2.5-O7Rational drug use and migration: awareness and attitudes towards antibiotic use among adults in Turkey and Turkish migrants in Sweden, the Netherlands and Germany

Abstract Background Antimicrobial resistance is considered one of the major threats to global health. The emergence of resistant microorganisms is a consequence of irrational use of antibiotics. In Turkey, the consumption of antibiotics is relatively high and antibiotics are among the most commonly used drugs. However, Turkey has adopted new, more restrictive policies and regulations on antibiotics. In addition, Turkish migrants to EU countries, such as Germany, the Netherlands and Sweden, may encounter health systems that promote a more restrictive and rational antibiotic use. The objective of this paper was to explore the variation in implemented policies related to rational antibiotic use that citizens in Turkey and Turkish migrants in Germany, the Netherlands and Sweden are subjected to and to discuss the implications for the promotion of rational antibiotic use. Data were collected through focus groups and individual interviews with citizens, physicians and pharmacists in the four countries. In total, 130 respondents were interviewed. Content analysis was used. Results Three relevant themes were identified: Implementation of regulations and recommendations, Access to antibiotics and Need for health communication. Irrational use of antibiotics was reported mainly in Turkey. While it had become less likely to get antibiotics without a prescription, non-prescribed antibiotics remained a problem in Turkey. In the three EU countries, there were also alternative ways of getting antibiotics. Low levels of knowledge about the rational antibiotic use were reported in Turkey, while there were several sources of information on this in the EU countries. Communication with and trust in physicians were considered to be important. There were also system barriers, such as lacking opportunities for physicians to manage care in accordance with current evidence in Turkey and factors limiting access to care in EU countries. Conclusions Several fields of importance for promoting rational antibiotic use were identified. There is a need for harmonisation of health-related regulations and policy programmes. Antibiotics should only be available with a prescription. Programmes for rational antibiotic use should be implemented on a broad scale, in medical care, at pharmacies and in the population. Methods for health communication and patient-centred care should be further developed and implemented in this field.

Download Full-text

Review of Drug Utilization Studies in Neonatal Units: A Global Perspective

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165669 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5669 ◽

Cited By ~ 1

Author(s):

Asma Al-Turkait ◽

Lisa Szatkowski ◽

Imti Choonara ◽

Shalini Ojha

Keyword(s):

Drug Use ◽

Drug Utilization ◽

Antibiotic Use ◽

Global Perspective ◽

Use Patterns ◽

Rational Prescribing ◽

Drug Use Patterns ◽

General Drug ◽

The Usa ◽

Drug Utilization Studies

Rational prescribing is challenging in neonatology. Drug utilization studies help identify and define the problem. We performed a review of the literature on drug use in neonatal units and describe global variations. We searched databases (EMBASE, CINAHL and Medline) from inception to July 2020, screened studies and extracted relevant data (two reviewers). The search revealed 573 studies of which 84 were included. India (n = 14) and the USA (n = 13) reported the most. Data collection was prospective (n = 56) and retrospective (n = 26), mostly (n = 52) from one center only. Sixty studies described general drug use in 34 to 450,386 infants (median (IQR) 190 (91–767)) over a median (IQR) of 6 (3–18) months. Of the participants, 20–87% were preterm. The mean number of drugs per infant (range 11.1 to 1.7, pooled mean (SD) 4 (2.4)) was high with some reporting very high burden (≥30 drugs per infant in 8 studies). This was not associated with the proportion of preterm infants included. Antibiotics were the most frequently used drug. Drug use patterns were generally uniform with some variation in antibiotic use and more use of phenobarbitone in Asia. This study provides a global perspective on drug utilization in neonates and highlights the need for better quality information to assess rational prescribing.

Download Full-text

Social Media in and Around a Temporary Large-Scale Refugee Shelter in the Netherlands

Social Media + Society ◽

10.1177/20563051211024961 ◽

2021 ◽

Vol 7 (2) ◽

pp. 205630512110249

Author(s):

Peer Smets ◽

Younes Younes ◽

Marinka Dohmen ◽

Kees Boersma ◽

Lenie Brouwer

Keyword(s):

Social Media ◽

The Netherlands ◽

Crisis Communication ◽

Asylum Seekers ◽

Large Scale ◽

State Policies ◽

Refugee Crisis ◽

Top Down ◽

And Migration

During the 2015 refugee crisis in Europe, temporary refugee shelters arose in the Netherlands to shelter the large influx of asylum seekers. The largest shelter was located in the eastern part of the country. This shelter, where tents housed nearly 3,000 asylum seekers, was managed with a firm top-down approach. However, many residents of the shelter—mainly Syrians and Eritreans—developed horizontal relations with the local receiving society, using social media to establish contact and exchange services and goods. This case study shows how various types of crisis communication played a role and how the different worlds came together. Connectivity is discussed in relation to inclusion, based on resilient (non-)humanitarian approaches that link society with social media. Moreover, we argue that the refugee crisis can be better understood by looking through the lens of connectivity, practices, and migration infrastructure instead of focusing only on state policies.

Download Full-text

Gender differences in response to family crisis: changes in household composition and migration of widowed parents with minor children in the Netherlands, 1863–1910

The History of the Family ◽

10.1080/1081602x.2018.1537881 ◽

2018 ◽

Vol 23 (4) ◽

pp. 679-705 ◽

Cited By ~ 5

Author(s):

Matthias Rosenbaum-Feldbrügge

Keyword(s):

Gender Differences ◽

The Netherlands ◽

Household Composition ◽

Family Crisis ◽

Minor Children ◽

And Migration

Download Full-text

Flexible Believers in the Netherlands: A Paradigm Shift toward Transreligious Multiplicity

Open Theology ◽

10.1515/opth-2017-0027 ◽

2017 ◽

Vol 3 (1) ◽

Cited By ~ 3

Author(s):

Manuela Kalsky

Keyword(s):

The Netherlands ◽

Religious Identity ◽

Paradigm Shift ◽

Religious Transformation ◽

Religious Traditions ◽

Religious Plurality ◽

And Migration ◽

Ritual Praxis ◽

The Church ◽

Hybrid Forms

AbstractThe Netherlands has undergone a radical religious transformation through secularization, individualization and migration. Expressions of Christian belief are no longer strictly defined by the Church and hybrid forms of religiosity incorporating other religions have emerged. After a brief sketch of Dutch religious plurality, the author focuses on interviews with ‘flexible believers’, people who combine elements from different religious traditions and worldviews. Through interviews, she discovers a number of characteristics of these multiple religious believers (MRB) - interviewees - such as ritual praxis, identity-making processes and belonging - and reflects on their impact for the wider picture of religiosity in today‘s post-Christian Dutch network society. She concludes that hybrid forms of lived religion like mrb, present a challenge to traditional concepts of religious identity and belonging. They require a paradigm shift from an ‘either/or’ to a relational ‘as well as’ approach within a rhizomatic network of meaning.

Download Full-text

Less discontinuation of ADHD drug use since the availability of long-acting ADHD medication in children, adolescents and adults under the age of 45 years in the Netherlands

ADHD Attention Deficit and Hyperactivity Disorders ◽

10.1007/s12402-010-0044-9 ◽

2010 ◽

Vol 2 (4) ◽

pp. 213-220 ◽

Cited By ~ 25

Author(s):

Els van den Ban ◽

Patrick C. Souverein ◽

Hanna Swaab ◽

Herman van Engeland ◽

Toine C. G. Egberts ◽

...

Keyword(s):

Drug Use ◽

The Netherlands ◽

Adhd Medication ◽

Adolescents And Adults ◽

Long Acting

Download Full-text

Incidence and predictors of Gram-negative bacilli in hospitalized people who inject drugs with injection drug use-attributable infections

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00925-21 ◽

2021 ◽

Author(s):

Megan C. Kelly ◽

Samantha D. Yeager ◽

Mahmoud A. Shorman ◽

Laurence R. Wright ◽

Michael P. Veve

Keyword(s):

Drug Use ◽

Injection Drug Use ◽

People Who Inject Drugs ◽

Bloodstream Infections ◽

Antibiotic Use ◽

Injection Drug ◽

Gram Positive ◽

Gram Negative ◽

Multivariable Regression ◽

Infection Types

Objective: Quantify incidence and determine predictors of Gram-negative bacilli (GNB) in people who inject drugs (PWID) with injection-drug use (IDU)-related infections. Design: Retrospective cohort of hospitalized PWID from 1/2017-12/2019. Methods: Inclusion criteria: age ≥18 years, active IDU, treated IDU-attributable infection, organism growth from microbiology cultures. Infection types: infective endocarditis (IE), acute bacterial skin/skin structure infection (ABSSSI), osteoarticular infection (OAI), other bloodstream infections (BSI). Primary outcome was GNB identification from microbiologic culture; descriptive statistics were used to describe the cohort. Multivariable regression was used to identify variables associated with GNB infection. Results: 230 PWID included; 65 (28%) GNB infections, 165 (72%) Gram-positive infections. The median (IQR) population age was 38 (31-45) years. Most patients were women (56%); 37% had no insurance. Infection types were: IE (41%), ABSSSI (37%), OAI (20%), other BSI (2%). 278 organisms were isolated from 230 patients; most common organisms were methicillin-resistant Staphylococcus aureus (43%), Streptococcus spp. (19%), methicillin-susceptible S. aureus (17%), Serratia marcescens (8%); 10% were mixed GNB and Gram-positive infections. 80% of patients received empiric Pseudomonas aeruginosa coverage; only 7% had P. aeruginosa infections. In multivariable regression, age >50 years (adjOR, 2.9; 95%CI; 1.2-7.2), prior hospitalization within 90-days (adjOR, 2.2; 95%CI; 1.2-4.3), and OAI (adjOR, 3.2; 95%CI; 1.5-6.6) were associated with GNB infection. Conclusions: GNB in PWID with IDU-attributed infections were more frequently observed in recently hospitalized, older patients with OAI. The majority of patients received empiric anti-pseudomonal antibiotic coverage, but P. aeruginosa was infrequent. PWID are a potential population to target improved empiric antibiotic use.

Download Full-text