Explore the vast range of titles available.

This paper focuses on six interpreter-mediated interactions between teachers, migrant parents, and their children in Italian primary schools, a topic that has not yet been widely examined in the literature on public service interpreting. The analysis draws on audio-recorded interpreter-mediated interactions collected in Italy during a European Horizon 2020 project. The paper shows the barriers that exist in engaging children in these interactions. The difficulties observed are varied and more challenging to overcome than those hindering parental involvement. While Childhood Studies shows that the important enhancement of children’s agency in social contexts needs particular non-hierarchical structures of interaction, in the analysed interpreter-mediated interactions the mutual positioning of teachers, parents and mediators does not allow this enhancement. Thus, the involved children stay silent, they provide minimal responses when addressed, they show feelings of distress, and their few initiatives are not supported by the other participants. The paper shows the reasons for the failure of both teachers’ actions and mediators’ coordination to involve children and support their exercise of agency.

With the spread of antibiotic resistance in pediatric urinary tract infections (UTIs), more patients are likely to be started empirically on antibiotics to which pathogens are later found to be resistant (discordant therapy). However, in-vivo effectiveness may be different from in-vitro susceptibility. Aims of this study were to describe clinical outcomes of discordant empirical treatments in pediatric UTIs and to investigate risk factors associated to treatment failure. This observational, retrospective study was conducted on children hospitalized for febrile UTIs with positive urine culture and started on discordant empirical therapy. Failure rates of discordant treatments and associated risk factors were investigated. A total of 142/1600 (8.9%) patients were treated with inadequate empirical antibiotics. Clinical failure was observed in 67/142 (47.2%) patients, with no fatal events. Higher failure rates were observed for combinations of penicillin and beta-lactamase inhibitors (57.1%). Significant risk factors for failure of discordant treatment were history of recurrent UTIs (95% CI: 1.13–9.98, OR: 3.23, p < 0.05), recent use of antibiotics (95% CI: 1.46–21.82, OR: 5.02, p < 0.01), infections caused by Pseudomonas aeruginosa (95% CI: 1.85–62.10, OR: 7.30, p < 0.05), and empirical treatment with combinations of penicillin and beta-lactamase inhibitors (95% CI: 0.94–4.03, OR: 1.94, p = 0.05). This study showed that discordant empirical treatments may still be effective in more than half of pediatric UTIs. Clinical effectiveness varies between different discordant antibiotics in pediatric UTIs, and patients presenting risk factors for treatment failure may need a differentiated empirical approach.