Learn More
OBJECTIVES To systematically review studies investigating the prevalence of antibiotic resistance in urinary tract infections caused by Escherichia coli in children and, when appropriate, to meta-analyse the relation between previous antibiotics prescribed in primary care and resistance. DESIGN AND DATA ANALYSIS Systematic review and meta-analysis. Pooled(More)
OBJECTIVES Correction of craniofacial microsomia (CFM) presents several challenges concerning the modality of surgical intervention. The aim of this study was to assess early and late surgical outcome, by undertaking Euclidean distance matrix analysis (EDMA) of CFM patients exhibiting an unilateral mandibular deformity that was surgically corrected by an(More)
This paper reports a cross-study analysis of four studies, aiming to understand the drivers of parental consulting and clinician prescribing behaviour when children under 12 years consult primary care with acute respiratory tract infections (RTI). Qualitative data were obtained from three primary studies and one systematic review. Purposeful samples were(More)
BACKGROUND Patients' expectations for antibiotics are known to influence prescribing, but little is known about patients' understanding of, and attitudes to, antibiotic resistance and whether these could modify treatment expectations. OBJECTIVE To explore primary care patients' perspectives on antibiotic resistance and methicillin-resistant Staphylococcus(More)
BACKGROUND Diagnosis is the traditional basis for decision-making in clinical practice. Evidence is often lacking about future benefits and harms of these decisions for patients diagnosed with and without disease. We propose that a model of clinical practice focused on patient prognosis and predicting the likelihood of future outcomes may be more useful. (More)
BACKGROUND Pre-school children are frequent users of health services, but little contemporary data are available describing their symptoms or why they consult. OBJECTIVE To describe symptom and consultation prevalence in pre-school children and to identify the socio-demographic factor or factors associated with consultations for those symptoms. METHODS(More)
OBJECTIVE To investigate whether paracetamol (acetaminophen) plus ibuprofen are superior to either drug alone for increasing time without fever and the relief of fever associated discomfort in febrile children managed at home. DESIGN Individually randomised, blinded, three arm trial. SETTING Primary care and households in England. PARTICIPANTS(More)
BACKGROUND CONTEXT Acute cough is a very common symptom presentation among children in primary care and is usually due to respiratory infection, yet its cost is unknown. An estimate of the cost to healthcare providers and parents would aid budgetary decision-making, and provide an insight into the need for interventions to reduce the burden. PURPOSE To(More)
BACKGROUND AND OBJECTIVE Clinicians often find it difficult to differentiate between subobtimal adherence and nonresponse to medical treatment if a patient's clinical condition does not improve. This study aimed to evaluate an adherence self-report tool to assess adherence to blood pressure lowering medication. STUDY DESIGN AND SETTING Participants were(More)
BACKGROUND Respiratory tract infections (RTIs) are common in children and generally self-limiting, yet often result in consultations to primary care. Frequent consultations divert resources from care for potentially more serious conditions and increase the opportunity for antibiotic overuse. Overuse of antibiotics is associated with adverse effects and(More)