The Use of Free Weight Squats in Sports: A Narrative Review-Squatting Movements, Adaptation, and Sports Performance: Physiological.

ABSTRACT: Stone, MH, Hornsby, G, Mizuguchi, S, Sato, K, Gahreman, D, Duca, M, Carroll, K, Ramsey, MW, Stone, ME, and Haff, GG. The use of free weight squats in sports: a narrative review-squatting movements, adaptation, and sports performance: physiological. J Strength Cond Res 38(8): 1494-1508, 2024-The squat and its variants can provide numerous benefits including positively affecting sports performance and injury prevention, injury severity reduction, and rehabilitation. The positive benefits of squat are likely the result of training-induced neural alterations and mechanical and morphological adaptations in tendons, skeletal muscles, and bones, resulting in increased tissue stiffness and cross-sectional area (CSA). Although direct evidence is lacking, structural adaptations can also be expected to occur in ligaments. These adaptations are thought to beneficially increase force transmission and mechanical resistance (e.g., resistance to mechanical strain) and reduce the likelihood and severity of injuries. Adaptations such as these, also likely play an important role in rehabilitation, particularly for injuries that require restricted use or immobilization of body parts and thus lead to a consequential reduction in the CSA and alterations in the mechanical properties of tendons, skeletal muscles, and ligaments. Both volume and particularly intensity (e.g., levels of loading used) of training seem to be important for the mechanical and morphological adaptations for at least skeletal muscles, tendons, and bones. Therefore, the training intensity and volume used for the squat and its variations should progressively become greater while adhering to the concept of periodization and recognized training principles.

Two Days Versus Four Days of Training Cessation Following a Step-Taper in Powerlifters.

ABSTRACT: Burke, BI, Carroll, KM, Travis, SK, Stone, ME, and Stone, MH. Two days versus four days of training cessation following a step-taper in powerlifters. J Strength Cond Res 37(12): e625-e632, 2023-Tapering and training cessation are methods of training load management aimed at optimizing athlete preparedness leading into competition. Such practices are often used by strength sport athletes such as powerlifters (i.e., athletes who compete in the back squat [BS], bench press [BP], and deadlift [DL]). The purpose of this study was to compare the differences in maximal strength, subjective recovery and stress state, and body composition alterations in strength athletes undergoing a 1-week step-taper followed by either a 2-day (2D) or 4-day (4D) period of training cessation. Twelve powerlifters (22.3 ± 2.1 yrs; 92.1 ± 20.4 kg; 174.8 ± 7.5 cm) completed a 6-week training protocol aimed at peaking 1 repetition maximum (1RM) strength on BS, BP, and DL. Body composition, subjective recovery and stress state, and 1RM on BS, BP, and DL were assessed before an overreach week (T1) and after the periods of training cessation (T2) for each group. Alpha criterion was set at p ≤ 0.05. There were significant increases in BP ( p = 0.032, g = 0.10), powerlifting total ( p = 0.014, g = 0.11), and DOTS score ( p = 0.006, g = 0.12) after 2D of cessation. However, after 4D of cessation, significant increases were only observed in DL ( p = 0.019, g = 0.11) along with significant decreases in BP ( p = 0.003, g = -0.13). There were no statistically significant changes in any other variable for either group indicating that BS, psychometric, and body composition data were maintained between T1 and T2. The results of this study support the use of 1-week step-tapers, followed by a short period of training cessation (2-4D) to maintain or improve maximal strength performance.

Development of a lifestyle intervention using the MRC framework for diabetes prevention in people with impaired glucose regulation.

BACKGROUND: We report development of a group-based lifestyle intervention, Let's Prevent, using the UK Medical Research Council (MRC) framework, and delivered by structured education to prevent type 2 diabetes mellitus (T2DM) in people with impaired glucose regulation (IGR) in a UK multi-ethnic population. METHODS: Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) is the first national T2DM programme that meets National Institute for Health and Care Excellence criteria and formed the basis for Let's Prevent. An iterative cycle of initial development, piloting, collecting and collating qualitative and quantitative data, and reflection and modification, was used to inform and refine lifestyle intervention until it was fit for evaluation in a definitive randomized controlled trial (RCT). The programme encouraged IGR self-management using simple, non-technical language and visual aids. RESULTS: Qualitative and quantitative data suggested that intervention resulted in beneficial short-term behaviour change such as healthier eating patterns, improved health beliefs and greater participant motivation and empowerment. We also demonstrated that recruitment strategy and data collection methods were feasible for RCT implementation. CONCLUSIONS: Let's Prevent was developed following successful application of MRC framework criteria and the subsequent RCT will determine whether it is feasible, reliable and transferable from research into a real-world NHS primary healthcare setting. TRIAL REGISTRATION: ISRCTN80605705.

Leishmaniasis Gone Viral: Social Media and an Outbreak of Cutaneous Leishmaniasis.

This report details how social media communication was used in a group of teens to diagnose cutaneous leishmaniasis that they acquired during a trip to Israel. Their posts quickly brought the cluster to the attention of the teens and their parents, leading to prompt recognition of the true etiology of their lesions and appropriate treatment.

Psychological care in a national health service: challenges for people with diabetes.

Recently, there has been a growing interest in psychological problems in people with diabetes and a concomitant increasing concern that these often go unreported and, thus, unidentified and treated. This has serious implications for both the self-management of diabetes and the individual's quality of life. In this review article we consider the question of screening for depression in people with diabetes within a national health service in the UK. The inadequacies of psychological care for patients with diabetes are discussed, in particular with regard to the importance of distinguishing between depressive symptoms and emotional distress related to having diabetes. Criteria for assessing the validity of screening for depression are discussed, together with national and international recommendations, with particular emphasis on current practice. The screening strategy currently recommended for implementation in primary care in the UK is outlined. The need for rigorous evaluation of screening initiatives is highlighted and a key conclusion is that case-finding alone is unlikely to be effective in terms of improving patient outcomes unless considered and applied in the context of overall case management. This review highlights the barriers and challenges to optimizing care for patients with co-morbid diabetes and depression, and outlines the therapies currently available in the UK, which might be disseminated in other countries.

The association between depression and health-related quality of life in people with type 2 diabetes: a systematic literature review.

The relationships between co-morbid depression in people with diabetes and adverse outcomes including poor HbA(1c) control, adherence to medication and mortality have been examined and confirmed. However, as the awareness of the decrement to health-related quality of life (HRQOL) in people with diabetes and its clinical consequences grows, investigators have become increasingly interested in measuring HRQOL in clinical trials. Given that the psychological factors such as depression may contribute to diminished HRQOL, the present review sought to summarize the association between these variables in people with type 2 diabetes. Articles for a systematic review were obtained via a search performed using MEDLINE, EMBASE and PsycINFO (1980-2007).Fourteen articles fulfilled the inclusion criteria. Studies indicated that self-reported depressive symptoms markedly impaired HRQOL on several domains. However, depression was not related to all sub-domains of HRQOL in all studies, suggesting that the effects of depression on certain aspects of HRQOL may vary between clinical and demographic subgroups. Although a number of shortcomings identified in the current literature should be taken into account for future research, the importance of this review lies in the possibility it raises that the improvements in HRQOL and clinical practice may potentially be achieved by placing greater attention on the identification and management of depression.

Alterations in Adiponectin, Leptin, Resistin, Testosterone, and Cortisol across Eleven Weeks of Training among Division One Collegiate Throwers: A Preliminary Study.

Cytokine and hormone concentrations can be linked to the manipulation of training variables and to subsequent alterations in performance. SUBJECTS: Nine D-1 collegiate throwers and 4 control subjects participated in this preliminary and exploratory report. METHODS: Hormone (testosterone (T) and cortisol (C)) and adipokine (adiponectin, leptin, and resistin) measurements were taken at weeks 1, 7, and 11 for the throwers and weeks 1 and 11 for the control group. The throwers participated in an 11-week periodized resistance training and throws program during the fall preparatory period. Volume load was recorded throughout the study. RESULTS: Hormone values did not exhibit statistically significant changes across time; however, there were notable changes for C, the testosterone to cortisol ratio (T:C), and adiponectin. CONCLUSIONS: T:C was increased as volume load decreased, and adiponectin increased in concert with decreases in C and increases in the T:C, possibly suggesting a lesser degree of obesity-related inflammation and a higher degree of "fitness" and preparedness.

Waist circumference measurement: knowledge, attitudes and barriers in patients and practitioners in a multi-ethnic population.

BACKGROUND: Currently, body mass index (BMI) is widely used to identify health risk due to overweight or obesity. However, waist circumference is considered by many to be a better indicator of health risk than BMI. The primary health care team are ideally suited to screen for people at high risk of glucose intolerance and increased cardiovascular risk using waist circumference measurement (WCM). OBJECTIVES: To determine the knowledge and attitudes of patients and primary care practitioners concerning WCM, with particular reference to exploring barriers in a multi-ethnic setting. METHODS: A qualitative study using purposive sampling, semi-structured interviews and thematic analysis was conducted. Nine general practices were selected from Leicestershire, UK. The participants were 10 practitioners (four practice nurses, six general practitioners) and 18 patients (six south Asians). RESULTS: Two overarching themes were identified from patient and practitioner interviews: understanding of waist size measurement to assess or monitor risk and attitudes related to perceived barriers and facilitators to waist measurement. A few practitioners felt uncomfortable about carrying out WCM and some perceived that patients might feel embarrassed. Practical barriers raised by professionals included lack of time, extra workload and financial implications. In contrast, patients generally raised few barriers to WCM. Being given an explanation appeared to be what was most important to them. No clear differences emerged when comparing views of patients from different ethnic groups or general practitioners and practice nurses. CONCLUSIONS: This study adds to our understanding of views on WCM in a multi-ethnic setting, highlighting factors for consideration if WCM is to be facilitated in routine practice.

Educational interventions in kidney disease care: a systematic review of randomized trials.

BACKGROUND: There is increasing evidence that educational interventions aimed at empowering patients are successful in chronic disease management. Our aim was to conduct a systematic review of the effectiveness of such educational interventions in people with kidney disease. SYSTEMATIC REVIEW: A comprehensive search strategy was applied by using major electronic databases from 1980 to March 2007. Researchers independently reviewed titles and abstracts and extracted data from identified studies. SETTING & POPULATION: Patients in any of the following stages of chronic kidney disease: early, predialysis, and dialysis. Kidney transplant recipients were excluded because this group has additional educational needs that are beyond the scope of this review. SELECTION CRITERIA FOR STUDIES: Randomized controlled trials. INTERVENTIONS: Structured educational interventions (involving informational and psychological components) with usual care. OUTCOMES: Clinical, behavioral, psychological, and knowledge outcomes were considered. RESULTS: 22 studies were identified involving a wide range of multicomponent interventions with variable aims and outcomes depending on the area of kidney disease care. 18 studies provided significant results for at least 1 of the outcomes. The majority of studies aimed to improve diet and/or fluid concordance in dialysis patients and involved short- and medium-term follow-up. A single major long-term study was a 20-year follow-up of a predialysis educational intervention that showed increased survival rates. No study was found that addressed chronic kidney disease at an earlier stage. LIMITATIONS: Meta-analysis was not possible because of study heterogeneity. CONCLUSIONS: Multicomponent structured educational interventions were effective in predialysis and dialysis care, but the quality of many studies was suboptimal. Effective frameworks to develop, implement, and evaluate educational interventions are required, especially those that target patients with early stages of chronic kidney disease. This could lead to possible prevention or delay in progression of kidney disease.

Qualitative investigation of patient adherence to 5-aminosalicylic acid therapy in patients with ulcerative colitis.

BACKGROUND: There has been a lack of qualitative research specifically in patients with inflammatory bowel disease relating to reasons for failure to take medication. We aimed to address this gap and also identify factors which might increase adherence. METHODS: Twenty-seven patients from 3 UK hospital sites (Leicester, Norwich, and Cardiff) were recruited to take part in a qualitative study based on semistructured interviews. RESULTS: A model was developed to illustrate the way in which patients appear to balance the benefits and disadvantages of taking 5-aminosalicylic acid (5-ASA) medication. The degree of information held by patients regarding ulcerative colitis (UC) and self-evaluation of the benefits of 5-ASA appears to impact whether patients accept or reject the medication. Decision-making on an ill-informed basis may be a factor leading to a reduction in adherence. Due to the nature of the condition, adherence levels may be affected by potential difficulties in terms of experiencing and understanding the links between the medication and health outcomes. CONCLUSIONS: Important determinants of adherence to 5-ASA medication in patients with UC appear to include the level of information provided and patient beliefs about prescribed 5-ASA. Patient adherence to 5-ASA requires encouragement and reinforcement and the patient-clinician relationship has a crucial role to play in this dynamic.

Educational intervention to reduce disease related to sub-optimal basic hygiene in Rwanda: initial evaluation and feasibility study.

BACKGROUND: Despite a global reduction in morbidity related to sub-optimal water, sanitation and hygiene, the incidence of such diseases remains a significant problem in sub-Saharan Africa. This study aimed to initially assess the potential effectiveness (primarily in terms of impact on morbidity) of a simple educational intervention delivered in Rwanda. Additionally, we sought to explore feasibility relating to the practicality of evaluating and implementing this type of intervention in a low- and middle-income country. METHODS: Two districts in Northern Province were purposively selected; one was randomly allocated to receive the intervention, with the other acting as control. The intervention was based on an interactive DVD about basic hygiene. Baseline and follow-up data for incident cases of relevant morbidities were collected from health centre records. Changes were compared between the two districts using descriptive statistics and chi-squared tests. Qualitative data were obtained through observations, discussions and feedback and were analysed thematically. RESULTS: Cases of infection with intestinal worms and parasites were frequently recorded in both districts. For these morbidities, there was a 39% decrease in cases between baseline and follow-up in the intervention district (4995 reduced to 3069), compared to 13% (5002 reduced to 4356) in the control district (p < 0.001). Numbers of cases recorded as diarrhoea or dysentery, and changes between baseline and follow-up, were much lower (intervention district 1274 cases reduced to 1171; control district 1949 reduced to 1944). Qualitative data indicated a high level of acceptability for the intervention and also feasibility relating to the practicality of evaluation and implementation, whilst also highlighting problems encountered and possible solutions, in particular, the potential advantages of training local personnel to deliver this type of intervention. CONCLUSIONS: This small-scale study has a number of acknowledged limitations which would need to be addressed in a larger study in order to confidently confirm the effectiveness of the intervention. It nevertheless provides evidence suggesting that the educational intervention is promising in terms of a potential impact on health and feasible to deliver and evaluate. These findings indicate that further evaluation and possibly early implementation are warranted. TRIAL REGISTRATION: Research Registry, researchregistry2180.

A cross sectional survey of secondary prevention measures in patients with peripheral arterial disease in primary care.

BACKGROUND: The National Service Framework for coronary heart disease (CHD) defines standards for the secondary prevention of cardiovascular disease in at risk individuals, including those with peripheral arterial disease (PAD). AIM: To assess current standards of secondary prevention and health monitoring in patients with PAD following a vascular procedure, and additionally compare care in patients with and without diagnosed CHD. METHODS: Indicators for this cross sectional survey were identified from national recommendations and evidence. A retrospective review was conducted of general practitioner records, for patients who were treated in hospital for PAD. RESULTS: Data were collected for 103 patients from 42 practices. Overall, prescribing was well achieved for antiplatelets but poor for statins. Standards of assessment of blood pressure, smoking status, and smoking cessation advice were high. However, approximately only half of the patients received advice about exercise or had their body mass index checked. Furthermore, for all indicators, standards of care for patients who additionally had a diagnosis of CHD were better than for patients without CHD. CONCLUSION: The cross sectional survey suggested the treatment received by some patients with established PAD is substandard. There is considerable potential to increase secondary prevention of CHD in patients with PAD disease in primary care.

Dietary habits of young people attending secondary schools serving a multiethnic, inner-city community in the UK.

BACKGROUND: Childhood obesity is an escalating health concern with important implications, including increased risk of type 2 diabetes and cardiovascular disease. Although South Asians in the UK have an increased risk of developing these conditions, detailed studies on their lifestyles including the dietary habits of young people are scarce. METHODS: As part of an action research project, a food intake questionnaire was used to survey the dietary habits of 11-15-year olds attending five inner-city schools serving a predominantly South Asian population. Food choices were considered in the overall sample and in South Asians compared with white Europeans. RESULTS: 3418 (72% of registered pupils) responses were obtained. A subset of 3018 pupils could be categorised as either South Asian (86%) or white European (14%). Around one fifth of pupils started the school day without eating anything. Responses indicated high consumption of "negative" foods such as sweets, including Asian sweets (63%), but lower rates for "positive" foods such as vegetables (34%). In the full sample, 26% said they had consumed more than one can of sugar-sweetened fizzy drink and 17% reported eating more than one packet of full-fat crisps on the previous day. Poor dietary habits were indicated in both South Asian and white European pupils. CONCLUSIONS: Our large-scale survey confirmed poor dietary habits in secondary school pupils from a multiethnic community. Urgent efforts are needed to find ways of encouraging healthy lifestyles, particularly in populations with a high risk of developing cardiovascular disease and type 2 diabetes.

Understanding and supporting women with polycystic ovary syndrome: a qualitative study in an ethnically diverse UK sample.

OBJECTIVE: Polycystic ovary syndrome (PCOS) is a lifelong condition. Its symptoms have been linked with psychological consequences, but less attention has been given to the daily implications of living with PCOS. We aimed to explore women's experiences living with PCOS, and the potential acceptability of group education sessions for this target group. METHODS: Women with PCOS were recruited from an ethnically diverse UK community. Twelve semi-structured interviews were conducted. Analysis was underpinned by the constant comparative approach and involved the identification and exploration of key themes. RESULTS: Participants reported a range of symptoms linked with PCOS, including problems relating to menstruation and weight difficulties. Hirsutism was reported as the most distressing symptom. Emergent themes included perceptions about symptoms and delays in receiving a diagnosis; psychological distress; practical implications of living with the condition; coping with PCOS and perceived support needs. Some findings were specific to cultural backgrounds. Participants were supportive of the idea of group education for women with PCOS and suggested a need to provide education within the community and health care providers. DISCUSSION: Women with PCOS experience high psychological distress and difficulties with coping with their condition. Suggested strategies to reduce the negative psychological impact include education at various levels.

Community screening for left ventricular systolic dysfunction using plasma and urinary natriuretic peptides.

OBJECTIVES: We sought to compare urinary and plasma N-terminal pro-brain natriuretic peptide (N-BNP) in left ventricular systolic dysfunction (LVSD) diagnosis. BACKGROUND: Plasma N-BNP is elevated in LVSD. Renal tubule cells produce BNP. We tested the incremental value of urinary N-BNP in LVSD diagnosis. METHODS: In this prospective, community-screening study of undiagnosed LVSD, 1,360 subjects (45 to 80 years of age) were invited, and 1,308 had analyzable echocardiographic scans and urine and plasma specimens. The criterion standard for LVSD was defined as a wall motion score over 1.8 (ejection fraction < or =40%). RESULTS: Twenty-eight patients with LVSD had elevated urinary and plasma N-BNP levels compared with normal subjects (p < 0.0005). Receiver-operating characteristic (ROC) areas under the curve (AUCs) for urinary and plasma N-BNP were 0.831 and 0.840, respectively. Both tests had high negative predictive values (>99%) for excluding LVSD. Urinary N-BNP was more specific (67.2%) than plasma N-BNP (41%). The plasma/urinary N-BNP product yielded a higher ROC-AUC (0.923) and specificity (78%), reducing the number of cases to scan to detect one case of LVSD to 11.4 (compared with 16.6 [urinary N-BNP] and 29.0 [plasma N-BNP]). Sequential application of tests (urinary N-BNP, then plasma N-BNP in the urine-"positive" cases) achieved similar reductions in the number of cases to scan (10.8), while limiting the number of N-BNP tests to be performed. Urinary N-BNP performed poorly in detection of other cardiac abnormalities with preserved systolic function. It was less costly to test urinary N-BNP in the whole population as compared with other strategies, including scanning high-risk cases with N-BNP testing in the remainder. CONCLUSIONS: Urinary N-BNP used together with plasma N-BNP could reduce the echocardiographic burden in screening programs.

Randomised controlled trial of near-patient testing for glycated haemoglobin in people with type 2 diabetes mellitus.

BACKGROUND: Tight glycaemic control in people with type 2 diabetes can lead to a reduction in microvascular and possibly macrovascular complications. The use of near-patient (rapid) testing offers a potential method to improve glycaemic control. AIM: To assess the effect and costs of rapid testing for glycated haemoglobin (HbA1c) in people with type 2 diabetes. DESIGN OF STUDY: Pragmatic open randomised controlled trial. SETTING: Eight practices in Leicestershire, UK. METHOD: Patients were randomised to receive instant results for HbA1c or to routine care. The principal outcome measure was the proportion of patients with an HbA1c <7% at 12 months. We also assessed costs for the two groups. RESULTS: Of the 681 patients recruited to the study 638 (94%) were included in the analysis. The mean age at baseline was 65.7 years (SD = 10.8 years) with a median (interquartile range) duration of diabetes of 4(1-8) years. The proportion of patients with HbA1c < 7% did not differ significantly between the intervention and control groups (37 versus 38%, odds ratio 0.95 [95% confidence interval = 0.69 to 1.31]) at 12 months follow up. The total cost for diabetes-related care was 390 UK pounds per patient for the control group and 370 UK pounds for the intervention group. This difference was not statistically significant. CONCLUSION: Near-patient testing for HbA1c alone does not lead to outcome or cost benefits in managing people with type 2 diabetes in primary care. Further research is required into the use of rapid testing as part of an optimised patient management model including arrangements for patient review and testing.

"And now for the good news..." the impact of negative and positive messages in self-management education for people with Type 2 diabetes: A qualitative study in an ethnically diverse population.

OBJECTIVES: To explore the impact of Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND) Foundation education, particularly from interviewees' narratives regarding recall of good and bad news messages and behaviour changes. METHODS: In-depth, semi-structured interviews were conducted with a purposive sample (n=19) of people who had attended education sessions as part of a randomised controlled trial in two UK sites with ethnically diverse populations. Data collection and analysis were informed by the constant comparative approach and facilitated through charting. RESULTS: Findings were similar in people from different ethnic backgrounds. Exploration of levels of recall of the sessions suggested that this was variable and sometimes very limited, but that interviewees had all assimilated some relevant learning. Key themes emerged relating to the way in which interviewees recalled and had been influenced by positive (good news) and negative (bad news) messages within the education sessions, including biomedical explanations. Both types of message appeared to have an important role in terms of motivation to change behaviour, but a notable observation was that none of the interviewees recalled receiving bad news messages when diagnosed. DISCUSSION: Our findings have highlighted the importance of providing and combining both negative and positive messages within education designed to promote self-management behaviour change.

Developing a Conceptually Equivalent Type 2 Diabetes Risk Score for Indian Gujaratis in the UK.

Aims. To apply and assess the suitability of a model consisting of commonly used cross-cultural translation methods to achieve a conceptually equivalent Gujarati language version of the Leicester self-assessment type 2 diabetes risk score. Methods. Implementation of the model involved multiple stages, including pretesting of the translated risk score by conducting semistructured interviews with a purposive sample of volunteers. Interviews were conducted on an iterative basis to enable findings to inform translation revisions and to elicit volunteers' ability to self-complete and understand the risk score. Results. The pretest stage was an essential component involving recruitment of a diverse sample of 18 Gujarati volunteers, many of whom gave detailed suggestions for improving the instructions for the calculation of the risk score and BMI table. Volunteers found the standard and level of Gujarati accessible and helpful in understanding the concept of risk, although many of the volunteers struggled to calculate their BMI. Conclusions. This is the first time that a multicomponent translation model has been applied to the translation of a type 2 diabetes risk score into another language. This project provides an invaluable opportunity to share learning about the transferability of this model for translation of self-completed risk scores in other health conditions.

Practice costs of implementing guidelines for asthma and angina: findings from a randomised controlled trial.

We collected information about the costs of three interventions (dissemination of full guidelines or prioritised review criteria or criteria plus feedback) to improve care of adults with stable angina or asthma within the context of a randomised controlled trial. The cost of criteria with feedback was pound180 per practice compared to pound9.60-31.45 for the other interventions. Total mean costs borne by practices varied between pound838 and pound2127 per practice depending upon disease and intervention type.

Sharing patient data: competing demands of privacy, trust and research in primary care.

BACKGROUND: Patient privacy may conflict with the advancement of knowledge through data sharing. The data contained in primary care records are uniquely comprehensive. AIM: To explore the knowledge and attitudes of patients and members of the primary healthcare team regarding the sharing of data held in primary care records, with particular reference to data sharing for research and the impact that this may have on trust between patients and health professionals. DESIGN OF STUDY: Qualitative study using quota sampled, semi-structured interviews. SETTING: Five general practices in Leicestershire, UK. METHOD: Grounded theory and framework methodology were used. Interviews were transcribed and analysed thematically. RESULTS: Twenty patients and 15 healthcare professionals and managers were interviewed. Patients had limited knowledge of the type of information held in their general practice records and the ways in which these data are shared, but appeared ready to form preliminary views on issues such as data sharing for audit and disease registration. In this climate of limited awareness, there was no suggestion that concern about data sharing for research adversely affects patient trust or leads patients to withhold relevant information from health professionals in primary care. Interviews carried out with staff suggested a lack of clear practice policies regarding data sharing. CONCLUSIONS: General practices may need to develop policies on data sharing, bring these to the attention of their patient population and improve patient awareness about the nature of the data contained in their records. Researchers should ensure that patients are adequately informed about the nature of data contained in patient records when seeking consent for data extraction.