The relationship between GPs and hospital consultants and the implications for patient care : a qualitative study

Acknowledgements Clinicians assisting development of topic guide, all based in NHS Highland; Mr Angus Cain (Consultant Ear, Nose & Throat), Professor Steve Leslie (Consultant Cardiologist), Professor Ronald Macvicar (Postgraduate Dean, North of Scotland Region of NHS Education for Scotland (NES)), Dr Jerry O’Rourke (General Practice Principal), Professor Ken Walker (Consultant Colorectal surgeon). Clinicians involved in pilot of the semi-structured questionnaire; Dr Beth Macfarlane (General Practice Principal), and Dr Russell Drummond (Consultant Endocrinologist). Gillian Heron, Cairn Medical Practice who transcribed interview recordings. Funding The research was funded by both the local NHS Highland Research & Development Committee, and the “RCGP Allen & Margaret Wilson Memorial Fund.” The Chief Investigator (Dr Rod Sampson) received no personal payment for the study. No drug company is involved in this research.Peer reviewedPublisher PD

Patients’ perspectives on the medical primary-secondary care interface : systematic review and synthesis of qualitative research

Funding NHS Highland Research, Development & Innovation Department, Aberdeen University, and Stirling University provided funds to meet publication costs.Peer reviewedPublisher PD

Improving the primary-secondary care interface in Scotland : a qualitative exploration of impact on clinicians of an educational complex intervention

This work was supported by NHS Highland Research & Development Committee [ref HIGHLAND 976]. The Chief Investigator (Dr Rod Sampson) received no personal payment for the study. No drug company was involved in this research. Group Facilitators Mr Angus Cain (Consultant Ear, Nose & Throat), Dr Sian Jones (General Practice Principal), Dr Jerry O’Rourke (General Practice Principal), Professor Ken Walker (Consultant Colorectal Surgeon), all based in NHS Highland. Gillian Heron, Cairn Medical Practice for transcription services.Peer reviewedPublisher PD

Changing Gear: Delivering the Social Dividend

In December 2001, the Institute of Policy Studies and Business New Zealand co-hosted a one day symposium entitled ‘Changing Gear: Delivering the Social Dividend’. It was addressed and attended by members of academia, the public sector and the business sector. This IPS Policy Paper brings together a number of the presentations to that symposium. It includes papers delivered by Arthur Grimes, Colin Campbell-Hunt and Ross Wilson, plus a summary of key points raised in the address by Glenn Withers, and some concluding remarks by Rod Oram

Online Workforce Development in Community Colleges Connection With Community, Institutional, and Governance Factors

This study examined community and institutional factors that influence offering online workforce development programs in community colleges. The study included a random sample of 321 community college in the United States. Findings conclude that colleges operating under statewide governance structures and in states with more highly centralized statewide practices have more online occupational programs than other types of institutions. In addition, student racial demographics factor into online course offerings. Institutions with higher percentages of White students are more likely to offer online occupational programs. These findings illustrate a potential need for additional online program development in colleges with larger percentages of students of color and raise questions about how states with decentralized systems can increase educational access by facilitating additional online workforce development programs

A 96-Channel FPGA-based Time-to-Digital Converter

We describe an FPGA-based, 96-channel, time-to-digital converter (TDC) intended for use with the Central Outer Tracker (COT) in the CDF Experiment at the Fermilab Tevatron. The COT system is digitized and read out by 315 TDC cards, each serving 96 wires of the chamber. The TDC is physically configured as a 9U VME card. The functionality is almost entirely programmed in firmware in two Altera Stratix FPGA's. The special capabilities of this device are the availability of 840 MHz LVDS inputs, multiple phase-locked clock modules, and abundant memory. The TDC system operates with an input resolution of 1.2 ns. Each input can accept up to 7 hits per collision. The time-to-digital conversion is done by first sampling each of the 96 inputs in 1.2-ns bins and filling a circular memory; the memory addresses of logical transitions (edges) in the input data are then translated into the time of arrival and width of the COT pulses. Memory pipelines with a depth of 5.5 $\mu$s allow deadtime-less operation in the first-level trigger. The TDC VME interface allows a 64-bit Chain Block Transfer of multiple boards in a crate with transfer-rates up to 47 Mbytes/sec. The TDC also contains a separately-programmed data path that produces prompt trigger data every Tevatron crossing. The full TDC design and multi-card test results are described. The physical simplicity ensures low-maintenance; the functionality being in firmware allows reprogramming for other applications.Comment: 32 pages, 13 figure

Non-consumptive effects of native and invasive predators on juvenile Caribbean parrotfish

Non-consumptive effects of predators can have important impacts on aquatic food webs, but there are few data on how predators change the behaviour of Caribbean reef fishes. Such changes may include behavioural responses to the invasive predatory lionfish (Pterois volitans/P. miles). This study used an aquarium experiment to examine the behaviour of herbivorous parrotfish (Scarus iseri) in the absence of other fish (control), with a non-piscivore present, and with a predatory threat from a native grouper or lionfish. Treatments were repeated with and without additional parrotfish shelters to examine the potential effects of degraded reefs (loss of refuges). Using video, parrotfish behaviours (sheltering, swimming in open areas, foraging, aggressive conspecific interactions, bite rates, and shoaling behaviour) were recorded for groups of four parrotfish. Compared to the control, the average number of parrotfish hiding was reduced by 65 % and foraging shoals were 10 % larger when threatened by grouper, likely as a specific response to an ambush predator. When exposed to lionfish, parrotfish reduced their bite rates by 50 %, possibly to be more vigilant of this predator’s unique stalking behaviour. The absence of additional shelter had limited effects although parrotfish formed 10 % larger shoals when swimming in open water, potentially as a defensive behaviour because of a perceived lack of refuges. The reduction in parrotfish bite rates caused by lionfish may have important demographic consequences. Furthermore, parrotfishes are important grazers of macroalgae, and these behavioural changes may exacerbate the direct effects of lionfish predation and potentially affect reef benthic dynamics

Complications of Subcutaneous Contraception: A Review.

Over 62 million women in the United States are of childbearing age and 60% of them use contraception. Subcutaneous contraceptives include implantable contraceptives and subcutaneous injections. Implantable contraception involves subdermal time-release of synthetic progestin, which allows for several years of continuous, highly effective contraception. Its main effects are inhibition of ovulation and thickening of the cervical mucus. Many complications have been associated with subcutaneous contraception, including menstrual disturbances, headache, weight gain, acne, dizziness, mood disturbances, nausea, lower abdominal pain, hair loss, loss of libido, pain at the implant site, neuropathy, and follicular cysts. Using standard search engines, the complications of subcutaneous contraception are reviewed. Patients should be adequately counseled on the possible complications and side effects of subcutaneous contraception to help them make an informed decision when choosing the right contraceptive to meet their needs

Hematoma in the Bucco-Mandibular Space: First Case Report.

Our previous studies based on intraoral dissection of fresh cadavers revealed that the fissure and loose connective tissues deep to the mucosa between the incisivus labii inferioris muscle and buccinator muscle form the entrance of the newly discovered bucco-mandibular space. To support the clinical significance of this space, we report the finding of a hematoma within this space in an adult fresh cadaver. Such a finding lends credence to studying the bucco-mandibular space and might help better understand the spread of some infections in the oral region