A theory-based exploration of antibiotic use in primary healthcare in Gezira state, Sudan

Background Inappropriate use of antibiotics is a major contributing factor to the emergence of antimicrobial resistance globally, including in Sudan. Objectives The project aimed to develop a theory-driven behaviour change strategy addressing both prescribers and patients based on factors that are driving antibiotic use in primary healthcare settings in Gezira state in Sudan. Methods The strategy was designed based on the Theoretical Domains Framework (TDF) to identify behavioural domains and the Behaviour Change Wheel (BCW) to select appropriate intervention functions. The process included (1) a formative qualitative research study and (2) a knowledge co-production workshop that utilized the results of the qualitative study to design a salient, appropriate, and credible behaviour change strategy. Results The TDF domains related to prescribers that emerged from the study included knowledge, skills, and intention. The selected BCW intervention functions included education, training, modelling, and persuasion. The main TDF domains related to patients included social influences and intention. The selected BCW intervention functions included enablement and education. Conclusion Using the TDF and BCW intervention functions, the study identified behavioural domains that influence antibiotic prescription and consumption in rural primary healthcare settings in Gezira state in Sudan and appropriate intervention functions to modify these behaviours. Knowledge co-production ensured that the evidence-based strategy was acceptable and practical in the local context.

Rock-Paper-Scissors Play: Beyond the Win-Stay/Lose-Change Strategy

This research studied the strategies that players use in sequential adversarial games. We took the Rock-Paper-Scissors (RPS) game as an example and ran players in two experiments. The first experiment involved two humans, who played the RPS together for 100 times. Importantly, our payoff design in the RPS allowed us to differentiate between participants who used a random strategy from those who used a Nash strategy. We found that participants did not play in agreement with the Nash strategy, but rather, their behavior was closer to random. Moreover, the analyses of the participants’ sequential actions indicated heterogeneous cycle-based behaviors: some participants’ actions were independent of their past outcomes, some followed a well-known win-stay/lose-change strategy, and others exhibited the win-change/lose-stay behavior. To understand the sequential patterns of outcome-dependent actions, we designed probabilistic computer algorithms involving specific change actions (i.e., to downgrade or upgrade according to the immediate past outcome): the Win-Downgrade/Lose-Stay (WDLS) or Win-Stay/Lose-Upgrade (WSLU) strategies. Experiment 2 used these strategies against a human player. Our findings show that participants followed a win-stay strategy against the WDLS algorithm and a lose-change strategy against the WSLU algorithm, while they had difficulty in using an upgrade/downgrade direction, suggesting humans’ limited ability to detect and counter the actions of the algorithm. Taken together, our two experiments showed a large diversity of sequential strategies, where the win-stay/lose-change strategy did not describe the majority of human players’ dynamic behaviors in this adversarial situation.

Launching the Change Initiative

The first implementation step is to determine an overall change strategy (empirical-rational, normative-reeducative, or power-coercive). Broadly and fully communicating the need and desirability of the change is necessary for staff to see the relevance of the change goal. This can include data from the earlier assessment of the problem and how achievement of the change goal will lead to a better future for the organization. Change leaders might show how the change is compatible with the organization’s mission, vision, and values. Change leaders cannot “overcommunicate” regarding the need for change. Creating a sense of urgency needs to be framed from the employees’ perspectives: how the change will address a real problem and what bad outcomes are likely if the problem is not addressed. Communicating the change vision involves referring to the new ideal future of the organization and also outlining the basics of the change process to be used.

Smartphone Operated Elevator

additionally as an interface as a connection among cell phones and lift control boards. Moreover, we'll show the arrangement of the apparatus which animates an effect board for the lift call and interface which can get signals, measure them and send them to the fundamental lift instrument board. The introduced framework may be used in shrewd house projects and, particularly for crippled individuals. The common link change framework includes a long change cycle on the change of level floor, running bends, and including running parts for the lift. Then again, it generally requires close coordination between two agents. So this paper plans a lift remote change framework, including Bluetooth innovation, Android telephone innovation, and microcontroller innovation. The lift remote change framework makes the technique for change natural, decreases the responsibility of the adjustor, and speeds up the lift change cycle. Contrasted to the typical lift change strategy, this procedure makes it conceivable to utilize an Android telephone as a lift change apparatus to troubleshoot the lift with Bluetooth. Other than contrasted and other remote lift change strategies, the remote module is fixed on the regulator for the lift as opposed to the lift regulator, this technique maintains a strategic distance from the restriction of remote distance and subsequently, the adjustor simply should remain inside the lift while changing the boundary of the lift instead of running here and there, the continuous change result's fit to be seen inside the Android telephone. The test has demonstrated the achievability, viability, and dependability of the plan of a lift remote change framework.