General practitioners’ perceptions of asynchronous telemedicine in a randomized controlled trial of teledermatology.

Background: Telemedicine is viewed as having a key role to play in the Government’s plans to modernise the NHS.1 However, to date there are few studies which have explored the views and acceptability of GPs towards telemedicine in primary care. Aim: To elicit the perceptions of GPs towards teledermatology (TD) before and after it’s introduction into their Practices and to observe whether GP views of TD had changed over the course of the study. Design of study: A postal questionnaire administered as part of a wider randomised controlled trial of telemedicine in dermatology. Setting: A locality group of eight General Practices in Sheffield and a single teaching hospital in Sheffield that provided the local dermatology referral service. Method: A postal questionnaire circulated to all GPs from the eight participating Practices. Results: A 85.7% (36/42) response rate was achieved. Only 21% (n=7; 95% CI: 10-37%) of respondents felt satisfied/very satisfied with TD in their Practice, 47% (n=16) said that they were dissatisfied or very dissatisfied. Thirty one per cent (n=10; 95% CI: 18-49%) said that they felt confident about diagnosis and management of care through TD, with 28% (n=9) reporting that they were unconfident. Only 23% (n=8; 95% CI: 12-39%) of respondents said that they would consider using a telemedicine system in the future, 34% (n=12) said they would probably or definitely not and 43% (n=15) were unsure. There was some evidence that GPs views about TD became more negative over the course of the study. Conclusions: The study reports less favourable GP responses to telemedicine than observed in previous studies, and suggests that the model of telemedicine described in this study paper would not be widely acceptable to GPs

Service of process in the United States under Insolvency Rule 12.12

Explains the procedure to be followed by a UK based liquidator wishing to serve insolvency proceedings on parties based in the US under the Insolvency Rules 1986 r.12.12. Discusses the rule's requirements for obtaining leave of the court for service outside the jurisdiction, the court's discretion to order the manner of service, including the approach of the Chancery Division in Re Busytoday Ltd, and the obligations imposed by the Hague Convention on the Service Abroad of Judicial and Extrajudicial Documents in Civil or Commercial Matters 1965. Evaluates the methods of service authorised by the Convention and details the main elements involved in service by the Central Authority route or by a local process server

The AF structure of non commutative toroidal Z/4Z orbifolds

For any irrational theta and rational number p/q such that q|qtheta-p|<1, a projection e of trace q|qtheta-p| is constructed in the the irrational rotation algebra A_theta that is invariant under the Fourier transform. (The latter is the order four automorphism U mapped to V, V mapped to U^{-1}, where U, V are the canonical unitaries generating A_theta.) Further, the projection e is approximately central, the cut down algebra eA_theta e contains a Fourier invariant q x q matrix algebra whose unit is e, and the cut downs eUe, eVe are approximately inside the matrix algebra. (In particular, there are Fourier invariant projections of trace k|qtheta-p| for k=1,...,q.) It is also shown that for all theta the crossed product A_theta rtimes Z_4 satisfies the Universal Coefficient Theorem. (Z_4 := Z/4Z.) As a consequence, using the Classification Theorem of G. Elliott and G. Gong for AH-algebras, a theorem of M. Rieffel, and by recent results of H. Lin, we show that A_theta rtimes Z_4 is an AF-algebra for all irrational theta in a dense G_delta.Comment: 35 page

Recent trends in the incidence of anxiety diagnoses and symptoms in primary care.

Anxiety is common, with significant morbidity, but little is known about presentations and recording of anxiety diagnoses and symptoms in primary care. This study aimed to determine trends in incidence and socio-demographic variation in General Practitioner (GP) recorded diagnoses of anxiety, mixed anxiety/depression, panic and anxiety symptoms

Immunoglobulin variable-region gene mutational lineage tree analysis: application to autoimmune diseases

Lineage trees have frequently been drawn to illustrate diversification, via somatic hypermutation (SHM), of immunoglobulin variable-region (IGV) genes. In order to extract more information from IGV sequences, we developed a novel mathematical method for analyzing the graphical properties of IgV gene lineage trees, allowing quantification of the differences between the dynamics of SHM and antigen-driven selection in different lymphoid tissues, species, and disease situations. Here, we investigated trees generated from published IGV sequence data from B cell clones participating in autoimmune responses in patients with Myasthenia Gravis (MG), Rheumatoid Arthritis (RA), and Sjögren's Syndrome (SS). At present, as no standards exist for cell sampling and sequence extraction methods, data obtained by different research groups from two studies of the same disease often vary considerably. Nevertheless, based on comparisons of data groups within individual studies, we show here that lineage trees from different individual patients are often similar and can be grouped together, as can trees from two different tissues in the same patient, and even from IgG- and IgA-expressing B cell clones. Additionally, lineage trees from most studies reflect the chronic character of autoimmune diseases

Domestic violence: Service providers\u27 perceptions of factors affecting women\u27s decision to leave abusive relationships

Review of research conducted into woman abuse indicates there was an emphasis on questions looking at why women stayed in abusive relationships. Little or no research was specifically designed to answer questions about how women leave abusive relationships or determine the salient factors involved. The literature review also highlighted the importance of services and service providers because women who had experienced abuse would seek help and Knight and Hatty (1992) found that the quality of help received determined their future responses. Kurz and Stark (1988) found that workers\u27 perceptions about woman abuse influenced how workers responded to the women seeking help. Hoff (1990) indicated that workers\u27 negative responses may cause their services to be inaccessible to women who have experienced abuse. A theory emphasising an individual\u27s subjective experiences and how these perceptions influence their actions is Kelly\u27s (1955) personal construct theory. The exploratory study was designed to elicit and examine the construct systems employed by service providers, within the domestic violence domain in the Perth metropolitan area, concerning factors affecting women\u27s decisions to leave abusive relationships. Twelve participants (1 male and 11 females), ages ranging from 25-50 years (mean age= 35 years), with 2 to 15 years (mean = 5.8 years) experience volunteered for the study. They completed repertory grids, using the triadic method and 5-point rating scale, consisting of eight supplied elements selected to be representative of abusive and non-abusive relationships. Analysis of the individual and group grids was performed by REPGRID 2 and SOCIO (Shaw, 1989) using principal components analysis. Results indicated that the participants\u27 perceptions of woman abuse focused on individual characteristics which may have negative consequences for their service delivery practices as found by Hoff (1990). An inference was drawn that the factors employment status (NiCarthy, 1987), education level (Gelles & Cornell, 1990) and the presence of physical violence (Knight & Hatty, 1992) are critical factors involved in a woman\u27s decision to leave and abusive relationship. Repertory grid technique was thought to be useful in the area of woman abuse and service providers found the technique of benefit

Semiconductor technology program: Progress briefs

Measurement technology for semiconductor materials, process control, and devices, is discussed. Silicon and silicon based devices are emphasized. Highlighted activities include semiinsulating GaAs characterization, an automatic scanning spectroscopic ellipsometer, linewidth measurement and coherence, bandgap narrowing effects in silicon, the evaluation of electrical linewidth uniformity, and arsenicomplanted profiles in silicon

What is a robot companion - friend, assistant or butler?

The study presented in this paper explored people's perceptions and attitudes towards the idea of a future robot companion for the home. A human-centred approach was adopted using questionnaires and human-robot interaction trials to derive data from 28 adults. Results indicated that a large proportion of participants were in favour of a robot companion and saw the potential role as being an assistant, machine or servant. Few wanted a robot companion to be a friend. Household tasks were preferred to child/animal care tasks. Humanlike communication was desirable for a robot companion, whereas humanlike behaviour and appearance were less essential. Results are discussed in relation to future research directions for the development of robot companions

Black Hole Entropy, Topological Entropy and the Baum-Connes Conjecture in K-Theory

We shall try to exhibit a relation between black hole entropy and topological entropy using the famous Baum-Connes conjecture for foliated manifolds which are particular examples of noncommutative spaces. Our argument is qualitative and it is based on the microscopic origin of the Beckenstein-Hawking area-entropy formula for black holes, provided by superstring theory, in the more general noncommutative geometric context of M-Theory following the Connes- Douglas-Schwarz article.Comment: 17 pages, Latex, contains an important paragraph in section 2 which gives a better understandin