Placebo prescription and empathy of the physician: a cross-sectional study

Background: Empathy in the patient-physician relationship is a major component in an effective placebo treatment, as in every medical treatment. Understanding the role of empathy of the physician in the placebo effect may help dissect some of the context variables responsible for the effectiveness of the placebo. Objectives: To determine the frequency of placebo prescription, doctors' beliefs, motivation, and attitudes to placebos in general practice in northern Portugal and to test the association between placebo prescription and physician empathy. Methods: A cross-sectional study was conducted between November 2014 and January 2015 among general practice specialists and interns from 14 health centres in a northern Portuguese health region. The self-report questionnaire included the Portuguese version of the Jefferson scale of physician empathy (JSPE) and a questionnaire about placebo prescription. Associations between demographic variables, JSPE score, prescription of placebo, and the attitudes to placebo score were tested with the chi-squared statistic, student t-tests for independent samples, and Pearson correlation. Results: The study included 93 general practitioners (GP) (response rate: 74%). Placebos were prescribed by 73% (n = 68) of the respondents. GPs who prescribe placebo are significantly younger (mean age = 38.4 years; SD = 11.1; t (90) = 2.98, P<.05, d = 0.67) than non-prescribers (mean age = 46.5 years; SD = 13.3). Favourable attitudes towards placebo prescription are associated with higher empathy scores (R = 0.310, P<.01). Conclusion: Placebo prescription is frequent and associated with empathy from the prescriber, especially among younger GPs.info:eu-repo/semantics/publishedVersio

Low sensitivity of nested PCR using Plasmodium DNA extracted from stained thick blood smears: an epidemiological retrospective study among subjects with low parasitaemia in an endemic area of the Brazilian Amazon region

BACKGROUND: The success of PCR technique depends on many factors, such as high quality DNA pellets obtained from blood samples, good reagents and adequate conditions of amplification. Taking these limitations into account, a retrospective epidemiological study for malaria diagnosis was conducted in a mesoendemic area in the Brazilian Amazon. METHODS: A nested PCR protocol with DNA extracted from two blood storage devices obtained from Giemsa-stained thick blood smears and filter-papers was used for malaria diagnosis. The extracted DNA was used as a template to amplify approximately 100 bp species-specific sequences of the small subunit of the ribosomal RNA (18S SSU rRNA) of Plasmodium sp. The prevalence of single and mixed infections was examined in a cross-sectional survey carried out among 369 miners living in the district of Apiacás, Mato Grosso State. The parasitemia levels detected by microscopic examination were compared to the PCR results. RESULTS: DNA samples isolated from blood on filter-paper allowed the detection and identification of Plasmodium in 165 (44.7%) of the 369 individuals evaluated, while only 62 (16.8%) had positive results using DNA obtained from thick smears, a similar rate observed by microscopic examination. The sensitivities of PCR using DNA from blood smears and filter-papers were 65% and 73.0%, respectively. Low parasite infections (below 20 parasites/µL blood) were not detected when thick blood smears were used as a DNA source. CONCLUSIONS: Although the blood preserved as thick blood smears provides an alternative and useful tool for malaria molecular diagnosis, its relatively poor performance at low level parasitemias impairs the correct determination of malaria prevalence in epidemiological studies. However, the results obtained in the present study confirm that the use of filter-paper to collect blood is useful for field studies

Rings in the Solar System: a short review

Rings are ubiquitous around giant planets in our Solar System. They evolve jointly with the nearby satellite system. They could form either during the giant planet formation process or much later, as a result of large scale dynamical instabilities either in the local satellite system, or at the planetary scale. We review here the main characteristics of rings in our solar system, and discuss their main evolution processes and possible origin. We also discuss the recent discovery of rings around small bodies.Comment: Accepted for the Handbook of Exoplanet

Sampling solution traces for the problem of sorting permutations by signed reversals

International audienceBackgroundTraditional algorithms to solve the problem of sorting by signed reversals output just one optimal solution while the space of all optimal solutions can be huge. A so-called trace represents a group of solutions which share the same set of reversals that must be applied to sort the original permutation following a partial ordering. By using traces, we therefore can represent the set of optimal solutions in a more compact way. Algorithms for enumerating the complete set of traces of solutions were developed. However, due to their exponential complexity, their practical use is limited to small permutations. A partial enumeration of traces is a sampling of the complete set of traces and can be an alternative for the study of distinct evolutionary scenarios of big permutations. Ideally, the sampling should be done uniformly from the space of all optimal solutions. This is however conjectured to be ♯P-complete.ResultsWe propose and evaluate three algorithms for producing a sampling of the complete set of traces that instead can be shown in practice to preserve some of the characteristics of the space of all solutions. The first algorithm (RA) performs the construction of traces through a random selection of reversals on the list of optimal 1-sequences. The second algorithm (DFALT) consists in a slight modification of an algorithm that performs the complete enumeration of traces. Finally, the third algorithm (SWA) is based on a sliding window strategy to improve the enumeration of traces. All proposed algorithms were able to enumerate traces for permutations with up to 200 elements.ConclusionsWe analysed the distribution of the enumerated traces with respect to their height and average reversal length. Various works indicate that the reversal length can be an important aspect in genome rearrangements. The algorithms RA and SWA show a tendency to lose traces with high average reversal length. Such traces are however rare, and qualitatively our results show that, for testable-sized permutations, the algorithms DFALT and SWA produce distributions which approximate the reversal length distributions observed with a complete enumeration of the set of traces

Social research on neglected diseases of poverty: Continuing and emerging themes

Copyright: © 2009 Manderson et al.Neglected tropical diseases (NTDs) exist and persist for social and economic reasons that enable the vectors and pathogens to take advantage of changes in the behavioral and physical environment. Persistent poverty at household, community, and national levels, and inequalities within and between sectors, contribute to the perpetuation and re-emergence of NTDs. Changes in production and habitat affect the physical environment, so that agricultural development, mining and forestry, rapid industrialization, and urbanization all result in changes in human uses of the environment, exposure to vectors, and vulnerability to infection. Concurrently, political instability and lack of resources limit the capacity of governments to manage environments, control disease transmission, and ensure an effective health system. Social, cultural, economic, and political factors interact and influence government capacity and individual willingness to reduce the risks of infection and transmission, and to recognize and treat disease. Understanding the dynamic interaction of diverse factors in varying contexts is a complex task, yet critical for successful health promotion, disease prevention, and disease control. Many of the research techniques and tools needed for this purpose are available in the applied social sciences. In this article we use this term broadly, and so include behavioral, population and economic social sciences, social and cultural epidemiology, and the multiple disciplines of public health, health services, and health policy and planning. These latter fields, informed by foundational social science theory and methods, include health promotion, health communication, and heath education

Effect of lactation length adjustment procedures on genetic parameter estimates for buffalo milk yield

The objectives of this study were to estimate the genetic parameters for milk yield unadjusted and adjusted for days in milk and, subsequently, to assess the influence of adjusting for days in milk on sire rank. Complete lactations from 90 or 150 days of lactation to 270 or 350 days in milk were considered in these analyses. Milk yield was adjusted for days in milk by multiplicative correction factors, or by including lactation length as a covariable in the model. Milk yields adjusted by different procedures were considered as different traits. Heritability estimates varied from 0.17 to 0.28. Genetic correlation estimates between milk yields unadjusted and adjusted for days in milk were greater than 0.82. Adjusting for days in milk affected the parameter estimates. Multiplicative correction factors produced the highest heritability estimates. More reliable breeding value estimates can be expected by including short length lactation records in the analyses and adjusting the milk yields for days in milk, regardless of the method used for the adjustment. High selection intensity coupled to the inclusion of short length lactations and adjustment with multiplicative factors can change the sire rank.

In-situ upgrading of Napier grass pyrolysis vapour over microporous and hierarchical mesoporous zeolites

This study presents in-situ upgrading of pyrolysis vapour derived from Napier grass over microporous and mesoporous ZSM-5 catalysts. It evaluates effect of process variables such catalyst–biomass ratio and catalyst type in a vertical fixed bed pyrolysis system at 600 °C, 50 °C/min under 5 L/min nitrogen flow. Increasing catalyst–biomass ratio during the catalytic process with microporous structure reduced production of organic phase bio-oil by approximately 7.0 wt%. Using mesoporous catalyst promoted nearly 4.0 wt% higher organic yield relative to microporous catalyst, which translate to only about 3.0 wt% reduction in organic phase compared to the yield of organic phase from non-catalytic process. GC–MS analysis of bio-oil organic phase revealed maximum degree of deoxygenation of about 36.9% with microporous catalyst compared to the mesoporous catalysts, which had between 39 and 43%. Mesoporous catalysts promoted production olefins and alkanes, normal phenol, monoaromatic hydrocarbons while microporous catalyst favoured the production of alkenes and polyaromatic hydrocarbons. There was no significant increase in the production of normal phenols over microporous catalyst due to its inability to transform the methoxyphenols and methoxy aromatics. This study demonstrated that upgrading of Napier grass pyrolysis vapour over mesoporous ZSM-5 produced bio-oil with improved physicochemical properties