An internet survey of psychiatrists who have a particular interest in cognitive behavioural therapy: what is the place for the cognitive behavioural model in their role as a psychiatrist?

A survey of psychiatrists with a special interest in CBT was conducted by email correspondence to answer two main questions: ‘What are the uses and the usefulness of the cognitive behavioural model within the day-to-day practice of psychiatrists?’ and ‘What are the most important roles of the consultant medical psychotherapist who has specialized in CBT?’ Despite the constraints of a low response rate the results still reflected the views of 46 psychiatrists who were particularly experienced in the area of CBT. They reported that the cognitive behavioural model was useful in general psychiatric settings, in particular in the engagement of patients, improving client's insight, adherence to medications, and for trainee supervision. The responders reaffirmed previously held views about the role of the consultant medical psychotherapist (CBT), in particular the roles of the assessment and management of complex cases, of taking responsibility for patients with a combination of medical and psychological issues and of teaching CBT to psychiatrists and other mental health professionals. The challenges of translating CBT competencies into generic non-CBT psychiatric settings are discussed, with the important potential role of the medical psychotherapist in this respect. The key skill of formulating cases in secondary care is emphasized

Life cycle analysis for the cultivation and combustion of miscanthus for biofuel compared with natural gas

As negative environmental and economic impacts of fossil fuels have escalated, so has the importance of renewable bioenergy crops whose feedstocks are noncompetitive with food supplies. Compared with fossil fuels, use of lignocellulosic feedstocks offers potential for greenhouse gas reduction and highly positive net energy returns because of low input demand and high yields per unit of land area, thus making them advantageous for the emerging biofuel industry. The aim of this study was to simulate environmental impacts of producing a biofuel grass for combustion use based on the inventory of inputs and their effects on eutrophication of surface waters; acidification of land and water; photochemical ozone-creation potential (i.e. smog); global atmospheric warming; and nonrenewable resource depletion (mainly fossil fuels). Hybrid miscanthus (Miscanthus x giganteus, or giant miscanthus), a perennial C4 grass originating from East Asia, was compared with natural gas by using a life-cycle analysis model for biomass production in France. The analysis showed a trade-off between natural gas and miscanthus. The latter had a lower global-warming potential and consumed less primary nonrenewable energy but produced more emissions that promote acidification and eutrophication than did natural gas

Information Technology and Organizational Learning: An Empirical Analysis

Organizational learning theory suggests that organizations “learn from experience” and are thus able to adapt their range of potential behaviors through the processing of information. Our research integrates this perspective with information systems economics theory and empirically tests whether new information technology investments contribute to an organization’s ability to learn from experience. Based on a cross- sectional time series analysis of data spanning 48 months and six independently operated payment processing facilities owned by a major international financial institution, our results indicate that IT has a significant positive impact on the rate at which organizations can translate learning from cumulative experience into incremental productivity gains

A Survey of Horse Training in New England

New England no longer has a significant horse training industry. It has many small operations with no obvious and overlapping training philosophies or practices. Show and competition programs are intense and competitive at regional, national and even international levels leading to the observation that techniques employed are equally strategic and tediously designed in order to encourage the exemplary results in the show ring. This study aimed to examine the methods, routines, and strategies that are used by top tier trainers in the New England region of the United States. This information was collected both in survey form and in interview form, to maximize collection and indications of how each particular trainer, breeder, or owner was most easily contacted. The data was then compiled, analyzed for trends, outliers, and other points of interest with the end goal of giving a basic but thorough view of the methods and strategies used by trainers of prestige in the New England area. Results of this study will hold relevance both to those interested in this luxury hobby and to economy minded individuals, as horses are still a substantial percentage of livestock in the New England area. Future studies in the New England area could target a larger group of trainers and stables, while future studies could also be performed in other regions of the United States

Enacting a depoliticised alterity: law and traditional medicine at the World Health Organization

This paper interrogates the depoliticising effects of a seemingly neutral regulatory drive at the heart of the World Health Organization (WHO)'s promotion of traditional medicine. Emerging at WHO in the late 1960s against a political backdrop of decolonisation and pan-Africanism, traditional medicine has continued to be promoted in subsequent decades, culminating in the latest global Traditional Medicine Strategy (2014 to 2023). Yet WHO's promotion and acceptance of traditional medicine have also become increasingly conditional upon its standardisation and regulation – something that appears fundamentally at odds with traditional medicine's heterogeneity. Drawing on insights from critical law and science and technology studies, we suggest that such a process at WHO has done more than simply disqualify the toxic and the dangerous. Rather, it has implicitly and explicitly marginalised and excluded those aspects of traditional medicine that deviate from scientific, biomedical ways of seeing, knowing and organising

Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices

OBJECTIVES: Overutilisation of antibiotics may contribute to the emergence of antimicrobial drug resistance, a growing international concern. This study aimed to analyse the performance of UK general practices with respect to antibiotic prescribing for respiratory tract infections (RTIs) among young and middle-aged adults.SETTING: Data are reported for 568 UK general practices contributing to the Clinical Practice Research Datalink.PARTICIPANTS: Participants were adults aged 18-59?years. Consultations were identified for acute upper RTIs including colds, cough, otitis-media, rhino-sinusitis and sore throat.PRIMARY AND SECONDARY OUTCOME MEASURES: For each consultation, we identified whether an antibiotic was prescribed. The proportion of RTI consultations with antibiotics prescribed was estimated.RESULTS: There were 568 general practices analysed. The median general practice prescribed antibiotics at 54% of RTI consultations. At the highest prescribing 10% of practices, antibiotics were prescribed at 69% of RTI consultations. At the lowest prescribing 10% of practices, antibiotics were prescribed at 39% RTI consultations. The median practice prescribed antibiotics at 38% of consultations for 'colds and upper RTIs', 48% for 'cough and bronchitis', 60% for 'sore throat', 60% for 'otitis-media' and 91% for 'rhino-sinusitis'. The highest prescribing 10% of practices issued antibiotic prescriptions at 72% of consultations for 'colds', 67% for 'cough', 78% for 'sore throat', 90% for 'otitis-media' and 100% for 'rhino-sinusitis'.CONCLUSIONS: Most UK general practices prescribe antibiotics to young and middle-aged adults with respiratory infections at rates that are considerably in excess of what is clinically justified. This will fuel antibiotic resistance.<br/

The Impact of Outcrossing on Yields of ‘Hass’ Avocado

‘Hass’ avocado (Persea americana Mill.) is characterized by excessive flower and fruit abscission, resulting in extremely low fruit set. Low outcrossing rates might be a factor contributing to low yields. It is hypothesized that self-fertilized flowers and resulting fruit abscise at a much higher rate than fruit that are the product of outcrossing. However, significant relationships between outcrossing rates and yields have only been established in a few avocado studies. The objective of this research was to investigate the importance of outcrossing to yield in a commercial ‘Hass’ orchard containing ‘Bacon’, an effective pollinizer of ‘Hass’. Microsatellite markers were used to determine the rate of outcrossing of fruit persisting to harvest on ‘Hass’ trees. Experiments were conducted during sequential on-and off-crop years. During both years, outcrossing rates were not related to yield or alternate bearing. These results indicate that outcrossing was not the primary factor affecting flower and fruit persistence and ultimately yield in this orchard for the two sequential years of this research