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In 2021, two US military hospitals, Landstuhl Regional Medical Center in Landstuhl, Germany, and Walter Reed National Military Medical Center (WRNMMC) in Bethesda, Maryland, USA, observed a high prevalence of multidrug-resistant bacteria among refugees evacuated from Afghanistan during Operation Allies Refuge. Multidrug-resistant isolates collected from 80 patients carried an array of antimicrobial resistance genes, including carbapenemases (blaNDM-1, blaNDM-5, and blaOXA-23) and 16S methyltransferases (rmtC and rmtF). Considering the rising transmission of antimicrobial resistance and unprecedented population displacement globally, these data are a reminder of the need for robust infection control measures and surveillance.

Abstract Increasing levels of physical inactivity is a global burden for mankind and is also an emerging problem in companion dogs. In both humans and dogs, insufficient physical activity is associated with increased risk for noncommunicable diseases and impaired quality of life (QoL). The aim of the current pilot study was to evaluate effects of a joint outdoor exercise program for dog owners (n = 22) and dogs (n = 22) with focus on QoL and body measurements. Results indicate that an eight-week exercise intervention alone, with a target distance of at least 2 km twice a week, may be sufficient to significantly increase self-reported QoL and acceptance of bodily appearance in dog owners despite no reductions in body measurements. In dogs, a significantly reduced body condition score (BCS) was registered, despite no considerable changes in feeding. The increased owner motivation for continued joint exercise suggests potential for lifestyle changes, which could be investigated in future studies including control groups and long-term follow-ups. The importance of the human-animal bond as a success factor for increased mutual physical activity and health benefits in both dog owners and dogs is recommended to be studied in a more in-depth manner.

Blood and surveillance cultures from an injured service member from Ukraine grew Acinetobacter baumannii, Klebsiella pneumoniae, Enterococcus faecium, and 3 distinct Pseudomonas aeruginosa strains. Isolates were nonsusceptible to most antibiotics and carried an array of antibiotic resistant genes, including carbapenemases (blaIMP-1, blaNDM-1, blaOXA-23, blaOXA-48, blaOXA-72) and 16S methyltransferases (armA and rmtB4).

Objectives To describe the incidence of acute aortic dissection in a clearly defined population, to assess onset symptoms and admission biochemical marker levels and to analyse variables potentially associated to mortality.Methods Medical records and CT angiograms of all patients hospitalised for acute aortic dissection in the Stockholm County during the 5-year period 2012–2016 were reviewed. The patients were followed until date of death or until 31 December 2020. The annual incidence was determined. Associations between clinical and biochemical variables and 30-day mortality, respectively, were analysed using multivariable logistic regression models.Results A total of 344 patients were included. The mean annual incidence of acute aortic dissection was 4.1 per 100 000. Median age was 67 years (range 24–91) and 34% (n=118) were women. Type A dissection was predominant; 220 patients (64%) had type A and 124 (36%) had type B. Painless dissection was more common in type A than in type B (18% vs 15%, p=0.003). Type A dissection patients also more commonly had elevated plasma troponin T (44% vs 21%, p

I Kristina Lugns diktsamling Hej då, ha det så bra! (2003) liksom i den postuma ”Inte alls dåligt” (2022) drivs den egna poetiken till sin spets. Metaforikens oegentlighet och bokstavlighetens absurditet blottas. Enligt Lars Elleström ringar Lugns dikter ”in människans konkret kroppsliga, och därmed också mentala, villkor” (Elleström 2006, 28). I min artikel gäller detta resonemang inte bara den kroppsliga metaforiken utan hela den bokstavliga språkdräkten. Ann-Helén Andersson formulerar i sin avhandling ”Jag är baserad på verkliga personer”. Ironi och röstgivande i Kristina Lugns författarskap att ”I Lugns texter kan det komiska ses som ett element inom en dominerande ironisk tendens.” (Andersson 2010, 115). Med hjälp av Luigi Pirandellos essä L’umorismo (1908) och begreppet sentimento del contrario, kommer jag här istället argumentera för att Lugns bokstavliga språkdräkt, föremålet för min analys, öppnar för en humoristisk, snarare än ironisk, verkan som kan få verkligheten att framträda som aningen mer fattbar och gripbar – i all sin fasansfulla absurditet.

Abstract Background Digital stress management interventions are considered promising additions to the spectrum of the programs companies use to support the well-being of their employees. However, a series of constraints are identified that hinder the potential benefits of such interventions. These constraints include a lack of user engagement and personalisation, poor adherence and high attrition. Understanding the specific user needs and requirements is essential to increase the likelihood of success in implementing ICT (Information and Communication Technology)-supported stress management interventions. Thus, following the findings from a previous quantitative study, the proposed study aimed to further explore the user needs and requirements for designing digital stress management interventions for software employees in Sri Lanka. Methods The study used a qualitative approach based on three focus groups with 22 software employees in Sri Lanka. The focus group discussions were conducted online and recorded digitally. Inductive thematic analysis was used to analyse the collected data. The consolidated criteria for reporting qualitative studies (COREQ)-32 items were followed for reporting this study. Results The analysis revealed three major themes: self-help in a personal space, social support in a collaborative space, and general design considerations for achieving success. The first theme revealed the users’ preference for having a personal space where they could engage in individual activities without support from an external party. The second theme elaborated on the importance of adding a collaborative platform to seek help from peers and professionals. The final theme explored the user-desired design features that could increase user engagement and adherence. Conclusions This study used a qualitative approach to further explore the findings of a previous quantitative study. The focus group discussions confirmed the results of the previous study and provided the opportunity to better understand user needs and yield new insights. Such insights revealed user preference for embedding personal and collaborative platforms in a single intervention, embedding gamified elements, the provision of passive content generation via sensory systems, and the need for personalisation. These empirical findings will feed into the design of ICT-supported interventions for occupational stress management among Sri Lankan software employees.

Abstract Background Multisite practical clinical trials evaluate treatments in real-world practice. A multisite randomized Veterans Health Administration (VHA) cooperative study (CSP#555) published in 2011 compared the first long-acting injectable (LAI) second-generation antipsychotic (SGA), Risperidone Consta®, in veterans with a diagnosis of schizophrenia or schizoaffective disorder, to oral antipsychotics, with unexpected null results for effectiveness and cost-effectiveness. Whether null results of this type could change VHA practice has not been studied. Methods A longitudinal observational analysis was used to evaluate the impact of the trial findings on VHA clinical practices. National administrative data compared new starts on LAI risperidone during the 4 years before the publication of CSP#555 in 2011 to new starts on LAI risperidone during the 4 years after. Results Among 119,565 Veterans with the indicated diagnoses treated with antipsychotics from 2007 to 2015, the number and proportion of new starts on LAI risperidone declined significantly following the study publication, as did the total number of annual users and drug expenditures. However, data from 2007 to 2010 showed the decline in new starts actually preceded the publication of CSP#555. This change was likely explained by the increase in new starts, total use, and expenditures on a newer medicine, LAI paliperidone, a 4-week LAI treatment, in the 2 years prior to the publication of CSP#555. Conclusions The declining use of LAI risperidone likely primarily reflects the substitution of a longer-acting LAI SGA, paliperidone, that came to market 2 years before the study publication, a substitution that may have been reinforced by null CSP#555 study results for LAI risperidone.

Introduction: Pulmonary embolism (PE) is a rare, severe complication in pregnancy, in which case thrombolysis can be lifesaving but has risks. We aim to highlight actions specific to pregnant women. Case Description: A 24-week pregnant woman developed shortness of breath and experienced sudden cardiac arrest. Cardiopulmonary resuscitation (CPR) was begun immediately in the ambulance and a perimortem caesarean section was performed upon arrival at hospital, but the new-born died. After 55 minutes of CPR, bedside echocardiography revealed right ventricular strain and thrombolysis was given. The uterus was bandaged to minimize blood loss. After massive transfusions and correction of haemostasis, a hysterectomy was performed due to inability of the uterus to contract. After 3 weeks, the patient was discharged in good health and placed on continuous anticoagulant treatment with warfarin. Discussion: Approximately 3% of all out-of-hospital cardiac arrest cases are due to PE. Among the few patients who survive at the scene, thrombolysis can be lifesaving and should be considered in pregnant women with unstable PE. Prompt collaborative diagnostic work-up in the emergency room is necessary. In a pregnant woman with cardiac arrest, a perimortem caesarean section improves the chances of both maternal and fetal survival. Conclusion: Thrombolysis should be considered for patients with PE in pregnancy with the same indications as in a non-pregnant woman. In case of survival, there is profuse bleeding with need for massive transfusions and haemostasis correction. Despite being in very poor condition, the above patient survived and was fully restored to health.

Many research studies have highlighted the low completion rate and slow progress in PhD education. Universities strive to improve throughput and quality in their PhD education programs. In this study, the perceived problems of PhD education are investigated from PhD students' points of view, and how an Information and Communication Technology Support System (ICTSS) may alleviate these problems. Data were collected through an online open questionnaire sent to the PhD students at the Department of (the institution's name has been removed during the double-blind review) with a 59% response rate. The results revealed a number of problems in the PhD education and highlighted how online technology can support PhD education and facilitate interaction and communication, affect the PhD students' satisfaction, and have positive impacts on PhD students' stress. A system was prototyped, in order to facilitate different types of online interaction through accessing a set of online and structured resources and specific communication channels. Although the number of informants was not large, the result of the study provided some rudimentary ideas that refer to interaction problems and how an online ICTSS may facilitate PhD education by providing distance and collaborative learning, and PhD students' self-managed communication.

Objectives To describe medical management in aortic dissection (AD) and to analyse the possible associations between antihypertensive, antithrombotic, anticoagulant and statin agents, respectively, and long-term survival.Methods From Swedish medical registers, all patients diagnosed with AD in 2006–2015 were identified. Filled prescriptions prior to admission and within 1 year from discharge in patients discharged and alive at 30 days were registered. Associations between pharmacological treatment and long-term survival were analysed using Cox proportional hazards models.Results Of 3951 patients hospitalised with acute AD, 3046 (77%) were discharged and alive at 30 days. In hospitalised patients, mean age was 66 years (SD 13), and 36% (n=1098) were women. Within 1 year from discharge, 96% (n=2939) had at least one antihypertensive drug. Beta blocker was the most commonly used drug type (90%, n=2741). Statin treatment (47%, n=1418) was associated with higher long-term survival; HR 0.74 (95% CI 0.63 to 0.87, p

Introduction The software industry is considered a growing industry with a high propensity to cause stress reactions among employees due to its demanding and technology-driven nature. There are convincing shreds of evidence that information and communications technology (ICT) interventions can effectively solve stress-related disorders. However, several identified constraints have hindered its potential benefits, such as poor adherence, lack of engagement, high attrition and lack of personalisation. Objective The study presented in this article aims to gather the user needs of software employees in Sri Lanka to identify design ideas for an ICT-supported intervention for occupational stress management (ICTSMI) in the software industry. Materials and methods The study followed a quantitative approach using an online questionnaire in which three key areas were investigated: (1) stressors, (2) coping strategies and (3) design preferences. A total of 408 valid responses were collected and analysed using SPSS software. Results Findings revealed that the majority of software employees were with a moderate level of stress. They perceived work stressors and role stressors as common causes of stress. The most frequently used coping strategy was to seek social support, followed by digital activities and sports and physical exercises. The male and female design preferences varied to a greater extent but only slightly varied based on their job category. However, findings suggested the necessity of further elicitation of user needs to support the design process.

Abstract Background A plasma glutamine concentration outside the normal range at Intensive Care Unit (ICU) admission has been reported to be associated with an increased mortality rate. Whereas hypoglutaminemia has been frequently reported, the number of patients with hyperglutaminemia has so far been quite few. Therefore, the association between hyperglutaminemia and mortality outcomes was studied in a prospective, observational study. Patients and methods Consecutive admissions to a mixed general ICU were eligible. Exclusion criteria were

Abstract Background Epidemiological studies show an association between masticatory function and cognitive impairment. This has further strengthened the notion that tooth loss and impaired masticatory function may be risk factors for dementia and cognitive decline. Animal experiments have indicated a causal relationship and several possible mechanisms have been discussed. This evidence is, however, lacking in humans. Therefore, in the current interventional study, we aim to investigate the effect of rehabilitation of masticatory function on cognition in older adults. Methods Eighty patients indicated for prosthodontic rehabilitation will be randomly assigned to an experimental or a control group. Participants will conduct neuropsychological assessments, masticatory performance tests, saliva tests, optional magnetic resonance imaging, and answer questionnaires on oral health impact profiles and hospital anxiety and depression scale before, 3 months, and 1 year after oral rehabilitation. The difference between the two groups is that the control group will be tested an additional time, (at an interval of about 3 months) before the onset of the oral rehabilitation procedure. The primary outcome is a change in measures of episodic memory performance. Discussion Although tooth loss and masticatory function are widespread in older people, it is still an underexplored modifiable risk factor potentially contributing to the development of cognitive impairment. If rehabilitation of masticatory function shows positive effects on the neurocognitive function, this will have great implications on future health care for patients with impaired masticatory status. The present project may provide a new avenue for the prevention of cognitive decline in older individuals. Trial registration: The protocol for the study was retrospectively registered in ClinicalTrials.gov Identifier: NCT04458207, dated 02-07-2020.

Both construct specification equations (CSEs) and entropy can be used to provide a specific, causal, and rigorously mathematical conceptualization of item attributes in order to provide fit-for-purpose measurements of person abilities. This has been previously demonstrated for memory measurements. It can also be reasonably expected to be applicable to other kinds of measures of human abilities and task difficulty in health care, but further exploration is needed about how to incorporate qualitative explanatory variables in the CSE formulation. In this paper we report two case studies exploring the possibilities of advancing CSE and entropy to include human functional balance measurements. In case study I, physiotherapists have formulated a CSE for balance task difficulty by principal component regression of empirical balance task difficulty values from Berg’s Balance Scale transformed using the Rasch model. In case study II, four balance tasks of increasing difficulty due to diminishing bases of support and vision were briefly investigated in relation to entropy as a measure of the amount of information and order as well as physical thermodynamics. The pilot study has explored both methodological and conceptual possibilities and concerns to be considered in further work. The results should not be considered as fully comprehensive or absolute, but rather open up for further discussion and investigations to advance measurements of person balance ability in clinical practice, research, and trials.

Introduction: Our objective was to determine whether the educational game SonoQz can improve diagnostic performance in ultrasound assessment of ovarian tumors. Material and Methods: The SonoQz mobile application was developed as an educational tool for medical doctors to practice ultrasound assessment, based on still images of ovarian tumors. The game comprises images from 324 ovarian tumors, examined by an ultrasound expert prior to surgery. A training phase, where the participants assessed at least 200 cases in the SonoQz app, was preceded by a pretraining test, and followed by a posttraining test. Two equal tests (A and B), each consisting of 20 cases, were used as pre‐ and posttraining tests. Half the users took test A first, B second, and the remaining took the tests in the opposite order. Users were asked to classify the tumors (1) according to International Ovarian Tumor Analysis (IOTA) Simple Rules, (2) as benign or malignant, and (3) suggest a specific histological diagnosis. Logistic mixed models with fixed effects for pre‐ and posttraining tests, and crossed random effects for participants and cases, were used to determine any improvement in test scores, sensitivity, and specificity. Results: Fifty‐eight doctors from 19 medical centers participated. Comparing the pre‐ and posttraining test, the median of correctly classified cases, in Simple Rules assessment increased from 72% to 83%, p < 0.001; in classifying the lesion as benign or malignant tumors from 86% to 95%, p < 0.001; and in making a specific diagnosis from 43% to 63%, p < 0.001. When classifying tumors as benign or malignant, at an unchanged level of sensitivity (98% vs. 97%, p = 0.157), the specificity increased from 70% to 89%, p < 0.001. Conclusions: Our results indicate that the educational game SonoQz is an effective tool that may improve diagnostic performance in assessing ovarian tumors, specifically by reducing the number of false positives while maintaining high sensitivity. [ABSTRACT FROM AUTHOR]

This article studies the rise of market research and opinion surveys in Sweden from the 1930s and onward. By focusing on promotion of empirical knowledge by actors between the academic and the commercial world, such as Gerhard Törnqvist, I show how new knowledge practices of classifying consumers into social classes were established among marketers and advertisers. These approaches were overtaken by the Swedish Gallup, which produced opinion surveys from early 1940s framing opinions ordered into classed responses. In the final section of the article, I chart newspapers preoccupation with classifying practices of the Swedish population into classes. The article investigates market research and opinion surveys through the theoretical prism of following “the social life of methods”, a perspective that sees methods of knowledge as political. I follow how a class taxonomy in social groups (socialgrupper), constructed by the Swedish statistical bureau in 1911, migrated and became productive in the commercial sector starting in the 1930s. I call these surveys difference machines (skillnadsmaskiner), in that they repeatedly produced statistical differences as new knowledge. In understanding the history of class and class identity, it is crucial to include these often-overlooked knowledge practices since they through media had a significant presence in people’s everyday lives, influencing ways of understanding and discussing society and the self.

ABSTRACT The coronavirus disease 2019 (COVID-19) pandemic is complicated by cases of vaccine breakthrough and reinfection and widespread transmission of variants of concern (VOCs). Consequently, the need to interpret longitudinal positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests is crucial in guiding clinical decisions regarding infection control precautions and treatment. Although diagnostic real-time reverse transcription (RT)-PCR tests yield CT values that are inversely correlated with RNA quantity, these tests are only approved for qualitative interpretation. In this study, we performed a retrospective review of 72,217 SARS-CoV-2 positive tests and identified 264 patients with longitudinal positivity prior to vaccination and VOC circulation. Patients with longitudinal positivity fell into two categories: short-term (207, 78%) or prolonged (57, 22%) positivity, defined as ≤28 (range, 1 to 28; median, 16) days and >28 (range, 29 to 152; median, 41) days, respectively. In general, CT values increased over time in both groups; however, 11 short-term-positive patients had greater amounts of RNA detected at their terminal test than at the first positive test, and 6 patients had RNA detected at CT values of

Adequately managing project interdependencies among diverse and simultaneous projects is deemed critical for successful implementation of project portfolios. The challenge is significant because it may entail managing a complex network of project interdependencies that keeps changing over time. The present study investigates the managerial challenges that may undermine effective management of project interdependencies in IT/IS project portfolios. The investigation is based on evidence from reviewing relevant literature and documented studies associated with managing project interdependencies. The main contribution of this study is to discuss three managerial challenges of project interdependencies in project portfolios. We discuss the challenges from three perspectives: types of interdependencies; patterns of interaction in interdependencies; and cost/benefit impact of project interdependencies.

In today’s uncertain and competitive market, where manufacturing enterprises are subjected to increasingly shortened product lifecycles and frequent volume changes, reconfigurable manufacturing system (RMS) applications play significant roles in the success of the manufacturing industry. Despite the advantages offered by RMSs, achieving high efficiency constitutes a challenging task for stakeholders and decision makers when they face the trade-off decisions inherent in these complex systems. This study addresses work task and resource allocations to workstations together with buffer capacity allocation in an RMS. The aim is to simultaneously maximize throughput and to minimize total buffer capacity under fluctuating production volumes and capacity changes while considering the stochastic behavior of the system. An enhanced simulation-based multi-objective optimization (SMO) approach with customized simulation and optimization components is proposed to address the abovementioned challenges. Apart from presenting the optimal solutions subject to volume and capacity changes, the proposed approach supports decision makers with knowledge discovery to further understand RMS design. In particular, this study presents a customized SMO approach combined with a novel flexible pattern mining method for optimizing an RMS and conducts post-optimal analyses. To this extent, this study demonstrates the benefits of applying SMO and knowledge discovery methods for fast decision support and production planning of an RMS.

Background and purpose — Data regarding long-term behavior of metal ion levels in metal-on-metal total hip arthroplasty (MoM THA) patients is scarce. Therefore, we assessed whether there is any change in whole blood (WB) chromium (Cr), and cobalt (Co) ion measurements in Durom and MMC MoM THA patients over time. The secondary aim was to report the clinical outcomes using these devices in a single district. Patients and methods — Durom and MMC cups were used in 249 MoM THAs from 2005 to 2011 in our district. Median follow-up time was 12 years for Durom THA (interquartile range [IQR] = 3) and 9 years for MMC THA (IQR = 1). A random coefficient model was used to compare individual differences in repeated WB Cr and Co ion measurements. The Kaplan–Meier estimator was used to analyze implant survival with any reason for revision as the endpoint. Results — Geometric means of Cr in Durom THA and MMC THA patients decreased from 2.2 ppb (geometric standard deviation [SD] = 1.9) to 1.5 ppb (geometric SD = 2.5, p< 0.001) and from 1.8 ppb (geometric SD = 1.8) to 1.1 ppb (geometric SD = 2.8, p = 0.01) respectively. The geometric means of Co values remained unchanged. The 10-year survival of Durom THA was 82%, and that of MMC THA 89% for any revision reason as endpoint. Interpretation — WB Cr levels decreased over time, and Co levels remained unchanged at long-term follow-up. Despite this we recommend continuing the follow-up of these devices due to relatively low implant survival.

Current market requirements force manufacturing companies to face production changes more often than ever before. Reconfigurable manufacturing systems (RMS) are considered a key enabler in today’s manufacturing industry to cope with such dynamic and volatile markets. The literature confirms that the use of simulation-based multi-objective optimization offers a promising approach that leads to improvements in RMS. However, due to the dynamic behavior of real-world RMS, applying conventional optimization approaches can be very time-consuming, specifically when there is no general knowledge about the quality of solutions. Meanwhile, Pareto-optimal solutions may share some common design principles that can be discovered with data mining and machine learning methods and exploited by the optimization. In this study, the authors investigate a novel knowledge-driven optimization (KDO) approach to speed up the convergence in RMS applications. This approach generates generalized knowledge from previous scenarios, which is then applied to improve the efficiency of the optimization of new scenarios. This study applied the proposed approach to a multi-part flow line RMS that considers scalable capacities while addressing the tasks assignment to workstations and the buffer allocation problems. The results demonstrate how a KDO approach leads to convergence rate improvements in a real-world RMS case.

Class in the age of the pool of talent: Taxonomic struggles in and through Swedish education research, c. 1945–1960. This article studies conceptualisations of social class in Swedish education research, c. 1945–1960. The article follows knowledge produced about talent and class in state commissions and in the newly expanded social sciences, and how it in turn was interpreted and used in political debates and in the media. I show that the taxonomy of the population in social groups (Socialgrupper) was key for conceptualising notions of talent and framing education policy, beginning with debates around ”the pool of talent” (Begåvningsreserven) in 1948. At the same time as becoming a standard tool for mapping social difference in Sweden, the social group taxonomy was criticised for being unscientific.

Introduction Symptoms associated with SARS-CoV-2 infection remain incompletely understood, especially among ambulatory, non-hospitalized individuals. With host factors, symptoms predictive of SARS-CoV-2 could be used to guide testing and intervention strategies. Methods Between March 16 and September 3, 2020, we examined the characteristics and symptoms reported by individuals presenting to a large outpatient testing program in the Southeastern US for nasopharyngeal SARS-CoV-2 RNA RT-PCR testing. Using self-reported symptoms, demographic characteristics, and exposure and travel histories, we identified the variables associated with testing positive using modified Poisson regression. Results Among 20,177 tested individuals, the proportion positive was 9.4% (95% CI, 9.0–9.8) and was higher for men, younger individuals, and racial/ethnic minorities (all PConclusions In a large outpatient population in the Southeastern US, several symptoms, most notably loss of taste or smell, and greater symptom burden were associated with detection of SARS-CoV-2 RNA. Persons of color and those with who were a contact of a COVID-19 case were also more likely to test positive. These findings suggest that, given limited SARS-CoV-2 testing capacity, symptom presentation and host characteristics can be used to guide testing and intervention prioritization.

This article explores the possibilities of combining literary and linguistic text analyses: a double perspective on the teacher education for secondary school. The aim is to analyze how two students, in a course in text analysis, solve an examination assignment where they are asked to combine literary and linguistic tools in their analysis of Pär Lagerkvist's short story "Father and I" (1924). We ask the following questions: How do students use literary and linguistic tools in the analysis of Lagerkvist's work and how do they combine these tools? What kind of didactic potentials do students see in a double perspective? The result shows both similarities and differences in how the students combine linguistic and literary tools and how they underpin the analysis. The students’ meta-reflections indicate that such double perspective provides a deeper understanding of literary texts containing both literary and linguistic resources. Our conclusion is that the double perspective may provide a powerful theoretical and didactic tool for students of the Swedish language at the teacher education for secondary school.

Abstract Background Antimicrobial resistance (AMR) is a growing public health threat. Primary care physicians are important inducers of the overuse of antimicrobials and inappropriate prescribing. Augmented reality (AR) might provide a potential educational tool in health care. The aim of this study was to identify the need for education and expectations for AR-based education in the context of improving the rational use of antibiotics by primary care physicians in China. Methods The study used a qualitative approach based on face-to-face interviews with eleven physicians from three community health service centers and stations in China. We used a hybrid thematic analysis approach to analyze the interview data. A conceptual design framework, mobile augmented reality education (MARE), guided the work. Results The physicians’ personal prescription paradigms included problems regarding the way they diagnosed and chose treatments and prescriptions. Although the physicians mentioned that they should not treat patients with antibiotics without proof of a bacterial infection, in practice, they often did not wait for necessary test results before they prescribed antibiotics. It was also revealed that they often experienced difficulties when trying to convince patients to follow non-antibiotic treatments. Physicians’ prescription of antibiotics was based on three different paths: if they thought there was a bacterial infection, if they thought preventing additional possible infections for the patient to be necessary; and if the patients requested antibiotics. The physicians expressed various learning needs for the rational use of antibiotics, and their expectations of an AR-based educational intervention included suggestions for contents, learning assets, learning environments and learning activities. Conclusions The results showed that the physicians were not only unfamiliar with national guidelines on the use of antibiotics and local AMR patterns but also had personal paradigm issues related to the physicians’ decision making. Moreover, the physicians provided meaningful insights into and expectations for possible AR-based education on AMR. In this article, we demonstrate how to apply the MARE framework to analyze the needs of educational interventions for rational use of antibiotics.