Bioprocesses

The application of remote sensing techniques to the study of eutrophication in natural waters and the location and characterization of fronts is considered. The specific problem to be studied is examined along with the feasibility and capabability of remote sensing techniques for each application

Physician Communication Skills: Results of a Survey of General/Family Practitioners in Newfoundland

Purpose: To describe the attitudes related to communication skills, confidence in using commnication skills, and use of communication skills during the physician-patient encounter among a population-based sample of family physicians. Procedures: A mailed survey, distributed to all family physicians and general practitioners currently practicing in Newfoundland. The questionnaire was designed to collect data in five general areas participant demographics, physician confidence in using specific communication strategies, perceived adequacy of time spent by physicians with their patients, physician use of specific communication strategies with the adult patients they saw in the prior week, and physician use of specific communication strategies during the closing minutes of the encounters they had with adult patients in the prior week. Main Findings: A total of 160 completed surveys was received from practicing family physicians/general practitioners in Newfoundland, yielding an adjusted response rate of 43.1%. Most of the respondents (83.8%) indicated their communication skills are as important as technical skills in terms of achieving positive patient outcomes. Between one-third and one-half of the respondents, depending on the educational level queried, rated their communications skills training as being inadequate. Fewer than 20% of the respondents rated the communications skills training they received as being excellent. Physicians indicated a need to improve their use of 8 of 13 specific communication strategies during patient encounters, and reported using few communication strategies during the closing minutes of the encounter. Interactions that occurred during a typical encounter tended to focus on biomedical versus psychosocial issues. Conclusions: Family physicians/general practitioners recognize a need to improve their commnications skills. Well-designed communications skills training programs should be implemented at multi-levels of physician training in order to improve patient satisfaction with their encounters with family/general practitioners, and to increase the likelihood of positive patient outcomes

Electronic health information and long term conditions

This article discusses the increasing availability of health-related information, and the impact that this can have for people with long-term conditions’ expectations of healthcare providers. The article suggests a framework for decision making about the role that healthcare staff should play in the information searching, retrieval, and synthesis activities which people with long-term conditions engage in. The framework is based on a series of decisions related to: perceptions of ownership of long-term conditions; whether intermediatory or apomediatory approaches to information management are deemed to be most appropriate; and, as a result of these considerations, what, if any, place healthcare staff should take in the process of patients searching or and interpreting information about long-term health needs. These decisions will enable healthcare providers to plan services based on clear decision pathways, and to clarify to all concerned what are deemed to be reasonable expectations of health service provision

Acute Sensitivity of Landslide Rates to Initial Soil Porosity

Some landslides move imperceptibly downslope, whereas others accelerate catastrophically. Experimental landslides triggered by rising pore water pressure moved at sharply contrasting rates due to small differences in initial porosity. Wet sandy soil with porosity of about 0.5 contracted during slope failure, partially liquefied, and accelerated within 1 second to speeds over 1 meter per second. The same soil with porosity of about 0.4 dilated during failure and slipped episodically at rates averaging 0.002 meter per second. Repeated slip episodes were induced by gradually rising pore water pressure and were arrested by pore dilation and attendant pore pressure decline

An Examination of the Factor Structure of Union Commitment in New Zealand

This paper examines the stability of the dimensionality of union commitment as proposed by Gordon, Philpot, Burt, Thompson, and Spillers (1980) in the cultural context of New Zealand. The results based on a sample of 489 academic and ancillary (i.e. technical, library, general, and services) staff using the sophisticated technique of confirmatory factor analysis (LISREL VIII) (Joreskog and Sorbom, 1993) indicate that union commitment is best represented by the four factors of union loyalty, responsibility to the union, willingness to work for the union, and belief in unionism. These factors displayed discriminant validity as evidenced by the differential relationships and explained variances with a co,mmon set of explanatory variables. For example, older members were found to be associated with a willingness to fulfil the day to day obligations of the union (i.e. responsibility). No support was found for any effect of gender, kinship responsibility, membership tenure or rank on union commitment. As expected, having represented or previously held a union position significantly influences staffs responsibility and willingness to work for the union. Surprisingly, academics were more ready to undertake special work for the union (i.e. willingness) than ancillary staff Both union instrumentality and passive participation (for example, voting in union elections) were strong predictors of all four factors of union commitment. Finally, active participation (for example, raising grievances) was observed to increase willingness to work for and belief in unionism. The results provide support for the generalisability of the factor structure of union commitment to New Zealand, where the implications for future research are discusse

Expert Panel Survey to Update the American Congress of Rehabilitation Medicine Definition of Mild Traumatic Brain Injury

Objective: As part of an initiative led by the Brain Injury Special Interest Group Mild Traumatic Brain Injury (TBI) Task Force of the American Congress of Rehabilitation Medicine (ACRM) to update the 1993 ACRM definition of mild TBI, the present study aimed to characterize current expert opinion on diagnostic considerations. Design: Cross-sectional web-based survey. Setting: Not applicable. Participants: An international, interdisciplinary group of clinician-scientists (N=31) with expertise in mild TBI completed the survey by invitation between May and July 2019 (100% completion rate). Interventions: Not applicable. Main Outcome Measures: Ratings of agreement with statements related to the diagnosis of mild TBI and ratings of the importance of various clinical signs, symptoms, test findings, and contextual factors for increasing the likelihood that the individual sustained a mild TBI, on a scale ranging from 1 (“not at all important”) to 10 (“extremely important”). Results: Men (n=25; 81%) and Americans (n=21; 68%) were over-represented in the sample. The survey revealed areas of expert agreement (eg, acute symptoms are diagnostically useful) and disagreement (eg, whether mild TBI with abnormal structural neuroimaging should be considered the same diagnostic entity as “concussion”). Observable signs were generally rated as more diagnostically important than subjective symptoms (Wilcoxon signed ranks test, Z=3.77; P&lt;.001; r=0.68). Diagnostic importance ratings for individual symptoms varied widely, with some common postconcussion symptoms (eg, fatigue) rated as unhelpful (&lt;75% of respondents indicated at least 5 out of 10 importance). Certain acute test findings (eg, cognitive and balance impairments) and contextual factors (eg, absence of confounds) were consistently rated as highly important for increasing the likelihood of a mild TBI diagnosis (≥75% of respondents indicated at least 7 out of 10). Conclusions: The expert survey findings identified several potential revisions to consider when updating the ACRM mild TBI definition, including preferentially weighing observable signs in a probabilistic framework, incorporating symptoms and test findings, and adding differential diagnosis considerations.</p

Dust storms on Mars: Considerations and simulations

Aeolian processes are important in modifying the surface of Mars at present, and appear to have been significant in the geological past. Aeolian activity includes local and global dust storms, the formation of erosional features such as yardangs and depositional features such as sand dunes, and the erosion of rock and soil. As a means of understanding aeolian processes on Mars, an investigation is in progress that includes laboratory simulations, field studies of earth analogs, and interpretation of spacecraft data. This report describes the Martian Surface Wind Tunnel, an experimental facility established at NASA-Ames Research Center, and presents some results of the general investigation. Experiments dealing with wind speeds and other conditions required for the initiation of particle movement on Mars are described and considerations are given to the resulting effectiveness of aeolian erosion