GPAQ-R: development and psychometric properties of a version of the general practice assessment questionnaire for use for revalidation by general practitioners in the UK.

BACKGROUND: The General Practice Assessment Questionnaire (GPAQ) has been widely used to assess patient experience in general practice in the UK since 2004. In 2013, new regulations were introduced by the General Medical Council (GMC) requiring UK doctors to undertake periodic revalidation, which includes assessment of patient experience for individual doctors. We describe the development of a new version of GPAQ - GPAQ-R which addresses the GMC's requirements for revalidation as well as additional NHS requirements for surveys that GPs may need to carry out in their own practices. METHODS: Questionnaires were given out by doctors or practice staff after routine consultations in line with the guidance given by the General Medical Council for surveys to be used for revalidation. Data analysis and practice reports were provided independently. RESULTS: Data were analysed for questionnaires from 7258 patients relating to 164 GPs in 29 general practices. Levels of missing data were generally low (typically 4.5-6%). The number of returned questionnaires required to achieve reliability of 0.7 were around 35 for individual doctor communication items and 29 for a composite score based on doctor communication items. This suggests that the responses to GPAQ-R had similar reliability to the GMC's own questionnaire and we recommend 30 completed GPAQ-R questionnaires are sufficient for revalidation purposes. However, where an initial screen raises concern, the survey might be repeated with 50 completed questionnaires in order to increase reliability. CONCLUSIONS: GPAQ-R is a development of a well-established patient experience questionnaire used in general practice in the UK since 2004. This new version can be recommended for use in order to meet the UK General Medical Council's requirements for surveys to be used in revalidation of doctors. It also meets the needs of GPs to ask about patient experience relating to aspects of practice care that are not specific to individual general practitioners (e.g. receptionists, telephone access) which meet other survey requirements of the National Health Service in England. Use of GPAQ-R has the potential to reduce the number of surveys that GPs need to carry out in their practices to meet the various regulatory requirements which they face

Search for lepton flavor violating decays of a heavy neutral particle in p-pbar collisions at root(s)=1.8 TeV

We report on a search for a high mass, narrow width particle that decays directly to e+mu, e+tau, or mu+tau. We use approximately 110 pb^-1 of data collected with the Collider Detector at Fermilab from 1992 to 1995. No evidence of lepton flavor violating decays is found. Limits are set on the production and decay of sneutrinos with R-parity violating interactions.Comment: Figure 2 fixed. Reference 4 fixed. Minor changes to tex

Measurement of Resonance Parameters of Orbitally Excited Narrow B^0 Mesons

We report a measurement of resonance parameters of the orbitally excited (L=1) narrow B^0 mesons in decays to B^{(*)+}\pi^- using 1.7/fb of data collected by the CDF II detector at the Fermilab Tevatron. The mass and width of the B^{*0}_2 state are measured to be m(B^{*0}_2) = 5740.2^{+1.7}_{-1.8}(stat.) ^{+0.9}_{-0.8}(syst.) MeV/c^2 and \Gamma(B^{*0}_2) = 22.7^{+3.8}_{-3.2}(stat.) ^{+3.2}_{-10.2}(syst.) MeV/c^2. The mass difference between the B^{*0}_2 and B^0_1 states is measured to be 14.9^{+2.2}_{-2.5}(stat.) ^{+1.2}_{-1.4}(syst.) MeV/c^2, resulting in a B^0_1 mass of 5725.3^{+1.6}_{-2.2}(stat.) ^{+1.4}_{-1.5}(syst.) MeV/c^2. This is currently the most precise measurement of the masses of these states and the first measurement of the B^{*0}_2 width.Comment: 7 pages, 1 figure, 1 table. Submitted to Phys.Rev.Let

Measurement of the fraction of t-tbar production via gluon-gluon fusion in p-pbar collisions at sqrt(s)=1.96 TeV

We present a measurement of the ratio of t-tbar production cross section via gluon-gluon fusion to the total t-tbar production cross section in p-pbar collisions at sqrt{s}=1.96 TeV at the Tevatron. Using a data sample with an integrated luminosity of 955/pb recorded by the CDF II detector at Fermilab, we select events based on the t-tbar decay to lepton+jets. Using an artificial neural network technique we discriminate between t-tbar events produced via q-qbar annihilation and gluon-gluon fusion, and find Cf=(gg->ttbar)/(pp->ttbar)<0.33 at the 68% confidence level. This result is combined with a previous measurement to obtain the most precise measurement of this quantity, Cf=0.07+0.15-0.07.Comment: submitted to Phys. Rev.

Delivering at Home or in a Health Facility? Health-Seeking Behaviour of Women and the Role of Traditional birth attendants in Tanzania.

Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women's health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system. Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania. The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative. Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive and preventive health services, including maternal and neonatal health

The views of five participating undergraduate students of the Student Associates Scheme in England

This paper reports findings from a study which explored undergraduate perceptions of the Student Associates Scheme in England (SAS). The scheme was established by the Training and Development Agency for Schools in an attempt to increase the number of graduates entering the teaching profession, particularly in shortage subjects such as the physical sciences and mathematics. The scheme places undergraduate students on short-term placements in secondary schools throughout England to provide them with experiences that may encourage them to consider teaching as a career option. Findings show that the SAS school placements were a positive experience for the students participating in this study. However, a question emerged as to whether or not the scheme is targeting students who have yet to decide upon teaching as a career or just reinforcing the existing aspirations of students who have already decided to teach. As the scheme is attempting to increase the number of teachers entering the profession this question has important implications for this study and further work which will focus on undergraduates who think that their career ambitions would not be fulfilled by teaching

Lack of Mutual Respect in Relationship The Endangered Partner

Violence in a relationship and in a family setting has been an issue of concern to various interest groups and professional organizations. Of particular interest in this article is violence against women in a relationship. While there is an abundance of knowledge on violence against women in general, intimate or partner femicide seems to have received less attention. Unfortunately, the incidence of violence against women, and intimate femicide in particular, has been an issue of concern in the African setting. This article examines the trends of intimate femicide in an African setting in general, and in Botswana in particular. The increase in intimate femicide is an issue of concern, which calls for collective effort to address. This article also examines trends offemicide in Botswana, and the antecedents and the precipitating factors. Some studies have implicated societal and cultural dynamics as playing significant roles in intimate femicide in the African setting. It is believed that the patriarchal nature of most African settings and the ideology of male supremacy have relegated women to a subordinate role. Consequently, respect for women in any relationship with men is lopsided in favor of men and has led to abuse of women, including intimate femicide. Other militating factors in intimate femicide ,are examined and the implications for counseling to assist the endangered female partner are discussed

Macroalgae Decrease Growth and Alter Microbial Community Structure of the Reef-Building Coral, Porites astreoides

This is the publisher’s final pdf. The published article is copyrighted by the Public Library of Science and can be found at: http://www.plosone.org/home.action.With the continued and unprecedented decline of coral reefs worldwide, evaluating the factors that contribute to coral demise is of critical importance. As coral cover declines, macroalgae are becoming more common on tropical reefs. Interactions between these macroalgae and corals may alter the coral microbiome, which is thought to play an important role in colony health and survival. Together, such changes in benthic macroalgae and in the coral microbiome may result in a feedback mechanism that contributes to additional coral cover loss. To determine if macroalgae alter the coral microbiome, we conducted a field-based experiment in which the coral Porites astreoides was placed in competition with five species of macroalgae. Macroalgal contact increased variance in the coral-associated microbial community, and two algal species significantly altered microbial community composition. All macroalgae caused the disappearance of a γ-proteobacterium previously hypothesized to be an important mutualist of P. astreoides. Macroalgal contact also triggered: 1) increases or 2) decreases in microbial taxa already present in corals, 3) establishment of new taxa to the coral microbiome, and 4) vectoring and growth of microbial taxa from the macroalgae to the coral. Furthermore, macroalgal competition decreased coral growth rates by an average of 36.8%. Overall, this study found that competition between corals and certain species of macroalgae leads to an altered coral microbiome, providing a potential mechanism by which macroalgae-coral interactions reduce coral health and lead to coral loss on impacted reefs

Learning to Teach About Ideas and Evidence in Science : The Student Teacher as Change Agent

A collaborative curriculum development project was set up to address the lack of good examples of teaching about ideas and evidence and the nature of science encountered by student teachers training to teach in the age range 11-16 in schools in England. Student and teacher-mentor pairs devised, taught and evaluated novel lessons and approaches. The project design required increasing levels of critique through cycles of teaching, evaluation and revision of lessons. Data were gathered from interviews and students' reports to assess the impact of the project on student teachers and to what extent any influences survived when they gained their first teaching posts. A significant outcome was the perception of teaching shifting from the delivery of standard lessons in prescribed ways to endeavours demanding creativity and decision-making. Although school-based factors limited newly qualified teachers' chances to use new lessons and approaches and therefore act as change-agents in schools, the ability to critique curriculum materials and the recognition of the need to create space for professional dialogue were durable gains

Translation to practice: a randomised controlled study of an evidenced based booklet targeted at breast care nurses in the United Kingdom

BACKGROUND: In the United Kingdom (UK), it was documented that a problem of knowledge transfer existed within the speciality of breast-cancer care, thus depriving patients of receiving optimal care. Despite increasingly robust research evidence indicating recommendation of whole body exercise for people affected by breast cancer, commensurate changes to practice were not noted amongst breast-care nurses (BCNs). AIM: To evaluate the effect of a targeted booklet, Exercise and Breast Cancer: A Booklet for Breast-Care Nurses, on changes in knowledge, reported practice, and attitudes of BCNs in the UK. METHOD: A prospective, experimental approach was used for designing a pre- and post-test randomised controlled study. Comparisons of knowledge, reported practice, and attitudes based on responses to a questionnaire were made at two time-points in two groups of BCNs (control and experimental). The unit of randomisation and analysis was hospital clusters of BCNs. The sample comprised 92 nurses from 62 hospitals. Analysis consisted of descriptive statistics and clustered regression techniques: clustered logistic regression for knowledge items, clustered linear regression for knowledge scores, ologit for attitude and reported practice items, and clustered multiple regression for paired and multiple variable analysis. RESULTS: A statistically significant increase in knowledge and changes in reported practice and attitudes were found. Robust variables affecting knowledge acquisition were: promotion of health, promotion of exercise, and understanding how exercise can reduce cancer-related fatigue. DISCUSSION: The study has shown that evidence-based printed material, such as an information booklet, can be used as an effective research dissemination method when developed for needs, values, and context of a target audience. CONCLUSIONS: This practical approach to research dissemination could be replicated and applied to other groups of nurses.</p