Patterns and Determinants of Antibiotic Use Behaviors among Rural Community Residents in Eastern China

Inappropriate antibiotic use may lead to antibiotic resistance, which has become a serious global crisis. Addressing suboptimal antibiotic use in the general population can play a significant role in the fight against antimicrobial resistance. This study aims to describe antibiotic use and sources of acquisition, and to identify factors influencing antibiotic access among rural community residents in Eastern China. A cross-sectional survey was conducted from July to August 2020, and 1494 participants from two villages in Eastern China were enrolled. Information was obtained using face-to-face interviews with a structured electronic questionnaire. Chi-squared and multinominal logistic regression analysis were used to explore possible determinants. In total, 1379 participants were eligible for the analysis. In the past 12 months, nearly half the respondents had taken any antibiotic (48.4%), and this proportion varied across marital status and age group. Two thirds of them (59.9%) obtained antibiotics from medical facilities with a prescription when they last took antibiotics, while 17.7% and 22.4% chose retail pharmacies and other sources, respectively. Multinominal analysis found that a higher proportion obtained antibiotics outside medical facilities among those aged 15 to 44 years, unmarried, non-white collar workers, with more years of education, lower annual household income per capita and lower levels of antibiotic knowledge. The antibiotic use behavior of rural community residents in Eastern China remains suboptimal. Antibiotic use and access behaviors need to be further addressed. Effective antibiotic stewardship in non-medical facility sources and training programs targeted for rural Chinese is warranted in future

Use of tramadol in a Labrador retriever presenting with self-mutilation of the tail

A 30-month-old Labrador retriever bitch with a history of atopy was presented for acuteonset tail biting that was leading to self-mutilation. The problem began 8 months before consultation and was resolved after 2 months, but it recurred 3 months later and continued for 3 months until the time of consultation. The current episode was difficult to interrupt and was being controlled through the use of an Elizabethan collar. There had been no history of injury to the tail. On examination of the tail, an irregularity was palpated approximately midway on the dorsal surface. Radiographs of the tail showed soft-tissue swelling cranially and presence of an ossicle between the mid-caudal vertebrae. Mutilation stopped with administration of tramadol and paracetamol and started again when the medication was discontinued. No behavior modification was implemented. Although there is a possibility that the tramadol was treating a psychogenically driven self-mutilation behavior, it is more likely that pain was the initiating cause for the behavior. This case report highlights the importance of careful medical evaluation of suspected behavioral problems and discusses the possible use of tramadol in self-mutilation.http://www.journals.elsevier.com/journal-of-veterinary-behavior-clinical-applications-and-research/mn201

The experience of conducting collaborative and intensive pragmatic qualitative (CLIP-Q) research to support rapid public health and healthcare innovation

A key challenge for qualitative methods in applied health research is the fast pace that can characterize the public health and health and care service landscape, where there is a need for research informed by immediate pragmatic questions and relevant findings are required quickly to inform decision-making. The COVID-19 pandemic accelerated the pace at which evidence was needed to inform urgent public health and healthcare decision-making. This required qualitative researchers to step up to the challenge of conducting research at speed whilst maintaining rigor and ensuring the findings are credible. This article illustrates how working with multidisciplinary, collaborative teams and the tailoring of qualitative methods to be more pragmatic and efficient can provide timely and credible results. Using time-limited case studies of applied qualitative health research drawn from the work of the Behavioral and Qualitative Science Team from the National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), we illustrate our collaborative and intensive pragmatic qualitative (CLIP-Q) approach. CLIP-Q involves (i) collaboration at all stages of the design, conduct and implementation of projects and, where possible, co-production with people with lived experience, (ii) an intensive team-based approach to data collection and analysis at pace, and (iii) pragmatic study design and efficient strategies at each stage of the research process. The case studies include projects conducted pre COVID-19 and during the first wave of the pandemic, where urgent evidence was required in weeks rather than months to inform rapid public health and healthcare decision making