Despite the publication of guidance for GPs on CFS/ME, confidence with making a diagnosis and management was found to be low. Educational initiatives and guidance for GPs should stress the importance of accepting CFS/ME as a recognisable clinical entity, as this is linked to having a positive attitude and could lead to improved confidence to make a diagnosis and treat CFS/ME patients.

Objectives: To explore the reasons for the 40-fold variation in diagnostic testing for genital Chlamydia trachomatis by general practices. Methods: A qualitative study with focus groups. We randomly selected urban and rural high and low testing practices served by Bristol, Hereford, and Gloucester microbiology laboratories. Open questions were asked about the investigation of C trachomatis in men and women in different clinical contexts. Results: The high and low testing practices did not differ in their age/sex make-up or by deprivation indices. There were major differences between high and low chlamydia testing practices. Low testing practices knew very little about the epidemiology and presentation of genital chlamydia infection and did not consider it in their differential diagnosis of genitourinary symptoms until patients had consulted several times. Low testers were less aware that chlamydia was usually asymptomatic, thought it was an inner city problem, and had poor knowledge of how to take diagnostic specimens. High testing practices either had a general practitioner with an interest in sexual health or a practice nurse who had completed specialist training in family planning. High testing practices were more cognizant of the symptoms and signs of chlamydia and always considered it in their differential diagnosis of genitourinary symptoms, including patients attending family planning clinics. Conclusions: Any programme to increase chlamydia testing in primary care must be accompanied by an education and awareness programme especially targeted at low testing practices. This will need to include information about the benefits of testing and who, when, and how to test.T he 2001 UK national sexual health strategy proposed a comprehensive framework for promoting good sexual health with an increased role of primary care in service delivery, which will include diagnostic testing for chlamydia. 1The proposed national roll-out of chlamydia screening is commencing with an initial pilot at 10 sites providing specialist sexual health services.2 Although general practitioners (GPs) are not actively involved in this initial stage, GP pilots have demonstrated that screening in primary care is a particularly effective strategy. suggesting that GPs should test sexually active women with vaginal discharge for chlamydial infection, the audit found that only 44% of 16-25 year old women in Gloucestershire and Herefordshire who had a high vaginal swab sent to the microbiology department also had a specific swab for Chlamydia trachomatis. Moreover, 70% of chlamydia test submissions were in women over 25 years of age who are known to be at lower risk of infection. In this study we used qualitative approaches to explore GPs' and practice nurses' awareness of genital chlamydia infection and determined differences in the strategies used by high and low testers of C trachomatis in rural and urban areas in England. METHODSThis qualitative research was essentially exploratory, aimed at obtaining information from all members of the pr...

Purpose -The aim of this study is to measure the effectiveness of the "Bug Investigators" pack in improving children's knowledge about micro-organisms, hygiene and antibiotics when it is used within the National Curriculum in junior schools. Design/methodology/approach -Teaching, using the "Bug Investigators" pack, was given by Gloucestershire primary school teachers. Children's general knowledge about hygiene, micro-organisms and antibiotics was measured by questionnaire before and after lessons using the pack. A sample of 198 children aged 10 and 11 years in eight primary schools completed the questionnaires before and after teaching. A focus group was held with teachers to explore their views after using the pack. Findings -Children's knowledge improved in all topic areas. Improved knowledge was most significant for what antibiotics do and how to use them and the value of our own good bugs (27, 31 and 16 percent improvement respectively). Knowledge about how bugs spread and hand hygiene was excellent (88 and 90 percent) before the education, but there was still 4 percent improvement in these topics. An exploratory discussion with teachers disclosed that some worksheets on viruses and resistant bacteria were too advanced for junior schools.Research limitations/implications -The study in this paper was undertaken in schools with relatively high-level four-science attainment, which could affect generalisability of findings. Originality/value -The "Bug Investigators" teaching pack was effective at improving knowledge about micro-organisms, hygiene and antibiotic use; it should be used more widely by junior schools. It is now a recognised teaching resource. Increased awareness of hygiene and prudent use of antibiotics should lower school absenteeism and improve antibiotic use in this generation of future adults.

No abstract

No abstract