190 research outputs found
A Field Study In An Urban Area: Examining Distracted Pedestrian Unsafe Crossing Behavior
A field study examining distracted pedestrian unsafe crossing behavior in an urban area. The study is among the first to contribute knowledge to environmental alterations impact on crossing behavior. Portions of the abstract are a part of a manuscript that will be submitted to Psi Chi Journal of Psychological Research for undergraduate students
Distracted Pedestrians: Looking Left?
Distracted pedestrians, those talking or texting on phones as examples, are potentially at risk when crossing urban intersections. They may lack traffic awareness of risk as distracted drivers often do. The transportation field has limited data on distracted pedestrians. This study aimed to contribute to the literature by observing pedestrian behaviors at four urban-area, downtown crosswalks over five weeks in June-July 2021. Overall, 2,055 pedestrians were observed, with 25.4% being distracted. Common distractions were texting, talking on a cell phone, and using headphones. Chi-square analyses found that while distraction did not predict looking left, one behavior that keeps them out of harm’s way in the United States, women who were distracted looked left less often than men, an atypical gender difference in the traffic safety literature. These and other results are discussed in terms of the next steps for increasing pedestrian safety.https://digitalcommons.odu.edu/reu2021_psychology/1007/thumbnail.jp
Superradiant and subradiant states in lifetime-limited organic molecules through laser-induced tuning
An array of radiatively coupled emitters is an exciting new platform for
generating, storing, and manipulating quantum light. However, the simultaneous
positioning and tuning of multiple lifetime-limited emitters into resonance
remains a significant challenge. Here we report the creation of superradiant
and subradiant entangled states in pairs of lifetime-limited and sub-wavelength
spaced organic molecules by permanently shifting them into resonance with
laser-induced tuning. The molecules are embedded as defects in an organic
nanocrystal. The pump light redistributes charges in the nanocrystal and
dramatically increases the likelihood of resonant molecules. The frequency
spectra, lifetimes, and second-order correlation agree with a simple quantum
model. This scalable tuning approach with organic molecules provides a pathway
for observing collective quantum phenomena in sub-wavelength arrays of quantum
emitters
Community fire prevention via population segmentation modelling
In this paper we examine the use of population segmentation modelling for targeting fire prevention to the needs of the community. A population segmentation approach based upon socio-economic characteristics data was developed to provide a deeper understanding of the fire risks associated with different social groups by a partnership consisting of a UK fire and rescue service, a National Health Service trust, a local council, and a police force. This approach supported more targeted and co-ordinated community fire prevention measures by the agencies involved. This approach was used to target those most at risk, and improve intra-agency co-ordination and collaboration between the agencies involved. The modelling enabled differences in terms of the risk of fire related injuries and fatalities between the population segments to be examined. Overall, the research examines how and why population segmentation was undertaken by the fire and rescue service studied, and how this was implemented and used operationally to support fire prevention activities. The project was funded by the UK Department of Communities and Local Government
Impact of a pilot NHS-funded sore throat test and treat service in community pharmacies on provision and quality of patient care
Objective A National Health Service (NHS)-funded sore throat test and treat (STTT) service was introduced in selected pharmacies in two local health boards in Wales, as an extension to the national pharmacy common ailment scheme. The aim of this study was to evaluate the impact of STTT on provision and quality of patient care, namely antibiotic use, patient safety and general practitioner (GP) consultation rates.
Methods Secondary analyses of STTT consultation data to describe service outcomes, and routine data to explore changes in antibiotic prescribing and the prevalence of complications. Data were also collected from one GP practice to explore the feasibility of measuring changes in sore throat consultation rates in general practice.
Results Less than 20% of 1725 consultations resulted in antibiotic supply. The availability of STTT was associated with greater reductions in prescriptions for phenoxymethylpenicillin than in areas where STTT was not available (−3.8% and −3.4%, difference 0.4%). When pharmacy supplies were included, the reductions in the supply of the antibiotic were similar. No increase in the monthly number of incidents of quinsy was detected, and patients were appropriately referred to other healthcare professionals during pharmacy consultations. GP consultation rates since introduction of STTT were found to be lower than the equivalent monthly average since 2014.
Conclusions Data from the first 5 months of the STTT service suggest that it may have a role in safely rebalancing uncomplicated sore throat management from general practice to community pharmacies while continuing to promote antibiotic stewardship
Impact of a deferred recruitment model in a randomised controlled trial in primary care (CREAM study)
Background
Recruitment of participants is particularly challenging in primary care, with less than a third of randomised controlled trials (RCT) achieving their target within the original time frame. Participant identification, consent, randomisation and data collection can all be time-consuming. Trials recruiting an incident, as opposed to a prevalent, population may be particularly affected. This paper describes the impact of a deferred recruitment model in a RCT of antibiotics for children with infected eczema in primary care, which required the recruitment of cases presenting acutely.
Methods
Eligible children were identified by participating general practitioners (GPs) and referred to a study research nurse, who then visited them at home. This allowed the consent and recruitment processes to take place outside the general practice setting.
Information was recorded about patients who were referred and recruited, or if not, the reasons for non-recruitment. Data on recruitment challenges were collected through semi-structured interviews and questionnaires with a sample of participating GPs. Data were thematically analysed to identify key themes.
Results
Of the children referred to the study 34% (58/171) were not recruited – 48% (28/58) because of difficulties arranging a baseline visit within the defined time frame, 31% (18/58) did not meet the study inclusion criteria at the time of nurse assessment, and 21% (12/58) declined participation. GPs had positive views about the recruitment process, reporting that parents valued and benefitted from additional contact with a nurse. GPs felt that the deferred recruitment model did not negatively impact on the study.
Conclusions
GPs and parents recognised the benefits of deferred recruitment, but these did not translate into enhanced recruitment of participants. The model resulted in the loss of a third of children who were identified by the GP as eligible, but not subsequently recruited to the study. If the potential for improving outcomes in primary care through complex studies is to be realised, new approaches to recruitment into primary care trials need to be developed and evaluated
Study protocol: azithromycin therapy for chronic lung disease of prematurity (AZTEC) - a randomised, placebo-controlled trial of azithromycin for the prevention of chronic lung disease of prematurity in preterm infants
Introduction Chronic lung disease of prematurity (CLD), also known as bronchopulmonary dysplasia (BPD), is a cause of significant respiratory morbidity in childhood and beyond. Coupled with lung immaturity, infections (especially by Ureaplasma spp) are implicated in the pathogenesis of CLD through promotion of pulmonary inflammation. Azithromycin, which is a highly effective against Ureaplasma spp also has potent anti-inflammatory properties. Thus, azithromycin therapy may improve respiratory outcomes by targeting infective and inflammatory pathways. Previous trials using macrolides have not been sufficiently powered to definitively assess CLD rates. To address this, the azithromycin therapy for chronic lung disease of prematurity (AZTEC) trial aims to determine if a 10-day early course of intravenous azithromycin improves rates of survival without CLD when compared with placebo with an appropriately powered study.
Methods and analysis 796 infants born at less than 30 weeks’ gestational age who require at least 2 hours of continuous respiratory support within the first 72 hours following birth are being enrolled by neonatal units in the UK. They are being randomised to receive a double-blind, once daily dose of intravenous azithromycin (20 mg/kg for 3 days, followed by 10 mg/kg for a further 7 days), or placebo. CLD is being assessed at 36 weeks’ PMA. Whether colonisation with Ureaplasma spp prior to randomisation modifies the treatment effect of azithromycin compared with placebo will also be investigated. Secondary outcomes include necrotising enterocolitis, intraventricular/cerebral haemorrhage, retinopathy of prematurity and nosocomial infections, development of antibiotic resistance and adverse reactions will be monitored.
Ethics and dissemination Ethics permission has been granted by Wales Research Ethics Committee 2 (Ref 18/WA/0199), and regulatory permission by the Medicines and Healthcare Products Regulatory Agency (Clinical Trials Authorisation reference 21323/0050/001–0001). The study is registered on ISRCTN (ISRCTN11650227). The study is overseen by an independent Data Monitoring Committee and an independent Trial Steering Committee. We shall disseminate our findings via national and international peer-reviewed journals, and conferences. A summary of the findings will also be posted on the trial website
Use of co-primary outcomes for trials of antimicrobial stewardship interventions
Antimicrobial resistance (AMR) is a major public health threat that will cause an estimated 10 million deaths worldwide by 2050. Because antimicrobial use drives selection and transmission of AMR, there is an urgent need to continue to develop, evaluate, and implement effective, evidence-based antimicrobial stewardship (AMS) interventions that safely reduce antimicrobial use in both primary and secondary healthcare
Point of care testing for urinary tract infection in primary care (POETIC): protocol for a randomised controlled trial of the clinical and cost effectiveness of FLEXICULT (TM) informed management of uncomplicated UTI in primary care
BACKGROUND: Urinary tract infections (UTI) are the most frequent bacterial infection affecting women and account for about 15% of antibiotics prescribed in primary care. However, some women with a UTI are not prescribed antibiotics or are prescribed the wrong antibiotics, while many women who do not have a microbiologically confirmed UTI are prescribed antibiotics. Inappropriate antibiotic prescribing unnecessarily increases the risk of side effects and the development of antibiotic resistance, and wastes resources. POETIC is a randomised controlled trial of a Point Of Care Test (POCT) (Flexicult™) guided UTI management strategy for use in primary care, which may help General Practitioners more effectively decide both whether or not to prescribe antibiotics, and if so, to select the most appropriate antibiotic. METHODS/DESIGN: 614 adult female patients will be recruited from four primary care research networks (Wales, England, Spain, the Netherlands) and individually randomised to either POCT guided care or the guideline-informed ‘standard care’ arm. Urine and stool samples (where possible) will be obtained at presentation (day 1) and two weeks later for microbiological analysis. All participants will be followed up on the course of their illness and their quality of life, using a 2 week self-completed symptom diary. At 3 months, a primary care notes review will be conducted for evidence of further evidence of treatment failures, recurrence, complications, hospitalisations and health service costs. The primary objective is to compare appropriate antibiotic use on day 3 between the POCT and standard care arms using multi-level logistic regression to produce an odds ratio and associated 95% confidence interval. Costs of the two management approaches will be assessed in terms of the primary outcome. DISCUSSION: Although the Flexicult™ POCT is used in some countries in routine primary care, it’s clinical and cost effectiveness has never been evaluated in a randomised clinical trial. If shown to be effective, the use of this POCT could benefit individual sufferers and provide evidence for health care authorities to develop evidence based policies to combat the spread and impact of the unprecedented rise of infections caused by antibiotic resistant bacteria in Europe. TRIAL REGISTRATION NUMBER: ISRCTN65200697 (Registered 10 September 2013)
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