Levels of State and Trait Anxiety in Patients Referred to Ophthalmology by Primary Care Clinicians: A Cross Sectional Study

Purpose There is a high level of over-referral from primary eye care leading to significant numbers of people without ocular pathology (false positives) being referred to secondary eye care. The present study used a psychometric instrument to determine whether there is a psychological burden on patients due to referral to secondary eye care, and used Rasch analysis to convert the data from an ordinal to an interval scale. Design Cross sectional study. Participants and Controls 322 participants and 80 control participants. Methods State (i.e. current) and trait (i.e. propensity to) anxiety were measured in a group of patients referred to a hospital eye department in the UK and in a control group who have had a sight test but were not referred. Response category analysis plus infit and outfit Rasch statistics and person separation indices were used to determine the usefulness of individual items and the response categories. Principal components analysis was used to determine dimensionality. Main Outcome Measure Levels of state and trait anxiety measured using the State-Trait Anxiety Inventory. Results State anxiety scores were significantly higher in the patients referred to secondary eye care than the controls (p0.1). Rasch analysis highlighted that the questionnaire results needed to be split into “anxiety-absent” and “anxiety-present” items for both state and trait anxiety, but both subscales showed the same profile of results between patients and controls. Conclusions State anxiety was shown to be higher in patients referred to secondary eye care than the controls, and at similar levels to people with moderate to high perceived susceptibility to breast cancer. This suggests that referral from primary to secondary eye care can result in a significant psychological burden on some patients

The duo “pascaline and e-pascaline”: an example of using material and digital artefacts at primary school.

International audienceThe paper presents the design and the analysis of teaching experiments at primary school concerning the introduction and use of a “duo of artefacts”, constituted by the pascaline i.e., the arithmetical machine Zero+1 and its digital version e-pascaline. The idea of ‘duo of artefacts’ represents the innovative component of this research work, because the e-pascaline is constructed in a complementary way with respect to the pascaline. The duo of artefacts is proposed to support student’s conceptualization processes of numbers as sign of a quantity, number sequences and recursive addition. Computation and manipulation of base ten notation are two processes that students often consider separately. This duo enables the design of situations that required those two processes to be connected and to consider their effect on each other. With duo of artefacts, technology allows the development of learning environments in which it is possible to study the articulation between material and virtual manipulatives for mathematical conceptualization

Fetuin-B, a second member of the fetuin family in mammals.

A set of orthologous plasma proteins found in human, sheep, pig, cow and rodents, now collectively designated fetuin-A, constitutes the fetuin family. Fetuin-A has been identified as a major protein during fetal life and is also involved in important functions such as inhibition of the insulin receptor tyrosine kinase activity, protease inhibitory activities and development-associated regulation of calcium metabolism and osteogenesis. Furthermore, fetuin-A is a key partner in the recovery phase of an acute inflammatory response. We now describe a second protein of the fetuin family, called fetuin-B, which is found at least in human and rodents. On grounds of domain homology, overall conservation of cysteine residues and chromosomal assignments of the corresponding genes in these species, fetuin-B is unambiguously a paralogue of fetuin-A. Yet, fetuin-A and fetuin-B exhibit significant differences at the amino acid sequence level, notably including variations with respect to the archetypal fetuin-specific signature. Differences and similarities in terms of gene regulation were also observed. Indeed, studies performed during development in rat and mouse showed for the first time high expression of a member of the fetuin family in adulthood, as shown with the fetuin-B mRNA in rat. However, like its fetuin-A counterpart, the fetuin-B mRNA level is down-regulated during the acute phase of experimentally induced inflammation in rat

Annalen der Physik ; t. XLII, nos 14, 15 et 16 ; 1913

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The drivers of tree cover expansion: Global, temperate, and tropical zone analyses

This paper uses new, high resolution satellite-derived data to explore recent cross-national differences in expanding tree cover. Increases in tree cover have concentrated in nations with recent histories of extensive deforestation, humid climates, high crop yields, and small numbers of farm workers. The associations of expanded tree cover with high yields for cereal crops and small populations of cultivators suggests a dynamic, sometimes referred to as a forest transition, in which urbanization and industrialization promote a long-term expansion in tree cover on certain types of land. The association of tree cover gains with tree cover losses and humid climates suggests a second dynamic, a churning, treadmill-like production of wood products from lands subjected to recurring harvests of wood products followed by tree cover gains in the recently harvested areas. The forest transition dynamic suggests that many smallholders would allow tree cover to expand on their lands if payments for environmental services were available. The salience of the treadmill dynamic of tree cover losses followed by tree cover gains underscores the importance of questions about the implications of commercial tree monocultures for biodiversity, carbon sequestration, and social justice. © 2016 Elsevier Lt