Mothers' beliefs and evaluations of their child's illness were studied in a group of 30 mothers who had consulted a general practitioner because of a cough. Data were collected by tape-recorded semi-structured interviews conducted in their own homes. A major concern for mothers was their fear that their child was going to die, usually because of choking on phlegm or vomit, but also through an asthma attack or cot death. Mothers were also worried that their child would develop long-term chest damage. Particularly important in mothers' assessments were their experience of disturbed sleep because of worries about their child dying at night and their belief that the cough was 'on the chest' which gave rise to worries about dying through choking on phlegm and long-term chest damage. Antibiotics were commonly believed to be required to break up phlegm which might cause the long-term damage or the choking and death.

Patients' views about depressive symptoms are significantly different from conventional medical views. A 'disease management approach' fits uncomfortably with patients' experiences. Acknowledging feelings of loss of control and loss of self-identity in consultations may be useful. The wide employment of techniques patients use to control their disorders, such as support from others, engagement in activities and working at relationships, may be useful to encourage in consultations as alternatives to the use of antidepressant medication.

Objective: To determine doctors' and nurses' attitudes and beliefs about treating patients with type 2 diabetes with less than ideal glycaemic control while receiving maximal oral treatment in primary care. Design: Focus groups. Setting: Primary care. Participants: Four focus groups of 23 GPs and practice nurses. Results: General practice was thought to be the best setting for managing all patients with type 2 diabetes but there were concerns about a lack of resources and unfamiliarity with starting insulin. Issues around compliance were extensively discussed; the ''failing diabetic'' had dual meanings of failing glycaemic control and failing compliance and effort by both patient and doctor. Although views about insulin therapy differed, patients were understood to be resistant to starting insulin, representing for them a more serious stage of diabetes, with fears of needles and hypoglycaemia. Conclusion: The role of diabetes specialist nurses working in primary care will be crucial in managing such patients to improve knowledge, for extra resources, for their experience of insulin use, and to change attitudes.

The British Thoracic Society (BTS) has recently published a guideline for the management of non-cystic fibrosis (non-CF) bronchiectasis in children and adults. This paper summarises the key recommendations applicable to the primary care setting. The key points are:• Think of the diagnosis of bronchiectasis in adults and children who present with a chronic productive cough or unexplained haemoptysis, and in children with asthma which responds poorly to treatment

BackgroundUsers of illicit opioids are at increased risk of hospital admission for deep vein thromboses (DVTs); however, the community prevalence, risk factors, and complications of DVTs in this group are poorly understood.