Barriers to apply cardiovascular prediction rules in primary care: a postal survey

BACKGROUND: Although cardiovascular prediction rules are recommended by guidelines to evaluate global cardiovascular risk for primary prevention, they are rarely used in primary care. Little is known about barriers for application. The objective of this study was to evaluate barriers impeding the application of cardiovascular prediction rules in primary prevention. METHODS: We performed a postal survey among general physicians in two Swiss Cantons by a purpose designed questionnaire. RESULTS: 356 of 772 dispatched questionnaires were returned (response rate 49.3%). About three quarters (74%) of general physicians rarely or never use cardiovascular prediction rules. Most often stated barriers to apply prediction rules among rarely- or never-users are doubts concerning over-simplification of risk assessment using these instruments (58%) and potential risk of (medical) over-treatment (54%). 57% report that the numerical information resulting from prediction rules is often not helpful for decision-making in practice. CONCLUSION: If regular application of cardiovascular prediction rules in primary care is in demand additional interventions are needed to increase acceptance of these tools for patient management among general physicians

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

The offer of tasks to work on multiplication in grades 2 and 3

International audienceIn this paper, we present an analysis of four teaching materials of grades 2 and 3, which are widely used in Germany. We analyzed the tasks in these textbooks and workbooks with a focus on developing and consolidating the operational understanding of multiplication. For this purpose, we present a framework developed by us. Its foundations are the levels of representation according to Bruner and the fact that mathematical terms are concepts. The analysis shows a homogeneous picture across all four textbooks and workbooks: Already in class 2, the vast majority of tasks require working on the non-verbal–symbolic level alone. Only a small part of the tasks promotes connections to the iconic, to the enactive or to the verbal-symbolic level and challenges students to intermodal translations from one level of representation to another. In grade 3, compared to grade 2, an even larger proportion of tasks are limited to the non-verbal–symbolic level

The offer of tasks to work on multiplication in grades 2 and 3

International audienceIn this paper, we present an analysis of four teaching materials of grades 2 and 3, which are widely used in Germany. We analyzed the tasks in these textbooks and workbooks with a focus on developing and consolidating the operational understanding of multiplication. For this purpose, we present a framework developed by us. Its foundations are the levels of representation according to Bruner and the fact that mathematical terms are concepts. The analysis shows a homogeneous picture across all four textbooks and workbooks: Already in class 2, the vast majority of tasks require working on the non-verbal–symbolic level alone. Only a small part of the tasks promotes connections to the iconic, to the enactive or to the verbal-symbolic level and challenges students to intermodal translations from one level of representation to another. In grade 3, compared to grade 2, an even larger proportion of tasks are limited to the non-verbal–symbolic level

Einfluss von systematischen Journalclubs auf Wissen, Einstellung und Vertrautheit bezüglich Evidenzbasierter Medizin : eine prospektive kontrollierte Interventionsstudie an Schweizer Spitälern

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