Is \u3cem\u3eLa bohѐme\u3c/em\u3e a \u3cem\u3everismo\u3c/em\u3e Opera?

Verismo is an Italian term that came to be used in reference to literature, theatre, and opera during the end of the nineteenth century. According to William Berger, “verismo is often translated as ‘realism’ but the word is closer to ‘truth’ in Italian.” The term was applied to literature beginning in the 1870s, and began to be applied to opera during the 1890s. However, it has never been particularly well understood. Evaluating it today is especially difficult because the modern perceptions of the term are not quite the same as the original meaning. La bohѐme was composed by Giacomo Puccini in 1895 and was based on the novel Scѐnes de la vie de bohѐme by Henri Murger. Since it was written in the verismo period and was based on literature, La bohѐme has been categorized as a verismo opera by many. To others, on the other hand, La bohѐme does not fit the definition of verismo either in part or in whole. This paper will examine the original use of the term verismo, Puccini’s original intentions, and La bohѐme itself. For research, this paper draws on the score of La bohѐme, biographies of Puccini, letters by Puccini, scholarly analyses, critical articles, and research on Italian operatic history. La bohѐme exhibits the characteristics of verismo opera based on these considerations

Involving the public in health research in Latin America: making the case for mental health

Patient and Public Involvement and Engagement (PPIE) has been increasingly encouraged in health services and research over the last two decades. Particularly strong evidence has been presented with regard to the impact PPIE has in certain research areas, such as mental health. Involving the public in mental health research has the potential to improve the quality of research and reduce the power imbalance between researchers and participants. However, limitations can be frequent and include tokenistic involvement and lack of infrastructure and support. Nevertheless, PPIE has the potential to impact mental health research in the Latin American context, where existing policies already support public involvement in health research and where the burden of mental disorders is significant. There are many lessons to learn from the evidence of PPIE in other regions. Latin America now has the opportunity tackle one of today’s most important issues: effective health care service delivery for all, based on evidence from comprehensive health research. Health research policy; community-based participatory research; mental health; Latin America

Lay Health Trainers Supporting Self-Management amongst Those with Low Heath Literacy and Diabetes: Lessons from a Mixed Methods Pilot, Feasibility Study

This article reports a mixed methods process evaluation of a pilot feasibility randomised controlled trial comparing a Lay Health Trainer (LHT) intervention and usual care for those with poorly controlled Type 2 Diabetes Melitus (T2DM). Set in a deprived area in the UK, this research explores patient and health care practitioner (HCP) views on whether a structured interview between a patient and a Lay Health Trainer (LHT), for the purpose of developing a tailored self-management plan for patients, is acceptable and likely to change health behaviours. In doing so, it considers the implications for a future, randomised controlled trial (RCT). Participants were patients, LHTs delivering the intervention, service managers, and practice nurses recruiting patients to the study. Patients were purposively sampled on their responses to a baseline survey, and semistructured interviews were conducted within an exploratory thematic analysis framework. Findings indicate that the intervention is acceptable to patients and HCPs. However, LHTs found it challenging to work with older patients with long-term and/or complex conditions. In order to address this, given an ageing population and concomitant increases in those with such health needs, LHT training should develop skills working with these populations. The design of any future RCT intervention should take account of this

Health Literacy, Diabetes Prevention, and Self-Management

International audienceOBJECTIVE:To identify the factors that can predict physicians' use of electronic prescribing.DESIGN:All primary care physicians who practised in a single geographic region in Quebec were invited to use a free, advanced, research-based electronic prescribing and drug management system. This natural experiment was studied with an expansion of the Technology Acceptance Model (TAM), which was used to explain early adopters' use of this electronic prescribing technology.SETTING:Quebec city region.PARTICIPANTS:A total of 61 primary care physicians who practised in a single geographic region where there was no electronic prescribing.MAIN OUTCOME MEASURES:Actual use of electronic prescribing; physicians' perceptions of and intentions to use electronic prescribing; physician and practice characteristics.RESULTS:During the 9-month study period, 61 primary care physicians located in 26 practice sites used electronic prescribing to write 15 160 electronic prescriptions for 18 604 patients. Physician electronic prescribing rates varied considerably, from a low of 0 to a high of 75 per 100 patient visits, with a mean utilization rate of 30 per 100 patient visits. Overall, 34% of the variance in the use of electronic prescribing was explained by the expanded TAM. Computer experience (P=.001), physicians' information-acquisition style (P=.01), and mean medication use in the practice (P=.02) were significant predictors. Other TAM factors that generally predict new technology adoption (eg, intention to use, perceived ease of use, and perceived usefulness) were not predictive in this study.CONCLUSION:The adoption of electronic prescribing was a highly challenging task, even among early adopters. The insight that this pilot study provides into the determinants of the adoption of electronic prescribing suggests that novel physician-related factors (eg, information-acquisition style) and practice-related variables (eg, prevalence of medication use) influence the adoption of electronic prescribing

Repeatability and reproducibility of visual field tests in people with established visual field loss

The thesis investigated the repeatability of the Esterman Visual Field Test (EVFT) on the Humphrey Field Analyser (HFA), and the reproducibility of the EVFT on the HFA and Henson Pro 5000 Perimeter. The reproducibility of the Ring of Sight (ROS) 24-2 full threshold (FT) examination was also evaluated. These were investigated with participants with established visual field loss (VFL) using case control studies. The reduced sensitivity that influences test-retest variability in those with VFL and differences within the perimeter methodologies, including the influence of background luminance were considered. Agreement in sensitivity threshold values or the Esterman Efficiency Scores (EES) between perimeters were analysed and pointwise analysis was undertaken. Any change in fitness-to-drive status or ability to determine/rule out disease was investigated. Principal Findings: The EVFT possesses poor repeatability and reproducibility for individuals with VFL with significant change in EES on test-retest at different sessions and significant lack of agreement when comparing EES on the HFA and the Henson Pro 5000 Perimeter. The EVFT possesses good repeatability and reproducibility in fitness-to-drive status. The significant variation in EES and location of defect in those with VFL does not impact upon on an individual’s fitness-to-drive status. It is recommended that a repeat examination is performed on the HFA for those with VFL who fails the EVFT on initial examination to account for variability of test-retest and the significantly lower EES recorded by the Henson Pro 5000 Perimeter. There is a large proportion of those with VFL (33.33%) who are unable to see a target, which is required to be seen, in order to conduct a visual field test on the ROS. There is significant lack of agreement in defect depth, defect location, mean deviation and sensitivity threshold values found on the ROS 24-2 FT examination compared to the SITA Standard 24-2 examination performed on the HFA. The ROS possesses a sensitivity value of 33.33%

Transport mechanism of a glutamate transporter homologue GltPh.

Glutamate transporters are responsible for uptake of the neurotransmitter glutamate in mammalian central nervous systems. Their archaeal homologue GltPh, an aspartate transporter isolated from Pyrococcus horikoshii, has been the focus of extensive studies through crystallography, MD simulations and single-molecule FRET (smFRET). Here, we summarize the recent research progress on GltPh, in the hope of gaining some insights into the transport mechanism of this aspartate transporter