Undergraduate research in primary care: Is it sustainable?

To describe the research project component of the BSc in Primary Health Care and to discuss the issues faced by students and faculty in attempting to complete a student-led research project. Medical schools increasingly expect medical students to undertake research as part of intercalated BSc’s or in self-selected study modules. This research has historically been laboratory based, ‘piggybacking’ onto existing projects. Projects initiated by students themselves and studies in primary care or community settings are more unusual. A qualitative study, based on interviews with students and examiners, triangulated with data from the peer review process and personal observations on the running of the course. A London medical school, running an intercalated BSc in Primary Health Care. We interviewed 24 of 26 students and two external examiners during the interview period of the study. Students successfully undertook research, from initial question through to publication. Overall, 90 dissertations were completed since 1997, of which half used a qualitative methodology (45/90). Ten projects have subsequently been published; there were also 16 conference presentations and 6 research letters. Themes from the interview data include: the students’ strong sense of project ownership, the difficulties of being a novice researcher, the difficulties posed by the research governance hurdles, the beneficial and for some students adverse impact (stress and coping with unsuccessful projects) and finally, the impact on their careers. Students gain considerably from this learning process, not only by undertaking their own research, but they also gain in terms of acquisition of transferable skills such as critical appraisal and improved self-directedness. Project completion and publication rates suggest that programmes developing undergraduate initiated research projects can be as successful as those for other novice researchers. The student-led project is a fragile endeavour, but currently is sustainable. © 2008, Cambridge University Press. All rights reserved

Smoluchowski's equation for cluster exogenous growth

We introduce an extended Smoluchowski equation describing coagulation processes for which clusters of mass s grow between collisions with $ds/dt=As^\beta$. A physical example, dropwise condensation is provided, and its collision kernel K is derived. In the general case, the gelation criterion is determined. Exact solutions are found and scaling solutions are investigated. Finally we show how these results apply to nucleation of discs on a planeComment: Revtex, 4 pages (multicol.sty), 1 eps figures (uses epsfig

Is it really possible to grow isotropic on-lattice diffusion-limited aggregates?

In a recent paper (Bogoyavlenskiy V A 2002 \JPA \textbf{35} 2533), an algorithm aiming to generate isotropic clusters of the on-lattice diffusion-limited aggregation (DLA) model was proposed. The procedure consists of aggregation probabilities proportional to the squared number of occupied sites ($k^2$). In the present work, we analyzed this algorithm using the noise reduced version of the DLA model and large scale simulations. In the noiseless limit, instead of isotropic patterns, a $45^\circ$ ($30^\circ$) rotation in the anisotropy directions of the clusters grown on square (triangular) lattices was observed. A generalized algorithm, in which the aggregation probability is proportional to $k^\nu$, was proposed. The exponent $\nu$ has a nonuniversal critical value $\nu_c$, for which the patterns generated in the noiseless limit exhibit the original (axial) anisotropy for $\nu<\nu_c$ and the rotated one (diagonal) for $\nu>\nu_c$. The values $\nu_c = 1.395\pm0.005$ and $\nu_c = 0.82\pm 0.01$ were found for square and triangular lattices, respectively. Moreover, large scale simulations show that there are a nontrivial relation between noise reduction and anisotropy direction. The case $\nu=2$ (\bogo's rule) is an example where the patterns exhibit the axial anisotropy for small and the diagonal one for large noise reduction.Comment: 12 pages, 8 figure

Views and attitudes towards blood donation: a qualitative investigation of Indian non-donors living in England

OBJECTIVE: To explore the views and attitudes of Indians living in England on blood donation. BACKGROUND: In light of the predicted shortages in blood supply, it is vital to consider ways in which to maximise donation rates. These include addressing the issue of lower donation rates among ethnic minorities, including Indians. However research specifically among minority ethnicities in UK is sparse. SETTING: General practice in North London. PARTICIPANTS: A convenience sample of 12 non-donor Indians living in England. METHODS: This is a qualitative investigation involving semistructured interviews. Themes derived were analysed using thematic framework analysis. RESULTS: Five key themes emerged from the data, and these concerned participants’ perspectives regarding attitudes towards blood, blood donation as a ‘good thing’, donation disincentives, the recipient matters and the donor matters. CONCLUSION: A variety of attitudes were presented, but were generally positive, and blood was conceptualised in a manner previously found to be consistent with donation. However, lack of awareness and accessibility were prominent barriers, indicating the need for improvement in these capacities. In contrast to this, blood was also greatly associated with family and acted as a symbol of kinship: this ‘emotional charge’ often acted to dissuade participants from separating with their blood through donation. Possibly due to this, there was also a strong preference for donated blood to be distributed within the family, as opposed to strangers. This presents a potential barrier to blood donation for some Indians within the current system in which donations are given to unknown recipients

Multifractal Dimensions for Branched Growth

A recently proposed theory for diffusion-limited aggregation (DLA), which models this system as a random branched growth process, is reviewed. Like DLA, this process is stochastic, and ensemble averaging is needed in order to define multifractal dimensions. In an earlier work [T. C. Halsey and M. Leibig, Phys. Rev. A46, 7793 (1992)], annealed average dimensions were computed for this model. In this paper, we compute the quenched average dimensions, which are expected to apply to typical members of the ensemble. We develop a perturbative expansion for the average of the logarithm of the multifractal partition function; the leading and sub-leading divergent terms in this expansion are then resummed to all orders. The result is that in the limit where the number of particles n -> \infty, the quenched and annealed dimensions are {\it identical}; however, the attainment of this limit requires enormous values of n. At smaller, more realistic values of n, the apparent quenched dimensions differ from the annealed dimensions. We interpret these results to mean that while multifractality as an ensemble property of random branched growth (and hence of DLA) is quite robust, it subtly fails for typical members of the ensemble.Comment: 82 pages, 24 included figures in 16 files, 1 included tabl

Modeling the effect of variation in sagittal curvature on the force required to produce a follower load in the lumbar spine

Peer reviewedPreprin

The lumbar spine has an intrinsic shape specific to each individual that remains a characteristic throughout flexion and extension

Peer reviewedPostprin

Beliefs about hypertension among Nigerian immigrants to the United Kingdom: A qualitative study

OBJECTIVE: The aim of the study was to elicit beliefs about hypertension among Nigerian immigrants in the United Kingdom. BACKGROUND: The distributions of cardiovascular risk factors and diseases are not shared equally across ethnic and economic groups in the United Kingdom. Its burden is more clustered among minority ethnic populations and migrant groups including black African Nigerian migrants. Similar patterns have been reported across Europe, Australia, Canada, Nordic countries and the United States of America. There are about 300 distinct ethnic groups in Nigeria and reliable information about their beliefs about hypertension is not available. Given that the United Kingdom has a large community of Nigerian immigrants from these different ethno-cultural backgrounds, understanding their unique beliefs about hypertension may help promote appropriate care for this population in the United Kingdom and Nigeria. SETTING: A single Pentecostal church community in West London PARTICIPANTS: Twenty-seven Nigerian migrant members of the church entered and completed the study METHODS AND OUTCOME MEASURE: A qualitative interview study was conducted. The interviews were analysed using thematic framework analysis. The outcome measures were emerging themes from the thematic framework analysis. RESULTS: Participants expressed beliefs in four major areas related to hypertension: (1) The Meaning of the term hypertension, (2) Perceptions of causation, (3) Effects of hypertension, and (4) Perceptions of treatment. The study revealed a diversity of beliefs about hypertension which incorporated both orthodox and culturally framed ideas. CONCLUSIONS: This study identified important beliefs among Nigerian migrants about hypertension that can contribute to our understanding of the management of hypertension in this group and suggests the need for further research to determine whether these beliefs may be representative of this group

Exploring senior doctors' beliefs and attitudes regarding mental illness within the medical profession: a qualitative study

OBJECTIVE: To explore the views of senior doctors on mental illness within the medical profession. BACKGROUND: There has been increasing interest on the issue of doctors' mental health. However, there have been few qualitative studies on senior doctors' general attitude towards mental illness within the medical profession. SETTING: Large North London teaching hospital. PARTICIPANTS: 13 hospital consultants and senior academic general practitioners. METHODS: A qualitative study involving semi-structured interviews and reflective work. The outcome measures were the themes derived from the thematic framework approach to analysis. RESULTS: Four main themes were identified. (1) 'Doctors' attitudes to mental illness'—doctors felt that there remained a significant stigma attached to suffering from a mental illness within the profession. (2) ‘Barriers to seeking help’—doctors felt that there were numerous barriers to seeking help such as negative career implications, being perceived as weak, denial and fear of prejudice. (3) ‘Support’—doctors felt that the use of support depended on certainty concerning confidentiality, which for occupational health was not thought to be guaranteed. Confiding in colleagues was rare except among close friends. Supervision for all doctors was raised. (4) ‘General Medical Council (GMC) involvement’—doctors felt that uneasy referring colleagues to the GMC and the appraisal and revalidation process was thought not to be thorough enough in picking up doctors with a mental illness. CONCLUSIONS: Owing to the small size of this study, the conclusions are limited; however, if the findings are confirmed by larger studies, they suggest that greater efforts are needed to destigmatise mental illness in the profession and improve support for doctors. Additional research should be carried out into doctors’ views on occupational health services in managing doctors with mental illness, the provision of supervision for all doctors and the effectiveness of the current appraisal and revalidation process at identifying doctors with a mental illness

Anisotropic Diffusion Limited Aggregation

Using stochastic conformal mappings we study the effects of anisotropic perturbations on diffusion limited aggregation (DLA) in two dimensions. The harmonic measure of the growth probability for DLA can be conformally mapped onto a constant measure on a unit circle. Here we map $m$ preferred directions for growth of angular width $\sigma$ to a distribution on the unit circle which is a periodic function with $m$ peaks in $[-\pi, \pi)$ such that the width $\sigma$ of each peak scales as $\sigma \sim 1/\sqrt{k}$, where $k$ defines the ``strength'' of anisotropy along any of the $m$ chosen directions. The two parameters $(m,k)$ map out a parameter space of perturbations that allows a continuous transition from DLA (for $m=0$ or $k=0$) to $m$ needle-like fingers as $k \to \infty$. We show that at fixed $m$ the effective fractal dimension of the clusters $D(m,k)$ obtained from mass-radius scaling decreases with increasing $k$ from $D_{DLA} \simeq 1.71$ to a value bounded from below by $D_{min} = 3/2$. Scaling arguments suggest a specific form for the dependence of the fractal dimension $D(m,k)$ on $k$ for large $k$, form which compares favorably with numerical results.Comment: 6 pages, 4 figures, submitted to Phys. Rev.