Stakeholder perspectives on the development of a virtual clinic for diabetes care : qualitative study

Background: The development of the Internet has created new opportunities for health care provision, including its use as a tool to aid the self-management of chronic conditions. We studied stakeholder reactions to an Internet-based “virtual clinic,” which would allow people with diabetes to communicate with their health care providers, find information about their condition, and share information and support with other users. Objective: The aim of the study was to present the results of a detailed consultation with a variety of stakeholder groups in order to identify what they regard as the desirable, important, and feasible characteristics of an Internet-based intervention to aid diabetes self-management. Methods: Three focus groups were conducted with 12 people with type 1 diabetes who used insulin pumps. Participants were recruited through a local diabetes clinic. One-on-one interviews were conducted with 5 health care professionals from the same clinic (2 doctors, 2 nurses, 1 dietitian) and with 1 representative of an insulin pump company. We gathered patient consensus via email on the important and useful features of Internet-based systems used for other chronic conditions (asthma, epilepsy, myalgic encephalopathy, mental health problems). A workshop to gather expert consensus on the use of information technology to improve the care of young people with diabetes was organized. Results: Stakeholder groups identified the following important characteristics of an Internet-based virtual clinic: being grounded on personal needs rather than only providing general information; having the facility to communicate with, and learn from, peers; providing information on the latest developments and news in diabetes; being quick and easy to use. This paper discusses these characteristics in light of a review of the relevant literature. The development of a virtual clinic for diabetes that embodies these principles, and that is based on self-efficacy theory, is described. Conclusions: Involvement of stakeholders is vital early in the development of a complex intervention. Stakeholders have clear and relevant views on what a virtual clinic system should provide, and these views can be captured and synthesized with relative ease. This work has led to the design of a system that is able to meet user needs and is currently being evaluated in a pilot study

The structure of the South-Central-Pyrenean fold and thrust belt as constrained by subsurface data

The interpretation of the available seismic lines of the South-Central-Pyrenean fold and thrust belt, conveniently tied with the exploration wells, define the main structural features of this realm of the Pyrenees. In particular, they define the geometry and areal extension of the autochthonous foreland underneath the sole thrust. The mapping ofseveral selected structural lines brings constraints for the structural interpretation of the South-Central Pyrenees, including the cut-off lines between selected stratigraphic horizons of the autochthonous foreland and the branch line between basement-involved thrust sheets and the sole thrust. The thrust salient which characterizes at surface the geometry of the South-Pyrenean fold and thrust belt contrasts with the linear trend of these structural lines at subsurface. This salient has been the result of a secondary progressive curvature developed since Middle Eocene times by thrust displacement gradients during verthrusting of the South-Pyrenean thrust sheets above a Paleogene autochthonous sequence. Displacement gradients resulted from the uneven distribution of weak salt layers, mostly the Triassic and the Upper Eocene ones. The minimum amount of South-directed displacement from early MiddleEocene times to Late Oligocene is 52km, which would be significantly higher if internal shortening by folding and cleavage/fracture development as well as hanging-wall erosion is added

Weld kinematics of syn-rift salt during basement-involved extension and subsequent inversion: Results from analog models

Scaled analog models based on extensional basins with synrift salt show how basement topography exerts a control factor on weld kinematics during the extension and inversion phases. In the case of basement-involved extension, syn-rift salt thickness differences may lead to variable degrees of extensional decoupling between basement topography and overburden, which in turn have a strong impact on the development of salt structures. With ongoing extension and after welding, the basin kinematics evolves toward a coupled deformation style. The basin architecture of our experimental results record the halokinetic activity related to growing diapirs and the timing of weld formationduring extension. Moreover, the structures that result from anysubsequent inversion of these basins strongly depends on the inherited welds and salt structures. While those basins are uplifted,the main contractional deformation during inversion is absorbed by the pre-existing salt structures, whose are squeezed developing secondary welds that often evolve into thrust welds. The analysis of our analog models shows that shortening of diapirs is favored by: i) basement topography changes that induce reactivation of primary welds as thrust welds; ii) reactivation of the salt unit as a contractional detachment and iii) synkinematic sedimentation during basin inversion. Finally, in this article, we also compare two natural examples from the southern North Sea that highlight deformation patterns very similar to those observed in our analog models

Diagnosis and Decision-Making in Telemedicine

This article provides an analysis of the skills that health professionals and patients employ in reaching diagnosis and decision-making in telemedicine consultations. As governmental priorities continue to emphasize patient involvement in the management of their disease, there is an increasing need to accurately capture the provider–patient interactions in clinical encounters. Drawing on conversation analysis of 10 video-mediated consultations in 3 National Health Service settings in England, this study examines the interaction between patients, General Practitioner (GPs), nurses, and consultants during diagnosis and decision-making, with the aim to identify the range of skills that participants use in the process and capture the interprofessional communication and patient involvement in the diagnosis and decision-making phases of telemedicine consultations. The analysis shows that teleconsultations enhance collaborative working among professionals and enable GPs and nurses to develop their skills and actively participate in diagnosis and decision-making by contributing primary care–specific knowledge to the consultation. However, interprofessional interaction may result in limited patient involvement in decisionmaking. The findings of this study can be used to inform training programs in telemedicine that focus on the development of effective skills for professionals and the provision of information to patients

Physics demos for all UVEG degrees: a unique project in Spain

The Physics Demo Project at the University of Valencia (www.uv.es/fisicademos) has developed a collection of physics demonstrations to be used during lectures. It consists of more than 130 experimental demos about different physics topics. More than 30 professors borrow them whenever they lecture on physics in any of our 40 courses in 17 different science or technical degrees, involving 246 ECTS and more than 3500 students. Each demo kit with a simple experimental set displays a particular physics phenomenon. An on-line user guide highlights the main physics principles involved, instructions on how to use it and advices of how to link it to the theoretical concepts or to technical applications. Demo lectures (and collections) are a usual and widespread practice in many countries but not in Spain. This unique initiative aims at the recovery of this practice by involving a growing collaborative team of users and with the aid of educational innovation projects. Here we explain the project content, organization and recent developments. Our experience, together with the positive students comments, allows us to draw the following conclusions: demos introduce the real sensible world in the lecture hall, providing the necessary link between concepts and everyday life, and becoming, again, something more than "chalk and talk"

Determination of the high-pressure crystal structure of BaWO4 and PbWO4

We report the results of both angle-dispersive x-ray diffraction and x-ray absorption near-edge structure studies in BaWO4 and PbWO4 at pressures of up to 56 GPa and 24 GPa, respectively. BaWO4 is found to undergo a pressure-driven phase transition at 7.1 GPa from the tetragonal scheelite structure (which is stable under normal conditions) to the monoclinic fergusonite structure whereas the same transition takes place in PbWO4 at 9 GPa. We observe a second transition to another monoclinic structure which we identify as that of the isostructural phases BaWO4-II and PbWO4-III (space group P21/n). We have also performed ab initio total energy calculations which support the stability of this structure at high pressures in both compounds. The theoretical calculations further find that upon increase of pressure the scheelite phases become locally unstable and transform displacively into the fergusonite structure. The fergusonite structure is however metastable and can only occur if the transition to the P21/n phases were kinetically inhibited. Our experiments in BaWO4 indicate that it becomes amorphous beyond 47 GPa.Comment: 46 pages, 11 figures, 3 table

The structure of the South-Central-Pyrenean fold and thrust belt as constrained by subsurface dat

The interpretation of the available seismic lines of the South-Central-Pyrenean fold and thrust belt, conveniently tied with the exploration wells, define the main structural features of this realm of the Pyrenees. In particular, they define the geometry and areal extension of the autochthonous foreland underneath the sole thrust. The mapping ofseveral selected structural lines brings constraints for the structural interpretation of the South-Central Pyrenees, including the cut-off lines between selected stratigraphic horizons of the autochthonous foreland and the branch line between basement-involved thrust sheets and the sole thrust. The thrust salient which characterizes at surface the geometry of the South-Pyrenean fold and thrust belt contrasts with the linear trend of these structural lines at subsurface. This salient has been the result of a secondary progressive curvature developed since Middle Eocene times by thrust displacement gradients during verthrusting of the South-Pyrenean thrust sheets above a Paleogene autochthonous sequence. Displacement gradients resulted from the uneven distribution of weak salt layers, mostly the Triassic and the Upper Eocene ones. The minimum amount of South-directed displacement from early MiddleEocene times to Late Oligocene is 52km, which would be significantly higher if internal shortening by folding and cleavage/fracture development as well as hanging-wall erosion is added

High-pressure x-ray diffraction and ab initio study of Ni2Mo3N, Pd2Mo3N, Pt2Mo3N, Co3Mo3N, and Fe3Mo3N: Two families of ultra-incompressible bimetallic interstitial nitrides

We have studied by means of high-pressure x-ray diffraction the structural stability of Ni2Mo3N, Co3Mo3N, and Fe3Mo3N. We also report ab initio computing modeling of the high-pressure properties of these compounds, Pd2Mo3N, and Pt2Mo3N. We have found that the nitrides remain stable in the ambient-pressure cubic structure at least up to 50 GPa and determined their equation of state. All of them have a bulk modulus larger than 300 GPa. Single-crystal elastic constants have been calculated in order to quantify the stiffness of the investigated nitrides. We found that they should have a Vickers hardness similar to that of cubic spinel nitrides like gamma-Si3N4Comment: 25 pages, 6 figures, 3 table