Background: COVID-19 arise global attention since their first public reporting. Infection prevention and control (IPC) is critical to combat COVID-19, especially at the early stage of pandemic outbreak. This study aimed to measure level of healthcare workers' (HCW') self-reported IPC behaviors with the risk of COVID-19 emerges and increases. Methods: A cross-sectional study was conducted in two tertiary hospitals. A structured self-administered questionnaire was delivered to HCWs in selected hospitals. The dependent variables were self-reported IPC behavior compliance; and independent variables were outbreak risk and three intent of infection risk (risk of contact with suspected patients, high-risk department, risk of affected area). Chi-square tests and multivariable negative binomial regression models were employed. Results: A total of 1386 participants were surveyed. The risk of outbreak increased self-reported IPC behavior on each item (coefficient varied from 0.029 to 0.151). Considering different extent of risk, HCWs from high-risk department had better self-reported practice in most IPC behavior (coefficient ranged from 0.027 to 0.149). HCWs in risk-affected area had higher self-reported compliance in several IPC behavior (coefficient ranged from 0.028 to 0.113). However, HCWs contacting with suspected patients had lower self-reported compliance in several IPC behavior (coefficient varied from − 0.159 to − 0.087).

Public reporting can positively influence antibiotic prescribing patterns of physicians for URTIs in primary care settings, with reduction in antibiotic and combined antibiotic prescriptions. The reduction was mainly attributed to average and high antibiotic prescribers.

Supplemental Digital Content is available in the text

PRHCP showed positive effects on physicians' prescribing behaviour, considering the downward trends on the use of antibiotics and injections and average expenditure through the intervention. However, the effect was not immediately observed; a lag time existed before public reporting intervention worked.

Promoting patient-centered communication among physicians is one core strategy for improving physician–patient relationships and patient outcomes. Our study aims to understand the physicians’ attitudes towards patient-centered communication and its effects on physicians’ intention and behavior of involving patients in medical decisions in primary care in China. One cross-sectional study was conducted in primary facilities in Hubei province, China, from December 2019 to January 2020, where physicians’ attitudes towards patient-centered communication were measured by the Chinese-revised patient–practitioner orientation scale. Multilevel ordinal logistic regression was conducted for estimating the effects of physicians’ attitudes on their intention and behavior of patient involvement in medical decisions. Six hundred and seventeen physicians were investigated for the main study. Physicians had a medium score of patient-centered communication (3.78, SD = 0.56), with relatively high caring subscale score (4.59, SD = 0.64), and low sharing subscale score (3.09, SD = 0.75). After controlling physicians’ covariates, physicians’ attitudes towards patient-centered communication was significantly associated with a higher intention of involving patients in medical decisions (OR > 1, p = 0.020). Physicians’ positive attitudes towards patient-centered communication affected their intention of involving patients in medical decisions, which implies the importance of taking the physicians’ attitudes into account for the accomplishment of patient involvement processes.

No abstract

The general population has increasingly become the key contributor to irrational antibiotic use in China, which fuels the emergence of antibiotic resistance. This study aimed to estimate the prevalence of the general population’s irrational use behaviors of antibiotics and identify the potential reasons behind them. A systematic review and meta-analysis were performed concerning four main behaviors relevant to easy access and irrational use of antibiotics and common misunderstandings among the population about antibiotics. Four databases were searched, and studies published before 28 February 2021 were retrieved. Medium and high-level quality studies were included. Random effects meta-analysis was performed to calculate the prevalence of the general population’s irrational behaviors and misunderstandings relevant to antibiotic use. A total of 8468 studies were retrieved and 78 met the criteria and were included. The synthesis showed the public can easily obtain unnecessary antibiotics, with an estimated 37% (95% CI: 29–46) of the population demanding antibiotics from physicians and 47% (95% CI: 38–57) purchasing non-prescription antibiotics from pharmacies. This situation is severe in the western area of China. People also commonly inappropriately use antibiotics by not following antibiotic prescriptions (pooled estimate: 48%, 95% CI: 41–55) and preventatively use antibiotics for non-indicated diseases (pooled estimate: 35%, 95% CI: 29–42). Misunderstanding of antibiotic use was also popular among people, including incorrect antibiotic recognition, wrong antibiotic use indication, inappropriate usage, and ignorance of potential adverse outcomes. Over-and inappropriate use of antibiotics is evident in China and a multifaceted antibiotic strategy targeted at the general population is urgently required.

Background & aimsNutritional support for patients in the intensive-care unit (ICU) is a part of standard care which promotes medical quality and decreases nosocomial infection. Supplemental parenteral nutrition (SPN) approach (enteral nutrition (EN) combined with parenteral nutrition (PN) when EN alone is insufficient) has become one major concern in nutrition research field. This research aims to explore the following relationships: (i) the relationship between SPN and nosocomial infection, (ii) the relationship between early and late SPN initiation and the development of nosocomial infection.MethodsA retrospective study was conducted in patients who met the inclusion criteria from February 2012 to February 2015 in Pediatric ICU (PICU). Patients were classified into two groups according to nutrition delivery approach-SPN group and EN alone group. Then SPN group were further divided into two subgroups by initiation timing, which were defined as early-initiation SPN and late-initiation SPN group respectively. Age, gender, serum albumin at admission, severity of disease, length of stay in PICU, nutrition delivery approach, amounts of delivered caloric intake and occurence of nosocomial infection were recorded. Univariate analysis and binary logistic regression analysis were performed to identify the risk factors and assess the independent effect of SPN approach on nosocomial infection in PICU of Emergency Department.Results204 patients were included in our study. Compared with EN alone group, patients delivered by SPN approach had a higher nosocomial infection rate (34.0 vs.10.9 %, p < 0.001). The late-initiation subgroup of SPN approach was found to be an independent predictor of nosocomial infection in the logistic regression analysis model (OR = 3.40; 95 % CI, 1.13 ~ 10.19; p = 0.029). Serum albumin at admission (OR = 0.91; 95 % CI, 0.84 ~ 0.97; p = 0.008), mechanical ventilation (OR = 3.85; 95 % CI, 1.43 ~ 10.39; p = 0.008), severity of disease (OR = 3.79; 95 % CI, 1.03 ~ 13.99; p = 0.045) and PICU length of stay (OR = 1.23; 95 % CI, 1.11 ~ 1.35; p < 0.001) were also identified as significant risk factors for nosocomial infection.ConclusionsOur study shows late-initiation SPN approach increases the incidence of nosocomial infection compared with early-initiation approach in critically ill children in PICU of Emergency Department. Compared with EN alone group, patients delivered by SPN approach had a higher nosocomial infection rate.