A pragmatic cluster randomized controlled trial of an educational intervention for GPs in the assessment and management of depression

Background. General practitioners (GPs) can be provided with effective training in the skills to manage depression. However, it remains uncertain whether such training achieves health gain for their patients. Method. The study aimed to measure the health gain from training GPs in skills for the assessment and management of depression. The study design was a cluster randomized controlled trial. GP participants were assessed for recognition of psychological disorders, attitudes to depression, prescribing patterns and experience of psychiatry and communication skills training. They were then randomized to receive training at baseline or the end of the study. Patients selected by GPs were assessed at baseline, 3 and 12 months. The primary outcome was depression status, measured by HAM-D. Secondary outcomes were psychiatric symptoms (GHQ-12) quality of life (SF-36), satisfaction with consultations, and health service use and costs. Results. Thirty-eight GPs were recruited and 36 (95%) completed the study. They selected 318 patients, of whom 189 (59%) were successfully recruited. At 3 months there were no significant differences between intervention and control patients on HAM-D, GHQ-12 or SF-36. At 12 months there was a positive training effect in two domains of the SF-36, but no differences in HAM-D, GHQ-12 or health care costs. Patients reported trained GPs as somewhat better at listening and understanding but not in the other aspects of satisfaction. Conclusions. Although training programmes may improve GPs' skills in managing depression, this does not appear to translate into health gain for depressed patients or the health service

Low-speed aerodynamic characteristics of a 0.08-scale YF-17 airplane model at high angles of attack and sideslip

Data were obtained with and without the nose boom and with several strake configurations; also, data were obtained for various control surface deflections. Analysis of the results revealed that selected strake configurations adequately provided low Reynolds number simulation of the high Reynolds number characteristics. The addition of the boom in general tended to reduce the Reynolds number effects

Variations in the spatial distribution of 11 Micron radiation from omicron Ceti

The spatial distribution of 11 micron radiation from omicron Ceti was observed at various phases of its light cycle using a stellar interferometer. Changes were seen which can be attributed to variation in the strength of thermal emission from circumstellar dust relative to the stellar continuum at 11 microns. These changes are shown to be correlated with the changes in luminosity of micron Ceti in such a way that dust grain emission at 11 microns was increased more than the continuum during the period of maximum luminosity. The degree of the change in dust grain emission implies that the maximum dust temperature is in the range of 500 K to 700 K during minimum stellar luminosity

Impacts of a professional practice doctorate: a collaborative enquiry

Doctoral education aims to benefit those who undertake it, but does it exert a wider influence? Professional doctorates are commonly designed to have an impact beyond the individual concerned, but is this influence realised? This paper focuses on a collaborative enquiry by a group of academics and doctoral alumni from non-discipline-specific professional doctorates. The enquiry examined how the professional practice of the graduates changed as a result of their studies and what influence this had on their work and their profession. It found that there was considerable impact on the wider context of the alumni, but that these effects were due more to the capacity-building effect of the doctorate than on the particular outcomes of the study undertaken. Key words: doctoral education, research impact, collaborative enquiry, professional practic

A phenomenological study of occupational engagement in recovery from mental illness

This study aimed to uncover the meaning of occupation for 13 people who self identified as being in recovery from mental illness. Recovery narratives were collected from the participants in a series of open ended conversational interviews that were recorded and transcribed. The interview transcripts were analysed using phenomenological and hermeneutic approaches, with a focus on participants’ descriptions of engagement in everyday occupations. A range of experiences were evident, from complete disengagement to complete absorption in occupations. Participants described significant shifts in their experience of time, space, body and other people while in different modes of occupation and these were captured under the themes of ‘non-doing’, ‘half-doing’, ‘engaged doing’ and ‘absorbed doing’. Each mode had the potential to support recovery by creating opportunities for participants to reconnect with aspects of their being-in-the-world. The findings highlight the dynamics at play in different modes of occupation and suggest that all forms of engagement, including disengagement, can be significant in the recovery process. A greater understanding of the dynamics of occupation for people experiencing mental illness will enable carers and mental health services to more effectively support people in their recovery

Visualising gas heating from an RF plasma loudspeaker

In an electro-acoustic transduction mechanism, an ac modulation (here in the audio frequency range) of the electric field in an atmospheric pressure air plasma gives rise to a rapid increase in the gas temperature and dimensions of the gas volume. As in natural lightning, the rapid expansion in the ionised column though the air produces external pressure variations at the modulation frequency.  \ud Spatial and temporal measurement of the gas temperature can identify the nature of the thermal expansion and provide a direct approach to understanding its relationship to the sound pressure wave that is generated. However, the established method through spectroscopic measurement of rotational line emission from nitrogen molecules is limited to the main current channel where relaxation and subsequent optical emission of the excited nitrogen molecules occurs. The wider picture is revealed through the use of the Schlieren method where the refractive index gradients caused by gas heating in the plasma are imaged

Model of the W3(OH) environment based on data for both maser and 'quasi-thermal' methanol lines

In studies of the environment of massive young stellar objects, recent progress in both observations and theory allows a unified treatment of data for maser and 'quasi-thermal' lines. Interferometric maser images provide information on the distribution and kinematics of masing gas on small spatial scales. Observations of multiple masing transitions provide constraints on the physical parameters. Interferometric data on 'quasi-thermal' molecular lines permits an investigation of the overall distribution and kinematics of the molecular gas in the vicinity of young stellar objects, including those which are deeply embedded. Using multiple transitions of different molecules, one can obtain good constraints on the physical and chemical parameters. Combining these data enables the construction of unified models, which take into account spatial scales differing by orders of magnitude. Here we present such a combined analysis of the environment around the ultracompact HII region in W3(OH). This includes the structure of the methanol masing region, physical structure of the near vicinity of W3(OH), detection of new masers in the large-scale shock front and embedded sources in the vicinity of the TW young stellar object.Comment: To appear in the Proceedings of the 2004 European Workshop: "Dense Molecular Gas around Protostars and in Galactic Nuclei", Eds. Y.Hagiwara, W.A.Baan, H.J. van Langevelde, 2004, a special issue of ApSS, Kluwe

Spatial heterodyne interferometry of VY Canis Major's, alpha Orionis, alpha Scorpii, and R leonis at 11 microns

Using the technique of heterodyne interferometry, measurements were made of the spatial distribution of 11 micron radiation from four late type stars. The circumstellar shells surrounding VY Canis Majoris, alpha Orionis, and alpha Scorpii were resolved, whereas that of R Leonis was only partially resolved at a fringe spacing of 0.4 sec

The brightness distribution of IRC +10216 at 11 microns

The brightness distribution of IRC +10216 at a wavelength of 11 microns was measured in detail using a spatial interferometer. This brightness distribution appears to have azimuthal symmetry; an upper limit of 1.1 may be set to the ellipticity at 11 microns if the object has a major axis oriented either along or perpendicular to the major axis of the optical image. The radial distribution shows both compact and extended emission. The extended component, which is due to thermal emission from circumstellar dust, contributes 91% of the total flux and has a 1/e diameter of 0.90 minutes. The tapered shape of this component is consistent with a l/r squared dust density dependence. The compact component is unresolved (less than 0.2 minutes in diameter) and represents emission from the central star seen through the circumstellar envelope