27 research outputs found

    Physicians perceived usefulness of high-cost diagnostic imaging studies: results of a referral study in a German medical quality network

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    BACKGROUND: Medical and technological progress has led to increased numbers of diagnostic tests, some of them inducing high financial costs. In Germany, high-cost diagnostic imaging is performed by a medical specialist after referral by a general practitioner (GP) or specialist in primary care. The aim of this study was to evaluate the physicians' perceived usefulness of high-cost diagnostic imaging in patients with different clinical conditions. METHODS: Thirty-four GPs, one neurologist and one orthopaedic specialist in ambulatory care from a Medical Quality Network documented 234 referrals concerning 97 MRIs, 96 CTs-scan and 41 intracardiac catheters in a three month period. After having received the test results, they indicated if these were useful for diagnosis and treatment of the patient. RESULTS: The physicians' perceived usefulness of tests was lowest in suspected cerebral disease (40% of test results were seen as useful), cervical spine problems (64%) and unexplained abdominal complaints (67%). The perceived usefulness was highest in musculoskeletal symptoms (94%) and second best in cardiological diseases (82%). CONCLUSION: The perceived usefulness of high-cost diagnostic imaging was lower in unexplained complaints than in specific diseases. Interventions to improve the effectiveness and efficiency of test ordering should focus on clinical decision making in conditions where GPs perceived low usefulness

    Parity-preserving and magnetic field–resilient superconductivity in InSb nanowires with Sn shells

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    International audienceWe study bottom-up grown semiconductor indium antimonide nanowires that are coated with shells of tin. The shells are uniform in thickness. The interface between Sn and InSb is abrupt and without interdiffusion. Devices for transport are prepared by in-situ shadowing of nanowires using nearby nanowires as well as flakes, resulting in etch-free junctions. Tin is found to induce a hard superconducting gap in the range 600-700 micro-eV. Superconductivity persists up to 4 T in magnetic field. A tin island exhibits the coveted two-electron charging effect, a hallmark of charge parity stability. The findings open avenues for superconducting and topological quantum circuits based on new superconductor-semiconductor combinations

    Creatine supplementation with specific view to exercise/sports performance: An update

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    Creatine is one of the most popular and widely researched natural supplements. The majority of studies have focused on the effects of creatine monohydrate on performance and health; however, many other forms of creatine exist and are commercially available in the sports nutrition/supplement market. Regardless of the form, supplementation with creatine has regularly shown to increase strength, fat free mass, and muscle morphology with concurrent heavy resistance training more than resistance training alone. Creatine may be of benefit in other modes of exercise such as high-intensity sprints or endurance training. However, it appears that the effects of creatine diminish as the length of time spent exercising increases. Even though not all individuals respond similarly to creatine supplementation, it is generally accepted that its supplementation increases creatine storage and promotes a faster regeneration of adenosine triphosphate between high intensity exercises. These improved outcomes will increase performance and promote greater training adaptations. More recent research suggests that creatine supplementation in amounts of 0.1 g/kg of body weight combined with resistance training improves training adaptations at a cellular and sub-cellular level. Finally, although presently ingesting creatine as an oral supplement is considered safe and ethical, the perception of safety cannot be guaranteed, especially when administered for long period of time to different populations (athletes, sedentary, patient, active, young or elderly)

    I Do It Because I Feel that…Moral Disengagement and Emotions in Cyberbullying and Cybervictimisation

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    Few studies have jointly explored the role of factors such as the use of social media, the personality characteristics of young people, the use of thinking mechanisms aimed at moral disengagement, and the emotions experienced in relation to cyberbullying and cybervictimisation behaviour. The analysis presented here, carried out through a questionnaire distributed online and filled in by 655 Italian high school students, allowed to highlight the relationships between these variables. In particular, it emerged that the phenomena of cyberbullying and cybervictimisation are related to the time spent online and to the mechanisms of moral disengagement, which in turn are related to the personality trait of agreeableness. Emotions experienced are most clearly positive in cases of cyberbullying and negative for the victims. This correspondence, however, is reversed in bullies who resort more to thoughts aimed at moral disengagement and feel more negative emotions. The same reversal seems to occur in the victims who, in correspondence with an increased use of the mechanisms of moral disengagement, report to feel more positive emotions
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