Infectious disease management in primary care: perceptions of GPs

<p>Abstract</p> <p>Background</p> <p>It is important to keep the level of antibiotic prescribing low to contain the development of resistant bacteria. This study was conducted to reveal new knowledge about how GPs think in relation to the prescribing of antibiotics - knowledge that could be used in efforts toward rational treatment of infectious diseases in primary care. The aim was to explore and describe the variations in GPs' perceptions of infectious disease management, with special reference to antibiotic prescribing.</p> <p>Methods</p> <p>Twenty GPs working at primary care centres in a county in south-west Sweden were purposively selected based on the strategy of including GPs with different kinds of experience. The GPs were interviewed and perceptions among GPs were analysed by a phenomenographic approach.</p> <p>Results</p> <p>Five qualitatively different perceptions of infectious disease management were identified. They were: (A) the GP must help the patient to achieve health and well-being; (B) the management must meet the GP's perceived personal, professional and organisational demands; (C) restrictive antibiotic prescribing is time-consuming; (D) restrictive antibiotic prescribing can protect the effectiveness of antibiotics; and (E) patients benefit personally from restrictive antibiotic prescribing.</p> <p>Conclusions</p> <p>Restrictive antibiotic prescribing was considered important in two perceptions, was not an issue as such in two others, and was considered in one perception although the actual prescribing was greatly influenced by the interaction between patient and GP. Accordingly, to encourage restrictive antibiotic prescribing several aspects must be addressed. Furthermore, different GPs need various kinds of support. Infectious disease management in primary care is complex and time-consuming, which must be acknowledged in healthcare organisation and planning.</p

Biochar from cookstoves reduces greenhouse gas emissions from smallholder farms in Africa

Biochar produced in cookstoves has the potential to contribute to negative carbon emissions through sequestration of biomass carbon while also providing other benefits for sustainable development, including provision of clean renewable energy and increased yields in tropical agriculture. The aim of the reported research was to estimate effects on food production, household energy access and life cycle climate impact from introduction of biochar-producing cookstoves on smallholder farms in Kenya. Participatory research on biochar production and use was undertaken with 150 Kenyan smallholder farming households. Gasifier cookstove functionality, fuel efficiency and emissions were measured, as well as biochar effects on agricultural yields after application to soil. Cookstoves provided benefits through reduced smoke, fuel wood savings and char production, but challenges were found related to labour for fuel preparation, lighting and refilling. On-farm trials with varying rates of biochar inputs, in combination with and without mineral fertilizers, have led to a sustained increase of maize yields following one-time application. The climate impact in a life cycle perspective was considerably lower for the system with cookstove production of biochar and use of biochar in agriculture than for current cooking practices. Climate benefits from biochar production and use are thus possible on smallholder farms in sub-Saharan Africa, through reduced use of biomass in cooking, reduced emissions of products of incomplete combustion and sequestration of stable biochar carbon in soils. Biochar-producing cookstoves can be implemented as a climate change mitigation method in rural sub-Saharan Africa. Successful implementation will require changes in cooking systems including fuel supply, as well as farming systems, which, in turn, requires an understanding of local socio-cultural conditions, including power relations and gender aspects

Additional file 2: of Enhancing communication skills for telehealth: development and implementation of a Teach-Back intervention for a national maternal and child health helpline in Australia

Complete interview guide for nurse focus groups and telephone interviews. (DOCX 16 kb