General practitioners' opinions on how to improve treatment of mental disorders in primary health care. Interviews with one hundred Norwegian general practitioners

<p>Abstract</p> <p>Background</p> <p>Improvements in treatment of mental disorders are repeatedly called for. General practitioners (GPs) are responsible for the majority of treatment of mental disorders. Consequently, we interviewed GPs about their opinions on how treatment of mental disorders in primary health care contexts could be improved.</p> <p>Methods</p> <p>Among GPs affiliated within the Norwegian reimbursement system, we approached 353, and made contact with 246 GP's. One-hundred of these agreed to participate in our study, and 95 of them expressed opinions on how to improve treatment of mental disorders. The telephone interviews were based on open-ended questions, responses were transcribed continuously, and content analysis was applied. Results are presented both as frequency tables of common responses, and as qualitative descriptions and quotations of opinions.</p> <p>Results</p> <p>Nearly all (95%) of the GPs had suggestions on how to improve treatment of mental disorders in primary health care. Increased capacity in secondary health care was suggested by 59% of GPs. Suggestions of improved collaboration with secondary health care were also common (57%), as were improvements of GPs' skills and knowledge relevant for diagnosing and treating mental disorders (40%) and more time for patients with mental disorders in GP contexts (40%).</p> <p>Conclusions</p> <p>The GPs' suggestions are in line with international research and debate. It is thought-provoking that the majority of GPs call for increased capacity in secondary care, and also better collaboration with secondary care. Some GPs made comparisons to the health care system for physical disorders, which is described as better-functioning. Our study identified no simple short-term cost-effective interventions likely to improve treatment for mental disorders within primary health care. Under-treatment of mental disorders is, however, also associated with significant financial burdens.</p

Pilot optical alignment

PILOT (Polarized Instrument for Long wavelength Observations of the Tenuous interstellar medium) is a balloonborne astronomy experiment designed to study the polarization of dust emission in the diffuse interstellar medium in our Galaxy. The PILOT instrument allows observations at wavelengths 240 μm and 550 μm with an angular resolution of about two arcminutes. The observations performed during the two first flights performed from Timmins, Ontario Canada, and from Alice-springs, Australia, respectively in September 2015 and in April 2017 have demonstrated the good performances of the instrument. Pilot optics is composed of an off axis Gregorian type telescope combined with a refractive re-imager system. All optical elements, except the primary mirror, which is at ambient temperature, are inside a cryostat and cooled down to 3K. The whole optical system is aligned on ground at room temperature using dedicated means and procedures in order to keep the tight requirements on the focus position and ensure the instrument optical performances during the various phases of a flight. We’ll present the optical performances and the firsts results obtained during the two first flight campaigns. The talk describes the system analysis, the alignment methods, and finally the inflight performances

PILOT: optical performance and end-to-end characterisation

PILOT (Polarized Instrument for the Long-wavelength Observations of the Tenuous ISM), is a balloon-borne astronomy experiment dedicated to study the polarization of dust emission from the diffuse ISM in our Galaxy [1]. The observations of PILOT have two major scientific objectives. Firstly, they will allow us to constrain the large-scale geometry of the magnetic field in our Galaxy and to study in details the alignment properties of dust grains with respect to the magnetic field. In this domain, the measurements of PILOT will complement those of the Planck satellite at longer wavelengths. In particular, they will bring information at a better angular resolution, which is critical in crowded regions such as the Galactic plane. They will allow us to better understand how the magnetic field is shaping the ISM material on large scale in molecular clouds, and the role it plays in the gravitational collapse leading to star formation. Secondly, the PILOT observations will allow us to measure for the first time the polarized dust emission towards the most diffuse regions of the sky, where the measurements are the most easily interpreted in terms of the physics of dust. In this particular domain, PILOT will play a role for future CMB missions similar to that played by the Archeops experiment for Planck. The results of PILOT will allow us to gain knowledge about the magnetic properties of dust grains and about the structure of the magnetic field in the diffuse ISM that is necessary to a precise foreground subtraction in future polarized CMB measurements. The PILOT measurements, combined with those of Planck at longer wavelengths, will therefore allow us to further constrain the dust models. The outcome of such studies will likely impact the instrumental and technical choices for the future space missions dedicated to CMB polarization. The PILOT instrument will allow observations in two photometric channels at wavelengths 240 μm and 550 μm, with an angular resolution of a few arcminutes. We will make use of large format bolometer arrays, developed for the PACS instrument on board the Herschel satellite. With 1024 detectors per photometric channel and photometric band optimized for the measurement of dust emission, PILOT is likely to become the most sensitive experiment for this type of measurements. The PILOT experiment will take advantage of the large gain in sensitivity allowed by the use of large format, filled bolometer arrays at frequencies more favorable to the detection of dust emission. This paper presents the optical design, optical characterization and its performance. We begin with a presentation of the instrument and the optical system and then we summarise the main optical tests performed. In section III, we present preliminary end-to-end test results

PILOT: optical performance and end-to-end characterisation

PILOT (Polarized Instrument for the Long-wavelength Observations of the Tenuous ISM), is a balloon-borne astronomy experiment dedicated to study the polarization of dust emission from the diffuse ISM in our Galaxy [1]. The observations of PILOT have two major scientific objectives. Firstly, they will allow us to constrain the large-scale geometry of the magnetic field in our Galaxy and to study in details the alignment properties of dust grains with respect to the magnetic field. In this domain, the measurements of PILOT will complement those of the Planck satellite at longer wavelengths. In particular, they will bring information at a better angular resolution, which is critical in crowded regions such as the Galactic plane. They will allow us to better understand how the magnetic field is shaping the ISM material on large scale in molecular clouds, and the role it plays in the gravitational collapse leading to star formation. Secondly, the PILOT observations will allow us to measure for the first time the polarized dust emission towards the most diffuse regions of the sky, where the measurements are the most easily interpreted in terms of the physics of dust. In this particular domain, PILOT will play a role for future CMB missions similar to that played by the Archeops experiment for Planck. The results of PILOT will allow us to gain knowledge about the magnetic properties of dust grains and about the structure of the magnetic field in the diffuse ISM that is necessary to a precise foreground subtraction in future polarized CMB measurements. The PILOT measurements, combined with those of Planck at longer wavelengths, will therefore allow us to further constrain the dust models. The outcome of such studies will likely impact the instrumental and technical choices for the future space missions dedicated to CMB polarization. The PILOT instrument will allow observations in two photometric channels at wavelengths 240 μm and 550 μm, with an angular resolution of a few arcminutes. We will make use of large format bolometer arrays, developed for the PACS instrument on board the Herschel satellite. With 1024 detectors per photometric channel and photometric band optimized for the measurement of dust emission, PILOT is likely to become the most sensitive experiment for this type of measurements. The PILOT experiment will take advantage of the large gain in sensitivity allowed by the use of large format, filled bolometer arrays at frequencies more favorable to the detection of dust emission. This paper presents the optical design, optical characterization and its performance. We begin with a presentation of the instrument and the optical system and then we summarise the main optical tests performed. In section III, we present preliminary end-to-end test results

Pilot optical alignment

PILOT (Polarized Instrument for Long wavelength Observations of the Tenuous interstellar medium) is a balloonborne astronomy experiment designed to study the polarization of dust emission in the diffuse interstellar medium in our Galaxy. The PILOT instrument allows observations at wavelengths 240 μm (1.2THz) with an angular resolution about two arc-minutes. The observations performed during the first flight in September 2015 at Timmins, Ontario Canada, have demonstrated the optical performances of the instrument

Diversity management, moda manageriale e strumento organizzativo: i risultati dell'indagine dell'Osservatorio

I risultati dell'indagine annuale dell'Osservatorio organizzativo sul Diversity Management sullo stato dell’arte della gestione della diversità nelle aziende che partecipano alla survey

Il DM a supporto del benessere organizzativo: i risultati dell'indagine di benchmarking

Questo articolo di Chiara Paolino e Simonella Zenia si propone di illustrare i risultati della ricerca sulle prassi di Diversity Management, svolta dall'omonimo Osservatorio della SDA Bocconi

A Surface EMG analysis of sarcolemma excitability alteration and myofibre degeneration in Steinert disease

Objectives: To apply surface electromyography (EMG) using low and high stimulation frequencies, to establish the contribution of myotonia and/or dystrophy to muscle impairment in subjects affected by myotonic dystrophy (MyD). Methods: A motor point stimulation protocol, at 15 and 35 Hz, was carried out on the tibialis anterior (TA) of 25 MyD patients. These were subdivided into 3 subgroups, MyD3 (9), MyD4 (10) and MyD5 (6), on the basis of their TA MRC score. The surface myoelectric signal was recorded and the average rectified value of amplitude (ARV) was evaluated. In 4 MyD5 patients we simultaneously recorded EMG and force. Results: Each subgroup presented a characteristic ARV trend both at 15 and 35 Hz - increasing in MyD3 (like the controls), slightly decreasing in MyD4 and clearly decreasing in MyD5. The low frequency permitted a greater resolution of the statistical analysis. Two out of 4 patients showed an opposite trend of ARV with respect to the force, whereas the others presented a parallel decreasing trend. Conclusions: The analysis of the ARV during a stimulated contraction permits the identification and quantification of the sarcolemma excitability alteration and/or the myofibre degeneration contributing to muscle impairment in MyD. The lower frequency is more sensitive and offers better inter-experiment repeatability. © 2001 Published by Elsevier Science Ireland Ltd