Testing and characterization of herding dogs' behaviors.

Breeding for phenotype in herding dogs (HDs) mainly relies on their performance in national field trial competitions, which has been shown to be inadequate for identifying HDs suited for real livestock farming conditions. In this study, a different field trial with a new scoring system consisting of 28 items to consider was designed to assess young HDs, the results of which culminated in a statement of adequate phenotype (AP) or non-adequate phenotype (NAP). An AP HD was defined as being able: to control the direction of a flock, to keep it grouped close to a handler when needed, to confront animals it is dealing with in a respectful manner, and able to create movement of the flock without excessive disturbance, threatening or attacking it through chasing, or uncontrolled biting.

[Sometimes less is more. Preventing overdiagnosis by sharing decisions].

In this article, we will define «quaternary prevention», which consists in minimizing the iatrogenic effects of medical interventions, and more specifically the notion of «overdiagnosis». We will then discuss how a poor appreciation of the risks, on the part of both patients and clinicians, seems to fuel the phenomenon. We will discuss the interest of placing quaternary prevention within the broader framework of Shared Decision Making.

Integration, effectiveness and costs of different models of primary health care provision for people who are homeless: an evaluation study.

Background: There is a high prevalence of health problems among single people who are homeless. Specialist primary health care services for this population have been developed in several locations across England; however, there have been very few evaluations of these services.

Objectives: This study evaluated the work of different models of primary health care provision in England to determine their effectiveness in engaging people who are homeless in health care and in providing continuity of care for long-term conditions.

Impact of emotional competence on physicians' clinical reasoning: a scoping review protocol.

Introduction: Clinical reasoning (CR) is a key competence for physicians and a major source of damaging medical errors. Many strategies have been explored to improve CR quality, most of them based on knowledge enhancement, cognitive debiasing and the use of analytical reasoning. If increasing knowledge and fostering analytical reasoning have shown some positive results, the impact of debiasing is however mixed.

Antibiotic prescribing rate after optimal near-patient C-reactive protein testing in acutely ill children presenting to ambulatory care (ARON project): protocol for a cluster-randomized pragmatic trial.

Introduction: Children become ill quite often, mainly because of infections, most of which can be managed in the community. Many children are prescribed antibiotics which contributes to antimicrobial resistance and reinforces health-seeking behaviour. Point-of-care C reactive protein (POC CRP) testing, prescription guidance and safety-netting advice can help safely reduce antibiotic prescribing to acutely ill children in ambulatory care as well as save costs at a systems level.

Capturing complexity in clinician case-mix: classification system development using GP and physician associate data.

Background: There are limited case-mix classification systems for primary care settings which are applicable when considering the optimal clinical skill mix to provide services.

Aim: To develop a case-mix classification system (CMCS) and test its impact on analyses of patient outcomes by clinician type, using example data from physician associates' (PAs) and GPs' consultations with same-day appointment patients.

Design & Setting: Secondary analysis of controlled observational data from six general practices employing PAs and six matched practices not employing PAs in England.

Patients' experiences of consultations with physician associates in primary care in England: A qualitative study.

Background: Physician associates are new to English general practice and set to expand in numbers.

Objective: To investigate the patients' perspective on consulting with physician associates in general practice.

Design: A qualitative study, using semi-structured interviews, with thematic analysis.

Physician Associate and General Practitioner Consultations: A Comparative Observational Video Study.

Background: Physician associates, known internationally as physician assistants, are a mid-level practitioner, well established in the United States of America but new to the United Kingdom. A small number work in primary care under the supervision of general practitioners, where they most commonly see patients requesting same day appointments for new problems. As an adjunct to larger study, we investigated the quality of the patient consultation of physician associates in comparison to that of general practitioners.

Physician associates and GPs in primary care: a comparison.

Background: Physician associates [PAs] (also known as physician assistants) are new to the NHS and there is little evidence concerning their contribution in general practice.

Aim: This study aimed to compare outcomes and costs of same-day requested consultations by PAs with those of GPs.

Design And Setting: An observational study of 2086 patient records presenting at same-day appointments in 12 general practices in England.

'Complex' but coping: experience of symptoms of tuberculosis and health care seeking behaviours--a qualitative interview study of urban risk groups, London, UK.

Background: Tuberculosis awareness, grounded in social cognition models of health care seeking behaviour, relies on the ability of individuals to recognise symptoms, assess their risk and access health care (passive case finding). There is scant published research into the health actions of 'hard-to-reach' groups with tuberculosis, who represent approximately 17% of the London TB caseload. This study aimed to analyse patients' knowledge of tuberculosis, their experiences of symptoms and their health care seeking behaviours.

Quality of life in dementia: a systematically conducted narrative review of dementia-specific measurement scales.

Objectives: Ascertaining the quality of life (QoL) in people with dementia is important for evaluating service outcomes and cost-effectiveness. This paper identifies QoL measures for people with dementia and assesses their properties.

Method: A systematic narrative review identified articles using dementia QoL measures.

Reconciling recovery, personalisation and Housing First: integrating practice and outcome in the field of multiple exclusion homelessness.

'Recovery' is a key concept in the organisation and delivery of interdisciplinary support for people experiencing multiple exclusion homelessness (MEH, that is, situations where homelessness overlaps with a range of other complex problems such as mental health issues and drug and alcohol dependencies). At the level of individual support planning, practitioners are expected to 'work together' to motivate service users to make positive changes to their lives and to secure outcomes (results) such as employment and permanent accommodation. Drawing on the accounts of 34 (n = 34) people with first-hand experience of MEH in England, we outline some of the limitations of 'recovery-orientated practices', namely the exclusion of people with unresolved needs and the implications this may have for continuity of provision.