BackgroundGreater use of antibiotics during the past 50 years has exerted selective pressure on susceptible bacteria and may have favoured the survival of resistant strains. Existing information on antibiotic resistance patterns from pathogens circulating among community-based patients is substantially less than from hospitalized patients on whom guidelines are often based. We therefore chose to assess the relationship between the antibiotic resistance pattern of bacteria circulating in the community and the consumption of antibiotics in the community.MethodsBoth gray literature and published scientific literature in English and other European languages was examined. Multiple regression analysis was used to analyse whether studies found a positive relationship between antibiotic consumption and resistance. A subsequent meta-analysis and meta-regression was conducted for studies for which a common effect size measure (odds ratio) could be calculated.ResultsElectronic searches identified 974 studies but only 243 studies were considered eligible for inclusion by the two independent reviewers who extracted the data. A binomial test revealed a positive relationship between antibiotic consumption and resistance (p < .001) but multiple regression modelling did not produce any significant predictors of study outcome. The meta-analysis generated a significant pooled odds ratio of 2.3 (95% confidence interval 2.2 to 2.5) with a meta-regression producing several significant predictors (F(10,77) = 5.82, p < .01). Countries in southern Europe produced a stronger link between consumption and resistance than other regions.ConclusionsUsing a large set of studies we found that antibiotic consumption is associated with the development of antibiotic resistance. A subsequent meta-analysis, with a subsample of the studies, generated several significant predictors. Countries in southern Europe produced a stronger link between consumption and resistance than other regions so efforts at reducing antibiotic consumption may need to be strengthened in this area. Increased consumption of antibiotics may not only produce greater resistance at the individual patient level but may also produce greater resistance at the community, country, and regional levels, which can harm individual patients.

Because attention control partially mediates the effects of parenting on externalizing problems, intervention efforts could target both parenting and attentional processes.

Teams have become an integral and essential social component in organizations. There is no doubt that there are more businesses, industries, and agencies implementing team-based systems than ever before. Organizations believe that teams, teamwork, and effective team functioning can provide a competitive edge. Teams are, after all, dispatched to tackle difficult and complex problems. Why? Organizations think teams hold the solution to many problems. The perception is that teams can manage stress, teams can adapt and be flexible, teams can make better decisions, and teams can be more productive than individuals. So, teams are a popular commodity in organizations.While the evidence of the efficacy of teams remains open, social scientists have begun to provide much needed answers to this issue. In fact, the amount of research effort and resources aimed at understanding what comprises effective team performance is overwhelming. Military, human factors,

Longitudinal analysis of data on 658 children/families from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development addressed two issues regarding children's sleep problems (measured by maternal report in third and sixth grades when the child was 8 and 11 years old, respectively) and family functioning (measured using observations and questionnaires in third and fifth grades when the child was 8 and 10 years old): (1) Do family factors/processes in third grade predict change over time in child sleep problems and, reciprocally (2) Do child sleep problems when the child is in third grade predict change in family factors/processes? Results indicated that sleep problems were adversely affected (increased more/decreased less over time) when, in third grade, the father was absent, mothers were younger, experienced more negative emotions and were less sensitive in interacting with the child, and when the mother–child relationship was characterized by less closeness/more conflict. No linkages involving fathers and fathering were detected. Reciprocally, more sleep problems in the third grade predicted adverse changes in maternal negative emotionality, maternal sensitivity, and maternal closeness/conflict. Discussion highlights the need to conceptualize family functioning and children's sleep problems in family systems’ terms (i.e. reciprocal effects).

BackgroundMedication error is an important contributor to patient morbidity and mortality and is associated with inadequate patient safety measures. However, prescribing-safety tools specifically designed for use in general practice are lacking.

This systematic review considers the relationship between arthropods commonly found in and around livestock premises and zoonotic bacteria. The principal focus is upon insects and arachnids on poultry units, where houses, litter and manure provide good conditions for the growth, multiplication and protection of flies, beetles and mites, and where zoonotic pathogens such as Salmonella and Campylobacter are prevalent. Other members of the Enterobacteriaceae and the taxa Clostridium, Helicobacter, Erysipelas and Chlamydiaceae are also discussed. Salmonella is widely distributed in the flies of affected livestock units and is detectable to a lesser degree in beetles and mites. Persistent carriage appears to be common and there is some field and experimental evidence to support arthropod-mediated transmission between poultry flocks, particularly carry-over from one flock to the next. Campylobacter may readily be isolated from arthropods in contact with affected poultry flocks, although carriage is short-lived. There appears to be a role for flies, at least, in the breaching of biosecurity around Campylobacter-negative flocks. The carriage of other zoonotic bacteria by arthropods has been documented, but the duration and significance of such associations remain uncertain in the context of livestock production.

Parenting mediates some, but not all of the detectable effects of socioeconomic risk on health in childhood. As part of a package of measures that address other determinants, interventions to support parenting are likely to make a useful contribution to reducing childhood inequalities in health.

This paper reports the results of a seminar on poultry red mite (PRM), Dermanyssus gallinae. Eighteen researchers from eight European countries discussed life cycle issues of the mite, effects of mites on hens and egg production, and monitoring and control methods for PRM in poultry facilities. It was determined that PRM probably causes more damage than envisaged, with the cost in The Netherlands alone reaching 11 million euro per annum. However a great deal is still unknown about PRM (e.g. reproduction, survival methods, etc.) and that PRM monitoring is an important instrument in recognising and admitting the problem and in taking timely measures. Currently, the most promising control method combines heating the hen house in combination with chemical treatments. Future areas of development which show promise include the use of entomopathogenic fungi, vaccination and predatory mites. The final aim is to solve the problem of D. gallinae in housing systems for laying hens.