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Objectives: Electronic medical record (EMR) prescription data may identify high antibiotic prescribers in primary care. However, practitioners doubt that population differences between providers and delayed antibiotic prescriptions are adequately accounted for in EMR-derived prescription rates. This study assessed the validity of using EMR prescription data to produce antibiotic prescription rates, accounting for these factors. Methods: The study was a secondary analysis of antimicrobial prescriptions collected from 4 primary care clinics from 2015 to 2017. For adults with selected respiratory and urinary infections, EMR diagnostic codes, prescription data, clinical diagnoses and demographics were abstracted. Overall and delayed prescription rates were produced for EMR diagnostic codes, clinical diagnoses, by clinic, and types of infection. Direct standardization was used to adjust for case mix differences by clinic. High antibiotic prescribers, above the 75th percentile for prescriptions, were compared with low antibiotic prescribers. Results: Of 3108 EMR visits, there were 2577 (85.4%) eligible visits with a clinical diagnosis and prescription information. Overall antibiotic prescription rates were similar utilizing EMR records (31.6%) or clinical diagnoses (32.6%, P =.40). When delayed prescriptions were removed, prescribing rates were lower (22.4%, P <.01). EMR data overestimated prescribing rates for conditions where antibiotics are usually not indicated (17.7% EMR vs 7.6% clinical diagnoses, P <.001). High antibiotic prescribers saw more cases where antibiotics are usually indicated (23.4%) compared to low prescribers (16.8%; P =.001). Conclusions: Electronic medical record prescribing rates are similar to those using clinical diagnoses overall, but overestimate prescribing by clinicians for conditions usually not needing antibiotics. EMR prescription rates do not account for delayed antibiotic prescriptions or differences in infection case-mix. [ABSTRACT FROM AUTHOR]

Evidence-based guidelines recommend physical activity during pregnancy, however, most pregnant individuals fail to achieve the minimum recommended amount of physical activity. Uncertainty about the safety of physical activity is a common reason why pregnant individuals do not participate in regular physical activity. The purpose of this study was to develop an evidence-based educational video and evaluate its effectiveness at improving pregnant individuals' attitudes regarding the safety of physical activity during pregnancy. Pregnant individuals attending their first prenatal appointment from an urban academic interprofessional teaching unit in Toronto, Canada were invited to participate. Participants (n=37) completed a survey during their first trimester (x²= 12.4 weeks gestation) before watching an evidence-based physical activity safety video. The cohort was then asked to complete surveys two months later in their second trimester (x²= 22.6 weeks gestation) after watching the video. While all participants felt confident engaging in physical activity pre-intervention (100%), most participants expressed benefit from further education (80.8%). After watching the video, there was a significant difference in participants' beliefs regarding high impact activities (p=0.03) and knowledge about physical activity amount as recommended by current guidelines (p<0.01). Overall, participants felt the video improved their knowledge about the safety of physical activity during pregnancy (90.9%) and they would recommend the video to other pregnant individuals (95.5%). The evidence-based video provided to patients early in pregnancy appears effective in reinforcing positive attitudes towards the safety of prenatal physical activity. Future studies exploring more diverse populations are needed to confirm the results of this pilot study. [ABSTRACT FROM AUTHOR]

Background: Personal narrative plays an important role in the process of recovery from psychotic illnesses. Participatory video is a novel, active intervention that can be used as a tool for fostering narrative development among people with psychosis. Aim: To assess the feasibility, acceptability and potential clinical utility of participatory video as an innovative tool for promoting recovery in early psychosis. Methods: Ten outpatients of an early psychosis intervention programme were recruited to participate in 13 biweekly workshops to plan, film and produce documentary-style videos of their experiences. Feasibility was measured through recruitment and retention. Acceptability was measured through workshop attendance and client satisfaction. Clinical outcomes were assessed at baseline, post intervention and 3 months post intervention. Results: The participatory video intervention was feasible and associated with a high degree of satisfaction for participants who completed the workshops (n = 6). At 3-month follow-up, participants exhibited significant reductions (p <.05) in tension, self-stigma and negative perceptions of hoped-for selves. Conclusions: The findings of this pilot study suggest that participatory video is feasible and acceptable for individuals with early psychosis. This study also provides important pilot data supporting a larger trial investigating the effectiveness of participatory video as a recovery-oriented intervention. [ABSTRACT FROM AUTHOR]