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OBJECTIVE To establish whether an interactive booklet on respiratory tract infections in children reduces reconsultation for the same illness episode, reduces antibiotic use, and affects future consulting intentions, while maintaining parental satisfaction with care. DESIGN Pragmatic cluster randomised controlled trial. SETTING 61 general practices in(More)
Failure to address the putative etiologic and pathophysiologic heterogeneity of the schizophrenia syndrome and problems in definitive assessment of human brain function have impaired progress in schizophrenia research. New approaches to psychopathology and converging evidence from antemortem and postmortem study can now result in more decisive study of the(More)
BACKGROUND There is considerable variation within and between countries in general medical practitioners' (GPs') prescribing of broad-spectrum antibiotics such as fluroquinolones, and resistance to these agents is increasing worldwide. Urgently promoting cautious fluroquinolone prescribing in primary care may limit increase in resistance. OBJECTIVE We(More)
OBJECTIVES Behaviour of members of the public contributes to bacterial resistance. For behavioural change to occur, individuals need to perceive the issue as important to them and feel able to make a valuable contribution. Public campaigns have, so far, not been informed by detailed understanding of public attitudes to the problem. We therefore set out to(More)
OBJECTIVES Although the transition to secondary progressive multiple sclerosis (SPMS) is known to be a period of uncertainty for clinicians, who may find progressive disease challenging to objectively identify, little research has explored the experiences of patients and carers specifically during this transition period. Our objective was to explore what(More)
How, why, and under what kinds of circumstances lay people consult for symptoms of emotional distress are topics that have commanded various degrees of attention from secondary and primary care professionals. We argue below that many of the responses made by such professionals to these issues carry within them a set of very important assumptions about how(More)
BACKGROUND Inadequate health literacy has been associated with poor management of long-term health conditions and has been identified as a key social determinant of health outcomes. However, little is understood about how health literacy might develop over time or the processes by which people may become more health literate. Our objectives were to describe(More)
BACKGROUND Smoking, excessive alcohol consumption, lack of exercise and an unhealthy diet are the key modifiable factors contributing to premature morbidity and mortality in the developed world. Brief interventions in health care consultations can be effective in changing single health behaviours. General Practice holds considerable potential for primary(More)
OBJECTIVES To explore and compare primary care clinicians' perceptions of antibiotic resistance in relation to the management of community-acquired lower respiratory tract infection (LRTI) in contrasting European settings. METHODS Qualitative interview study with 80 primary care clinicians in nine European countries. Data were subjected to a five-stage(More)
BACKGROUND Antibiotic prescribing rates in care homes are higher than in the general population. Antibiotics disrupt the normal gut flora, sometimes causing antibiotic-associated diarrhoea (AAD). Clostridium difficile (Hall and O'Toole 1935) Prévot 1938 is the most commonly identified cause of AAD. Little is known either about the frequency or type of(More)