This survey (1) revealed that house staff are aware of the importance of antimicrobial resistance and believe better antimicrobial use will help this problem and (2) demonstrated differences between specialties with respect to antimicrobial use and knowledge. House staff at our hospital have suboptimal knowledge about antimicrobials, and this knowledge did not increase appreciably over the course of their training. Antimicrobial education is needed and is likely to be well received by house staff physicians in academic centers but may be more effective if it is tailored to specific specialties.

Psychologists have had very little to say about things. Things are one thing, people are another. There is now, however, a growing recognition of the importance of things within human psychology. But, in cognitive theory, the meanings of things are usually radically subjectivized. ‘Their’ meanings are really ‘our’ meanings that we mentally project upon them. James Gibson’s concept of affordances was an attempt to avoid subject–object dualism by defining the meanings of things-what we can do with them-as properties of the object but defined relative to the agent. Critics have rightly objected that Gibson himself, nevertheless, overly objectified or reified affordances. Yet the affordances of many objects in the human world are objective, or, better, impersonal. The present chapter, however, is concerned with such ‘canonical affordances’-the things that things are for. But, as it argues, this kind of ‘objectivity’ must itself be understood in relation to other objects and events, and other people.

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The PHASE research programme is an NHS-Executive funded, randomized controlled trial of assisted self-help for common mental disorders, delivered by practice nurses in primary care. The self-help guide-Managing anxiety and depression: a self-help guide published by the Mental Health Foundation-is conceptualized as a 'health technology' where the nurse's role is to educate patients how to get the best out of the technology, supervise its safe delivery and monitor its continued use by patients so that they can use it independently with little reliance on nurses or other health professionals. Twenty-three nurses were trained on one of ve, 3-day courses to deliver PHASE. As the nal task during the training course, nurses were asked to describe what they would say to a patient when delivering PHASE. From these data a qualitative thematic content analysis was used to develop a coding framework which showed that nurses were able to articulate a sophisticated health technology rationale, including relevant psychological models and the principle of an evidence base. This study demonstrates that it is possible to equip primary care nurses with both a highly developed understanding and the knowledge to deliver self-help mental health care. Training nurses using this model moves us away from traditional mental health training courses that have attempted to produce 'watered down' versions of specialist practitioners to a more appropriate skills and cultural 'health technology' t for delivering primary mental health care.

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