GPs’ Interactional Styles in Consultations with Dutch and Ethnic Minority Patients

The aim of this study was to examine interactional styles of general practitioners (GPs) in consultations with Dutch patients as compared to ethnic minority patients, from the perspective of level of mutual understanding between patient and GP. Data of 103 transcripts of video-registered medical interviews were analyzed to assess GPs’ communication styles in terms of involvement, detachment, shared decision-making and patient-centeredness. Surveys were used to collect data on patients’ characteristics and mutual understanding. Results show that overall, GPs communicate less adequately with ethnic minority patients than with Dutch patients; they involve them less in decision-making and check their understanding of what has been discussed less often. Intercultural consultations are thus markedly distinguishable from intracultural consultations by a lack of adequate communicative behavior by GPs. As every patient has a moral and legal right to make informed decisions, it is concluded that GPs should check more often whether their ethnic minority patients have understood what has been said during the medical consultation

How does scapula motion change after reverse total shoulder arthroplasty? - a preliminary report

<p>Abstract</p> <p>Background</p> <p>Arm elevation is composed of glenohumeral and scapulothoracic motion. Many reports have addressed changes of scapular position across a spectrum of shoulder disease. However, no study has examined changes in scapular position after reverse total shoulder arthroplasty (RTSA). The purpose of this study was to evaluate the changes in scapular position after RTSA compared to patients’ contralateral, nonoperated shoulder.</p> <p>Methods</p> <p>Seven patients that underwent RTSA for cuff tear arthropathy from July 2007 to October 2008 were enrolled. The distance between the long axis of the thoracic spine and the inferior pole of the scapula (lateralization of the scapula) was measured on shoulder A-P radiographs at 0 degrees (the neutral position) and at 30, 60, 90, and 120 degrees of shoulder abduction. In addition, the angle between the long axis of the thoracic spine and medial border of the scapula was measured and compared with the patients’ contralateral shoulder.</p> <p>Results</p> <p>Scapulohumeral rhythm was 2.4:1 on the operated shoulder and 4.1:1 on the nonoperated, contralateral shoulder at 120 degrees of abduction. The distance between the line of the interspinous process of upper thoracic vertebra and the inferior pole of the scapula showed a negative slope at 0 to 30 degrees abduction on the operated side, but beyond 30 degrees of abduction, this distance showed a more sudden increase than in the contralateral shoulder. The angle between the vertical vertebral line and the scapular medial border also showed greater increase beyond 30 degrees abduction on the operated limb.</p> <p>Conclusions</p> <p>The pattern of scapular position after RTSA, was found to differ from that of the contralateral shoulder, and showed a more scapular upward rotation.</p

Habitat manipulation to mitigate the impacts of invasive arthropod pests

Exotic invaders are some of the most serious insect pests of agricultural crops around the globe. Increasingly, the structure of landscape and habitat is recognized as having a major influence on both insect pests and their natural enemies. Habitat manipulation that aims at conserving natural enemies can potentially contribute to safer and more effective control of invasive pests. In this paper, we review habitat management experiments, published during the last 10 years, which have aimed to improve biological control of invasive pests. We then discuss during what conditions habitat management to conserve natural enemies is likely to be effective and how the likelihood of success of such methods can be improved. We finally suggest an ecologically driven research agenda for habitat management programmes.We acknowledge the following funding sources: the Tertiary Education Commission, New Zealand, through the Bio-Protection Research Centre, Lincoln University, New Zealand (Mattias Jonsson and Steve Wratten), the New Zealand Foundation for Research, Science and Technology (FRST); project LINX0303 (Steve Wratten, Ross Cullen, Jean Tompkins), Lincoln University, New Zealand, for a Post-graduate Scholarship to Jean Tompkins, USDA CSREES Risk Avoidance and Mitigation Program (2004-51101-02210), USDA NC SARE Project (LCN 04-249), USDA CSREES Arthropod and Nematode Biology (2004-35302-14811), North Central Regional IPM, NSF-LTER at Kellogg Biological Station (NSF DEB 0423627), and the Michigan Agricultural Experiment Station (Doug Landis)