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193 results

Page 1 of 10

  • Prioritizing emergency department antibiotic stewardship interventions for skin and soft tissue infections using judgment analysis

  • Meggie Griffin, Kimberly C. Claeys, Rebecca J. Schwei, Roger L. Brown, Michael S. Pulia
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 46 / Issue 3 / March 2025
    Published online by Cambridge University Press:
    20 January 2025, pp. 272-280
    Print publication:
    March 2025
    • Article
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      • Open access
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  • Objective:

    Skin and soft tissue infections (SSTIs) account for over 2.8 million annual emergency department (ED) visits and often result in suboptimal antibiotic therapy. The objective of this study was to evaluate a set of interventions in minimizing inappropriate prescription of antibiotics for presumed SSTIs in the ED.

    Design:

    Case vignette survey.

    Participants:

    A national sample of emergency medicine (EM) physicians.

    Methods:

    Each vignette described a clinical scenario of a presumed SSTI (cellulitis or abscess) and included a unique combination of zero to five interventions (outpatient follow-up, inappropriate antibiotic request flag, thermal imaging for cellulitis or rapid wound MRSA PCR for abscess, patient education/shared decision-making, and clinical decision support). Out of 64 possible vignettes, we asked participants to respond to eight vignettes. Following each vignette, we asked participants if they would prescribe an antibiotic in their everyday practice (yes/no). We built adjusted hierarchical logistic regression models to estimate the probability of prescribing an antibiotic for each intervention and vignette.

    Results:

    Surveys were completed by 113 EM physicians. The thermal imaging, rapid wound MRSA PCR, and patient education/shared decision-making interventions showed the largest decrease (15–20%) in antibiotic prescribing probability. Vignettes with a combination of both a diagnostic intervention (thermal imaging or rapid wound MRSA PCR) and a patient education/shared decision-making intervention had the lowest prescribing probabilities.

    Conclusion:

    We recommend future research focuses on the development and integration of novel diagnostic tools to identify true infection and incorporate shared decision-making to improve diagnosis and management of SSTIs.

The Letters of Oliver Goldsmith
  • Oliver Goldsmith
  • Edited by Michael Griffin, David O'Shaughnessy
  • Published online:
    12 December 2024
    Print publication:
    26 July 2018
  • This first modern scholarly edition of the letters of Oliver Goldsmith (1728–1774) sets the author of The Vicar of Wakefield, The Deserted Village, and She Stoops to Conquer in a rich context, showing how Goldsmith's Irish identity was marked and complicated by cosmopolitan ambition. He was at the very heart of Grub Street culture and the Georgian theatre, and was a founding member of Dr Johnson's Literary Club; his circle included Edmund Burke, Joshua Reynolds, David Garrick, George Colman and Hester Piozzi. Containing a detailed introduction and extensive notes, this edition is essential to those wishing to know more about Goldsmith the man and the writer, and provides a rich and suggestive nexus for understanding the cultural cross-currents of the literary Enlightenment in eighteenth-century London.

Oliver Goldsmith in Context
  • Edited by Michael Griffin, David O'Shaughnessy
  • Published online:
    28 November 2024
    Print publication:
    07 November 2024
  • Oliver Goldsmith has a claim to be the only eighteenth-century author who wrote canonical works in prose fiction, poetry, and drama. An Irish writer working at the centre of the British and Irish Enlightenments, with all the rich complications of identity this entailed, he authored The Vicar of Wakefield, The Deserted Village, and She Stoops to Conquer, works that number among the greatest literary productions of the century. He was also a major historian, biographer, journalist, and translator operating at the heart of literary London. Through four sections covering Goldsmith's Life and Career; Social, Cultural, and Intellectual Contexts; Literary Contexts; and Critical Fortunes and Afterlives, this volume engages with a wide range of illuminating topics that will allow both new and experienced readers of Goldsmith to understand more deeply the impact he had on his times and the powerful influence he exerted on subsequent literary culture.

  • Chapter 1 - Life

  • from Part I - Life and Career
  • Edited by Michael Griffin, University of Limerick, David O'Shaughnessy, University of Galway
  • Book:
    Oliver Goldsmith in Context
    Published online:
    28 November 2024
    Print publication:
    07 November 2024, pp 3-11

  • Summary

    This chapter provides a brief and accessible account, not just of Goldsmith’s life and literary career, but also of the ways in which he was perceived by his contemporaries, often as intellectually lightweight and somewhat foolish. That perception is questioned here, as is the traditional biographical presentation of Goldsmith as long-suffering and put upon. He is presented here rather as a survivor and a literary success. The tradition of biographical writing is also briefly sketched.

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