7,806 research outputs found

    General practitioner empathy, patient enablement, and patient-reported outcomes in primary care in an area of high socio-economic deprivation in Scotland - a pilot prospective study using structural equation modelling

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    <b>Objective</b> The aim of this pilot prospective study was to investigate the relationships between general practitioners (GPs) empathy, patient enablement, and patient-assessed outcomes in primary care consultations in an area of high socio-economic deprivation in Scotland.<p></p> <b>Methods</b> This prospective study was carried out in a five-doctor practice in an area of high socio-economic deprivation in Scotland. Patients’ views on the consultation were gathered using the Consultation and Relational Empathy (CARE) Measure and the Patient Enablement Instrument (PEI). Changes in main complaint and well-being 1 month after the contact consultation were gathered from patients by postal questionnaire. The effect of GP empathy on patient enablement and prospective change in outcome was investigated using structural equation modelling.<p></p> <b>Results</b> 323 patients completed the initial questionnaire at the contact consultation and of these 136 (42%) completed and returned the follow-up questionnaire at 1 month. Confirmatory factor analysis confirmed the construct validity of the CARE Measure, though omission of two of the six PEI items was required in order to reach an acceptable global data fit. The structural equation model revealed a direct positive relationship between GP empathy and patient enablement at contact consultation and a prospective relationship between patient enablement and changes in main complaint and well-being at 1 month.<p></p> <b>Conclusion</b> In a high deprivation setting, GP empathy is associated with patient enablement at consultation, and enablement predicts patient-rated changes 1 month later. Further larger studies are desirable to confirm or refute these findings.<p></p> <b>Practice implications</b> Ways of increasing GP empathy and patient enablement need to be established in order to maximise patient outcomes. Consultation length and relational continuity of care are known factors; the benefit of training and support for GPs needs to be further investigate

    Inversion of Eddy Current Data Using Holographic Principles

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    It has proven possible to convert eddy current data associated with flaws to images of these flaws using holographic principles [2,3] because electromagnetic waves propagate in metals [1] and because these waves have subsonic velocities at eddy current frequencies. The purpose of this paper is to review and clarify the physical and mathematical basis for this method of analyzing eddy current data

    Protein-mediated dethreading of a biotin-functionalised pseudorotaxane

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    In this article, we describe the synthesis of new biotin-functionalised naphthalene derivatives 3 and 4 and their complexation behaviour with avidin and neutravidin using a range of analytical techniques. We have shown using 2-(4prime or minute-hydroxyazobenzene)benzoic acid displacement and ITC experiments{,} that compounds 3 and 4 have the propensity to form reasonably high-affinity bioconjugates with avidin and neutravidin. We have also demonstrated using 1H NMR{,} UV-vis and fluorescence spectroscopy that the naphthalene moiety of 3 and 4 facilitates the formation of pseudorotaxane-like structures with 1 in water. We have then investigated the ability of avidin and neutravidin to modulate the complexation between 1 and 3 or 4. UV-vis and fluorescence spectroscopy has shown that in both cases the addition of the protein disrupts complexation between the naphthalene moieties of 3 and 4 with 1

    After the Standard Model: New Resonances at the LHC

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    Experiments will soon start taking data at CERN's Large Hadron Collider (LHC) with high expectations for discovery of new physics phenomena. Indeed, the LHC's unprecedented center-of-mass energy will allow the experiments to probe an energy regime where the standard model is known to break down. In this article, the experiments' capability to observe new resonances in various channels is reviewed.Comment: Preprint version of a Brief Review for Modern Physics Letters A. Changes w.r.t. the fully corrected version are smal

    The r-Process Enriched Low Metallicity Giant HD 115444

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    New high resolution, very high signal-to-noise spectra of ultra-metal-poor (UMP) giant stars HD 115444 and HD 122563 have been gathered with the High-Resolution Echelle Spectrometer of the McDonald Observatory 2.7m Telescope. With these spectra, line identification and model atmosphere analyses have been conducted, emphasizing the neutron-capture elements. Twenty elements with Z > 30 have been identified in the spectrum of HD 115444. This star is known to have overabundances of the neutron-capture elements, but it has lacked a detailed analysis necessary to compare with nucleosynthesis predictions. The new study features a line-by-line differential abundance comparison of HD 115444 with the bright, well-studied halo giant HD 122563. For HD 115444, the overall metallicity is [Fe/H]~ -3.0. The abundances of the light and iron-peak elements generally show the same pattern as other UMP stars (e.g. overdeficiencies of manganese and chromium, overabundances of cobalt), but the differential analysis indicates several nucleosynthesis signatures that are unique to each star.Comment: To Appear in the Astrophysical Journa

    A single transcription factor is sufficient to induce and maintain secretory cell architecture

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    We hypothesized that basic helix–loop–helix (bHLH) MIST1 (BHLHA15) is a “scaling factor” that universally establishes secretory morphology in cells that perform regulated secretion. Here, we show that targeted deletion of MIST1 caused dismantling of the secretory apparatus of diverse exocrine cells. Parietal cells (PCs), whose function is to pump acid into the stomach, normally lack MIST1 and do not perform regulated secretion. Forced expression of MIST1 in PCs caused them to expand their apical cytoplasm, rearrange mitochondrial/lysosome trafficking, and generate large secretory granules. Mist1 induced a cohort of genes regulated by MIST1 in multiple organs but did not affect PC function. MIST1 bound CATATG/CAGCTG E boxes in the first intron of genes that regulate autophagosome/lysosomal degradation, mitochondrial trafficking, and amino acid metabolism. Similar alterations in cell architecture and gene expression were also caused by ectopically inducing MIST1 in vivo in hepatocytes. Thus, MIST1 is a scaling factor necessary and sufficient by itself to induce and maintain secretory cell architecture. Our results indicate that, whereas mature cell types in each organ may have unique developmental origins, cells performing similar physiological functions throughout the body share similar transcription factor-mediated architectural “blueprints.
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