Alpha taxonomy of the Russian Permian procolophonoids

European Russia has been the source of many procolophonoid taxa from both the Permian and Triassic, and a Permian or− igin for the procolophonoid family Procolophonidae has been based on the Russian taxon Microphon exiguus. Recently, this taxon was reclassified as a seymouriamorph and, in its place, the taxa Nyctiphruretus, Suchonosaurus, and Kinelia from the Middle and Upper Permian of Russia were suggested as “procolophons”, using evolutionary−systematic classifi− cation methods. In recent phylogenies, however, Nyctiphruretus has been recovered as a non–procolophonoid para− reptile, whereas Kinelia and Suchonosaurus have never been included in a phylogenetic study. Re−examination indicates that Suchonosaurus is a member of the procolophonoid subfamily Procolophonidae based on the shape of the maxillary bone and the external naris, the laterally visible maxillary depression, and the number and type of maxillary teeth. Kinelia, on the other hand, is excluded from the Procolophonoidea because of its subpleurodont dental attachment and lack of any procolophonoid features. Thus, Suchonosaurus is the only confirmed Permian procolophonid from the Permian of Rus− sia. Additionally, re−examination of the holotype of Microphon exiguus confirms that it is identical to the seymouria− morph specimens recently included in the genus Microphon and that it lacks procolophonoid features. The earliest un− equivocal record of the subfamily Procolophonidae is confirmed from the Late Permian of Russia, making Russia the only region where, with certainty, both Permian and Triassic procolophonids have been discovered

New Basal Synapsid Supports Laurasian Origin for Therapsids

The distant evolutionary ancestry of mammals is documented by a rich therapsid fossil record. While sphenacodontid synapsids are considered the sister−group of therapsids, the place of origin of therapsids is an enigma, largely because of a long standing morphological and temporal gap (Olson’s Gap) in their fossil record. We describe a new large predatory synapsid, Raranimus dashankouensis gen. et sp. nov., from the Middle Permian of Dashankou in China which has a unique combination of therapsid and sphenacodontid features. This specimen is of great significance asit is a basal therapsid which is the sister taxon to all other therapsids. The fact that it was found in association with Early Permian tetrapods (Anakamacops and Belebey) suggests that it is the oldest therapsid and provides the first evidence of therapsid−bearing rocks which cover Olson’s Gap. It further supports that therapsids may have had a Laurasian rather than Gondwanan origin

Current approaches to obesity management in UK Primary Care : the Counterweight Programme

Background/Aims Primary care is expected to develop strategies to manage obese patients as part of coronary heart disease and diabetes national service frameworks. Little is known about current management practices for obesity in this setting. The aim of this study is to examine current approaches to obesity management in UK primary care and to identify potential gaps in care. Method A total of 141 general practitioners (GPs) and 66 practice nurses (PNs) from 40 primary care practices participated in structured interviews to examine clinician self-reported approaches to obesity management. Medical records were also reviewed for 100 randomly selected obese patients from each practice [body mass index (BMI) greater than or equal to30 kg m(-2), n = 4000] to review rates of diet counselling, dietetic or obesity centre referrals, and use of anti-obesity medication. Computerized medical records for the total practice population (n = 206 341, 18-75 years) were searched to examine the proportion of patients with a weight/BMI ever recorded. Results Eighty-three per cent of GPs and 97% of PNs reported that they would raise weight as an issue with obese patients (P < 0.01). Few GPs (15%) reported spending up to 10 min in a consultation discussing weight-related issues, compared with PNs (76%; P < 0.001). Over 18 months, practice-based diet counselling (20%), dietetic (4%) and obesity centre (1%) referrals, and any anti-obesity medication (2%) were recorded. BMI was recorded for 64.2% of patients and apparent prevalence of obesity was less than expected. Conclusion Obesity is under-recognized in primary care even in these 40 practices with an interest in weight management. Weight management appears to be based on brief opportunistic intervention undertaken mainly by PNs. While clinicians report the use of external sources of support, few patients are referred, with practice-based counselling being the most common intervention

Engaging patients, clinicians and health funders in weight management: the Counterweight Programme

Background. The Counterweight Programme provides an evidence based and effective approach for weight management in routine primary care. Uptake of the programme has been variable for practices and patients. Aim. To explore key barriers and facilitators of practice and patient engagement in the Counterweight Programme and to describe key strategies used to address barriers in the wider implementation of this weight management programme in UK primary care. Methods. All seven weight management advisers participated in a focus group. In-depth interviews were conducted with purposeful samples of GPs (n = 7) and practice nurses (n = 15) from 11 practices out of the 65 participating in the programme. A total of 37 patients participated through a mixture of in-depth interviews (n = 18) and three focus groups. Interviews and focus groups were analysed for key themes that emerged. Results. Engagement of practice staff was influenced by clinicians&rsquo; beliefs and attitudes, factors relating to the way the programme was initiated and implemented, the programme content and organizational/contextual factors. Patient engagement was influenced by practice endorsement of the programme, clear understanding of programme goals, structured proactive follow-up and perception of positive outcomes. Conclusions. Having a clear understanding of programme goals and expectations, enhancing self-efficacy in weight management and providing proactive follow-up is important for engaging both practices and patients. The widespread integration of weight management programmes into routine primary care is likely to require supportive public policy