Patient enablement requires physician empathy: a cross-sectional study of general practice consultations in areas of high and low socioeconomic deprivation in Scotland

<b>Background</b> Patient 'enablement' is a term closely aligned with 'empowerment' and its measurement in a general practice consultation has been operationalised in the widely used patient enablement instrument (PEI), a patient-rated measure of consultation outcome. However, there is limited knowledge regarding the factors that influence enablement, particularly the effect of socio-economic deprivation. The aim of the study is to assess the factors influencing patient enablement in GP consultations in areas of high and low deprivation.<p></p> <b>Methods</b> A questionnaire study was carried out on 3,044 patients attending 26 GPs (16 in areas of high socio-economic deprivation and 10 in low deprivation areas, in the west of Scotland). Patient expectation (confidence that the doctor would be able to help) was recorded prior to the consultation. PEI, GP empathy (measured by the CARE Measure), and a range of other measures and variables were recorded after the consultation. Data analysis employed multi-level modelling and multivariate analyses with the PEI as the dependant variable.<p></p> <b>Results</b> Although numerous variables showed a univariate association with patient enablement, only four factors were independently predictive after multilevel multivariate analysis; patients with multimorbidity of 3 or more long-term conditions (reflecting poor chronic general health), and those consulting about a long-standing problem had reduced enablement scores in both affluent and deprived areas. In deprived areas, emotional distress (GHQ-caseness) had an additional negative effect on enablement. Perceived GP empathy had a positive effect on enablement in both affluent and deprived areas. Maximal patient enablement was never found with low empathy.<p></p> <b>Conclusions</b> Although other factors influence patient enablement, the patients' perceptions of the doctors' empathy is of key importance in patient enablement in general practice consultations in both high and low deprivation settings

Raising the bar: legislating to achieve diversity in the professions is only half of the story

Purpose – Argues that merely complying with legislation is not sufficient to accomplish genuine diversity and that, rather than assuming its benefits will naturally be derived and accepted, diversity must be approached strategically and its advantages communicated effectively to stakeholders to ensure desired outcomes. Design/methodology/approach – Considers the business case for diversity, presents a case study of barristers and examines the role of the national equality standard. Findings – Advances the view that multi-layered approaches to diversity are essential for its successful implementation. Practical implications – Highlights the strong business case for diversity in the workforce, as well as possible social repercussions from failing to ensure that workforces are diverse. Social implications – Underlines how young people in European and Anglo-Saxon countries are increasingly demanding to work with colleagues from varied ethnicities, nationalities and sexual orientations who are similar to the peers they socialize with. Diverse workforces have thus become central to talent attraction. Originality/value – Presents an interesting case study of barristers and diversity. Keywords: Performance, Recruitment, Equal opportunities, Lawyer

Arcuate nucleus homeostatic systems reflect blood leptin concentration but not feeding behaviour during scheduled feeding on a high-fat diet in mice

Acknowledgements T.B. was funded by a CASE studentship from the BBSRC and AstraZeneca. J.B. was a summer student from Bordeaux Sciences Agro and funded by student laboratory experience grant from the British Society of Neuroendocrinology. The authors are also grateful for funding from the Scottish Government, and from the European Union Seventh Framework Programme (FP7/2007-2013) under grant agreements 266408 (Full4Health) and 245009 (NeuroFAST).Peer reviewedPublisher PD

Public understanding of solar radiation management

We report the results of the first large-scale international survey of public perception of geoengineering and solar radiation management (SRM). Our sample of 3105 individuals in the United States, Canada and the United Kingdom was recruited by survey firms that administer internet surveys to nationally representative population samples. Measured familiarity was higher than expected, with 8% and 45% of the population correctly defining the terms geoengineering and climate engineering respectively. There was strong support for allowing the study of SRM. Support decreased and uncertainty rose as subjects were asked about their support for using SRM immediately, or to stop a climate emergency. Support for SRM is associated with optimism about scientific research, a valuing of SRM's benefits and a stronger belief that SRM is natural, while opposition is associated with an attitude that nature should not be manipulated in this way. The potential risks of SRM are important drivers of public perception with the most salient being damage to the ozone layer and unknown risks. SRM is a new technology and public opinions are just forming; thus all reported results are sensitive to changes in framing, future information on risks and benefits, and changes to context.Physic

Identification of proteins in the postsynaptic density fraction by mass spectrometry

Our understanding of the organization of postsynaptic signaling systems at excitatory synapses has been aided by the identification of proteins in the postsynaptic density (PSD) fraction, a subcellular fraction enriched in structures with the morphology of PSDs. In this study, we have completed the identification of most major proteins in the PSD fraction with the use of an analytical method based on mass spectrometry coupled with searching of the protein sequence databases. At least one protein in each of 26 prominent protein bands from the PSD fraction has now been identified. We found 7 proteins not previously known to be constituents of the PSD fraction and 24 that had previously been associated with the PSD by other methods. The newly identified proteins include the heavy chain of myosin-Va (dilute myosin), a motor protein thought to be involved in vesicle trafficking, and the mammalian homolog of the yeast septin protein cdc10, which is important for bud formation in yeast. Both myosin-Va and cdc10 are threefold to fivefold enriched in the PSD fraction over brain homogenates. Immunocytochemical localization of myosin-Va in cultured hippocampal neurons shows that it partially colocalizes with PSD-95 at synapses and is also diffusely localized in cell bodies, dendrites, and axons. Cdc10 has a punctate distribution in cell bodies and dendrites, with some of the puncta colocalizing with PSD-95. The results support a role for myosin-Va in transport of materials into spines and for septins in the formation or maintenance of spines

What is the best strategy for retaining gestures in working memory?

This study aimed to determine whether the recall of gestures in working memory could be enhanced by verbal or gestural strategies. We also attempted to examine whether these strategies could help resist verbal or gestural interference. Fifty-four participants were divided into three groups according to the content of the training session. This included a control group, a verbal strategy group (where gestures were associated with labels) and a gestural strategy group (where participants repeated gestures and were told to imagine reproducing the movements). During the experiment, the participants had to reproduce a series of gestures under three conditions: "no interference", gestural interference (gestural suppression) and verbal interference (articulatory suppression). The results showed that task performance was enhanced in the verbal strategy group, but there was no significant difference between the gestural strategy and control groups. Moreover, compared to the "no interference" condition, performance decreased in the presence of gestural interference, except within the verbal strategy group. Finally, verbal interference hindered performance in all groups. The discussion focuses on the use of labels to recall gestures and differentiates the induced strategies from self-initiated strategies

Honey Bee Dopamine and Octopamine Receptors Linked to Intracellular Calcium Signaling Have a Close Phylogenetic and Pharmacological Relationship

BACKGROUND: Three dopamine receptor genes have been identified that are highly conserved among arthropod species. One of these genes, referred to in honey bees as Amdop2, shows a close phylogenetic relationship to the a-adrenergic-like octopamine receptor family. In this study we examined in parallel the functional and pharmacological properties of AmDOP2 and the honey bee octopamine receptor, AmOA1. For comparison, pharmacological properties of the honey bee dopamine receptors AmDOP1 and AmDOP3, and the tyramine receptor AmTYR1, were also examined. METHODOLOGY/PRINCIPAL FINDINGS: Using HEK293 cells heterologously expressing honey bee biogenic amine receptors, we found that activation of AmDOP2 receptors, like AmOA1 receptors, initiates a rapid increase in intracellular calcium levels. We found no evidence of calcium signaling via AmDOP1, AmDOP3 or AmTYR1 receptors. AmDOP2- and AmOA1-mediated increases in intracellular calcium were inhibited by 10 µM edelfosine indicating a requirement for phospholipase C-β activity in this signaling pathway. Edelfosine treatment had no effect on AmDOP2- or AmOA1-mediated increases in intracellular cAMP. The synthetic compounds mianserin and epinastine, like cis-(Z)-flupentixol and spiperone, were found to have significant antagonist activity on AmDOP2 receptors. All 4 compounds were effective antagonists also on AmOA1 receptors. Analysis of putative ligand binding sites offers a possible explanation for why epinastine acts as an antagonist at AmDOP2 receptors, but fails to block responses mediated via AmDOP1. CONCLUSIONS/SIGNIFICANCE: Our results indicate that AmDOP2, like AmOA1, is coupled not only to cAMP, but also to calcium-signalling and moreover, that the two signalling pathways are independent upstream of phospholipase C-β activity. The striking similarity between the pharmacological properties of these 2 receptors suggests an underlying conservation of structural properties related to receptor function. Taken together, these results strongly support phylogenetic analyses indicating that the AmDOP2 and AmOA1 receptor genes are immediate paralogs

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