Patient and physician gender concordance in preventive care in university primary care settings.

OBJECTIVE: To assess the quality of preventive care according to physician and patient gender in a country with universal health care coverage. METHODS: We assessed a retrospective cohort study of 1001 randomly selected patients aged 50-80years followed over 2years (2005-2006) in 4 Swiss university primary care settings (Basel, Geneva, Lausanne, Zürich). We used indicators derived from RAND's Quality Assessment Tools and examined percentages of recommended preventive care. Results were adjusted using hierarchical multivariate logistic regression models. RESULTS: 1001 patients (44% women) were followed by 189 physicians (52% women). Female patients received less preventive care than male patients (65.2% vs. 72.1%, p<0.001). Female physicians provided significantly more preventive care than male physicians (p=0.01) to both female (66.7% vs. 63.6%) and male patients (73.4% vs. 70.7%). After multivariate adjustment, differences according to physician (p=0.02) and patient gender (p<0.001) remained statistically significant. Female physicians provided more recommended cancer screening than male physicians (78.4 vs. 71.9%, p=0.01). CONCLUSIONS: In Swiss university primary care settings, female patients receive less preventive care than male patients, with female physicians providing more preventive care than male physicians. Greater attention should be paid to female patients in preventive care and to why female physicians tend to provide better preventive care

A jump-growth model for predator-prey dynamics: derivation and application to marine ecosystems

This paper investigates the dynamics of biomass in a marine ecosystem. A stochastic process is defined in which organisms undergo jumps in body size as they catch and eat smaller organisms. Using a systematic expansion of the master equation, we derive a deterministic equation for the macroscopic dynamics, which we call the deterministic jump-growth equation, and a linear Fokker-Planck equation for the stochastic fluctuations. The McKendrick--von Foerster equation, used in previous studies, is shown to be a first-order approximation, appropriate in equilibrium systems where predators are much larger than their prey. The model has a power-law steady state consistent with the approximate constancy of mass density in logarithmic intervals of body mass often observed in marine ecosystems. The behaviours of the stochastic process, the deterministic jump-growth equation and the McKendrick--von Foerster equation are compared using numerical methods. The numerical analysis shows two classes of attractors: steady states and travelling waves.Comment: 27 pages, 4 figures. Final version as published. Only minor change

Periodic Orbits and Escapes in Dynamical Systems

We study the periodic orbits and the escapes in two different dynamical systems, namely (1) a classical system of two coupled oscillators, and (2) the Manko-Novikov metric (1992) which is a perturbation of the Kerr metric (a general relativistic system). We find their simple periodic orbits, their characteristics and their stability. Then we find their ordered and chaotic domains. As the energy goes beyond the escape energy, most chaotic orbits escape. In the first case we consider escapes to infinity, while in the second case we emphasize escapes to the central "bumpy" black hole. When the energy reaches its escape value a particular family of periodic orbits reaches an infinite period and then the family disappears (the orbit escapes). As this family approaches termination it undergoes an infinity of equal period and double period bifurcations at transitions from stability to instability and vice versa. The bifurcating families continue to exist beyond the escape energy. We study the forms of the phase space for various energies, and the statistics of the chaotic and escaping orbits. The proportion of these orbits increases abruptly as the energy goes beyond the escape energy.Comment: 28 pages, 23 figures, accepted in "Celestial Mechanics and Dynamical Astronomy

The sensitivity of the vortex filament method to different reconnection models

We present a detailed analysis on the effect of using different algorithms to model the reconnection of vortices in quantum turbulence, using the thin-filament approach. We examine differences between four main algorithms for the case of turbulence driven by a counterflow. In calculating the velocity field we use both the local induction approximation (LIA) and the full Biot-Savart integral. We show that results of Biot-Savart simulations are not sensitive to the particular reconnection method used, but LIA results are.Comment: 9 pages, 9 figure

Tree method for quantum vortex dynamics

We present a numerical method to compute the evolution of vortex filaments in superfluid helium. The method is based on a tree algorithm which considerably speeds up the calculation of Biot-Savart integrals. We show that the computational cost scales as Nlog{(N) rather than N squared, where $N$ is the number of discretization points. We test the method and its properties for a variety of vortex configurations, ranging from simple vortex rings to a counterflow vortex tangle, and compare results against the Local Induction Approximation and the exact Biot-Savart law.Comment: 12 pages, 10 figure

Valor nutricional do mel e pólen de abelhas sem ferrão da região Amazônica

Avaliou-se os constituintes nutricionais de amostras do mel e pólen das espécies Melipona seminigra merrillae (jandaíra), Melipona compressipes manaosensis (jupará), Melipona rufiventris paraensis (uruçu boca de ralo), provenientes do meliponário da Fazenda Poranga no município de Itacoatiara - AM e Meliponário Abelhudo em Manaus - AM. Os resultados demonstraram o potencial do mel como fonte de energia, particularmente a M. rufiventris com 305,3±2,4 kcal em 100g. O pólen da espécie M. compressipes apresentou a maior concentração de proteína 15,7±0,0% e energia 309,8±0,8 kcal. Tais constatações sugerem a implementação de novos estudos visando à incorporação destes produtos na dieta dos amazônidas, possibilitando uma nova fonte alternativa de alimento potencialmente nutritivo e saudável.<br>We evaluated the nutricional constituent of honey and pollen samples of the Melipona species seminigra merrillae (jandaíra) Melipona compressipes manaosensis (jupará), Melipona rufiventris paraensis (uruçu boca de ralo), proceeding from the Poranga Honey Farm in Itacoatiara - AM, and Meliponário Abelhudo in Manaus, AM. The results demonstrated the potencial of honey as a source of energy, particularly the kcal M. rufiventris with 305.3±2.4 kcal in 100g. The compressis pollen of species presented the highest concentration of protein 15.7±0.0 % and energy 309.8±0.8 kcal. Thus we suggest the implementation of new studies aiming at the incorporation of these products in the diet of the Amazon population, making possible a new potentially nutritional and alternative healthful food source

Preface paper to the Semi-Arid Land-Surface-Atmosphere (SALSA) Program special issue

The Semi-Arid Land-Surface-Atmosphere Program (SALSA) is a multi-agency, multi-national research effort that seeks to evaluate the consequences of natural and human-induced environmental change in semi-arid regions. The ultimate goal of SALSA is to advance scientific understanding of the semi-arid portion of the hydrosphere–biosphere interface in order to provide reliable information for environmental decision making. SALSA approaches this goal through a program of long-term, integrated observations, process research, modeling, assessment, and information management that is sustained by cooperation among scientists and information users. In this preface to the SALSA special issue, general program background information and the critical nature of semi-arid regions is presented. A brief description of the Upper San Pedro River Basin, the initial location for focused SALSA research follows. Several overarching research objectives under which much of the interdisciplinary research contained in the special issue was undertaken are discussed. Principal methods, primary research sites and data collection used by numerous investigators during 1997–1999 are then presented. Scientists from about 20 US, five European (four French and one Dutch), and three Mexican agencies and institutions have collaborated closely to make the research leading to this special issue a reality. The SALSA Program has served as a model of interagency cooperation by breaking new ground in the approach to large scale interdisciplinary science with relatively limited resources

Dialysis initiation, modality choice, access, and prescription: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Globally, the number of patients undergoing maintenance dialysis is increasing, yet throughout the world there is significant variability in the practice of initiating dialysis. Factors such as availability of resources, reasons for starting dialysis, timing of dialysis initiation, patient education and preparedness, dialysis modality and access, as well as varied \u201ccountry-specific\u201d factors significantly affect patient experiences and outcomes. As the burden of end-stage kidney disease (ESKD) has increased globally, there has also been a growing recognition of the importance of patient involvement in determining the goals of care and decisions regarding treatment. In January 2018, KDIGO (Kidney Disease: Improving Global Outcomes) convened a Controversies Conference focused on dialysis initiation, including modality choice, access, and prescription. Here we present a summary of the conference discussions, including identified knowledge gaps, areas of controversy, and priorities for research. A major novel theme represented during the conference was the need to move away from a \u201cone-size-fits-all\u201d approach to dialysis and provide more individualized care that incorporates patient goals and preferences while still maintaining best practices for quality and safety. Identifying and including patient-centered goals that can be validated as quality indicators in the context of diverse health care systems to achieve equity of outcomes will require alignment of goals and incentives between patients, providers, regulators, and payers that will vary across health care jurisdictions

Size Doesn't Matter: Towards a More Inclusive Philosophy of Biology

notes: As the primary author, O’Malley drafted the paper, and gathered and analysed data (scientific papers and talks). Conceptual analysis was conducted by both authors.publication-status: Publishedtypes: ArticlePhilosophers of biology, along with everyone else, generally perceive life to fall into two broad categories, the microbes and macrobes, and then pay most of their attention to the latter. ‘Macrobe’ is the word we propose for larger life forms, and we use it as part of an argument for microbial equality. We suggest that taking more notice of microbes – the dominant life form on the planet, both now and throughout evolutionary history – will transform some of the philosophy of biology’s standard ideas on ontology, evolution, taxonomy and biodiversity. We set out a number of recent developments in microbiology – including biofilm formation, chemotaxis, quorum sensing and gene transfer – that highlight microbial capacities for cooperation and communication and break down conventional thinking that microbes are solely or primarily single-celled organisms. These insights also bring new perspectives to the levels of selection debate, as well as to discussions of the evolution and nature of multicellularity, and to neo-Darwinian understandings of evolutionary mechanisms. We show how these revisions lead to further complications for microbial classification and the philosophies of systematics and biodiversity. Incorporating microbial insights into the philosophy of biology will challenge many of its assumptions, but also give greater scope and depth to its investigations