Antibiotic Use

The goal of this clinical trial is to learn if a conditional social transfer works to improve rates of complementary breastfeeding. It will also learn about the impacts of social transfers on maternal and child health and development. The main questions it aims to answer are: * Does the social transfer increase complementary breastfeeding rates at 24-months postpartum? * Does the social transfer increase complementary breastfeeding duration? * Does the social transfer impact child health and development? * Does the social transfer impact maternal physical and mental health? Researchers will compare a conditional social transfer to a control group that only receives education about breastfeeding recommendations to see if a conditional social transfers works to increase complementary breastfeeding. Participants will: Receive a pamphlet explaining the current recommendations of breastfeeding Receive instructions that if they meet the recommendation to breastfeed until 24-months postpartum they receive a social transfer or receive no additional information Complete home visits at 12- and 24-months postpartum Complete detailed questionnaire

Antimicrobial resistance (AMR) is a global public health challenge. Due to overuse of antibiotics, bacteria are becoming resistant to antibiotics, which creates infections that can't be treated by modern medicine. To combat AMR, the public need to both know that AMR is an issue and know what actions they can take to address AMR. When patients are prescribed antibiotics, the information provided (and how this is provided) is likely to be influential on whether they are taken correctly, or if behaviours that contribute to antimicrobial resistance (such as not finishing the course) predominate. This study, a large online experiment involving 7,000 people across the UK, aims explore the influence of what information and how it is provided. The study looks at different ways of presenting information on antibiotic packets-from clear instructions to warnings and even scannable QR codes with extra details. The main goals are to see if these changes can help participants understand how to take antibiotics exactly as prescribed. The investigators also want to see if it helps participants understand what antibiotic resistance is and their role in preventing it. By understanding what works best, the investigators hope to find simple, effective ways to help everyone use antibiotics wisely, protecting these vital medicines for the future.

The goal of this clinical trial is to compare two different techniques: endoscopic saphenous vein harvesting versus conventional open harvesting in patients undergoing coronary artery bypass grafting, either alone or in combination with another cardiac surgical procedure (valve surgery or arrhythmia surgery). The main questions the trial aims to answer are: Does the endoscopic technique reduce surgical wound morbidity in terms of shorter hospital stays? Does endoscopic saphenous harvesting reduce the use of antibiotics for saphenectomy wound infections? Does the endoscopic technique reduce need for wound dressings due to necrosis and/or wound infection, and reduce need for analgesic treatment for wound pain? This prospective, randomized study will be conducted in the Cardiovascular Surgery Service at Hospital Clínico San Carlos. Participants will be randomly assigned to a different saphenectomy technique. All patients will be assessed for saphenectomy wound complications upon discharge, and by phone call at 7 days, 1 month, and 3 months following the intervention.

The study aims to develop community-based interventions targetting inappropriate antibiotic dispensing and use behaviours in rural Vietnam and has 3 research components. Community and primary healthcare interventions: The investigators will conduct a four-armed cluster randomised controlled trial. The first arm will be a control arm with no interventions. The second intervention arm will have a basic antimicrobial stewardship intervention, involving working with the Ministry of Health, Medical Services Administration to revise guidelines for antibiotic prescribing for acute respiratory infections (ARI) in primary care, and then training primary healthcare doctors in their use. The third intervention arm will have basic antimicrobial stewardship guidelines and training for primary healthcare doctors, plus educational materials for the community, disseminated through posters, leaflets and local media channels. The fourth intervention arm will use a participatory action research approach to engage primary healthcare doctors and communities, in addition to the basic guidelines and training materials. The participatory action research approach will train local facilitators to lead community and health-worker groups through a cycle of problem identification, strategy development, implementation and review, focusing on inappropriate human and small-scale agricultural use of antibiotics. Hospital interventions: The investigators will work with Provincial and District Hospitals serving these communities to implement quality improvement cycles for antibiotic stewardship, also using a participatory action research approach. This will also follow a cycle of a cycle of problem identification, strategy development, implementation and review.