General Practitioners' perceptions of the route to evidence-based medicine: a questionnaire survey

Objectives: To determine the attitude of general practitioners towards evidence based medicine and their related educational needs. Design: A questionnaire study of general practitioners. Setting: General practice in the former Wessex region, England. Subjects: Randomly selected sample of 25% of all general practitioners (452), of whom 302 replied. Main outcome measures: Respondents' attitude towards evidence based medicine, ability to access and interpret evidence, perceived barriers to practising evidence based medicine, and best method of moving from opinion based to evidence based medicine. Results: Respondents mainly welcomed evidence based medicine and agreed that its practice improves patient care. They had a low level of awareness of extracting journals, review publications, and databases (only 40% knew of the Cochrane Database of Systematic Reviews), and, even if aware, many did not use them. In their surgeries 20% had access to bibliographic databases and 17% to the world wide web. Most had some understanding of the technical terms used. The major perceived barrier to practising evidence based medicine was lack of personal time. Respondents thought the most appropriate way to move towards evidence based general practice was by using evidence based guidelines or proposals developed by colleagues. Conclusion: Promoting and improving access to summaries of evidence, rather than teaching all general practitioners literature searching and critical appraisal, would be the more appropriate method of encouraging evidence based general practice. General practitioners who are skilled in accessing and interpreting evidence should be encouraged to develop local evidence based guidelines and advice

The Effects Of A Weight Training Program For College Women

Most teen age girls resort to excuses to avoid participating in physical education or sports. Some excuses commonly heard are: Illness, can\u27t shower, Mother forbids them to participate, didn\u27t have time to wash their uniform, forgot to bring their uniform with them. They seem to want to remain dainty at all times probably feeling that this is necessary to make a favorable impression on the opposite sex. They fail to realize the value of exercise. According to Kraus and Hirschland too little attention has been paid to the fact that the dropping of muscular fitness below a certain minimum, actually jeopardize well being and health. There are many ways to develop muscular strength. A well-organized weight training program is one method quite frequently used. Although this type of exercise program is usually distained especially for women, the following quotation gives one opinion of women participating in a weight training program

Gravity darkening and brightening in binaries

We apply a von Zeipel gravity darkening model to corotating binaries to obtain a simple, analytical expression for the emergent radiative flux from a tidally distorted primary orbiting a point-mass secondary. We adopt a simple Roche model to determine the envelope structure of the primary, assumed massive and centrally condensed, and use the results to calculate the flux. As for single rotating stars, gravity darkening reduces the flux along the stellar equator of the primary, but, unlike for rotating stars, we find that gravity brightening enhances the flux in a region around the stellar poles. We identify a critical limiting separation beyond which hydrostatic equilibrium no longer is possible, whereby the flux vanishes at the point on the stellar equator of the primary facing the companion. For equal-mass binaries, the total luminosity is reduced by about 13 % when this limiting separation is reached.Comment: 7 pages, 5 figures, matches version published in Astrophysical Journa

The strength and timing of the mitochondrial bottleneck in salmon suggests a conserved mechanism in vertebrates

In most species mitochondrial DNA (mtDNA) is inherited maternally in an apparently clonal fashion, although how this is achieved remains uncertain. Population genetic studies show not only that individuals can harbor more than one type of mtDNA (heteroplasmy) but that heteroplasmy is common and widespread across a diversity of taxa. Females harboring a mixture of mtDNAs may transmit varying proportions of each mtDNA type (haplotype) to their offspring. However, mtDNA variants are also observed to segregate rapidly between generations despite the high mtDNA copy number in the oocyte, which suggests a genetic bottleneck acts during mtDNA transmission. Understanding the size and timing of this bottleneck is important for interpreting population genetic relationships and for predicting the inheritance of mtDNA based disease, but despite its importance the underlying mechanisms remain unclear. Empirical studies, restricted to mice, have shown that the mtDNA bottleneck could act either at embryogenesis, oogenesis or both. To investigate whether the size and timing of the mitochondrial bottleneck is conserved between distant vertebrates, we measured the genetic variance in mtDNA heteroplasmy at three developmental stages (female, ova and fry) in chinook salmon and applied a new mathematical model to estimate the number of segregating units (N(e)) of the mitochondrial bottleneck between each stage. Using these data we estimate values for mtDNA Ne of 88.3 for oogenesis, and 80.3 for embryogenesis. Our results confirm the presence of a mitochondrial bottleneck in fish, and show that segregation of mtDNA variation is effectively complete by the end of oogenesis. Considering the extensive differences in reproductive physiology between fish and mammals, our results suggest the mechanism underlying the mtDNA bottleneck is conserved in these distant vertebrates both in terms of it magnitude and timing. This finding may lead to improvements in our understanding of mitochondrial disorders and population interpretations using mtDNA data

Psychometric properties of the Mental Health Recovery Star.

BACKGROUND: The Mental Health Recovery Star (MHRS) is a popular outcome measure rated collaboratively by staff and service users, but its psychometric properties are unknown. AIMS: To assess the MHRS's acceptability, reliability and convergent validity. METHOD: A total of 172 services users and 120 staff from in-patient and community services participated. Interrater reliability of staff-only ratings and test-retest reliability of staff-only and collaborative ratings were assessed using intraclass correlation coefficients (ICCs). Convergent validity between MHRS ratings and standardised measures of social functioning and recovery was assessed using Pearson correlation. The influence of collaboration on ratings was assessed using descriptive statistics and ICCs. RESULTS: The MHRS was relatively quick and easy to use and had good test-retest reliability, but interrater reliability was inadequate. Collaborative ratings were slightly higher than staff-only ratings. Convergent validity suggests it assesses social function more than recovery. CONCLUSIONS: The MHRS cannot be recommended as a routine clinical outcome tool but may facilitate collaborative care planning

Errors in certain essentials of English form and usage in grades seven, eight, and nine

Thesis (M.A.)--Boston University, 1936. This item was digitized by the Internet Archive

Tissue, cell type and stage-specific ectopic gene expression and RNAi induction in the Drosophila testis

The Drosophila testis has numerous advantages for the study of basic cellular processes, as production of sperm requires a highly orchestrated and complex combination of morphological changes and developmentally regulated transitions. Experimental genetics using Drosophila melanogaster has advanced dramatically with the advent of systems for ectopic expression of genetic elements in specific cells. However the genetic tools used in Drosophila research have rarely been generated with the testes in mind, and the utility of relatively few systems has been documented for this tissue. Here I will summarize ectopic expression systems that are known to work for the testis, and provide advice for selection of the most appropriate expression system in specific experimental situations

Isotopic constraints on the sources and associations of organic compounds in marine sediments

Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at the Massachusetts Institute of Technology and the Woods Hole Oceanographic Institution February 2006To provide a new perspective on the fate of both natural organic matter and hydrophobic organic contaminants (HOCs) in marine sediments, we have investigated the relationship between radiocarbon (14C) age and the different modes of association in aquatic sediments and soils. Radiocarbon is a sensitive tracer of OM provenance, with variations in its natural abundance reflecting the age and origin of material. The main objective has been to determine the significance of these associations, and to assess how they affect the transport, bioavailability, preservation and residence times of organic compounds in the environment. Our results indicate that the majority of HOCs that persist in marine sediments are solvent-extractable and incorporation into insoluble sediment residues is not quantitatively significant. For pristine sediments, systematic variations in 14C content are observed between different chemically defined sedimentary organic fractions. These variations are dependent on organic matter inputs and/or the affects of diagenesis. Our observations also provide evidence for the protection of labile marine carbon by chemical binding. Finally, the persistence of n-alkanes from biogenic sources compared to those derived from petroleum indicates that protective matrix association can play a crucial role in determining the long-term fate of a compound. Overall, it is clear that both natural organic compounds and HOCs can undergo very different fates depending on their mode of introduction to, and physical disposition in environmental matrices.Funding for this research was provided by the National Science Foundation, CHE-0089172 to T.I. Eglinton and C.M. Reddy, and OCE-82567700 to T.I. Eglinton. I received support from a Charles Davis Hollister Fellowship from Woods Hole Oceanographic Institution

Understanding patients’ experiences of hayfever and its treatment: a survey of illness and medication cognitions

Background: Although effective medication for hayfever (seasonal allergic rhinitis) is available, treatment outcomes are often be poor. Patient beliefs influence outcomes in many other diseases. Assessing patients’ beliefs about their illness and medication may identify targets for intervention to optimize self management and lessen disease impact. Objective: The application of validated health-related analytical models (Leventhal’s illness representations and Horne’s beliefs about medications) to explore patients’ understanding and experience of hayfever and its treatment. Methods: Cross-sectional postal questionnaire sent to 20% sample of adults attending four General Practices in South England and prescribed medication for hayfever symptoms in the previous two years. Measures included the Revised Illness Perception Questionnaire and the Beliefs about Medicines Questionnaire. Results: 316/586 questionnaires were returned (54%). Cluster analysis identified two patient groups; those with negative beliefs (n=132) and those with more positive beliefs about hayfever and its treatment (n=182). Those with negative beliefs were more likely to believe that their hayfever would last for a long time, that they have little personal control over their illness and that their treatment is not effective. Conversely, they reported greater consequences, greater emotional impact, less understanding of hayfever and more medication concerns than those with more positive beliefs. Conclusions and clinical relevance: Patients with hayfever fall into two distinct groups: nearly half (41% of those sampled) have negative beliefs about their condition. Eliciting patient beliefs during the consultation may reveal assumptions that differ from those of healthcare professionals. Such beliefs should be considered when negotiating treatment plans

(The) relation of an understanding of the situation involved in a problem and success in its solution ..

Typewritten sheets in cover. Thesis (M.A.)--Boston University Bibliography: p. 180-181