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Vidthiya Menon Rebecca Davis Nick Shackel Bjorn A. Espedido Alicia G. Beukers Slade O. Jensen Sebastiaan J. van Hal 《Diagnostic microbiology and infectious disease》2018,90(2):120-122
Daptomycin β-Lactam combination therapy offers “protection” against daptomycin non-susceptibility (DNS) development in Enterococcus faecium. We report failure of this strategy and the importance of source control. Mutations were detected in the LiaF and cls genes in DNS isolates. A single DNS isolate contained an unrecognized mutation, which requires confirmation. 相似文献
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Nick Spencer 《Paediatrics & Child Health》2018,28(3):138-143
Social determinants of health have long been recognised but their importance is often overlooked. Globally social determinants are responsible for most childhood illness and death. In the UK, conditions which constitute a large part of paediatric practice are socially patterned. Social determinants exert their influence on child health through a complex inter-relationship of more distal social factors such as income and education with more proximal factors such as health behaviours.The pathways by which the social determinants exert their influence operate over time and across generations. Socially related risk and protective factors cluster in different social groups and accumulate over time. Social determinants are profoundly influenced by social and political decisions which are beyond the control of parents and individual paediatricians. Societies can protect children against the adverse effects of social disadvantage. National paediatric societies have a key role in promoting policies which protect children. This brief review summarises the impact of social determinants on children's health in the UK and considers the role of paediatricians in reducing the health inequities generated by these determinants. 相似文献
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ObjectivesTo report findings from a systematic review, this article sought to address two related questions. First, how has the practice of UK pediatric cost-utility analyses evolved over time, in particular how are health-related outcomes assessed and valued? Second, how do the methods compare to the limited guidance available, in particular, the National Institute for Health and Care Excellence (NICE) reference case(s)?MethodsElectronic searches of MEDLINE, Embase, and Cochrane databases were conducted for the period May 2004 to April 2012 and the Paediatric Economic Database Evaluation database for the period May 2004 to December 2010. Identified studies were screened by three independent reviewers.ResultsForty-three studies were identified, 11 of which elicit utility values through primary research. A discrepancy was identified between the methods used for outcome measurement and valuation and the methods advocated within the NICE reference case. Despite NICE recommending the use of preference-based instruments designed specifically for children, most studies that were identified had used adult measures. In fact, the measurement of quality-adjusted life-years is the aspect of economic evaluation with the greatest amount of variability and the area that most digressed from the NICE reference case.ConclusionsRecommendations stemming from the review are that all studies should specify the age range of childhood and include separate statements of perspective for costs and effects as well as the reallocation of research funding away from systematic review studies toward good quality primary research measuring utilities in children. 相似文献
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Nick Wlazlo Marleen M.J. van Greevenbroek Isabel Ferreira Eugene J.H.M. Jansen Edith J.M. Feskens Carla J.H. van der Kallen Casper G. Schalkwijk Bert Bravenboer Coen D.A. Stehouwer 《Metabolism: clinical and experimental》2012,61(12):1787-1796
ObjectiveTo investigate the role of low-grade inflammation and insulin resistance (HOMA2-IR) in adiposity-related increases in serum complement factor 3 (C3). Although C3 has been linked to type 2 diabetes and cardiovascular diseases, and C3 levels are closely related to body fat, the underlying mechanisms explaining this association are still unknown.MethodsAdiposity measures (including BMI, waist circumference (WC), sagittal diameter and several skinfolds), HOMA2-IR and markers of inflammation (hs-CRP, IL-6, SAA, haptoglobin, ceruloplasmin, sICAM-1) were determined in 532 individuals (62% men, mean age 59 ± 6.9 yrs) from the Cohort on Diabetes and Atherosclerosis Maastricht study. Markers of inflammation were standardized and compiled into an averaged inflammation score. Cross-sectional associations between adiposity measures and C3 and the mediating role of low-grade inflammation and/or HOMA2-IR herein were analysed with multiple linear regression models.ResultsAdiposity measurements were significantly associated with C3 levels, with the strongest (adjusted) associations found for WC (β = 0.383; 95%CI 0.302–0.464) and sagittal diameter (β = 0.412; 95%CI 0.333-0.490). Further adjustment for inflammation and HOMA2-IR attenuated these associations to β = 0.115 (95%CI 0.030-0.200) and β = 0.163 (95%CI 0.082-0.244) respectively. Multiple mediation analyses showed that inflammation [β = 0.090 (95%CI 0.060–0.126)] and HOMA2-IR [β = 0.179 (95%CI 0.128–0.236)] each explained, independently of one another, a significant portion of the association between WC and C3 (23% and 47%, respectively). Similar mediation by inflammation (19-27%) and HOMA2-IR (37-56%) was found for other adiposity measures.ConclusionSystemic low-grade inflammation and insulin resistance may represent two independent pathways by which body fat leads to elevated C3 levels. 相似文献
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Agreement of infrared temporal artery thermometry with other thermometry methods in adults: systematic review
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Measuring child well-being is an important basis for planning needs-led children’s services and charting their impact on outcomes.
The quality of this work in the UK varies widely and little of it gets used in policy and practice. This article examines
an attempt to develop and implement a new instrument to address these problems. The setting is an urban local authority seeking
to plan and develop services in the context of a renewed focus on outcomes and multi-agency working. The article describes
the development and implementation of an epidemiological survey of child health and development outcomes with a sample of
children selected to be representative of all children aged 0–18 in the city. It discusses the strengths and weaknesses of
the approach and considers future challenges as regards conceptualising child well-being, enhancing participation in such
surveys and exploiting the data that emerges. 相似文献