General practitioner empathy, patient enablement, and patient-reported outcomes in primary care in an area of high socio-economic deprivation in Scotland - a pilot prospective study using structural equation modelling

<b>Objective</b> The aim of this pilot prospective study was to investigate the relationships between general practitioners (GPs) empathy, patient enablement, and patient-assessed outcomes in primary care consultations in an area of high socio-economic deprivation in Scotland.<p></p> <b>Methods</b> This prospective study was carried out in a five-doctor practice in an area of high socio-economic deprivation in Scotland. Patients’ views on the consultation were gathered using the Consultation and Relational Empathy (CARE) Measure and the Patient Enablement Instrument (PEI). Changes in main complaint and well-being 1 month after the contact consultation were gathered from patients by postal questionnaire. The effect of GP empathy on patient enablement and prospective change in outcome was investigated using structural equation modelling.<p></p> <b>Results</b> 323 patients completed the initial questionnaire at the contact consultation and of these 136 (42%) completed and returned the follow-up questionnaire at 1 month. Confirmatory factor analysis confirmed the construct validity of the CARE Measure, though omission of two of the six PEI items was required in order to reach an acceptable global data fit. The structural equation model revealed a direct positive relationship between GP empathy and patient enablement at contact consultation and a prospective relationship between patient enablement and changes in main complaint and well-being at 1 month.<p></p> <b>Conclusion</b> In a high deprivation setting, GP empathy is associated with patient enablement at consultation, and enablement predicts patient-rated changes 1 month later. Further larger studies are desirable to confirm or refute these findings.<p></p> <b>Practice implications</b> Ways of increasing GP empathy and patient enablement need to be established in order to maximise patient outcomes. Consultation length and relational continuity of care are known factors; the benefit of training and support for GPs needs to be further investigate

Coalescent Theory and Yule Trees in time and space

Mathematically, Coalescent Theory describes genealogies within a population in the form of (binary) trees. The original Coalescent Model is based on population models that are evolving neutrally. With respect to graph isomorphy, the tree-structures it provides can be equivalently described in a discrete setting by the Yule Process. As a population evolves (in time), the genealogy of the population is subject to change, and so is the tree structure associated with it. A similar statement holds true if the population is assumed to be recombining; then, in space, i.e. along the genome, the genealogy of a sample may be subject to change in a similar way. The two main focuses of this thesis are the description of the processes that shape the genealogy in time and in space, making use of the relation between Coalescent and Yule Process. As for the process in time, the presented approach differs from existing ones mainly in that the population considered is strictly finite. The results we obtain are of mainly theoretical nature. In case of the process along the genome, we focus on mathematical properties of Linkage Disequilibrium, a quantity that is relevant in the analysis of population-genetical data. Similarities and differences between the two are discussed, and a possibility of performing similar analyses when the assumption of neutrality is abandoned is pointed out

Division of labor between firms: business services, non-ownership-value and the rise of the service economy

Why have services grown into the dominant sector of developed economies? Our analysis of macroeconomic data shows that business services make the strongest contribution to the rise of the service sector. We integrate three related economic theories of the firm to explain business services in shaping firms, industries and economies. Business service providers relieve their clients from the costs of asset ownership (Property Rights Theory), unlock management capacity (Resource-Based View) and support their clients in navigating their firm's boundaries towards their most valuable business opportunities (Entrepreneurial Theory of the Firm). We show how these theories build on the non-ownership value provided by business services that result from sound division of labor between organizations. We highlight three areas that call for research and provide opportunities for service science: (1) Systematic design of business-models for fostering service performance, (2) the transformation of high-tech-products into service-hubs, and (3) service-driven innovation and the transformation of R&D into a service industry

Capturing value in the service economy

The benefits of specialization have been driving the rise of the service economy and pushing capability frontiers and economic growth. In service economies, almost any activity, asset, and skill can be bought on competitive markets, making it harder to build competitive advantage on those inputs. Therefore, firms have to carefully decide what to own in order to capture value, and they need to prioritize investments in those assets while outsourcing almost everything else. Service businesses capture value by connecting resource markets with service markets, and we identified three types of assets that allow a firm to connect markets and capture value in the process. They are: (1) resource-based assets shaping capabilities and capacities of services; (2) platform-based assets connecting resource owners with users,allowing to generate network effects, critical mass, volume and/or liquidity; and (3) market-based assets providing the interface for interaction with customers. We propose further three key dimensions that shape each service-asset type: Physical capital, intellectual capital and social capital including service climate as a framework for a typology of service assets. We identify further two domains of service management that allow firms to capture value: (1) business models for designing the architecture and "Gestalt" of value creation; and (2) the effective management of an integrated web of processes and activities. We discuss implications for management and further research

Designing Dental Student Portfolios to Assess Performance

The purpose of this poster is to share a project developed by Marquette University’s liaisons to the American Dental Education Association’s Commission on Change and Innovation in Dental Education with others interested in learning about the use of portfolios to assess the quality of student performance in dental school. Sample components from the pilot portfolios will be integrated into the poster to provide participants with a view from portfolio design to completion. Portfolios are becoming a more common method of assessing the quality of student performance in health professions education. Portfolios can assist in documenting evidence of specific competencies at the student level and also serve as a longitudinal measure of a student’s development

Impact of Many-Body Effects on Landau Levels in Graphene

We present magneto-Raman spectroscopy measurements on suspended graphene to investigate the charge carrier density-dependent electron-electron interaction in the presence of Landau levels. Utilizing gate-tunable magneto-phonon resonances, we extract the charge carrier density dependence of the Landau level transition energies and the associated effective Fermi velocity $v_\mathrm{F}$. In contrast to the logarithmic divergence of $v_\mathrm{F}$ at zero magnetic field, we find a piecewise linear scaling of $v_\mathrm{F}$ as a function of charge carrier density, due to a magnetic field-induced suppression of the long-range Coulomb interaction. We quantitatively confirm our experimental findings by performing tight-binding calculations on the level of the Hartree-Fock approximation, which also allow us to estimate an excitonic binding energy of $\approx$ 6 meV contained in the experimentally extracted Landau level transitions energies.Comment: 10 pages, 6 figure

Relational governance mechanisms and uncertainties in nonownership services

Entrepreneurs, managers and consumers are attracted by the promise of nonownership services in the sharing economy - to enjoy benefits of assets without bearing the costs and downsides of ownership. In many cases, reality of nonownership does not live-up to the promised value propositions, as present in the struggle of companies like Uber, BP or the entire Biopharma industry to exploit the potential of nonownership. In this article we unveil the underlying paradox of nonownership, which aims at a smart allocation of uncertainty upsides and downsides between providers and clients. We identify the potential of relational governance mechanisms to handle the uncertainty challenges apparent in nonownership. We present a pioneering case study of Rolls Royce airplane engines which unveils the contribution of relational governance in unfolding the economic benefits of nonownership

Excitons in boron nitride nanotubes: dimensionality effects

We show that the optical absorption spectra of boron nitride (BN) nanotubes are dominated by strongly bound excitons. Our first-principles calculations indicate that the binding energy for the first and dominant excitonic peak depends sensitively on the dimensionality of the system, varying from 0.7 eV in bulk hexagonal BN via 2.1 eV in the single sheet of BN to more than 3 eV in the hypothetical (2,2) tube. The strongly localized nature of this exciton dictates the fast convergence of its binding energy with increasing tube diameter towards the sheet value. The absolute position of the first excitonic peak is almost independent of the tube radius and system dimensionality. This provides an explanation for the observed "optical gap" constancy for different tubes and bulk hBN [R. Arenal et al., to appear in Phys. Rev. Lett. (2005)].Comment: 5 pages, 2 figure

A Framework For Discussing Ethics In Principles Of Accounting

The main focus of the discussion in this paper is on the principles or introductory level of accounting and is applicable for all students in the class, but much of its content is equally applicable to upper level accounting classes and our accounting majors. Early and Kelly (2004) and Clikeman (2003) support the value of ethics education in heightening a student’s moral reasoning skills. “The goals of ethics education are creating an awareness of ethical dilemmas and providing methods of resolution.” (Haas 2005

First record of Cobia (Rachycentron canadum) (Pisces: Rachycentridae) at the coast of Madeira Island (NE Atlantic Ocean

The Cobia Rachycentron canadum is recorded from Madeira Island for the first time. An individual of this species was encountered and video-documented while SCUBA-diving in about 12 m depth at the south coast of this island.info:eu-repo/semantics/publishedVersio