Objectives: To explore current practices and decision making regarding antimicrobial prescribing among emergency department (ED) clinical providers.
Methods: We conducted a survey of ED providers recruited from 8 sites in 3 cities. Using purposeful sampling, we then recruited 21 providers for in-depth interviews. Additionally, we observed 10 patient-provider interactions at one of the ED sites. SAS 9.3 was used for descriptive and predictive statistics. Interviews were audio recorded, transcribed, and analyzed using a thematic, constructivist approach with consensus coding using NVivo 10.0. Field and interview notes collected during the observational study were aligned with themes identified through individual interviews.
Results: Of 150 survey respondents, 76% agreed or strongly agreed that antibiotics are overused in the ED, while half believed they personally did not overprescribe. Eighty-nine percent used a smartphone or tablet in the ED for antibiotic prescribing decisions. Several significant differences were found between attending and resident physicians. Interview analysis identified 42 codes aggregated into the following themes: (1) resource and environmental factors that affect care; (2) access to and quality of care received outside of the ED consult; (3) patient-provider relationships; (4) clinical inertia; and (5) local knowledge generation. The observational study revealed limited patient understanding of antibiotic use. Providers relied heavily upon diagnostics and provided limited education to patients. Most patients denied a priori expectations of being prescribed antibiotics.
Conclusions: Patient, provider, and healthcare system factors should be considered when designing interventions to improve antimicrobial stewardship in the ED setting.
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http://dx.doi.org/10.1086/677637 | DOI Listing |
Background: The aim of the present study was to investigate the willingness of elderly individuals regarding their choice of elderly care modes in underdeveloped regions of Western China and to identify the key factors influencing the willingness.
Methods: We distributed a total of 20 000 questionnaires using the multistage stratified cluster random sampling method, and successfully collected 19 460 of them. After conducting quality checks, we deemed 19 040 questionnaires valid for analysis.
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Music College, Shanghai Normal University, Shanghai, China.
Introduction: The significance of music might be attributed to its role in social bonding, a function that has likely influenced the evolution of human musicality. Although there is substantial evidence for the relationship between prosocial songs and prosocial behavior, it remains unclear whether music alone, independent of lyrics, can influence prosocial behaviors. This study investigates whether music and the emotions it induces can influence prosocial decision-making, utilizing the classical two-dimensional model of emotion (mood and arousal).
View Article and Find Full Text PDFSecur J
January 2025
Department of Security and Crime Science, UCL, 35 Tavistock Square, London, WC1H 9EZ UK.
Project Servator is a strategic method of policing designed to deter, detect and disrupt a wide range of criminal activity including terrorism. This paper is the first empirical study to evaluate the stop and search aspect of Servator deployments. We compare the outcomes of 3488 routine stop and searches and 510 Servator stop and searches to determine whether the stop and search tactics used in this initiative produce more positive outcomes than routine stop and searches.
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Objective: The invasiveness of pituitary neuroendocrine tumor is an important basis for formulating individualized treatment plans and improving the prognosis of patients. Radiomics can predict invasiveness preoperatively. To investigate the value of multiparameter magnetic resonance imaging (mpMRI) radiomics in predicting pituitary neuroendocrine tumor invasion into the cavernous sinus (CS) before surgery.
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RSK ADAS, Cheshire, UK.
This paper presents the findings from a survey on factors influencing the adoption of agricultural Decision Support Systems (DSS). Our study focuses on examining the influence of behavioural, socioeconomic and farm specific characteristics on DSS adoption. Using two structural equation models, we investigate how these factors influence the willingness to pay (WTP) and willingness to adopt.
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