1,093 research outputs found

    An audit of antimicrobial prescribing by dental practitioners in the north east of England and Cumbria

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    Background Inappropriate prescribing of antimicrobials is a significant threat to global public health. In England, approximately 5% of all antimicrobial items are prescribed by dentists, despite the limited indications for their use in the treatment of oral infections in published clinical guidelines. The objective of this study was to survey antimicrobial prescribing by dental practitioners in North East England and Cumbria, identify educational and training needs and develop a self-assessment tool that can be used for Continued Professional Development by individual practitioners. Methods During October 2016, 275 dental practitioners used a standardised form to record anonymous information about patients who had been prescribed antimicrobials. Clinical information and prescribing details were compared against clinical guidelines published by the Faculty of General Dental Practitioners UK. Results Dental practitioners provided data on 1893 antimicrobial prescriptions. There was documented evidence of systemic spread, such as pyrexia in 18% of patients. Dentists recorded patients’ pain (91.1% of patients), local lymph gland involvement (41.5%) gross diffuse swelling (55.5%) dysphagia (7.2%) and trismus (13.6%). Reasons for prescribing antimicrobials included patient expectations (25.8%), patient preference (24.8%), time pressures (10.9%), and patients uncooperative with other treatments (10.4%). The most commonly prescribed antimicrobials were amoxicillin, accounting for 61.2% of prescriptions, followed by metronidazole (29.9%). Most prescriptions for amoxicillin were for either 5 days (66.8%) or 7 days (29.6%) and most prescriptions for metronidazole were for a 5-day course (65.2%) or 7-day (18.6%) course. Conclusion In most cases, when an antimicrobial was prescribed, practitioners used the correct choice of agents and usually prescribed these at the correct dose. However, some evidence of suboptimal prescribing practices when compared to the Faculty of General Dental Practitioner guidelines were identified. The audit has identified training needs across the region and aided the development of Continued Professional Development sessions. Further work to identify barriers and facilitators for improving antimicrobial prescribing and determining appropriate methods to improve clinical practice are required

    Analisis Laporan Keuangan Sebagai Alat Dalam Memprediksi Kecenderungan Terjadinya Kebangkrutan Pada Bank Umum Syariah; Bni Syariah, Bri Syariah, Mandiri Syariah, Mega Syariah, Bukopin Syariah (Suatu Studi Penggunaan Model Altman\u27s Z-score)

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    Kebangkrutan Perusahaan merupakan salah satu fenomena yang sering terjadidalam dunia USAha, baik itu dipengaruhi oleh pihak internal maupun eksternal Perusahaan. Untuk mengantisipasi terjadinya kebangkrutan, maka pihak Perusahaan seharusnya ada persiapan dini untuk mencegah agar tidak terjadi hal yang tidak diinginkan. Perusahaan dapat menilai kondisi Perusahaannya yang sedang berjalan, agar dapat mengetahui tindakan apa yang tepat untuk memperbaiki kekurangan dan mempertahankan Perusahaannya agar Perusahaan dapat bertahan dan bersaing, salah satu Perusahaan yang ada di Indonesia adalah Bank Umum Syariah. Tujuan dari penelitian ini adalah untuk memprediksi kecenderungan terjadinya kebangkrutan pada Bank Umum Syariah menggunakan modelAltman. Data yang digunakan dalam penelitian ini adalah data sekunder berupa laporan keuangan tahunan yang telah dipublikasikan oleh perbankan syariah periode 2010 sampai 2014. Bank Umum Syariah tersebut terdiri dari PT.BNI Syariah, PT.BRI Syariah, PT.Bank Mandiri Syariah, PT. Bank Mega Syariah dan PT.Bank Syariah Bukopin. Data diolah dengan menggunakan model Altman. Hasil dari penelitian ini menunjukkan bahwa model Altman dapat digunakan sebagai alat dalam memprediksi kecenderungan kebangkrutan Bank Umum Syariah. Dengan menggunakan model Altman, kita dapat mengetahui apakah Bank Umum Syariah berada dalam kategori bangkrut, grey area, dan tidak bangkrut. Apabila Bank Umum Syariah berada dalam kategori bangkrut, manajemen Perusahaan berhak untuk memutuskan apakah akan tetap mempertahankan Bank Syariahnya atau tidak. Bila tetap mempertahankan Bank Syariahnya, manajemen Bank Syariah diharapkan dapat mengambil tindakan yang cepat dan tepat untuk memperbaiki Bank Syariahnya tersebut, agar Bank Syariahnya tetap dapat berjalan dengan baik

    Culture, entrepreneurship and uneven development: a spatial analysis

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    Interest in the proposed connection between culture and entrepreneurship has grown significantly in recent years. However, less attention has been given to the nature of the overall impact of this proposed association on development outcomes, particularly at a local level. In response, this paper analyses the relationship between the nature of the culture, entrepreneurship and development experienced across localities, proposing that the link between culture and development is mediated by entrepreneurship. It focuses upon the concept of community culture, as well as embracing a notion of development incorporating both economic and social well-being outcomes. Drawing upon a multivariate spatial analysis of data from localities in Great Britain, the findings indicate that differences in rates of entrepreneurship are strongly influenced by the community culture present in these localities. Furthermore, a bidirectional relationship is found to exist between entrepreneurship and economic and social development outcomes. It is concluded that the embeddedness of local community culture presents a significant challenge for those places seeking to promote entrepreneurially-driven development

    De Jure Determinants of New Firm Formation: How the Pillars of Constitutions Influence Entrepreneurship

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    This paper provides empirical evidence supporting the view that constitutions may influence the organization of economic activities. Dealing with the issue of the institutional determinants of entrepreneurship, it shows that some of the provisions contained in national constitutions are positively and significantly associated to a standard measure of entrepreneurial dynamics, namely the rate of new business density. Using a novel dataset containing the characteristics of the constitutions enacted in the world and a sample of 115 countries, the paper finds that provisions about the right to conduct/establish a business, the right to strike, consumer protection, protection of trademarks, and education promote higher rates of new firm formation

    Evolutionary Repercussions of Avian Culling on Host Resistance and Influenza Virulence

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    Keeping pandemic influenza at bay is a global health priority. Of particular concern is the continued spread of the influenza subtype H5N1 in avian populations and the increasing frequency of transmission to humans. To decrease this threat, mass culling is the principal strategy for eradicating influenza in avian populations. Although culling has a crucial short-term epidemiological benefit, evolutionary repercussions on reservoir hosts and on the viral population have not been considered.To explore the epidemiological and evolutionary repercussions of mass avian culling, we combine population genetics and epidemiological influenza dynamics in a mathematical model parameterized by clinical, epidemiological, and poultry data. We model the virulence level of influenza and the selection on a dominant allele that confers resistance against influenza [1, 2] in a poultry population. Our findings indicate that culling impedes the evolution of avian host resistance against influenza. On the pathogen side of the coevolutionary race between pathogen and host, culling selects for heightened virulence and transmissibility of influenza.Mass culling achieves a short-term benefit at the expense of long-term detriments: a more genetically susceptible host population, ultimately greater mortality, and elevated influenza virulence

    Moral hazard in marriage: the use of domestic labor as an incentive device

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    This paper argues that some women in developing countries use domestic labor as a tool to incentivize husbands. A theoretical model is derived based on the traditions of rural Malawi, where men often supplement farm income with wage labor. As wage labor is not observed by the wife, this creates moral hazard: husbands may not make enough effort to bring home wages. The model predicts that women overcome this by using domestic labor as an incentive device: they increase their domestic labor and reduce their leisure in response to good consumption outcomes, but only if they cannot rely on divorce threat as an alternative source of incentives. This prediction is confirmed using survey data from Malawi. Identification is based on the fact that Malawi's kinship traditions exogenously determine women's accessibility to divorce. Where divorce is not an option, women make inefficient labor choices in order to provide incentives
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