Canadian physicians' knowledge and counseling practices related to antibiotic use and antimicrobial resistance: Two-cycle national survey.

OBJECTIVE: To establish a baseline for physicians' knowledge of and counseling practices on the use of antibiotics and antimicrobial resistance (AMR), and to determine potential changes in these measures after the implementation of a national AMR awareness campaign. DESIGN: Cross-sectional design. SETTING: Canada. PARTICIPANTS: A total of 1600 physicians. MAIN OUTCOME MEASURES: Physicians' knowledge of and counseling practices on antibiotic use and AMR at baseline and after implementation of the AMR awareness campaign. RESULTS: A total of 336 physicians responded to the first-cycle survey (before the campaign), and 351 physicians responded to the second-cycle survey (after the campaign). Overall, physicians' knowledge of appropriate antibiotic use and AMR was high and their counseling practices in relation to antibiotics were appropriate in both surveys. Counseling levels about topics related to infection prevention and control (eg, food handling, household hygiene) were slightly lower. Counseling levels were also lower for certain antibiotic-use practices (eg, proper disposal of antibiotics). In addition, physicians with less than 10 years of practice experience had significantly lower odds of counseling their patients on topics related to preventing antibiotic resistance and infection prevention than those with 15 or more years of practice experience (adjusted odds ratio = 0.27, 95% CI 0.10 to 0.74). Significantly more physicians from the second-cycle survey counseled patients on the appropriate disposal of antibiotics (P = .03), as well as on some of the infection prevention topics (eg, using antibacterial hand soap [P = .02] and cleaning supplies [P = .01]). Most respondents in both surveys reported feeling confident with respect to counseling their patients on the appropriate use of antibiotics and AMR. CONCLUSION: Physicians' knowledge of and levels of counseling on the use of antibiotics and AMR were high and fairly stable in both survey results. This shows that Canadian physicians are demonstrating behaviour patterns of AMR stewardship. Existing gaps in counseling practices might be a result of physicians believing that pharmacists or nurses are addressing these issues with patients. Future national surveys conducted among pharmacists and nurses would contribute to the evidence base for AMR stewardship activities.

Quantitatively Measuring Privacy in Interactive Query Settings Within RDBMS Framework.

Little attention has been paid to the measurement of risk to privacy in Database Management Systems, despite their prevalence as a modality of data access. This paper proposes PriDe, a quantitative privacy metric that provides a measure (privacy score) of privacy risk when executing queries in relational database management systems. PriDe measures the degree to which attribute values, retrieved by a principal (user) engaging in an interactive query session, represent a reduction of privacy with respect to the attribute values previously retrieved by the principal. It can be deployed in interactive query settings where the user sends SQL queries to the database and gets results at run-time and provides privacy-conscious organizations with a way to monitor the usage of the application data made available to third parties in terms of privacy. The proposed approach, without loss of generality, is applicable to BigSQL-style technologies. Additionally, the paper proposes a privacy equivalence relation that facilitates the computation of the privacy score.