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Abstract Background Antibiotic resistance is an increasing challenge for health care services worldwide. While up to 90% of antibiotics are being prescribed in the outpatient sector recommendations for the treatment of community-acquired infections are usually based on resistance findings from hospitalized patients. In context of the EU-project called "APRES - the appropriateness of prescribing antibiotic in primary health care in Europe with respect to antibiotic resistance" it was our aim to gain detailed information about the resistance data from Austria in both the scientific and the grey literature. Methods A systematic review was performed including scientific and grey literature published between 2000 and 2010. Inclusion and exclusion criteria were defined and the review process followed published recommendations. Results Seventeen scientific articles and 23 grey literature documents could be found. In contrast to the grey literature, the scientific publications describe only a small part of the resistance situation in the primary health care sector in Austria. Merely half of these publications contain data from the ambulatory sector exclusively but these data are older than ten years, are very heterogeneous concerning the observed time period, the number and origin of the isolates and the kind of bacteria analysed. The grey literature yields more comprehensive and up-to-date information of the content of interest. These sources are available in German only and are not easily accessible. The resistance situation described in the grey literature can be summarized as rather stable over the last two years. For Escherichia coli e.g. the highest antibiotic resistance rates can be seen with fluorochiniolones (19%) and trimethoprim/sulfamethoxazole (27%). Conclusion Comprehensive and up-to-date antibiotic resistance data of different pathogens isolated from the community level in Austria are presented. They could be found mainly in the grey literature, only few are published in peer-reviewed journals. The grey literature, therefore, is a very valuable source of relevant information. It could be speculated that the situation of published literature is similar in other countries as well.

Abstract Background A 'societal impact factor' that complements the scientific impact factor would contribute to a more comprehensive evaluation of scientific research. In order to develop a practical tool for its assessment, it is important to learn about perceptions of scientists on how to measure a societal impact factor. Methods This qualitative study presents the development of a practical tool to measure the societal impact of publications based on 8 focus group discussions with 24 biomedical scientists at the Medical University Vienna between May 2008 and May 2009. Topics focused on (1) features of an ideal tool, (2) criteria that should be considered in the assessment, and (3) the identification of practical pitfalls. In an iterative exercise involving the repeated application of the drafted tool to scientific papers, criteria for the assessment were refined. A small-scale exercise to evaluate the tool in terms of its comprehensibility, relevance and practicability was conducted using questionnaires for 6 external experts in leading positions of public health, and yielded acceptable results. Results The tool developed consists of three quantitative dimensions, that is (1) the aim of a publication, (2) the efforts of the authors to translate their research results, and, if translation was accomplished, (3) (a) the size of the area where translation was accomplished (regional, national or international), (b) its status (preliminary versus permanent) and (c) the target group of the translation (individuals, subgroup of population, total population). Conclusions Focus group discussions with scientists suggested that the societal impact factor of a publication should consider the effect of the publication in a wide set of non-scientific areas, but also the motivation behind the publication, and efforts by the authors to translate their findings. The proposed tool provides some valuable insights for further research and practical applications in the topic area.

Abstract Background Almost all societies carry responsibility towards patients who require continuous medical care at home. In many health systems the general practitioner cooperates with community based services of home care and coordinates all medical and non medical activities. In Austria the general practitioner together and in cooperation with relatives of the patient and professional organisations usually takes on this task by visiting his patients. This study was carried out to identify diseases that need home care and to describe the functional profile of home care patients in eastern Austria. Methods Cross sectional observational study with 17 GP practices participating during 2 study periods in 1997 and in 2004 in eastern Austria. Each GP identified patients requiring home care and assessed their underlying diseases and functional status by filling in a questionnaire personally after an encounter. Patients in nursing homes were excluded. Statistical tests used were t-tests, contingency tables, nonparametric Wilcoxon signed rank sum test and Fisher-combination test. Results Patients with degenerative diseases of the central nervous system (65%) caused by Alzheimer's disease and cerebrovascular occlusive disease and patients with degenerative diseases of the skeletal system (53%) were the largest groups among the 198 (1997) and 261 (2004) home care cases of the 11 (1997) and 13 (2004) practices. Malignant diseases in a terminal state constituted only 5% of the cases. More than two thirds of all cases were female with an average age of 80 years. Slightly more than 70% of the patients were at least partially mobile. Conclusion Home care and home visits for patients with degenerative diseases of the central nervous and skeletal system are important elements of GP's work. Further research should therefore focus on effective methods of training and rehabilitation to better the mental and physical status of patients living in their private homes.