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

Predicting sexual problems in women: The relevance of sexual excitation and sexual inhibition

This is the post-print version of the article. The official published version can be obtained from the link below.Data from a non-clinical sample of 540 heterosexual women were used to examine the relationships between scores on the Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) and ratings of current sexual problems, lifetime arousal difficulty, lifetime orgasm difficulty, and lifetime problems with low sexual interest. Multiple regression analyses also included several demographic/background variables as predictors: age, full-time employment, completed college, children in household, married, health ratings, importance of sex, and whether the woman was in a sexual relationship. The strongest statistical predictors of both current and lifetime sexual problems were the SESII-W inhibition factors Arousal Contingency and Concerns about Sexual Function. Demographic factors did not feature largely in any of the models predicting sexual problems even when statistically significant relationships were found. If future research supports the predictive utility of the SESII-W in identifying women who are more likely to experience sexual difficulties, these scales may be used as prognostic factors in treatment studies.This study was funded, in part, by a grant from the Lilly Centre for Women's Health

Navigational infrastructure at the East Pacific Rise 9°50′N area following the 2005–2006 eruption : seafloor benchmarks and near-bottom multibeam surveys

Author Posting. © American Geophysical Union, 2008. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geochemistry Geophysics Geosystems 9 (2008):Q11T04, doi:10.1029/2008GC002070.Four seafloor benchmarks were deployed with ROV Jason2 at frequently visited areas along the northern East Pacific Rise (NEPR) ridge crest near 9°50′N, within the Ridge2000 EPR integrated study site (ISS) bull's eye. When used in concert with established deep-ocean acoustic positioning techniques, these benchmarks provide navigational infrastructure to facilitate the integration of near-bottom data at this site by allowing efficient and quantitative coregistration of data and observations collected on multiple dives and over multiple cruises. High-resolution, near-bottom multibeam bathymetric surveys also were conducted along and across the ridge crest to provide a morphological and geological context for the benchmark areas. We describe the navigation and data processing techniques used to constrain the benchmark positions and outline operational details to effectively use benchmarks at this and other deep-ocean sites where multidisciplinary time series studies are conducted. The well-constrained positions of the benchmarks provide a consistent geospatial framework that can be used to limit navigational uncertainties during seafloor sampling and mapping programs and enable accurate spatial coregistration and integration of observations. These data are important to test a range of multidisciplinary hypotheses that seek to link geological, chemical, and biological processes associated with crustal accretion and energy transfer from the mantle to the hydrosphere at mid-ocean ridges

Controlling hybrid nonlinearities in transparent conducting oxides via two-colour excitation

Nanophotonics and metamaterials have revolutionised the way we think about optical space (epsilon, mu), enabling us to engineer the refractive index almost at will, to confine light to the smallest of the volumes, and to manipulate optical signals with extremely small footprints and energy requirements. Significant efforts are now devoted to finding suitable materials and strategies for the dynamic control of the optical properties. Transparent conductive oxides exhibit large ultrafast nonlinearities under both interband and intraband excitations. Here, we show that combining these two effects in aluminium-doped zinc oxide via a two colour laser field discloses new material functionalities. Owing to the independence of the two nonlinearities the ultrafast temporal dynamics of the material permittivity can be designed by acting on the amplitude and delay of the two fields. We demonstrate the potential applications of this novel degree of freedom by dynamically addressing the modulation bandwidth and optical spectral tuning of a probe optical pulse

The Lantern Vol. 6, No. 2, March 1938

• Among Our Contributors • Of Special Interest To You! • Jenny Lee • The Arguments Against Isolation • The Note • Visit of the Grandchildren • One Finds God • To The North Lies New Hampshire • The Two Camps in Washington • Substitutes • At Times It Seems So Very Strange • Episode on a Lake Shore • My Campus Song • Irony • A Chinese Mysteryhttps://digitalcommons.ursinus.edu/lantern/1017/thumbnail.jp