267 research outputs found
Supplemental Material - How service users envision their engagement in processes of collaborative innovation: A Q-methodological study on user involvement in eHealth collaborations
No full textSupplemental Material for How service users envision their engagement in processes of collaborative innovation: A Q-methodological study on user involvement in eHealth collaborations by Chesney Callens, Koen Verhoest, Erik Hans Klijn, Steven Nõmmik, Vicente Pina, and Lena Brogaard in Public Policy and Administration</p
Decentralisatie naar lokale besturen - Een onderzoek naar de wenselijkheid en haalbaarheid in Vlaanderen
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Decentralisatie naar lokale besturen - Een onderzoek naar de wenselijkheid en haalbaarheid in Vlaanderen
No full textNot availabl
Internal and external exploration for public service innovation-Measuring the impact of a climate for creativity and collaborative diversity on innovation
No full textPublic service innovation involves a process of creative exploration of new ideas, knowledge and perspectives. The article poses that creative exploration emerges from the combination of a climate for creativity that is active inside the organization, and collaborations with diverse actors that are present outside the organization. We test the effect of these conditions on innovation using data from the Australian Public Service. Our findings demonstrate that both a climate for creativity and collaborative diversity are positively related to innovation, yet a tipping point exists at which the positive effects of collaborative diversity on innovation turn negative.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Fonds Wetenschappelijk Onderzoek (1244720N) This article has benefited from the interaction within the GOVTRUST Centre of Excellence (University of Antwerp, Belgium)
Unmasking the dichotomy : analyzing male-female differences in treatment outcomes of pulmonary tuberculosis in Kenya
No full textHIV prevalence and healthcare service utilization among female sex workers, men who have sex with men, and transgender women in Papua New Guinea
No full textCervical cancer prevention in HIV-infected women within a high bacterial vaginosis setting in Kenya
No full textThe combined effect of systemic antibiotics and proton pump inhibitors on Clostridioides difficile infection and recurrence
No full textBackground Antibiotics and proton pump inhibitors (PPI) are recognized risk factors for acquisition and recurrence of Clostridioides difficile infection (CDI), yet combined effects remain unclear.Objectives To assess the short- and long-term effects of antibiotics and PPIs on CDI risk and recurrence.Methods Population-based study including all 43 152 patients diagnosed with CDI in Sweden (2006-2019), and 355 172 matched population controls without CDI. The impact of antibiotics and PPIs on CDI risk and recurrence was explored for recent (0-30 days) and preceding (31-180 days) use prior to their first CDI diagnosis, using multivariable conditional logistic regression presented as odds ratios (ORs) and 95% confidence interval, adjusted for demographics, comorbidities and other drugs.Results Compared to controls, the combined effect of recent PPIs and antibiotics [ORAB+PPI = 17.51 (17.48-17.53)] on CDI risk was stronger than the individual effects [ORAB = 15.37 (14.83-15.93); ORPPI = 2.65 (2.54-2.76)]. Results were less pronounced for exposure during the preceding months. Dose-response analyses showed increasing exposure correlated with CDI risk [recent use: ORAB = 6.32 (6.15-6.49); ORPPI = 1.65 (1.62-1.68) per prescription increase]. Compared to individuals without recurrence (rCDI), recent [ORAB = 1.30 (1.23-1.38)] and preceding [ORAB = 1.23 (1.16-1.31); ORPPI = 1.12 (1.03-1.21)] use also affected the risk of recurrence yet without significant interaction between both. Recent macrolides/lincosamides/streptogramins; other antibacterials including nitroimidazole derivates; non-penicillin beta lactams and quinolones showed the strongest association with CDI risk and recurrence, particularly for recent use. PPI use, both recent and preceding, further increased the CDI risk associated with almost all antibiotic classes.Results Compared to controls, the combined effect of recent PPIs and antibiotics [ORAB+PPI = 17.51 (17.48-17.53)] on CDI risk was stronger than the individual effects [ORAB = 15.37 (14.83-15.93); ORPPI = 2.65 (2.54-2.76)]. Results were less pronounced for exposure during the preceding months. Dose-response analyses showed increasing exposure correlated with CDI risk [recent use: ORAB = 6.32 (6.15-6.49); ORPPI = 1.65 (1.62-1.68) per prescription increase]. Compared to individuals without recurrence (rCDI), recent [ORAB = 1.30 (1.23-1.38)] and preceding [ORAB = 1.23 (1.16-1.31); ORPPI = 1.12 (1.03-1.21)] use also affected the risk of recurrence yet without significant interaction between both. Recent macrolides/lincosamides/streptogramins; other antibacterials including nitroimidazole derivates; non-penicillin beta lactams and quinolones showed the strongest association with CDI risk and recurrence, particularly for recent use. PPI use, both recent and preceding, further increased the CDI risk associated with almost all antibiotic classes.Conclusion Recent and less recent use of PPIs and systemic antibiotics was associated with an increased risk of CDI, particularly in combination.This work was supported by the Centre for Translational Microbiome Research (CTMR), Karolinska Institutet, Sweden through a Research Collaboration Agreement with Ferring Pharmaceuticals
Maternal and Early-Life Exposure to Antibiotics and the Risk of Autism and Attention-Deficit Hyperactivity Disorder in Childhood: a Swedish Population-Based Cohort Study
No full textIntroductionAntibiotics represent the most common type of medication used during pregnancy and infancy. Antibiotics have been proposed as a possible factor in changes in microbiota composition, which may play a role in the aetiology of autism and attention deficit/hyperactivity disorder (ADHD). Our aim was to investigate the association between maternal and early-life antibiotic use and autism and ADHD in childhood.MethodsThis Swedish nation-wide population-based cohort study included all first live singleton births (N = 483,459) between January 2006 and December 2016. The association of dispensed antibiotics with autism and ADHD in children aged = 1 antibiotic during the exposure period (from 3 months pre-conception to delivery), and 41.6% (n = 201,040) of the children received >= 1 antibiotic in early life (aged <= 2 years). Penicillin was the most prescribed antibiotic class (17.9% of mothers, 38.2% of children). Maternal antibiotic use was associated with an increased risk of autism [odds ratio (OR) = 1.16, 95% confidence interval (CI) 1.09-1.23] and ADHD (OR = 1.29, 95% CI 1.21-1.36) in childhood. Early-life exposure to antibiotics showed an even stronger association [autism (OR = 1.46, 95% CI 1.38-1.55); ADHD (OR = 1.90, 95% CI 1.80-2.00)]. Both maternal and childhood-exposure sub-analyses suggested a dose-response relationship.ConclusionMaternal and early-life antibiotic use was associated with an increased risk of autism and ADHD in childhood. However, differences were noted by exposure period and antibiotic classes. Plain Language SummaryAntibiotics are commonly prescribed to pregnant women, infants, and toddlers. Antibiotic use during pregnancy may alter the maternal microbiota, which can influence the microbial colonisation of the gastrointestinal system of the foetus. It has been claimed that antibiotic use during pregnancy may have an effect on the gut-brain axis and, as a result, neurodevelopment. Neurodevelopmental disorder (NDD) is a category of illnesses characterised by functional impairments that manifest early in development. The most frequent NDDs are autism and attention-deficit/hyperactivity disorder (ADHD). In this large Swedish nation-wide study, we assessed whether antibiotic use during pregnancy and/or early in life affects the risk of developing autism and ADHD. The study found that both maternal antibiotic usage, as well as early childhood antibiotic use, were associated with an increased risk of autism and ADHD in children. These associations were altered by the quantity, type, and timing of antibiotic exposure.Romina Fornes received funding from the "National Commission for Scientifc and Technological Research". CONICYT, scholarship program “Becas Chile, Postdoctorado en el extranjero”. RB was funded as a postdoctoral researcher by the Research Foundation—Flanders (FWO: 2019–2021, 12I6319N). We wish to acknowledge our gratitude to the thousands of people, physicians, and health care workers who contributed to the data collection, and the National Board of Health and Welfare for collecting the data
Second-trimester vaginal microbiota disruption and adverse birth outcomes among pregnant women attending antenatal care in Bukavu, Democratic Republic of the Congo
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