Estimating the burden of minor ailment consultations in general practices and emergency departments through retrospective review of routine data in North East Scotland

Minor ailment attendances in general practices and emergency departments (EDs) place significant burden on health care resources

The prevalence of medical reasons for non-participation in the Scottish breast and bowel cancer screening programmes

Objective: Increasing uptake of cancer screening is a priority for health systems internationally, however, some patients may not attend because they are undergoing active treatment for the cancer of interest or have other medical reasons that mean participation would be inappropriate. This study aims to quantify the proportion of non-participants who have a medical reason for not attending cancer screening.<p></p> Methods: Medical reasons for not participating in breast and bowel screening were defined a priori on the basis of a literature review and expert opinion. The notes of 700 patients at two GP practices in Scotland were reviewed, to ascertain the prevalence of medical reasons amongst non-participants. Simple proportions and confidence intervals were calculated.<p></p> Results: 17.4% of breast and 2.3% of bowel screening non-participants had a medical reason to not participate. The two most common reasons were previous breast cancer follow up (8.86%) and recent mammogram (6.57%).<p></p> Conclusion: These patients may not benefit from screening while also being distressed by receiving an invitation. This issue also makes accurate monitoring and target-setting for improving uptake difficult. Further work is needed to estimate robustly the extent to which medical reasons account for screening non-participation in a larger population.<p></p&gt

Geometric Algebras and Extensors

This is the first paper in a series (of four) designed to show how to use geometric algebras of multivectors and extensors to a novel presentation of some topics of differential geometry which are important for a deeper understanding of geometrical theories of the gravitational field. In this first paper we introduce the key algebraic tools for the development of our program, namely the euclidean geometrical algebra of multivectors Cl(V,G_{E}) and the theory of its deformations leading to metric geometric algebras Cl(V,G) and some special types of extensors. Those tools permit obtaining, the remarkable golden formula relating calculations in Cl(V,G) with easier ones in Cl(V,G_{E}) (e.g., a noticeable relation between the Hodge star operators associated to G and G_{E}). Several useful examples are worked in details fo the purpose of transmitting the "tricks of the trade".Comment: This paper (to appear in Int. J. Geom. Meth. Mod. Phys. 4 (6) 2007) is an improved version of material appearing in math.DG/0501556, math.DG/0501557, math.DG/050155

'Help for hay fever', a goal-focused intervention for people with intermittent allergic rhinitis, delivered in Scottish community pharmacies: study protocol for a pilot cluster randomized controlled trial

<b>Background</b> Despite the availability of evidence-based guidelines for managing allergic rhinitis in primary care, management of the condition in the United Kingdom (UK) remains sub-optimal. Its high prevalence and negative effects on quality of life, school performance, productivity and co-morbid respiratory conditions (in particular, asthma), and high health and societal costs, make this a priority for developing novel models of care. Recent Australian research demonstrated the potential of a community pharmacy-based ‘goal-focused’ intervention to help people with intermittent allergic rhinitis to self-manage their condition better, reduce symptom severity and improve quality of life. In this pilot study we will assess the transferability of the goal-focused intervention to a UK context, the suitability of the intervention materials, procedures and outcome measures and collect data to inform a future definitive UK randomized controlled trial (RCT). <p></p> <b>Methods/design</b> A pilot cluster RCT with associated preliminary economic analysis and embedded qualitative evaluation. The pilot trial will take place in two Scottish Health Board areas: Grampian and Greater Glasgow and Clyde. Twelve community pharmacies will be randomly assigned to intervention or usual care group. Each will recruit 12 customers seeking advice or treatment for intermittent allergic rhinitis. Pharmacy staff in intervention pharmacies will support recruited customers in developing strategies for setting and achieving goals that aim to avoid/minimize triggers for, and eliminate/minimize symptoms of allergic rhinitis. Customers recruited in non-intervention pharmacies will receive usual care. The co-primary outcome measures, selected to inform a sample size calculation for a future RCT, are: community pharmacy and customer recruitment and completion rates; and effect size of change in the validated mini-Rhinoconjunctivitis Quality of Life Questionnaire between baseline, one-week and six-weeks post-intervention. Secondary outcome measures relate to changes in symptom severity, productivity, medication adherence and self-efficacy. Quantitative data about accrual, retention and economic measures, and qualitative data about participants’ experiences during the trial will be collected to inform the future RCT.<P></P> <b>Discussion</b> This work will lay the foundations for a definitive RCT of a community pharmacy-based ‘goal-focused’ self-management intervention for people with intermittent allergic rhinitis. Results of the pilot trial are expected to be available in April 2013

A cohort study of influences, health outcomes and costs of patients' health-seeking behaviour for minor ailments from primary and emergency care settings

To compare health-related and cost-related outcomes of consultations for symptoms suggestive of minor ailments in emergency departments (EDs), general practices and community pharmacies

A geometric basis for the standard-model gauge group

A geometric approach to the standard model in terms of the Clifford algebra Cl_7 is advanced. A key feature of the model is its use of an algebraic spinor for one generation of leptons and quarks. Spinor transformations separate into left-sided ("exterior") and right-sided ("interior") types. By definition, Poincare transformations are exterior ones. We consider all rotations in the seven-dimensional space that (1) conserve the spacetime components of the particle and antiparticle currents and (2) do not couple the right-chiral neutrino. These rotations comprise additional exterior transformations that commute with the Poincare group and form the group SU(2)_L, interior ones that constitute SU(3)_C, and a unique group of coupled double-sided rotations with U(1)_Y symmetry. The spinor mediates a physical coupling of Poincare and isotopic symmetries within the restrictions of the Coleman--Mandula theorem. The four extra spacelike dimensions in the model form a basis for the Higgs isodoublet field, whose symmetry requires the chirality of SU(2). The charge assignments of both the fundamental fermions and the Higgs boson are produced exactly.Comment: 17 pages, LaTeX requires iopart. Accepted for publication in J. Phys. A: Math. Gen. 9 Mar 2001. Typos correcte

Cystic fibrosis mice carrying the missense mutation G551D replicate human genotype phenotype correlations

We have generated a mouse carrying the human G551D mutation in the cystic fibrosis transmembrane conductance regulator gene (CFTR) by a one-step gene targeting procedure. These mutant mice show cystic fibrosis pathology but have a reduced risk of fatal intestinal blockage compared with 'null' mutants, in keeping with the reduced incidence of meconium ileus in G551D patients. The G551D mutant mice show greatly reduced CFTR-related chloride transport, displaying activity intermediate between that of cftr(mlUNC) replacement ('null') and cftr(mlHGU) insertional (residual activity) mutants and equivalent to approximately 4% of wild-type CFTR activity. The long-term survival of these animals should provide an excellent model with which to study cystic fibrosis, and they illustrate the value of mouse models carrying relevant mutations for examining genotype-phenotype correlations