AIMS To test the efficacy of (i) computer-generated tailored letters and (ii) practitioner-delivered brief advice for smoking cessation against an assessment-only condition; and to compare both interventions directly. DESIGN Quasi-randomized controlled trial. SETTING A total of 34 randomly selected general practices from a German region (participation rate 87%). PARTICIPANTS A total of 14...

This case study reports the reasons why this large, multi-site general practice decided to move towards paperless practice in late 2001, and describes the progress and lessons learned to date. The principal operational reasons for this decision were problems associated with moving paper medical records between surgeries, and the realisation that resources to improve the computerised medical rec...

An editorial in the BMJ recommended discontinuation of the routine use of chloramphenicol eye drops largely on the basis of case reports suggesting an association between their use and serious haematological toxicity, particularly aplastic anaemia. Although this recommendation has been challenged, the debate has not been informed by reliable estimates of the size of any risk. Around 400 general...

BACKGROUND Unnecessary antibiotic prescribing contributes to antimicrobial resistance. In this trial, we aimed to reduce unnecessary prescriptions of antibiotics by general practitioners (GPs) in England. METHODS In this randomised, 2 × 2 factorial trial, publicly available databases were used to identify GP practices whose prescribing rate for antibiotics was in the top 20% for their Nationa...

2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is a by-product o f t he trichlorophenol (herbicide) production and is also produced through a variety of combustion processes. It appears that TCDD is a ubiquitous chemical, particularly in industrialised countries, and the liver is the target organ of its toxicity. The prominent hepatotoxic effect of TCDD is progressive centrilobular necrosis. Th...

BACKGROUND Little is known about the reasoning mechanisms used by physicians in decision-making and how this compares to diagnostic clinical practice guidelines. We explored the clinical reasoning process in a real life environment. METHOD This is a qualitative study evaluating transcriptions of sixteen physicians' reasoning during appointments with patients, clinical discussions between spec...

BACKGROUND Despite strong evidence of the benefits of preconception interventions to improve pregnancy outcomes, the delivery and uptake of preconception care in general and periconceptional folate supplementation in particular remains low. The aim of this study was to determine women's views of the barriers and enablers to the uptake of preconception care and periconceptional folate supplement...

let r be a ring and v be a matrix valuation on r. it is shown that, there exists a correspondence between matrix valuations on r and some special subsets ?(mvpr) of the set of all square matrices over r, analogous to the correspondence between invariant valuation rings and abelian valuation functions on a division ring. furthermore, based on malcolmson’s localization, an alternative proof for t...

There is ongoing debate on the position of research as an attribute of advanced practice. This letter highlights some issues to be considered in light of recent correspondence published in the JMRS.