3,425 research outputs found
A Fuzzy Logic Based Controller for the Automated Alignment of a Laser-beam-smoothing Spatial Filter
A fuzzy logic based controller for a laser-beam-smoothing spatial filter is described. It is demonstrated that a human operator's alignment actions can easily be described by a system of fuzzy rules of inference. The final configuration uses inexpensive, off-the-shelf hardware and allows for a compact, readily implemented embedded control system
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Barriers and facilitators to GP-patient communication about emotional concerns in UK primary care: a systematic review.
Background
In the UK, general practitioners (GPs) are the most commonly used providers of care for emotional concerns.
Objective
To update and synthesize literature on barriers and facilitators to GP–patient communication about emotional concerns in UK primary care.
Design
Systematic review and qualitative synthesis.
Method
We conducted a systematic search on MEDLINE (OvidSP), PsycInfo and EMBASE, supplemented by citation chasing. Eligible papers focused on how GPs and adult patients in the UK communicated about emotional concerns. Results were synthesized using thematic analysis.
Results
Across 30 studies involving 342 GPs and 720 patients, four themes relating to barriers were: (i) emotional concerns are difficult to disclose; (ii) tension between understanding emotional concerns as a medical condition or arising from social stressors; (iii) unspoken assumptions about agency resulting in too little or too much involvement in decisions and (iv) providing limited care driven by little time. Three facilitative themes were: (v) a human connection improves identification of emotional concerns and is therapeutic; (vi) exploring, explaining and negotiating a shared understanding or guiding patients towards new understandings and (vii) upfront information provision and involvement manages expectations about recovery and improves engagement in treatment.
Conclusion
The findings suggest that treatment guidelines should acknowledge: the therapeutic value of a positive GP–patient relationship; that diagnosis is a two-way negotiated process rather than an activity strictly in the doctor’s domain of expertise; and the value of exploring and shaping new understandings about patients’ emotional concerns and their management
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Patients' experiences of seeking help for emotional concerns in primary care: doctor as drug, detective and collaborator
Background
NICE guidelines for the management of emotional concerns in primary care emphasise the importance of communication and a trusting relationship, which is difficult to operationalise in practice. Current pressures in the NHS mean that it is important to understand care from a patient perspective. This study aimed to explore patients’ experiences of primary care consultations for emotional concerns and what patients valued when seeking care from their GP.
Methods
Eighteen adults with experience of consulting a GP for emotional concerns participated in 4 focus groups. Data were analysed thematically.
Results
(1) Doctor as Drug: Patients’ relationship with their GP was considered therapeutic with continuity particularly valued. (2) Doctor as Detective and Validator: Patients were often puzzled by their symptoms, not recognising their emotional concerns. GPs needed to play the role of detective by exploring not just symptoms, but the person and their life circumstances. GPs were crucial in helping patients understand and validate their emotional concerns. (3) Doctor as Collaborator: Patients prefer a collaborative partnership, but often need to relinquish involvement because they are too unwell, or take a more active role because they feel GPs are ill-equipped or under too much pressure to help. Patients valued: GPs booking their follow up appointments; acknowledgement of stressful life circumstances; not relying solely on medication.
Conclusions
Seeking help for emotional concerns is challenging due to stigma and unfamiliar symptoms. GPs can support disclosure and understanding of emotional concerns by fully exploring and validating patients’ concerns, taking into account patients’ life contexts. This process of exploration and validation forms the foundation of a curative, trusting GP-patient relationship. A trusting relationship, with an emphasis on empathy and understanding, can make patients more able to share involvement in their care with GPs. This process is cyclical, as patients feel that their GP is caring, interested, and treating them as a person, further strengthening their relationship. NICE guidance should acknowledge the importance of empathy and validation when building an effective GP-patient partnership, and the role this has in supporting patients’ involvement in their care
Gambling Alone? A Study of Solitary and Social Gambling in America
In his acclaimed 2000 book Bowling Alone, Robert Putnam documents a disturbing social trend of the broadest kind. Putnam cites a wide variety of data that indicate that over the past fifty years, Americans have become increasingly socially disengaged. In developing this theme, Putnam specifically cites the increase in casino gambling (and especially machine gambling) as evidence in support of his argument. Building on the empirical and theoretical work of Putnam, this exploratory article examines the subphenomenon of gambling alone by exploring sample survey data on solitary and social gambling behavior among adults who reside in Las Vegas, Nevada. Specifically, to further understand these phenomena, a number of demographic, attitudinal, and behavioral variables are examined for their explanatory power in predicting solitary vs. social gambling behavior
Space Data Integrator (SDI) and Space Program Integrated Data and Estimated Risk (SPIDER): Proof-of-Concept Software Solution for Integrating Launch and Reentry Vehicles into the National Airspace System (NAS)
The Space Data Integrator (SDI) Project is the initial step to satisfy the Federal Aviation Administration (FAA) strategic initiative to integrate commercial space launch and reentry vehicles into the National Airspace System. The project addresses the needs for greater situational awareness and monitoring, and increased response capability during non-nominal and catastrophic incidents during space operations.
The initial phase of this project leverages current FAA systems, and provide an initial demonstration of capability that will provide for state data from a commercial reentry vehicle to be ingested into a the FAA Traffic Flow Management System, and displayed on Traffic Situation Displays. Space vehicle data will be received at the William J. Hughes Technical Center, and transmitted to the Event Management Center at the Air Traffic Control System Command Center.
The second phase, called the Space Program Integrated Data and Estimated Risk system, will be built upon the initial SDI Demo phase, and deliver a Proof-of-Concept system that will provide added capability and situational awareness displays similar to current systems utilized at the major federal and commercial ranges
Quantitative Research on Peer-to-Peer Biblical Soul Care through the Encourager Program
This study sought to discover what impact a church program could have on personal well-being, spiritual well-being and church engagement, well-studied constructs in a variety of other clinical type settings. Quality, long-term research has been lacking in regard to the efficacy of pure, biblical soul care, a type of pastoral care methodology, that is provided strictly in a church setting. This type of research could allow for critical conversations about the larger ministry of soul care and potentially withstand scientific criticisms as biblical soul care becomes a proven, quantitative resource to help those who are hurting. The significance of this study is that it begins to provide a look at a potentially strong methodology that could test church programs for statistical significance. This study implements a quasi-experimental, pretest/posttest design, with a midtest measure added in an attempt to increase power analysis and further substantiate outcomes. Care Seekers attended the Encourager Program, a 3-session peer-to-peer biblical soul care program and provided frequencies and quantitative data points from an Intake and Feedback form at pre, mid and posttest. Sample size (N =5) showed no statistical significance in personal well-being (p = .55) or spiritual well-being (p = 1), largely due to lack in power analysis (\u3e ß = .50). However, this study showed promising beginnings for a methodological foundation to build upon in future studies. Recommendations for future researchers would be to continue improvement on design and methodology, as well as implementing additional ways of introducing biblical soul care to a general audience which could help reduce the stigma typically associated with counseling and mental illness. When it comes to caring for those who are hurting, the church must become equipped and respond in a way that is theologically rather than psychologically focused; this study means to bring encouragement toward that decisive action
Temperature-stable Gunn-diode oscillator
Oscillator consisting of Gunn diode embedded in coaxial circuit has excellent temperature stability and low fabrication costs as compared with automatic-frequency-control crystal oscillators
Magnetic properties of the Anderson model: a local moment approach
We develop a local moment approach to static properties of the symmetric
Anderson model in the presence of a magnetic field, focussing in particular on
the strong coupling Kondo regime. The approach is innately simple and
physically transparent; but is found to give good agreement, for essentially
all field strengths, with exact results for the Wilson ratio, impurity
magnetization, spin susceptibility and related properties.Comment: 7 pages, 3 postscript figues. Latex 2e using the epl.cls Europhysics
Letters macro packag
Unsung heroes: Constituency election agents in British general elections
Despite their central role in the electoral process, constituency agents have been largely overlooked by political scientists and this article seeks to rectify the omission. It sketches the origins and development of the role of agent from the late 19th century and suggests that a serious rethink of the role took place in the 1990s. Survey-based evidence about the social characteristics of agents is presented confirming that they are largely middle-aged, middle-class, well-educated men. They are also becoming more experienced, offer realistic assessments of the impact of constituency campaigning and, arguably, many take a long-term view of how their party's support can be maximised
The contribution of resilience to one-year independent living outcomes of care-leavers in South Africa
Abstract: The journey out of residential care towards independent living in South Africa is significantly under-researched. This article draws on data from the only longitudinal study on care-leaving in South Africa. It uses resilience theory to explain the differences observed in independent living outcomes of care-leavers, one year after leaving the residential care of Girls and Boys Town. A sample of 52 young people completed the Youth Ecological Resilience Scale just before disengaging from care between 2012 and 2015 and participated in a follow-up interview one year later, focused on assessing a range of independent living outcomes. Nonparametric bivariate analyses were used to determine which resilience variables predicted better outcomes for the careleavers. The results reveal that resilience processes help to understand transitional outcomes related to housing, education, employment, well-being and relationships with family and friends. The most prominent resilience processes for promoting better outcomes are located in the person-inenvironment domains of the social environment (community safety, family financial security and social activities) and social relationships (with family, friends and community), with fewer in the interactional (teamwork) and personal (optimism) domains, and, surprisingly, none in the in-care service domain. This supports a social-ecological view of resilience, and has important implications for child and youth care practice
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