BackgroundDelayed antibiotic prescribing reduces antibiotic use for acute respiratory infections in trials in general practice, but the uptake in clinical practice is low. The aim of the study was to identify facilitators and barriers to general practitioners’ (GPs’) use of delayed prescribing and to gain pharmacists’ and the public’s views about delayed prescribing in Australia.MethodsThis study used the Theoretical Domains Framework and the Behaviour Change Wheel to explore facilitators and barriers to delayed prescribing in Australia. Forty-three semi-structured, face-to-face interviews with general practitioners, pharmacists and patients were conducted. Responses were coded into domains of the Theoretical Domains Framework, and specific criteria from the Behaviour Change Wheel were used to identify which domains were relevant to increasing the use of delayed prescribing by GPs.ResultsThe interviews revealed nine key domains that influence GPs’ use of delayed prescribing: knowledge; cognitive and interpersonal skills; memory, attention and decision-making processes; optimism; beliefs about consequences; intentions; goals; emotion; and social influences: GPs knew about delayed prescribing; however, they did not use it consistently, preferring to bring patients back for review and only using it with patients in a highly selective way. Pharmacists would support GPs and the public in delayed prescribing but would fill the prescription if people insisted. The public said they would delay taking their antibiotics if asked by their GP and given the right information on managing symptoms and when to take antibiotics.ConclusionsUsing a theory-driven approach, we identified nine key domains that influence GPs’ willingness to provide a delayed prescription to patients with an acute respiratory infection presenting to general practice. These data can be used to develop a structured intervention to change this behaviour and thus reduce antibiotic use for acute respiratory infections in general practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-017-0589-1) contains supplementary material, which is available to authorized users.

Subterranean clover plants possessing two equally infectible and robust lateral root systems ("split roots") were used in conjunction with several specific mutant strains (derived from Rhizobium trifolii ANU843) to investigate a systemic plant response induced by infective Rhizobium strains. This plant response controls and inhibits subsequent nodulation on the plant. When strain ANU843 was inoculated onto both root systems simultaneously or 24, 48, 72, or 96 h apart, an inhibitory response occurred which retarded nodulation on the root exposed to the delayed inoculum but only when the delay period between inocula was greater than 24 h. Equal numbers of nodules were generated on both roots when ANU843 was inoculated simultaneously or 24 h apart. The ability to infect subterranean clover plants was required to initiate the plant inhibitory response since preexposure of one root system to non-nodulating strains did not retard the ability of the wild-type strain to nodulate the opposing root system (even when the delay period was 96 h). Moreover, the use of specific TnS-induced mutants subtly impaired in their ability to nodulate demonstrated that the plant could effectively and rapidly discriminate between infections initiated by either the parent or the mutant strains. When inoculated alone onto clover plants, these mutant strains were able to infect the most susceptible plant cells at the time of inoculation and induce nitrogen-fixing nodules. However, the separate but simultaneous inoculation on opposing root systems of the parent and the mutant strains resulted in the almost complete inhibition of the nodulation ability of the mutant strains. We concluded that the mutants were affected in their competitive ability, and this finding was reflected by poor nodule occupancy when the mutants were coinoculated with the parent strain onto a single root system. Thus the split-root system may form the basis of a simple screening method for the ranking of competitiveness of various rhizobia on small seeded legumes.

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Objective: The aim of the review is to critically appraise and synthesize quantitative and qualitative evidence on the barriers and facilitators to general practitioners participating in implementation research for the purposes of evaluating translation of evidence into practice. Introduction: General practice is a distinct medical specialty that requires its own specific research; therefore, general practitioner participation in research is key in translating new knowledge into practice. However, recruiting general practitioners to research as participants is challenging. Understanding general practitioner behavior in relation to their participation in implementation research is critical. Inclusion criteria: Implementation studies that include general practitioners in primary health care settings will be considered. This review will consider quantitative, qualitative, and mixed methods studies from developed countries investigating barriers and facilitators to general practitioners participating in implementation research. Methods: The review will be conducted in accordance with JBI methodology for mixed methods systematic reviews. The main databases accessed will be MEDLINE and Scopus, and include studies published in English between 2008 and the present. Two independent reviewers will read and screen relevant articles, assess for quality, extract study characteristics, and synthesize data. This review is taking an integrated approach involving transformed quantitative data. Primary outcome measures will include study details and outcomes related to the research question. Qualitative and transformed quantitative data will be mapped to the Theoretical Domains Framework at extraction phase. Synthesis will include identified barriers and facilitators categorized using the Theoretical Domains Framework indicators to provide future research and implementation recommendations for recruiting general practitioners to implementation research. Systematic review registration number: PROSPERO (CRD42020176759)