Search results for: D. Melles

Authors: Warsa Melles

Abstract:

This study examines the way second-generation Eritrean immigrants living in the French-speaking part of Switzerland behave linguistically and culturally. The aim of this research is to demonstrate how the participants deal with their bilingualism (Tigrinya and French). More precisely, how does their language use correlates with their socio-cultural attitudes and how do these aspects (re)construct their identity? Data for this research was collected via, questionnaires and semi-structured interviews. Participants were asked to answer questions regarding their linguistic habits, their perception on being bilingual and their cultural identity. The major findings demonstrate that generation 2 relates more with the host country’s language since French is used as the main language in their daily interactions. On the other hand, due to the fact that they have never lived in Eritrea yet were raised by Eritrean born parents in a foreign country, it is more difficult for them to unanimously identify with just one culture. In that sense, intergenerational transmission plays a major role in the perception of identity. All the participants have at least a basic knowledge of Tigrinya, but the use of languages varies according to the purpose. Proficiency in the native language and sense of belonging can be correlated with the frequency of visits to Eritrea. In conclusion, the question of identity in the second-generation Eritrean community cannot be given a categorical and clear-cut answer instead, the new-self image that this social group aims to build is shaped by different factors that are essential to take into consideration.

Keywords: biculturalism, identity, language, migration

Procedia PDF Downloads 245

Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon

Abstract:

Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.

Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy

Procedia PDF Downloads 357