General practitioners' perceptions of effective health care

Objectives: To explore general practitioners' perceptions of effective health care and its application in their own practice; to examine how these perceptions relate to assumptions about clinicians' values and behaviour implicit in the evidence based medicine approach. Design: A qualitative study using semistructured interviews. Setting: Eight general practices in North Thames region that were part of the Medical Research Council General Practice Research Framework. Participants: 24 general practitioners, three from each practice. Main outcome measures: Respondents' definitions of effective health care, reasons for not practising effectively according to their own criteria, sources of information used to answer clinical questions about patients, reasons for making changes in clinical practice. Results: Three categories of definitions emerged: clinical, patient related, and resource related. Patient factors were the main reason given for not practising effectively; others were lack of time, doctors' lack of knowledge and skills, lack of resources, and "human failings." Main sources of information used in situations of clinical uncertainty were general practitioner partners and hospital doctors. Contact with hospital doctors and observation of hospital practice were just as likely as information from medical and scientific literature to bring about changes in clinical practice. Conclusions: The findings suggest that the central assumptions of the evidence based medicine paradigm may not be shared by many general practitioners, making its application in general practice problematic. The promotion of effective care in general practice requires a broader vision and a more pragmatic approach which takes account of practitioners' concerns and is compatible with the complex nature of their work

Age group and gender differences in fears of aging

The purpose of this study is to investigate differences in fears of aging in two age groups (M=20 years and M=30 years) and gender differences in fears of aging. Two hundred twenty-two undergraduate (n=156) and graduate students (n=66) responded to three questionnaires, the Anxiety about Aging Scale (AAS), the Brief Life Satisfaction Scales (BLSS), and an open-ended questionnaire allowing participants to write in their five greatest personal fears of aging. The older age group had significantly higher Anxiety about Aging Psychological Concerns subscale scores. Males scored significantly higher than females in AAS total scores, and males also scored significantly higher than females in three AAS subscale scores, Psychological Concerns, Physical Appearance, and Fear of Losses. For the entire sample, the most common responses on the open-ended top five fears of personal aging questionnaire were health concerns first, followed by personal death, then physical appearance. There were no significant age group differences for any of the five fears of aging, but females rated their personal appearance fears of aging at a rate two to three times higher than males across all five fears of aging

The Academic Achievement Gap of Black American Students Vis-à-vis Whites and Asians

In response to the academic achievement gap of black American students� vis-�-vis whites and Asians, Paul C. Mocombe developed his Mocombeian Strategy and Reading Room Curriculum, which posit a comprehensive mentoring program of educated black professionals and the restructuring of the linguistic structure of black American inner-city students via phonetic and language arts instructions, as the solutions to resolving the gap. The two approaches are based on Mocombe�s hypothesis that the academic underachievement of black American students, vis-�-vis their white and Asian counterparts, on standardized tests is grounded in what he refers to as �a mismatch of linguistic structure and social class function.� This work explores the theoretical, practical, and pedagogical relationships between Mocombe�s �mismatch of linguistic structure and social class function hypothesis,� The Mocombeian Strategy, and Reading Room Curriculum (published as Mocombe�s Reading Room Series)

Constraint algebra in loop quantum gravity reloaded. II. Toy model of an Abelian gauge theory: Spatial diffeomorphisms

In [1] we initiated an approach towards quantizing the Hamiltonian constraint in Loop Quantum Gravity (LQG) by requiring that it generates an anomaly-free representation of constraint algebra off-shell. We investigated this issue in the case of a toy model of a 2+1-dimensional $U(1)^{3}$ gauge theory, which can be thought of as a weak coupling limit of Euclidean three dimensional gravity. However in [1] we only focused on the most non-trivial part of the constraint algebra that involves commutator of two Hamiltonian constraints. In this paper we continue with our analysis and obtain a representation of full constraint algebra in loop quantized framework. We show that there is a representation of the Diffeomorphism group with respect to which the Hamiltonian constraint quantized in [1] is diffeomorphism covariant. Our work can be thought of as a potential first step towards resolving some long standing issues with the Hamiltonian constraint in canonical LQG

Propfan test assessment testbed aircraft stability and control/performance 1/9-scale wind tunnel tests

One-ninth scale wind tunnel model tests of the Propfan Test Assessment (PTA) aircraft were performed in three different NASA facilities. Wing and propfan nacelle static pressures, model forces and moments, and flow field at the propfan plane were measured in these tests. Tests started in June 1985 and were completed in January 1987. These data were needed to assure PTA safety of flight, predict PTA performance, and validate analytical codes that will be used to predict flow fields in which the propfan will operate

Cartographic Modeling: Computer-assisted Analysis of Spatially Defined Neighborhoods

Cartographic models addressing a wide variety of applications are composed of fundamental map processing operations. These primitive operations are neither data base nor application-specific. By organizing the set of operations into a mathematical-like structure, the basis for a generalized cartographic modeling framework can be developed. Among the major classes of primitive operations are those associated with reclassifying map categories, overlaying maps, determining distance and connectivity, and characterizing cartographic neighborhoods. The conceptual framework of cartographic modeling is established and techniques for characterizing neighborhoods are used as a means of demonstrating some of the more sophisticated procedures of computer-assisted map analysis. A cartographic model for assessing effective roundwood supply is briefly described as an example of a computer analysis. Most of the techniques described have been implemented as part of the map analysis package developed at the Yale School of Forestry and Environmental Studies

Black Emasculated Patriarchy

This article posits that the shift from industrial capitalism to postindustrial capitalism in the West has led to what Mocombe deems emasculated and feminine patriarchy, the assumption of patriarchal norms by the state, its ideological apparatuses, queers, and women (given the feminization and queerification of the postindustrial workplace) from individual men whose masculinity is no longer associated with being producer and provider as it was under industrial capitalism; instead, they have been interpellated and embourgeoised, like their female counterparts, to define their masculinity as sensitive entrepreneurs, consumers, and or service workers. Black men in this social structure are, paradoxically, emasculated and hyper-masculinized. The former, given their poverty and under-education in the postindustrial social structure they are unable to assume the service-worker, consumer, and entrepreneur emasculated identity required to recursively organize and reproduce their being-in-the-world; the latter, the entertainment industry and athletic domain have become the spheres they are relegated to where their hyper-masculinity is overemphasized as means to the emasculated identity