GP prescribing of nicotine replacement and bupropion to aid smoking cessation in England and Wales

Aims Prescribing nicotine replacement therapy (NRT) or bupropion for smoking cessation is of considerable importance to public health but little is known about prescribing practices. This paper examines general practitioners' (GPs') prescribing patterns in Britain where these drugs are reimbursed. The results have implications for other health-care systems considering introducing reimbursement.Design, participants and setting Postal survey conducted in 2002 of a random sample of 1088 GPs in England and Wales, of whom 642 (59%) responded.Measures Number of requests GPs reported having received from patients for NRT and bupropion over the past month, the number of prescriptions they reported issuing and ratings of attitudes to these medications.Findings GPs reported receiving an average of 4.3 requests for NRT and 1.9 for bupropion in the previous month. They reported issuing 3.5 prescriptions for NRT and 1.2 for bupropion. Almost all GPs accepted that NRT (95%) and bupropion (97%) should be reimbursable on National Health Service (NHS) prescription. However, a significant minority of those who received requests for prescriptions did not issue any (81% for NRT and 26% for bupropion). This was related to whether they thought these products should be available on NHS prescription for both NRT and bupropion (OR = 0.66, P < 0.05), which in turn was related to beliefs about whether smokers should have to pay for treatment themselves, the cost-effectiveness of NRT/bupropion and the low priority they would give NRT/bupropion in the drug budget. For bupropion, concern about side-effects independently predicted not prescribing [odds ratio (OR) = 1.46, P < 0.03].Conclusion In the British health-care system, which has a well-established system for technology assessment and professionally endorsed guidelines, a significant minority of GPs decline all patient requests for stop-smoking medicines

Strength in diversity: enhancing learning in vocationally-orientated, master's level courses

Postgraduate education in geography, especially at the Master’s level, is undergoing significant changes in the developed world. There is an expansion of vocationally-oriented degree programmes, increasing recruitment of international students, integration of work place skills, and the engagement of non-traditional postgraduate students as departments respond to policies for a more ‘inclusive’ higher education. This paper sets the context by outlining some programmatic changes in selected countries (Australia, the UK, and the USA). We briefly reflect on how postgraduate ‘bars’ or ‘levels’ are defined and explore in detail what ‘diversity’ or ‘heterogeneity’ means in these new postgraduate settings. The paper then explores some examples of practice drawn from our own experiences, whilst recognising that relevance will vary in other contexts. Finally we consider how diversity can be harnessed as a strength that has potential to enhance taught elements of contemporary postgraduate education in and beyond the discipline

Non-parametric Cosmology with Cosmic Shear

We present a method to measure the growth of structure and the background geometry of the Universe -- with no a priori assumption about the underlying cosmological model. Using Canada-France-Hawaii Lensing Survey (CFHTLenS) shear data we simultaneously reconstruct the lensing amplitude, the linear intrinsic alignment amplitude, the redshift evolving matter power spectrum, P(k,z), and the co-moving distance, r(z). We find that lensing predominately constrains a single global power spectrum amplitude and several co-moving distance bins. Our approach can localise precise scales and redshifts where Lambda-Cold Dark Matter (LCDM) fails -- if any. We find that below z = 0.4, the measured co-moving distance r (z) is higher than that expected from the Planck LCDM cosmology by ~1.5 sigma, while at higher redshifts, our reconstruction is fully consistent. To validate our reconstruction, we compare LCDM parameter constraints from the standard cosmic shear likelihood analysis to those found by fitting to the non-parametric information and we find good agreement.Comment: 13 pages. Matches PRD accepted versio

Finding out If It Is True: Comparing Mediation and Negotiation through Research

In this article, we first use existing research evidence to contextualize more clearly the place of civil case mediation in the litigation process. When we understand civil mediation as part of adversarial litigation - rather than as distinct from it - we see the importance of comparing mediation and unassisted negotiation. Next, we discuss research and commentary on the barriers to negotiation and the ways in which mediation might help overcome them. This work provides a more pragmatic and empirically grounded perspective on the potential value of mediation than does mediation ideology and suggests a wide range of hypotheses to guide future research. Finally, we reexamine briefly the research about preferences for mediation and the modest body of existing studies that do contrast litigant experiences with mediation and unaided negotiation in the context of litigation. This reexamination hints that it may in fact be true - that is, participation in mediation may enhance parties\u27 perception of procedural justice. Before we can be confident in the answer to this question, however, research is needed that carefully compares the experiences of parties in mediation with those in unassisted negotiation

Ultrasound Investigations of Orbital Quadrupolar Ordering in UPd_3

For a high-quality single crystal of UPd_3 we present the relevant elastic constants and ultrasonic attenuation data. In addition to the magnetic phase transition at T_2=4.4 +/- 0.1K and the quadrupolar transition at T_1~6.8K, we find orbital ordering at T_0=7.6 +/- 0.1K concomitant with a symmetry change from hexagonal to orthorhombic. A striking feature is the splitting of the phase transition at T_1 into a second-order transition at T_{+1}=6.9 +/- 0.05K and a first-order transition at T_{-1}=6.7 +/- 0.05K. For the four phase transitions, the quadrupolar order parameters and the respective symmetry changes are specified.Comment: 14 pages (RevTex), 3 eps-figures, accepted by PR

Skylab 4 visual observations project report

The Skylab 4 Visual Observations Project was undertaken to determine the ways in which man can contribute to future earth-orbital observational programs. The premission training consisted of 17 hours of lectures by scientists representing 16 disciplines and provided the crewmen information on observational and photographic procedures and the scientific significance of this information. During the Skylab 4 mission, more than 850 observations and 2000 photographs with the 70-millimeter Hasselblad and 35-millimeter Nikon cameras were obtained for many investigative areas. Preliminary results of the project indicate that man can obtain new and unique information to support satellite earth-survey programs because of his inherent capability to make selective observations, to integrate the information, and to record the data by describing and photographing the observational sites