Patient enablement requires physician empathy: a cross-sectional study of general practice consultations in areas of high and low socioeconomic deprivation in Scotland

<b>Background</b> Patient 'enablement' is a term closely aligned with 'empowerment' and its measurement in a general practice consultation has been operationalised in the widely used patient enablement instrument (PEI), a patient-rated measure of consultation outcome. However, there is limited knowledge regarding the factors that influence enablement, particularly the effect of socio-economic deprivation. The aim of the study is to assess the factors influencing patient enablement in GP consultations in areas of high and low deprivation.<p></p> <b>Methods</b> A questionnaire study was carried out on 3,044 patients attending 26 GPs (16 in areas of high socio-economic deprivation and 10 in low deprivation areas, in the west of Scotland). Patient expectation (confidence that the doctor would be able to help) was recorded prior to the consultation. PEI, GP empathy (measured by the CARE Measure), and a range of other measures and variables were recorded after the consultation. Data analysis employed multi-level modelling and multivariate analyses with the PEI as the dependant variable.<p></p> <b>Results</b> Although numerous variables showed a univariate association with patient enablement, only four factors were independently predictive after multilevel multivariate analysis; patients with multimorbidity of 3 or more long-term conditions (reflecting poor chronic general health), and those consulting about a long-standing problem had reduced enablement scores in both affluent and deprived areas. In deprived areas, emotional distress (GHQ-caseness) had an additional negative effect on enablement. Perceived GP empathy had a positive effect on enablement in both affluent and deprived areas. Maximal patient enablement was never found with low empathy.<p></p> <b>Conclusions</b> Although other factors influence patient enablement, the patients' perceptions of the doctors' empathy is of key importance in patient enablement in general practice consultations in both high and low deprivation settings

Hypothalamic gene expression during voluntary hypophagia in the Sprague-Dawley rat on withdrawal of the palatable liquid diet, Ensure

Copyright © 2014 Elsevier Inc. All rights reserved.Peer reviewedPostprin

Overground vs. Treadmill Running: Do Runners Use the Same Strategy to Adjust Stride Length and Frequency While Running at Different Velocities?

Running speed is determined by stride frequency and stride length. As running speed is adjusted, runners make greater adjustments in stride length at slower speeds with a shift to stride frequency adjustments at the faster speeds. The relationship between stride frequency and stride length is largely based on overground research which leads to the purpose of this study to analyze whether the connection of stride frequency and stride length will adjust similar due to changes in running velocity during overground and treadmill running. The protocol was recently approved by The Institutional Review Board and data collection is currently in progress; - thus the following present abstract does not contain data. In order to compare runner’s gait pattern responses to velocity changes, two wearable technologies (Garmin Fenix2, Garmin, Kansas, USA; runScribe, Scribe Lab, San Francisco, USA) designed to measure stride length and stride frequency will be utilized. Subjects will run at a variety of velocities overground and then on the treadmill with speeds ranging from slow, preferred, and fast. The main dependent variables will be stride frequency and stride length. The null hypothesis is: The relationship between stride length and stride frequency is similar while running overground and on a treadmill at different velocities. The results of this study will be helpful to runners as well as development of wearable technology used to quantify run metrics

Structural and Signaling Elements Important for the Efficient Degradation of BHMT through Macroautophagy

Healthy cells maintain a dynamic and responsive intracellular environment that is marked by the synthesis and degradation of proteins, complex macromolecules and organelles. Autophagy, literally self-eating, is a mechanism that delivers cellular cargo to the lytic compartment for digestion. Defects in the regulation of autophagy have been implicated in pathologies such as cancer and neurodegenerative disease, making the study of its regulation compelling. However, few studies have looked at the regulation of mammalian autophagy as a function of a specific cargo protein. Previous studies had indicated that the metabolic enzyme betaine homocysteine methyltransferase (BHMT) is degraded through an autophagic mechanism. One aim of this study has centered on the role of BHMT quaternary structure in determining the efficiency of autophagic sequestration and degradation. In these studies, an oligomerization deficient form of BHMT was used to show that modulation of the Class III PI3 kinase signaling pathway is likely involved in discerning monomeric from multimeric BHMT and that this has a role in the subsequent degradation of BHMT by autophagy. The second aim has been to study to role of the nutrient-regulated mTOR pathway in the autophagic degradation of BHMT. It has been proposed that mTOR-mediated inactivation of S6 kinase is required for induction of autophagy in mammals. However in Drosophila melanogaster, S6 kinase activity has been shown to be essential for induction of autophagy. The current study demonstrates that the inhibitory signal from mTOR to autophagy does not go through S6 kinase or subsequent phosphorylation of the ribosomal protein S6. The significance of these observations in terms of misfolded proteins, neurodegenerative diseases and therapeutics is discussed

Alien Registration- Mercer, John A. (Northport, Waldo County)

https://digitalmaine.com/alien_docs/5018/thumbnail.jp

Collaborative Epistemic Discourse in Classroom Information Seeking Tasks

We discuss the relationship between information seeking, and epistemic beliefs – beliefs about the source, structure, complexity, and stability of knowledge – in the context of collaborative information seeking discourses. We further suggest that both information seeking, and epistemic cognition research agendas have suffered from a lack of attention to how information seeking as a collaborative activity is mediated by talk between partners – an area we seek to address in this paper. A small-scale observational study using sociocultural discourse analysis was conducted with eight eleven year old pupils who carried out search engine tasks in small groups. Qualitative and quantitative analysis were performed on their discussions using sociocultural discourse analytic techniques. Extracts of the dialogue are reported, informed by concordance analysis and quantitative coding of dialogue duration. We find that 1) discourse which could be characterised as ‘epistemic’ is identifiable in student talk, 2) that it is possible to identify talk which is more or less productive, and 3) that epistemic talk is associated with positive learning outcomes

Junior Recital: Michael A. Mercer, Percussion

Kemp Recital Hall Friday Afternoon April 7, 1995 5:00p.m