Objectives Unnecessary antibiotic prescribing contributes to antimicrobial resistance. A randomized controlled trial in 2014–15 showed that a letter from England’s Chief Medical Officer (CMO) to high-prescribing GPs, giving feedback about their prescribing relative to the norm, decreased antibiotic prescribing. The CMO sent further feedback letters in succeeding years. We evaluated the effectiveness of the repeated feedback intervention. Methods Publicly available databases were used to identify GP practices whose antibiotic prescribing was in the top 20% nationally (the intervention group). In April 2017, GPs in every practice in the intervention group (n=1439) were sent a letter from the CMO. The letter stated that, ‘the great majority of practices in England prescribe fewer antibiotics per head than yours’. Practices in the control group received no communication (n=5986). We used a regression discontinuity design to evaluate the intervention because assignment to the intervention condition was exogenous, depending on a ‘rating variable’. The outcome measure was the average rate of antibiotic items dispensed from April 2017 to September 2017. Results The GP practices who received the letter changed their prescribing rates by −3.69% (95% CI=−2.29 to −5.10; P<0.001), representing an estimated 124 952 fewer antibiotic items dispensed. The effect is robust to different specifications of the model. Conclusions Social norm feedback from a high-profile messenger continues to be effective when repeated. It can substantially reduce antibiotic prescribing at low cost and on a national scale. Therefore, it is a worthwhile addition to antimicrobial stewardship programmes.
One of the special arrangements in testing contexts is to allow dyslexic students to listen to the text while they read. In our study, we investigated the effect of read-aloud assistance on young English learners' language comprehension scores. We also examined whether students with dyslexia identification benefit from this assistance differently from their peers with no official identification of dyslexia.Our research was conducted with young Slovenian learners of English who performed four language assessment tasks adapted from a standardized battery of Slovenian national English language tests. In a counter-balanced design, 233 students with no identified dyslexia and 47 students with dyslexia identification completed two language comprehension tasks in a readingonly condition, one task with read-aloud assistance and one task in listening-only mode. We used Generalized Linear Mixed-Effects Modelling (GLMM) to estimate accurately the effects of Article Language Testing 36(1) the mode of administration, dyslexia status, and input text difficulty, while accounting for error variance owing to random differences between students, texts, and questions.The results of our study revealed that young L2 learners with no dyslexia identification performed similarly in the three conditions. The read-aloud assistance, however, was found to increase the comprehension scores of dyslexic participants when reading difficult texts, allowing them to perform at the level of their non-dyslexic peers. Therefore, our study suggests that this modification of the test administration mode might assist dyslexic students in demonstrating their text comprehension abilities.
This study used eye‐tracking to examine changes in how second language (L2) learners process target grammatical exemplars in written L2 input in implicit and explicit instructional conditions and how these changes relate to learning gains. In three separate sessions, 77 L2 learners of English read a story containing seven examples of a grammatical construction. The results of a growth curve analysis indicated significant main effects for the instructional condition and test sessions on total fixation duration and a significant interaction between these two variables. There was minimal attentional processing and no improvement in processing efficiency of the target construction in the unenhanced condition. Learners’ attentional processing in the textually enhanced conditions decreased and, by the end of the experiment, they engaged in establishing and fine tuning form–meaning links. In the two explicit instructional conditions, participants’ attention decreased over time and form–meaning representations of the target structure were strengthened. Open Practices This article has been awarded an Open Materials badge. All materials are publicly accessible via the IRIS Repository at https://www.iris-database.org. Learn more about the Open Practices badges from the Center for Open Science: https://osf.io/tvyxz/wiki.
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