Better Patient-Doctor Communication – A Survey and Focus Group Study

The study explored barriers to effective communication between doctors and patients, and to encourage patients to be more knowledgeable about their health. A survey was conducted with 128 people who commented on the effectiveness of the process of consulting their doctor and rated a number of alternatives to face-to-face consultations. A focus group explored the topics further and a range of possible solutions to address current barriers were suggested. These include: considering alternative methods for GP consultation, providing new systems to give doctors better overviews of the patient population, devising new methods for patients to record information from consultations, use of diagnostic systems in the surgery and meetings or online forums to promote better informed patients

Geodynamic evolution of the lithosphere and upper mantle beneath the Alboran region of the western Mediterranean: Constraints from travel time tomography

An edited version of this paper was published by the American Geophysical Union. Copyright 2000, AGU. See also: http://www.agu.org/pubs/crossref/2000/2000JB900024.shtml; http://atlas.geo.cornell.edu/morocco/publications/calvert2000.htmA number of different geodynamic models have been proposed to explain the extension that occurred during the Miocene in the Alboran Sea region of the western Mediterranean despite the continued convergence and shortening of northern Africa and southern Iberia. In an effort to provide additional geophysical constraints on these models, we performed a local, regional, and teleseismic tomographic travel time inversion for the lithospheric and upper mantle velocity structure and earthquake locations beneath the Alboran region in an area of 800 x 800 km^2. We picked P and S arrival times from digital and analog seismograms recorded by 96 seismic stations in Morocco and Spain between 1989 and 1996 and combined them with arrivals carefully selected from local and global catalogs (1964-1998) to generate a starting data set containing over 100,000 arrival times. Our results indicate that a N-S line of intermediate depth earthquakes extending from crustal depths significantly inland from the southern Iberian coat to depths of over 100 km beneath the center of the Alboran Sea coincided with a W to E transition from high to low velocities imaged in the uppermost mantle. A high-velocity body, striking approximately NE-SW, is imaged to dip southeastwards from lithospheric depths beneath the low-velocity region to depths of ~350 km. Between 350 and 500 km the imaged velocity anomalies become more diffuse. However, pronounced high-velocity anomalies are again imaged at 600 km near an isolated cluster of deep earthquakes. In addition to standard tomographic methods of error assessment, the effects of systematic and random errors were assessed using block shifting and bootstrap resampling techniques, respectively. We interpret the upper mantle high-velocity anomalies as regions of colder mantle that originate from lithospheric depths. These observations, when combined with results from other studies, suggest that delamination of a continental lithosphere played an important role in the Neogene and Quaternary evolution of the region

Propagation of regional seismic phases (Lg and Sn) and Pn velocity structure along the Africa-Iberia plate boundary zone

An edited version of this paper was published by Blackwell Publishing. Copyright 2000, Blackwell Publishing. See also: http://www.blackwell-synergy.com/doi/abs/10.1046/j.1365-246x.2000.00160.x; http://atlas.geo.cornell.edu/morocco/publications/calvert2000GJI.htmWe used over 1000 regional waveforms recorded by 60 seismic stations located in northwest Africa and Iberia to map the efficiency of L g and Sn wave propagation beneath the Gulf of Cadiz, Alboran Sea and bounding Betic, Rif and Atlas mountain belts. Crustal attenuation is inferred from the tomographic inversion of L g/Pg amplitude ratios. Upper mantle attenuation is inferred from maps of Sn propagation efficiency derived by inversion of well-defined qualitative efficiency assignments based on waveform characteristics. Regions of L g attenuation correlate well with areas of thinned continental or oceanic crust, significant sedimentary basins, and lateral crustal variations. Comparison of the Sn efficiency results with velocities obtained from an anisotropic Pn traveltime inversion shows a fairly good correlation between regions of poor Sn efficiency and low Pn velocity. A low Pn velocity (7.6?7.8 km s-1) and significant Sn attenuation in the uppermost mantle is imaged beneath the Betics in southern Spain, in sharp contrast to the relatively normal Pn velocity (8.0?8.1 km s-1) and efficient Sn imaged beneath the Alboran Sea. Slow Pn velocity anomalies are also imaged beneath the Rif and Middle Atlas in Morocco. We do not identify any conclusive evidence of lithospheric-scale upper mantle attenuation beneath the Rif, although the crust in the Gibraltar region appears highly attenuating, making observations at stations in this region ambiguous. Paths crossing the Gulf of Cadiz, eastern Atlantic and the Moroccan and Iberian mesetas show very efficient Sn propagation and are imaged with high Pn velocities (8.1?8.2 km s-1). The spatial distribution of attenuation and velocity anomalies lead us to conclude that some recovery of the mantle lid beneath the Alboran Sea must have occurred since the early Miocene episode of extension and volcanism. We interpret the low velocity and attenuating regions beneath the Betics and possibly the Rif as indicating the presence of partial melt in the uppermost mantle which may be underlain by faster less attenuating mantle. In the light of observations from other geophysical and geological studies, the presence of melt at the base of the Betic crust may be an indication that delamination of continental lithosphere has played a role in the Neogene evolution of the Alboran Sea region