Ethnicity and politics in Africa

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General practitioners' and nurses' experiences of using computerised decision support in screening for diabetic foot disease:implementing Scottish Clinical Information - Diabetes Care in routine clinical practice

<strong>Objective</strong> The Scottish Care Information - Diabetes Collaboration (SCI-DC) developed a computer- based information system to create a shared electronic record for use by all involved in the care of patients with diabetes mellitus. The objectives of this study were to understand primary care practitioners' views towards screening for diabetic foot disease and their experience of the SCI-DC system. <strong>Method</strong> We conducted an exploratory study using qualitativemethods. Semi-structured interviews were audiotape-recorded, transcribed and subjected to thematic analysis. Seven practice nurses and six general practitioners (GPs) with special responsibility for diabetes care inNHS Lothian participated. <strong>Results</strong> Primary care clinicians reported good systems in place to screen for diabetes-related complications and to refer their patients to specialist care. Foot ulceration was rarely observed; other diabetesrelated conditions were seen as a higher priority. Most had heard of the SCI-DC foot assessment tool, but its failure to integrate with other primary care information technology (IT) systems meant it was not used in these general practices. <strong>Conclusions</strong> Adoption of the SCI-DC foot assessment tool in primary care is not perceived as clinically necessary. Although information recorded by specialist services on SCI-DC is helpful, important structural barriers to its implementation mean the potential benefits associated with its use are unlikely to be realised; greater engagement with primary care priorities for diabetes management is needed to assist its successful implementation and adoption

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Hands Across The Atlantic?

The war in Iraq created a division between the United States and some members of the European Union.  The war also split the EU, with France and Germany leading the anti-war camp and Britain, Italy, Portugal, and Spain supporting Washington.  With organized warfare over, the United States has shifted its attention from the military campaign to the installation of a legitimate and stable government in Iraq.  However, the administration of post-war Iraq has caused the division between the US and Europe to widen. The multilateralists, France and Germany, are demanding a central role for the UN in rebuilding Iraq.  France, in particular, believes that the task should be left to the UN alone.  They suggest this would help legitimize what they consider to be an illegal war.  On the other hand, the US, which accepted a great burden with the pre-emptive attack on Iraq, wants the UN to have a “vital” but limited role in post-war Iraq.  The US believes that the UN needs serious repair before any responsibilities can be handed to it.This study examines the economic, political, and security implications of the division between these old allies.  The relationship between the US and EU is based on years of cooperation.  Both sides know that they must mend fences sooner rather than later.  We contend that pragmatism will triumph over geo-politics

At A Crossroad: The U.S. Economy

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he Global Impact Of Chinas Currency Policy: U.S. And Beyond

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The optical variability of the narrow line Seyfert 1 galaxy IRAS 13224-3809

We report on a short optical monitoring programme of the narrow-line Seyfert 1 Galaxy IRAS 13224-3809. Previous X-ray observations of this object have shown persistent giant variability. The degree of variability at other wavelengths may then be used to constrain the conditions and emission processes within the nucleus. Optical variability is expected if the electron population responsible for the soft X-ray emission is changing rapidly and Compton-upscattering infrared photons in the nucleus, or if the mechanism responsible for X-ray emission causes all the emission processes to vary together. We find that there is no significant optical variability with a firm upper limit of 2 per cent and conclude that the primary soft X-ray emission region produces little of the observed optical emission. The X-ray and optical emission regions must be physically distinct and any reprocessing of X-rays into the optical waveband occurs some distance from the nucleus. The lack of optical variability indicates that the energy density of infrared radiation in the nucleus is at most equal to that of the ultraviolet radiation since little is upscattered into the optical waveband. The extremely large X-ray variability of IRAS 13224-3809 may be explained by relativistic boosting of more modest variations. Although such boosting enhances X-ray variability over optical variability, this only partially explains the lack of optical variability.Comment: 5 pages with 8 postscript figures. Accepted for publication in MNRA