Age-Related Differences in Doctor-Patient Interaction and Patient Satisfaction

Background. Relatively little is known about patient characteristics associated with doctor-patient interaction style and satisfaction with the medical visit. Objective. The primary study objectives are to assess: whether doctors interact in a more or less patient-centered style with elderly patients and whether patient age moderates the relationship between interaction style and satisfaction, that is, whether elderly patients are more or less satisfied with patient-centered medical encounters. Methods. We collected pre- and post-visit questionnaire data from 177 patients at a large family medicine clinic. We audiotaped the encounters between doctors and patients. Patient-centered interaction style was measured from coding from the audiotapes of the doctor-patient interactions. Patient satisfaction was measured using the Patient Satisfaction Questionnaire. Results. We found physicians were more likely to have patient-centered encounters with patients over age 65. We also found patient age moderated the association between interaction style and patient satisfaction: older patients were more satisfied with patient-centered encounters. Conclusion. Patient age is associated with style of interaction, which is, in turn, associated with patient satisfaction. Understanding the factors and processes by which doctors and patients interact has the potential to improve many facets of health care delivery

Socio-Environmental Factors Associated With Pubertal Development in Female Adolescents: The Role of Prepubertal Tobacco and Alcohol Use

This cross-sectional study of 3,106 female adolescents, aged 11–21 years, evaluated the association between prepubertal alcohol and tobacco use and the onset of puberty. Ages at initial breast development, body hair growth, and menarche were self-reported. Prepubertal alcohol and tobacco use were defined as the age at first use before the age of pubertal development and accompanied by regular use. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazard models. Logistic regression was used to estimate the association between substance use and delayed puberty, defined as lack of breast development by the age of 13 years

Towards ‘languages for all’ in England: the state of the debate

Whether the study of languages should be a core element of a balanced and broadly based curriculum for all pupils in England’s 11–16 state-funded secondary schools is also part of a wider debate concerning how to harness England’s rich linguistic and cultural diversity and improve the quality and range of language skills of the country. While learning a second language throughout compulsory schooling is increasingly the norm across the world, fewer than 50% of 14–16 year olds in state-funded schools in England gained a modern language qualification (General Certification of Secondary Education or GCSE) in 2015. From 2015, recent government education policy has required the majority of pupils commencing secondary school to study a language to GCSE level, suggesting that schools who do not comply will be unable to gain the top inspection grade. This paper reviews the state of the debate examining divergent and contradictory perspectives within education policy and in the literature. It concludes by setting out six conditions for achieving this policy goal for enabling secondary schools to successfully implement a coherent and relevant languages curriculum for all young people, such that they can develop the linguistic and intercultural competencies needed to contribute to and thrive in increasingly diverse local and global communities

The low-frequency environment of the Murchison Widefield Array : radio-frequency interference analysis and mitigation

This is the Accepted Manuscript version of the following article: A. R. Offringa, et al., “The low-frequency environment of the Murchison Widefield Array: radio-frequency interference analysis and mitigation”, Publications of the Astronomical Society of Australia, Vol. 32, March 2015. The final published version is available at: https://doi.org/10.1017/pasa.2015.7 © Astronomical Society of Australia 2015The Murchison Widefield Array (MWA) is a new low-frequency interferometric radio telescope built in Western Australia at one of the locations of the future Square Kilometre Array (SKA). We describe the automated radio-frequency interference (RFI) detection strategy implemented for the MWA, which is based on the AOFlagger platform, and present 72-231-MHz RFI statistics from 10 observing nights. RFI detection removes 1.1% of the data. RFI from digital TV (DTV) is observed 3% of the time due to occasional ionospheric or atmospheric propagation. After RFI detection and excision, almost all data can be calibrated and imaged without further RFI mitigation efforts, including observations within the FM and DTV bands. The results are compared to a previously published Low-Frequency Array (LOFAR) RFI survey. The remote location of the MWA results in a substantially cleaner RFI environment compared to LOFAR's radio environment, but adequate detection of RFI is still required before data can be analysed. We include specific recommendations designed to make the SKA more robust to RFI, including: the availability of sufficient computing power for RFI detection; accounting for RFI in the receiver design; a smooth band-pass response; and the capability of RFI detection at high time and frequency resolution (second and kHz-scale respectively).Peer reviewedFinal Accepted Versio

Broadband Spectral Modeling of the Extreme Gigahertz-Peaked Spectrum Radio Source PKS B0008-421

J. R. Callingham, et al., “Broadband Spectral Modeling of the Extreme Gigahertz-Peaked Spectrum Radio Source PKS B0008-421”, Astrophysical Journal, Vol. 809(2), August 2015. © 2015. The American Astronomical Society. All rights reserved.We present broadband observations and spectral modeling of PKS B0008-421, and identify it as an extreme gigahertz-peaked spectrum (GPS) source. PKS B0008-421 is characterized by the steepest known spectral slope below the turnover, close to the theoretical limit of synchrotron self-absorption, and the smallest known spectral width of any GPS source. Spectral coverage of the source spans from 0.118 to 22 GHz, which includes data from the Murchison Widefield Array and the wide bandpass receivers on the Australia Telescope Compact Array. We have implemented a Bayesian inference model fitting routine to fit the data with various absorption models. We find that without the inclusion of a high-frequency exponential break the absorption models can not accurately fit the data, with significant deviations above and below the peak in the radio spectrum. The addition of a high-frequency break provides acceptable spectral fits for the inhomogeneous free-free absorption and double-component synchrotron self-absorption models, with the inhomogeneous free-free absorption model statistically favored. The requirement of a high-frequency spectral break implies that the source has ceased injecting fresh particles. Additional support for the inhomogeneous free-free absorption model as being responsible for the turnover in the spectrum is given by the consistency between the physical parameters derived from the model fit and the implications of the exponential spectral break, such as the necessity of the source being surrounded by a dense ambient medium to maintain the peak frequency near the gigahertz region. The discovery of PKS B0008-421 suggests that the next generation of low radio frequency surveys could reveal a large population of GPS sources that have ceased activity, and that a portion of the ultra-steep spectrum source population could be composed of these GPS sources in a relic phase.Peer reviewedFinal Published versio

A New (Old), Invasive Ant in the Hardwood Forests of Eastern North America and Its Potentially Widespread Impacts

Biological invasions represent a serious threat for the conservation of biodiversity in many ecosystems. While many social insect species and in particular ant species have been introduced outside their native ranges, few species have been successful at invading temperate forests. In this study, we document for the first time the relationship between the abundance of the introduced ant, Pachycondyla chinensis, in mature forests of North Carolina and the composition, abundance and diversity of native ant species using both a matched pair approach and generalized linear models. Where present, P. chinensis was more abundant than all native species combined. The diversity and abundance of native ants in general and many individual species were negatively associated with the presence and abundance of P. chinensis. These patterns held regardless of our statistical approach and across spatial scales. Interestingly, while the majority of ant species was strongly and negatively correlated with the abundance and presence of P. chinensis, a small subset of ant species larger than P. chinensis was either as abundant or even more abundant in invaded than in uninvaded sites. The large geographic range of this ant species combined with its apparent impact on native species make it likely to have cascading consequences on eastern forests in years to come, effects mediated by the specifics of its life history which is very different from those of other invasive ants. The apparent ecological impacts of P. chinensis are in addition to public health concerns associated with this species due to its sometimes, deadly sting

Management control systems in innovation companies: A literature based framework

Past research has traditionally argued that management control systems (MCSs) may present a hindrance to the creativity of innovation companies. This theoretical paper surveys the literature to focus an investigation on the MCSs of innovation companies. Within the object of control paradigm the paper develops and presents a theoretical model of the impact of eleven external, organisational and innovation related contingency factors on the MCSs in companies that engage in innovation activities. We also suggest measures for further empirical research. By formulating hypotheses on 43 potential interactions the model predicts contradictory influences on two direct control categories, results and action control, but stresses the importance of two indirect categories, personnel and cultural control. More specifically, the high levels of technological complexity and innovation capability in this type of company are expected to be negatively associated with the application of results and action control, whereas personnel and cultural seem to be more appropriate. Furthermore, important sources of finance, venture capital and public funding, are both hypothesised to be positively associated with the application of results, action and personnel control; whereas only public funding is predicted to be positively related to the application of cultural control. The principal contribution of this paper lies in synthesising the literature to provide a model of the impact of a unique set of eleven contingency factors for innovation companies on a broad scope of controls. In addition, the contingency model, if empirically validated, would add value by inferring the particular forms of management control which would be beneficial in innovative company settings. © 2014 Springer-Verlag Berlin Heidelberg

COVID-19: Rapid antigen detection for SARS-CoV-2 by lateral flow assay: A national systematic evaluation of sensitivity and specificity for mass-testing

Background Lateral flow device (LFD) viral antigen immunoassays have been developed around the world as diagnostic tests for SARS-CoV-2 infection. They have been proposed to deliver an infrastructure-light, cost-economical solution giving results within half an hour. Methods LFDs were initially reviewed by a Department of Health and Social Care team, part of the UK government, from which 64 were selected for further evaluation from 1st August to 15th December 2020. Standardised laboratory evaluations, and for those that met the published criteria, field testing in the Falcon-C19 research study and UK pilots were performed (UK COVID-19 testing centres, hospital, schools, armed forces). Findings 4/64 LFDs so far have desirable performance characteristics (orient Gene, Deepblue, Abbott and Innova SARS-CoV-2 Antigen Rapid Qualitative Test). All these LFDs have a viral antigen detection of >90% at 100,000 RNA copies/ml. 8951 Innova LFD tests were performed with a kit failure rate of 5.6% (502/8951, 95% CI: 5.1–6.1), false positive rate of 0.32% (22/6954, 95% CI: 0.20–0.48). Viral antigen detection/sensitivity across the sampling cohort when performed by laboratory scientists was 78.8% (156/198, 95% CI 72.4–84.3). Interpretation Our results suggest LFDs have promising performance characteristics for mass population testing and can be used to identify infectious positive individuals. The Innova LFD shows good viral antigen detection/sensitivity with excellent specificity, although kit failure rates and the impact of training are potential issues. These results support the expanded evaluation of LFDs, and assessment of greater access to testing on COVID-19 transmission. Funding Department of Health and Social Care. University of Oxford. Public Health England Porton Down, Manchester University NHS Foundation Trust, National Institute of Health Research

Synthetic biology to access and expand nature's chemical diversity

Bacterial genomes encode the biosynthetic potential to produce hundreds of thousands of complex molecules with diverse applications, from medicine to agriculture and materials. Accessing these natural products promises to reinvigorate drug discovery pipelines and provide novel routes to synthesize complex chemicals. The pathways leading to the production of these molecules often comprise dozens of genes spanning large areas of the genome and are controlled by complex regulatory networks with some of the most interesting molecules being produced by non-model organisms. In this Review, we discuss how advances in synthetic biology — including novel DNA construction technologies, the use of genetic parts for the precise control of expression and for synthetic regulatory circuits — and multiplexed genome engineering can be used to optimize the design and synthesis of pathways that produce natural products