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

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

Vulnerability to bushfires in rural Australia: a case study from East Gippsland, Victoria

This paper investigates the nature and causes of vulnerability to bushfires in the Wulgulmerang district of East Gippsland, Victoria, in south-eastern Australia. In 2003 bushfires devastated the small population of this isolated farming district, destroying homes, agricultural assets and public infrastructure. The ?res also adversely affected the health, livelihoods and social lives of many local people. The paper examines: (i) how and why people were exposed to hazards during the bushfires; and (ii) how and why people were differentially capable of coping and adapting to the fires' impacts. Qualitative methods were primarily used to investigate these questions, including semi-structured interviews with residents and landholders of the district and others who responded to the fires in an official or unofficial capacity. Vulnerability is shown to arise from the circumstances of people's everyday lives, which are shaped by factors both within and beyond their control. Local pressures and challenges such as drought, declining farm incomes, depopulation, and the inaccessibility of essential services e are shown to increase people's exposure to hazards and reduce their capacities to cope and adapt. The paper demonstrates the fundamental importance of sustainable livelihoods and regional economic vitality to the long-term goal of vulnerability reduction

At The Jazz Band Ball

https://digitalcommons.library.umaine.edu/mmb-vp/5737/thumbnail.jp

Integrating communication skills into undergraduate science degrees: A practical and evidence-based approach

The introduction of generic skills, such as communication, into undergraduate science degrees is becoming common in higher education and has met with mixed implementation success. This study designed, piloted, and evaluated a set of adaptable activities that scaffold the explicit teaching and learning of science communication with non-scientific audiences. These activities were implemented in undergraduate science classes from three disciplines at an Australian research-intensive university. A mixed- methods approach was used to evaluate learning gains by collecting data from: student surveys; semi-structured interviews with academic teaching staff; and student performance by marking of assessment tasks. Self-reported learning gains showed 95% of all students perceived improvements in their ability to do all communication skills and 94% perceived improvements in their confidence in communicating science as a result of the activities. Academic teaching staff reported improvements in students’ communication skills and understanding of core science content, and indicated that the tasks were explicit, engaging, and sustainable for use in future years. Students successfully transferred their learning to their assignments, demonstrating on average, a ‘good,’ ‘excellent,’ or ‘outstanding’ standard for each of the science communication criteria. These activities provide a promising starting point for integrating employable communication skills into undergraduate science degrees

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

Computations for the 16-foot transonic tunnel, NASA, Langley Research Center, revision 1

The equations used by the 16 foot transonic tunnel in the data reduction programs are presented in eight modules. Each module consists of equations necessary to achieve a specific purpose. These modules are categorized in the following groups: tunnel parameters; jet exhaust measurements; skin friction drag; balance loads and model attitudes calculations; internal drag (or exit-flow distributions); pressure coefficients and integrated forces; thrust removal options; and turboprop options. This document is a companion document to NASA TM-83186, A User's Guide to the Langley 16 Foot Transonic Tunnel, August 1981

Life History of the Marine Isopod Cyathura polita in the Saint John River Estuary, New Brunswick: a Species at the Northern Extent of its Range

The marine isopod, Cyathura polita, inhabits estuaries on the east coast of North America from the Gulf of Mexico to the Bay of Fundy, Canada. We studied C. polita in the Saint John estuary to test for potential differences in life history that might occur because of the northern location of the population. In the Saint John, based on our interpretation from a six-month sampling program (May-October), the population exhibits a three-year life cycle, one year longer than more southern populations, and stretching over four summers. Our study supported the occurrence of protogynic hermaphroditism. After two summers as juveniles, individuals matured as females during their third summer, then displayed sex reversal by becoming males that fall, and finally reproducing as males in their fourth summer of life before death. Mean length of C. polita from the Saint John was greater than individuals from more southern populations (females, 13.8 ± 2.14 mm; males, 16.3 ± 2.41 mm). Annual brood release occurred in late July-early August. Mean fecundity of females was 53.2 ± 18.9 embryos per brood, which was greater than found in southern populations. Cyathura polita is rare in Canada and is known only from the Saint John and along the northern shore of the Bay of Fundy to the border of the United States

Crystallization of Yamato 980459 at 0.5 GPA: Are Residual Liquids Like QUE 94201?

The Martian basaltic meteorites Y980459 and QUE94201 (henceforth referred to as Y98 and QUE respectively) are thought to represent magmatic liquid compositions, rather than being products of protracted crystallization and accumulation like the majority of other martian meteorites. Both meteorite compositions have been experimentally crystallized at 1 bar, and liquidus phases were found to match corresponding mineral core compositions in the meteorites, consistent with the notion that these meteorites represent bona fide melts. They also represent the most primitive and most evolved basaltic martian samples, respectively. Y98 has Mg# (molar Mg/Mg+Fe) approximates 65, and lacks plagioclase; whereas QUE has Mg# approximates 40, and lacks olivine. However they share important geochemical characteristics (e.g. superchondritic CaO/Al2O3, very high epsilon(sub Nd) and low Sr-87/Sr-87) that suggest they sample a similar highly depleted mantle reservoir. As such, they represent likely endmembers of martian magmatic liquid compositions, and it is natural to seek petrogenetic linkages between the two. We make no claim that the actual meteorites themselves share a genetic link (the respective ages rule that out); we are exploring only in general whether primitive martian liquids like Y98 could evolve to liquids resembling QUE. Both experimental and computational efforts have been made to determine if there is indeed such a link. Recent petrological models at 1 bar generated using MELTS suggest that a QUE-like melt can be derived from a parental melt with a Y98 composition. However, experimental studies at 1 bar have been less successful at replicating this progression. Previous experimental crystallization studies of Y98 by our group at 0.5 GPa have produced melt compositions approaching that of QUE, although these results were complicated by the presence of small, variable amounts of H2O in some of the runs owing to the use of talc/pyrex experimental assemblies. Therefore we have repeated the four experiments, augmented with additional runs, all using BaCO3 cell assemblies, which are devoid of water, and these new experiments supersede those reported earlier. Here we report results of experiments simulating equilibrium crystallization; fractional crystallization experiments are currently underway