recent change, all clearly interrelated, can be identified: economic, political, technological and cultural. A further important aspect of cultural change in Ireland has been the continuing trend towards urbanisation, and the corresponding impact, largely negative, on rural communities. Particularly significant in the context of a Development Plan for Youth Work is the migration of young people away from rural areas to study or work, with most of them unlikely to return on a permanent basis. This, along with the rapid reduction in farm holdings and other changes in the countryside, has profound sociological and psychological repercussions for rural Ireland and indeed for Irish society as a whole. For young people living in rural areas the challenge is to provide youth work opportunities which are specially tailored to their needs and which take account of the ways in which their circumstances (e.g. regarding transport and access) are different from those of their urban peers

Sex, drugs and chronic illness: health behaviours among chronically ill youth.

BACKGROUND: A growing body of literature indicates that adolescents with chronic conditions are as likely, or more likely, to take risky behaviours than their healthy peers. The objective of this research was to assess whether adolescents with chronic illness in Catalonia differ from their healthy peers in risk-taking behaviour. METHODS: Data were drawn from the Catalonia Adolescent Health database, a survey including a random school-based sample of 6952 young people, aged 14-19 years. The index group (IG) included 665 adolescents (450 females) reporting several chronic conditions. The comparison group (CG) comprised 6287 healthy adolescents (3306 females). Personal, family and school-related variables were analysed to ensure comparability between groups. Sexual behaviour, drug use (tobacco, alcohol, cannabis, cocaine and synthetic drugs) and perception of drug use among peers and in school were compared. Analysis was carried out separately by gender. chi-square, Fisher's and Student's tests were used to compare categorical and continuous variables. RESULTS: The prevalence of chronic conditions was 9.6%, with females showing a higher prevalence than males. The IG showed similar or higher rates of sexual intercourse and risky sexual behaviour. For most studied drugs, IG males reported slightly lower rates of use than CG males, while IG females showed higher rates for every drug studied. No differences were found in the perceptions of drug use among peers or in their school. CONCLUSIONS: Similar to previous research, chronically ill adolescents in our sample are as likely, or more likely, to take risky behaviours than their healthy counterparts and should receive the same anticipatory guidance.

How to foster sharing of educational resources?

The future of OER is highly dependent on the future of education in general. A future that will be determined by major changes in society that demand more people with a higher education and life long learning. Each vision for the long term future needs to take the qualitative and quantitative demands into account. Backcasting from a vision we arrive at useful steps to take, some of which we managed to start up in the form of pilots as part of the European research project Share.TEC.

Do labour mobility and networks foster geographical knowledge diffusion? The case of European regions

The goal of this paper is twofold: first, we aim to assess the role played by inventors’ cross-regional mobility and networks of collaboration in fostering knowledge diffusion across regions and subsequent innovation. Second, we intend to evaluate the feasibility of using mobility and networks information to build cross-regional interaction matrices to be used within the spatial econometrics toolbox. To do so, we depart from a knowledge production function where regional innovation intensity is a function not only of the own regional innovation inputs but also external accessible R&D gained through interregional interactions. Differently from much of the previous literature, cross-section gravity models of mobility and networks are estimated to use the fitted values to build our ‘spatial’ weights matrices, which characterize the intensity of knowledge interactions across a panel of 269 regions covering most European countries over 6 years.

Determinants of Spanish firms' life cycle and job

This paper examines the role of human capital, individual entrepreneurial traits and the business environment on firms' life cycle and on job creation in Spain. For this purpose, we have constructed a pseudo-panel, by using the Global Entrepreneurship Monitor survey over the period 2001-2008. We have found that the creation, maturity and survival of firms were aided by the availability of bank credit and the large immigration inflows that Spain received over this period. However, of these two factors, only bank credit had a positive effect on the creation of jobs and on improving expectations of job expansion. The relatively high levels of youth unemployment experienced even before the crises of 2008 hurt the firm's chances of maturity and survival. The results also suggested that the gender gap in entrepreneurial activities had narrowed. In relative terms, women with higher levels of education were more likely to create mature firms than men. Based on the empirical findings and those of related literature, the paper offers policy recommendations to foster a sustainable entrepreneurial sector capable of contributing to the recovery of the Spanish economy.

Assessment of youth-friendly health care: a systematic review of indicators drawn from young people's perspectives.

PURPOSE: To review the literature on young people's perspectives on health care with a view to defining domains and indicators of youth-friendly care. METHODS: Three bibliographic databases were searched to identify studies that purportedly measured young people's perspectives on health care. Each study was assessed to identify the constructs, domains, and indicators of adolescent-friendly health care. RESULTS: Twenty-two studies were identified: 15 used quantitative methods, six used qualitative methods and one used mixed methodology. Eight domains stood out as central to young people's positive experience of care. These were: accessibility of health care; staff attitude; communication; medical competency; guideline-driven care; age appropriate environments; youth involvement in health care; and health outcomes. Staff attitudes, which included notions of respect and friendliness, appeared universally applicable, whereas other domains, such as an appropriate environment including cleanliness, were more specific to particular contexts. CONCLUSION: These eight domains provide a practical framework for assessing how well services are engaging young people. Measures of youth-friendly health care should address universally applicable indicators of youth-friendly care and may benefit from additional questions that are specific to the local health setting.

Serving Iowa Youth and Families with a Youth Development Approach : JJDP Act Formula Grant Application and Three-Year Comprehensive Plan

This report is Iowa’s Three-Year Plan, which serves as the application for federal Juvenile Justice and Delinquency Prevention Act formula grant funding (JJDP Act). The Division of Criminal and Juvenile Justice Planning (CJJP) wrote Iowa’s Three-Year Plan. CJJP is the state agency responsible for administering the JJDP Act in Iowa. Federal officials refer to state administering agencies as the state planning agency (SPA). The Plan was developed and approved by Iowa’s Juvenile Justice Advisory Council. That Council assists with administration of the JJDP Act, and also provides guidance and direction to the SPA, the Governor and the legislature regarding juvenile justice issues in Iowa. Federal officials refer to such state level groups as state advisory groups (SAG’s). The acronyms SPA and SAG are used through this report.

5B Judicial District Youth Services, June 30, 2001 & June 30, 2002

Other Audit Reports

5B Judicial District Youth Services, June 30, 2002 & 2003

Other Audit Reports - Independent Auditor's Reports, Financial Statements, Schedule of Findings

5B Judicial District Youth Services, June 30, 2001 & June 30, 2002

Other Audit Reports