Analysis of General Practitioners’ Attitudes and Beliefs about Psychological Intervention and the Medicine-Psychology Relationship in Primary Care: Toward a New Comprehensive Approach to Primary Health Care

The biopsychosocial paradigm is a model of care that has been proposed in order to improve the effectiveness of health care by promoting collaboration between different professions and disciplines. However, its application still faces several issues. A quantitative-qualitative survey was conducted on a sample of general practitioners (GPs) from Milan, Italy, to investigate their attitudes and beliefs regarding the role of the psychologist, the approach adopted to manage psychological diseases, and their experiences of collaboration with psychologists. The results show a partial view of the psychologist’s profession that limits the potential of integration between medicine and psychology in primary care. GPs recognized that many patients (66%) would often benefit from psychological intervention, but only in a few cases (9%) were these patients regularly referred to a psychologist. Furthermore, the referral represents an almost exclusive form of collaboration present in the opinions of GPs. Only 8% of GPs would consider the joint and integrated work of the psychologist and doctor useful within the primary health care setting. This vision of the role of psychologists among GPs represents a constraint in implementing a comprehensive primary health care approach, as advocated by the World Health Organization

The role of contact angle and pore width on pore condensation and freezing

It has recently been shown that pore condensation and freezing (PCF) is a mechanism responsible for ice formation under cirrus cloud conditions. PCF is defined as the condensation of liquid water in narrow capillaries below water saturation due to the inverse Kelvin effect, followed by either heterogeneous or homogeneous nucleation depending on the temperature regime and presence of an ice-nucleating active site. By using sol–gel synthesized silica with well-defined pore diameters, morphology and distinct chemical surface-functionalization, the role of the water–silica contact angle and pore width on PCF is investigated. We find that for the pore diameters (2.2–9.2 nm) and water contact angles (15–78°) covered in this study, our results reveal that the water contact angle plays an important role in predicting the humidity required for pore filling, while the pore diameter determines the ability of pore water to freeze. For T>235 K and below water saturation, pore diameters and water contact angles were not able to predict the freezing ability of the particles, suggesting an absence of active sites; thus ice nucleation did not proceed via a PCF mechanism. Rather, the ice-nucleating ability of the particles depended solely on chemical functionalization. Therefore, parameterizations for the ice-nucleating abilities of particles in cirrus conditions should differ from parameterizations at mixed-phase clouds conditions. Our results support PCF as the atmospherically relevant ice nucleation mechanism below water saturation when porous surfaces are encountered in the troposphere

Pore condensation and freezing is responsible for ice formation below water saturation for porous particles

Ice nucleation in the atmosphere influences cloud properties, altering precipitation and the radiative balance, ultimately regulating Earth’s climate. An accepted ice nucleation pathway, known as deposition nucleation, assumes a direct transition of water from the vapor to the ice phase, without an intermediate liquid phase. However, studies have shown that nucleation occurs through a liquid phase in porous particles with narrow cracks or surface imperfections where the condensation of liquid below water saturation can occur, questioning the validity of deposition nucleation. We show that deposition nucleation cannot explain the strongly enhanced ice nucleation efficiency of porous compared with nonporous particles at temperatures below −40 °C and the absence of ice nucleation below water saturation at −35 °C. Using classical nucleation theory (CNT) and molecular dynamics simulations (MDS), we show that a network of closely spaced pores is necessary to overcome the barrier for macroscopic ice-crystal growth from narrow cylindrical pores. In the absence of pores, CNT predicts that the nucleation barrier is insurmountable, consistent with the absence of ice formation in MDS. Our results confirm that pore condensation and freezing (PCF), i.e., a mechanism of ice formation that proceeds via liquid water condensation in pores, is a dominant pathway for atmospheric ice nucleation below water saturation. We conclude that the ice nucleation activity of particles in the cirrus regime is determined by the porosity and wettability of pores. PCF represents a mechanism by which porous particles like dust could impact cloud radiative forcing and, thus, the climate via ice cloud formation.Fil: David, Robert O.. Institute for Atmospheric and Climate Science; SuizaFil: Marcolli, Claudia. Institute for Atmospheric and Climate Science; SuizaFil: Fahrni, Jonas. Zurich University of Applied Sciences; SuizaFil: Qiu, Yuqing. University of Utah; Estados UnidosFil: Pérez Sirkin, Yamila Anahí. University of Utah; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química, Física de los Materiales, Medioambiente y Energía. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química, Física de los Materiales, Medioambiente y Energía; ArgentinaFil: Molinero, Valeria. University of Utah; Estados UnidosFil: Mahrt, Fabian. Institute for Atmospheric and Climate Science; SuizaFil: Brühwiler, Dominik. University of Applied Sciences; SuizaFil: Lohmann, Ulrike. Institute for Atmospheric and Climate Science; SuizaFil: Kanji, Zamin A.. Institute for Atmospheric and Climate Science; Suiz

A new test for topographic disorientation in elderly people. Preliminary results in a healthy sample

In the physiological aging, a reduction in processing speed, episodic memory and working memory have been well established. However, little is known about navigational abilities in elderly people and a few ecological tools are available. Recently, some evidences (Cushman & Stein, 2008; Hort et al., 2007) have suggested topographic disorientation (TD) as a possible marker of conversion from amnesic Mild Cognitive Impairment (a-MCI) to Alzheimer’s disease (AD). The purpose of this research was to create a new ecological instrument in healthy elderly subjects to be subsequently used in clinical setting. Sample: 38 healthy volunteer participants were enrolled, mean age 67.05 (SD = 8.06), 18 males and 15 females. All of them were right-handed. Instruments: a neuropsychological standard battery and experimental tasks that consist of Bidimensional stimuli and the Plastic City with several subtests have been administered. The role of cognitive reserve in navigation abilities has been also evaluated by a recent standardized questionnaire (CRIq) (Nucci, Mondini & Mapelli, 2011). Results: significant correlations among the experimental tests, spatial planning tasks and executive functions have been found. In navigation testing, no differences were detected according to gender, while age resulted to play an important role. Younger elderly showed better performances in execution times, learning of different paths and remembering landmarks met in the previous way. Participants who made many navigational mistakes showed worse scores in cognitive reserve and in visual-spatial memory task (Map Replacement, Recall Replacement on Map and Bidimensional stimuli). Conclusion: according to the previous studies (deIpolyi, Rankin, Mucke, Miller & Gorno-Tempini, 2007; Cushman & Stein, 2008), remembering the correct place of landmarks seems to be an important ability in orientation, along with age and cognitive reserve. These preliminary interesting results support going on the research in elderly navigation; however the Plastic City needs to be improved and subsequently test and re-test. In future research, the Plastic City deserves to be applied also in MCI and early AD patients

Analysis of General Practitioners’ Attitudes and Beliefs about Psychological Intervention and the Medicine-Psychology Relationship in Primary Care: Toward a New Comprehensive Approach to Primary Health Care

The biopsychosocial paradigm is a model of care that has been proposed in order to improve the effectiveness of health care by promoting collaboration between different professions and disciplines. However, its application still faces several issues. A quantitative-qualitative survey was conducted on a sample of general practitioners (GPs) from Milan, Italy, to investigate their attitudes and beliefs regarding the role of the psychologist, the approach adopted to manage psychological diseases, and their experiences of collaboration with psychologists. The results show a partial view of the psychologist’s profession that limits the potential of integration between medicine and psychology in primary care. GPs recognized that many patients (66%) would often benefit from psychological intervention, but only in a few cases (9%) were these patients regularly referred to a psychologist. Furthermore, the referral represents an almost exclusive form of collaboration present in the opinions of GPs. Only 8% of GPs would consider the joint and integrated work of the psychologist and doctor useful within the primary health care setting. This vision of the role of psychologists among GPs represents a constraint in implementing a comprehensive primary health care approach, as advocated by the World Health Organization

The role of contact angle and pore width on pore condensation and freezing

It has recently been shown that pore condensation and freezing (PCF) is a mechanism responsible for ice formation under cirrus cloud conditions. PCF is defined as the condensation of liquid water in narrow capillaries below water saturation due to the inverse Kelvin effect, followed by either heterogeneous or homogeneous nucleation depending on the temperature regime and presence of an ice-nucleating active site. By using sol-gel synthesized silica with well-defined pore diameters, morphology and distinct chemical surface-functionalization, the role of the water-silica contact angle and pore width on PCF is investigated. We find that for the pore diameters (2.2-9.2 nm) and water contact angles (15-78 degrees) covered in this study, our results reveal that the water contact angle plays an important role in predicting the humidity required for pore filling, while the pore diameter determines the ability of pore water to freeze. For T > 235 K and below water saturation, pore diameters and water contact angles were not able to predict the freezing ability of the particles, suggesting an absence of active sites; thus ice nucleation did not proceed via a PCF mechanism. Rather, the ice-nucleating ability of the particles depended solely on chemical functionalization. Therefore, parameterizations for the ice-nucleating abilities of particles in cirrus conditions should differ from parameterizations at mixed-phase clouds conditions. Our results support PCF as the atmospherically relevant ice nucleation mechanism below water saturation when porous surfaces are encountered in the troposphere.ISSN:1680-7375ISSN:1680-736

Towards parameterising atmospheric concentrations of ice-nucleating particles active at moderate supercooling

A small fraction of freezing cloud droplets probably initiates much of the precipitation above continents. Only a minute fraction of aerosol particles, so-called icenucleating particles (INPs), can trigger initial ice formation at 15 C, at which cloud-Top temperatures are frequently associated with snowfall. At a mountaintop site in the Swiss Alps, we found that concentrations of INPs active at 15 C can be parameterised by different functions of coarse (2 um) aerosol particle concentrations, depending on whether an air mass is (a) precipitating, (b) nonprecipitating, or (c) carrying a substantial fraction of dust particles while non-precipitating. Consequently, we suggest that a parameterisation at moderate supercooling should consider coarse particles in combination with air mass differentiation. © 2021 Mary Ann Liebert Inc.. All rights reserved

Homogeneous freezing of water droplets for different volumes and cooling rates

To understand the crystallization of aqueous solutions in the atmosphere, biological specimens, or pharmaceutical formulations, the rate at which ice nucleates from pure liquid water must be quantified. There is still an orders-of-magnitude spread in the homogeneous nucleation rate of water measured using different instruments, with the most important source of uncertainty being that of the measured temperature. Microfluidic platforms can generate hundreds to thousands of monodisperse water-in-oil droplets, unachievable by most other techniques. However, most microfluidic devices previously used to quantify homogeneous ice nucleation rates have reported high temperature uncertainties, between +/- 0.3 and +/- 0.7 K. We use the recently developed Microfluidic Ice Nuclei Counter Zurich (MINCZ) to observe the freezing of spherical water droplets with two diameters (75 and 100 mu m) at two cooling rates (1 and 0.1 K min(-1)). By varying both droplet volume and cooling rate, we were able to probe a temperature range of 236.5-239.3 K with an accuracy of +/- 0.2 K, providing reliable data where previously determined nucleation rates suffered from large uncertainties and inconsistencies, especially at temperatures above 238 K. From these data and from Monte Carlo simulations, we demonstrate the importance of obtaining a sufficiently large dataset so that underlying nucleation rates are not overestimated at higher temperatures. Finally, we obtain new parameters for a previous parameterisation by fitting to our newly measured nucleation rates, enabling its use in applications where ice formation needs to be predicted.ISSN:1463-9084ISSN:1463-907