Objectives To understand why general practitioners prescribe antibiotics for some cases of sore throat and to explore the factors that influence their prescribing.

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Objective To explore general practitioners' perceptions of their role in implementing genetic technology. Design Grounded theory interview study. Setting Primary care.

This cohort study, aims to explore formal care provision to stroke survivors and their informal carers in the community in the UK. An initial cohort of 105 cohabitant carers of first-time stroke patients was recruited while the stroke patient was in hospital. Structured face-to-face interviews were carried out with carers prior to discharge of the stroke patient home, at 6 weeks after discharge, and 15 months after stroke. Questionnaires included measures of psychological health (CIS-R), physical health (self-rated health), social well-being (relationship quality and Sarason's social support questionnaire), handicap of the stroke survivor (Oxford Handicap Scale) and formal community support (amount of formal support and carer satisfaction). Multiple services were involved with most survivor-carer pairs (mean 5.4; range 2-9; SD = 1.7), and 74% of carers were satisfied with formal support provided. Number of services decreased with time (5.5 versus 4.1, t = 4.201, d.f. = 52, P < 0.001, 95% confidence interval: 0.71-2.01) but not time allocated. Using stepwise linear regression, service provision early after discharge was predicted by: level of handicap, recruitment centre, carer self-rated health, number of informal supporters and other care commitments. Satisfaction was predicted by quality of informal support and activity restriction. Fifteen months after stroke, predictors of formal care were: level of handicap, quality of informal support and previous caring experience. Predictors of satisfaction were: quality of the relationship between the stroke survivor and carer, age and mood. Quality of services was good, but carers lacked information, had insufficient help and were not consulted enough. Carer distress is common, yet not currently a factor influencing support provision. Formal care provided adapts with time reflecting the importance of quality of support from friends and family rather than quantity of informal supporters. These factors should be taken into consideration when planning and providing formal support for stroke survivors and their carers.

Purpose This study compared digital images from a portable slit-lamp camera with 35 mm slit-lamp photographs and traditional ophthalmic assessments in anterior segment disorder's detection. Methods A total of 196 patients (392 eyes) were recruited from an anterior segment ophthalmology clinic. Each patient underwent an examination by an anterior segment ophthalmologist. Two to three standardized views of 640 Â 480 pixels digital images (portable digital slit-lamp camera) and 35 mm photographic slides (Zeiss slit-lamp camera) were taken after the examination. The same ophthalmologist reviewed these images in a masked fashion. Two other masked graders also assessed the digital images. The presence or absence of 33 specific findings was noted at each examination. Results Digital images showed moderate to excellent agreement to clinical findings (j 0.45-0.82) in areas other than lid pathologies. Lens findings from digital images had moderate to good agreement with the clinical gold standard (unweighted j 0.43-0.65, sensitivity 59-77%, specificity 86-94%). Gross cornea signs were well detected with digital images, (j 0.72-0.85, sensitivity 67-100%, specificity 98-99). More subtle corneal, conjunctival and lid abnormalities were not identified well. The statistical figures were very similar to the above-mentioned figures when the 35-mm film results were compared to clinical diagnoses. The two image formats showed better agreement when compared to each other than when either is compared with clinical findings. Conclusion Diagnoses using digital slit-lamp images were comparable to diagnosis using 35 mm photographic slides for some anterior segment abnormalities.