Antibiotic knowledge, attitudes, and practices: new insights from cross-sectional rural health behaviour surveys in low- and middle-income South-East Asia

Introduction: Low- and middle-income countries (LMICs) are crucial in the global response to antimicrobial resistance (AMR), but diverse health systems, healthcare practices, and cultural conceptions of medicine can complicate global education and awareness-raising campaigns. Social research can help understand LMIC contexts but remains underrepresented in AMR research. Objective: To (1) describe antibiotic-related knowledge, attitudes, and practices of the general population in two LMICs and to (2) assess the role of antibiotic-related knowledge and attitudes on antibiotic access from different types of healthcare providers. Design: Observational study: cross-sectional rural health behaviour survey, representative on the population level. Setting: General rural population in Chiang Rai (Thailand) and Salavan (Lao PDR), surveyed between November 2017 and May 2018. Participants: 2141 adult members (≥18 years) of the general rural population, representing 712,000 villagers. Outcome measures: Antibiotic-related knowledge, attitudes, and practices across sites and healthcare access channels. Findings: Villagers were aware of antibiotics (Chiang Rai: 95.7%; Salavan: 86.4%; p<0.001) and drug resistance (Chiang Rai: 74.8%; Salavan: 62.5%; p<0.001), but the usage of technical concepts for antibiotics was dwarfed by local expressions like “anti-inflammatory medicine” in Chiang Rai (87.6%; 95% confidence interval [CI]: 84.9–90.0) and “ampi” in Salavan (75.6%; 95% CI: 71.4–79.4). Multivariate linear regression suggested that attitudes against over-the-counter antibiotics were linked to 0.12 additional antibiotic use episodes from public healthcare providers in Chiang Rai (95% CI: 0.01 – 0.23) and 0.53 in Salavan (95% CI: 0.16 – 0.90). Conclusions: Locally specific conceptions and counter-intuitive practices around antimicrobials can complicate AMR communication efforts and entail unforeseen consequences. Overcoming “knowledge deficits” alone will therefore be insufficient for global AMR behaviour change. We call for an expansion of behavioural AMR strategies towards “AMR-sensitive interventions” that address context-specific upstream drivers of antimicrobial use (e.g. unemployment insurance) and complement education and awareness campaigns

Antibiotic knowledge, attitudes and practices: new insights from cross-sectional rural health behaviour surveys in low-income and middle-income South-East Asia

Introduction: Low-income and middle-income countries (LMICs) are crucial in the global response to antimicrobial resistance (AMR), but diverse health systems, healthcare practices and cultural conceptions of medicine can complicate global education and awareness-raising campaigns. Social research can help understand LMIC contexts but remains under-represented in AMR research. Objective: To (1) Describe antibiotic-related knowledge, attitudes and practices of the general population in two LMICs. (2) Assess the role of antibiotic-related knowledge and attitudes on antibiotic access from different types of healthcare providers. Design: Observational study: cross-sectional rural health behaviour survey, representative of the population level. Setting: General rural population in Chiang Rai (Thailand) and Salavan (Lao PDR), surveyed between November 2017 and May 2018. Participants: 2141 adult members (≥18 years) of the general rural population, representing 712,000 villagers. Outcome measures: Antibiotic-related knowledge, attitudes and practices across sites and healthcare access channels. Findings: Villagers were aware of antibiotics (Chiang Rai: 95.7%; Salavan: 86.4%; p&lt;0.001) and drug resistance (Chiang Rai: 74.8%; Salavan: 62.5%; p&lt;0.001), but the usage of technical concepts for antibiotics was dwarfed by local expressions like ‘anti-inflammatory medicine’ in Chiang Rai (87.6%; 95% CI 84.9% to 90.0%) and ‘ampi’ in Salavan (75.6%; 95% CI 71.4% to 79.4%). Multivariate linear regression suggested that attitudes against over-the-counter antibiotics were linked to 0.12 additional antibiotic use episodes from public healthcare providers in Chiang Rai (95% CI 0.01 to 0.23) and 0.53 in Salavan (95% CI 0.16 to 0.90). Conclusions: Locally specific conceptions and counterintuitive practices around antimicrobials can complicate AMR communication efforts and entail unforeseen consequences. Overcoming ‘knowledge deficits’ alone will therefore be insufficient for global AMR behaviour change. We call for an expansion of behavioural AMR strategies towards ‘AMR-sensitive interventions’ that address context-specific upstream drivers of antimicrobial use (eg, unemployment insurance) and complement education and awareness campaigns. Trial Registration Number: clinicaltrials.gov identifier NCT03241316.</p

Matter radius of 78Kr^{78}Kr from proton elastic scattering at 153 MeV

8 pags., 5 figs., 1 tab.Small-angle differential cross sections of proton elastic scattering off Kr78 with a collision energy of 152.7 MeV/u were measured at the experimental Cooler Storage Ring of the Heavy Ion Research Facility in Lanzhou (HIRFL-CSR). Low energy recoil protons from the elastic scattering were counted by a silicon-strip detector to determine relative differential cross sections. A model-dependent root-mean-square matter radius of 4.16(12) fm for the Kr78 nucleus was deduced by employing the Glauber model. Compared to the proton radius of 4.13 fm for Kr78, our center value of matter radius is slightly larger. This finding in Kr78 is opposite to the known results of Kr76,80, where the matter radii are smaller than the corresponding proton radii. However, considering the relatively large radius error of Kr78, the difference is not statistically significant, and further experiments are necessary.This work is supported in part by the NSFC (12022504, 12121005, U1932140), by the CAS Pioneer Hundred Talents Program, and by the CAS Open Research Project of large research infrastructures. P. S. acknowledges MCI/AEI/FEDER, UE (Spain) under Grant No. PGC2018-093636-B-I00.Peer reviewe

A sequential approach to the characteristic function and the core in games with externalities

High-accuracy mass measurements have been performed with the Penning trap mass spectrometer ISOLTRAP at ISOLDE/CERN. The short-lived nuclides $^{70,71,72,73}$Se, $^{72,73,74,75}$Br, and $^{98,99,100,101,103}$Ag have been measured with an average uncertainty of a few keV. The data are important input for nucleosynthesis calculations of the rp-process beyond Z = 32

Precise measurements of half-lives and branching ratios for the β \beta mirror transitions in the decay of 23^{23}Mg and 27^{27}Si

Half-lives and branching ratios for the two mirror $\beta$ decays of$^{23}$Mg and$^{27}$Si have been measured at the University of Jyväskylä with the IGISOL facility. The results obtained, $T_{1/2}=11.303(3)$ s and $T_{1/2}= 4.112(2)$ s for the half-lives of$^{23}$Mg and$^{27}$Si , respectively, are 7 and 8 times more precise than the averages of previous measurements. The values obtained for the super-allowed branching ratios of$^{23}$Mg and$^{27}$Si are $B.R.=92.18(8)\%$ and $B.R.=99.74(2)\%$ , respectively. The result for$^{23}$Mg is three times more precise than the average of the previous measurements, while for$^{27}$Si the precision has not been improved, the average of the previous measurements being already very precise. Isospin-symmetry-breaking corrections have been calculated for the two nuclei to determine the corrected ${F}t$ value