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BACKGROUND Diseases caused by Streptococcus pneumoniae (S. pneumoniae) continue to cause substantial morbidity and mortality globally. Whilst pneumococcal polysaccharide vaccines (PPVs) have the potential to prevent disease and death, the degree of protection afforded against various clinical endpoints and within different populations is uncertain. (More)
Benzodiazepines are still widely prescribed in general practice, despite repeated warnings about the problems associated with their use. Other studies have shown that a variety of interventions can reduce prescribing, but these have been restricted to relatively few general practices or patients. We co-ordinated an audit of benzodiazepine prescribing and(More)
We describe a new illusion in which a single stationary stimulus appears to undergo coherent global motion. Contrast relationships between the stimulus elements suggest the illusion arises via processing of Off- and On-channel signals that remain independent until after passing through low-level motion detectors. We propose that patterns of activation(More)
  • John Holden
  • Journal of evaluation in clinical practice
  • 2001
The Hawthorne studies in the 1930s demonstrated how difficult it is to understand workplace behaviour, and this includes professional performance. Studies of interventions to improve professional performance, such as audit, can provide useful information for those considering using such methods, but cannot replace judgement. In particular, there is no(More)
General practice encounters often involve vague symptoms, potentially representing illness in its early stage. Managing such undifferentiated symptoms is difficult, but one of the key tasks of the general practitioner is to discover serious disease at an appropriate stage whilst also minimising over-investigation. Although the diagnostic process and methods(More)
The Forum urges a ‘transformation in the relationship’ between medical staff and patients and suggests health staff routinely talk to patients about their lifestyles, even when they are suffering an unrelated illness, and offer them advice to become healthier. The Forum suggests this responsibility should be included in the NHS Constitution. Contrast this(More)
BACKGROUND Patient safety is a key issue in primary care. Significant event analysis (SEA) is a long established method of improving safety. In 2004, SEA was introduced as part of the Quality and Outcomes Framework (QOF) of the new general medical services (GMS) contract. AIM To review SEAs submitted for the QOF by general practices for a primary care(More)