Treatment resistant depression in primary care: Co-constructing difficult encounters

Many patients with depression do not recover despite medication or therapy. Individuals with treatment resistant depression often have co-morbid anxiety, personality difficulties and drug or alcohol misuse and have been characterised as difficult, heartsink or problem personalities by general practitioners. Yet critical studies of interaction in medical settings suggest that the context may have a role in constructing the patient. A total of 12 audio-recorded routine consultations were analysed following guidelines for qualitative analysis of medical discourse. The interpretation focused on ways in which the context and structure of primary care consultations in a UK setting construct difficult encounters, which may lead to patients with treatment resistant depression being seen as difficult to manage in various ways. Three overarching observations were that presentation of multiple problems in multiple domains clash with the consultation format; that patients? atypically high level of activity in a time-limited setting prevents patient-centred work; that the question and answer format restricts multifaceted discussions of social and emotional problems, preventing shared understandings emerging. However, although interactions appear uneasy, they are repaired and may be moderately palliative. Suggestions are made for re-orienting general practitioner work with treatment resistant depression towards long-term goal setting outside of the traditional consultation structure in order to develop shared understandings

Experimentally estimated dead space for GaAs and InP based planar Gunn diodes

The authors would like to thank the staff of the James Watt Nanofabrication Centre at the University of Glasgow for help in fabricating the devices which is reported in this paper. ‘Part of this work was supported by ESPRC through EP/H011862/ 1, and EP/H012966/1.Peer reviewedPublisher PD

Feynman graph polynomials

The integrand of any multi-loop integral is characterised after Feynman parametrisation by two polynomials. In this review we summarise the properties of these polynomials. Topics covered in this article include among others: Spanning trees and spanning forests, the all-minors matrix-tree theorem, recursion relations due to contraction and deletion of edges, Dodgson's identity and matroids.Comment: 35 pages, references adde

Nonpolar resistance switching of metal/binary-transition-metal oxides/metal sandwiches: homogeneous/inhomogeneous transition of current distribution

Exotic features of a metal/oxide/metal (MOM) sandwich, which will be the basis for a drastically innovative nonvolatile memory device, is brought to light from a physical point of view. Here the insulator is one of the ubiquitous and classic binary-transition-metal oxides (TMO), such as Fe2O3, NiO, and CoO. The sandwich exhibits a resistance that reversibly switches between two states: one is a highly resistive off-state and the other is a conductive on-state. Several distinct features were universally observed in these binary TMO sandwiches: namely, nonpolar switching, non-volatile threshold switching, and current--voltage duality. From the systematic sample-size dependence of the resistance in on- and off-states, we conclude that the resistance switching is due to the homogeneous/inhomogeneous transition of the current distribution at the interface.Comment: 7 pages, 5 figures, REVTeX4, submitted to Phys. Rev. B (Feb. 23, 2007). If you can't download a PDF file of this manscript, an alternative one can be found on the author's website: http://staff.aist.go.jp/i.inoue

Impact ionisation electroluminescence in planar GaAs-based heterostructure Gunn diodes:Spatial distribution and impact of doping nonuniformities

When biased in the negative differential resistance regime, electroluminescence (EL) is emitted from planar GaAs heterostructure Gunn diodes. This EL is due to the recombination of electrons in the device channel with holes that are generated by impact ionisation when the Gunn domains reach the anode edge. The EL forms non-uniform patterns whose intensity shows short-range intensity variations in the direction parallel to the contacts and decreases along the device channel towards the cathode. This paper employs Monte Carlo models, in conjunction with the experimental data, to analyse these non-uniform EL patterns and to study the carrier dynamics responsible for them. It is found that the short-range lateral (i.e., parallel to the device contacts) EL patterns are probably due to non-uniformities in the doping of the anode contact, illustrating the usefulness of EL analysis on the detection of such inhomogeneities. The overall decreasing EL intensity towards the anode is also discussed in terms of the interaction of holes with the time-dependent electric field due to the transit of the Gunn domains. Due to their lower relative mobility and the low electric field outside of the Gunn domain, freshly generated holes remain close to the anode until the arrival of a new domain accelerates them towards the cathode. When the average over the transit of several Gunn domains is considered, this results in a higher hole density, and hence a higher EL intensity, next to the anode

A survey of rabbit handling methods within the United Kingdom and the Republic of Ireland

Rabbits are commonly kept in a variety of settings, including homes, laboratories, and veterinary clinics. Despite the popularity of keeping this prey species, little research has investigated current methods of handling. The aim of this study was to examine the experience of caregivers (owners and keepers) in using five handling methods commonly referred to in books written for companion animal (pet) owners and veterinary and/or laboratory personnel. An online survey was completed by 2644 respondents, representing all three of these groups, and breeders. Data were acquired to determine sources that participants used to gain knowledge of different handling methods, the methods they used and for what purposes they used them, and their perceptions of any associated difficulties or welfare concerns. Results indicated that participants most frequently used the method of supporting a rabbit’s body against a person’s chest, which was considered the easiest and most welfare-friendly method of the handling methods explored. “Scruffing with rear support” was the least used method and was considered to be distressing and painful for the rabbit. As rabbits are a terrestrial prey species, being picked up is likely an innately stressful experience. Additional research is encouraged to explore the experience of rabbits during handling to identify methods that can be easily used with the fewest welfare compromises

A survey of common rabbit handling methods and reasons for their use

Rabbits are both popular pets commonly seen within veterinary practices, and frequently used in laboratories in the United Kingdom and elsewhere. However, to date there is minimal research that has investigated why and how people handle rabbits and why they choose to use such methods. In addition, few studies have considered the sources individuals use to learn about rabbit handling and their reasons to not use specific handling methods

A review of handling methods of rabbits within pet, laboratory and veterinary contexts

Rabbits are considered to be the third most frequently kept pet in the UK as well as being utilised for medical and veterinary research. Despite this, little research has been conducted on rabbit handling methods. A literature review was conducted that focused directly on proposed handling methods of rabbits within different contexts. This included books where specific handling sections could be identified which were produced for pet owners, veterinary staff and laboratory staff. A range of textbooks were selected between the years [2000–2015] that were available on both Google books and Amazon. To identify the recommended handling methods and evaluate information available the following was recorded; number of handling and restraint methods described, justification for suggested methods, identification of inappropriate handling methods and relevant details, word count, use of images and any recommended equipment and its use (e.g. towel to avoid kicking or reduce stress). In total 20 books were reviewed, ten pet rabbit, seven veterinary animal/rabbit and three laboratory animal/rabbit books. Results indicate that recommended handling methods differ between contexts and that there is some confusion about the use of some methods, such as scruffing and ‘Tonic Immobility’, which have been noted to potentially be stressful. Some methods, such as picking a rabbit up by the ears, were consistently considered inappropriate. The authors describe research currently being undertaken and highlight the need for further research such as investigating handling methods and associated educational material provided by rescue centres and pet shops before, during and after the point of purchase/rehoming