1,405 research outputs found

    The association of types of training and practice settings with doctors’ empathy and patient enablement among patients with chronic illness in Hong Kong

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    Background: The increase in non-communicable disease (NCD) is becoming a global health problem and there is an increasing need for primary care doctors to look after these patients although whether family doctors are adequately trained and prepared is unknown. Objective: This study aimed to determine if doctors with family medicine (FM) training are associated with enhanced empathy in consultation and enablement for patients with chronic illness as compared to doctors with internal medicine training or without any postgraduate training in different clinic settings. Methods: This was a cross-sectional questionnaire survey using the validated Chinese version of the Consultation and Relational Empathy (CARE) Measure as well as Patient Enablement Instrument (PEI) for evaluation of quality and outcome of care. 14 doctors from hospital specialist clinics (7 with family medicine training, and 7 with internal medicine training) and 13 doctors from primary care clinics (7 with family medicine training, and 6 without specialist training) were recruited. In total, they consulted 823 patients with chronic illness. The CARE Measure and PEI scores were compared amongst doctors in these clinics with different training background: family medicine training, internal medicine training and those without specialist training. Generalized estimation equation (GEE) was used to account for cluster effects of patients nested with doctors. <b>Results</b> Within similar clinic settings, FM trained doctors had higher CARE score than doctors with no FM training. In hospital clinics, the difference of the mean CARE score for doctors who had family medicine training (39.2, SD = 7.04) and internal medicine training (35.5, SD = 8.92) was statistically significant after adjusting for consultation time and gender of the patient. In the community care clinics, the mean CARE score for doctors with family medicine training and those without specialist training were 32.1 (SD = 7.95) and 29.2 (SD = 7.43) respectively, but the difference was not found to be significant. For PEI, patients receiving care from doctors in the hospital clinics scored significantly higher than those in the community clinics, but there was no significant difference in PEI between patients receiving care from doctors with different training backgrounds within similar clinic setting. Conclusion: Family medicine training was associated with higher patient perceived empathy for chronic illness patients in the hospital clinics. Patient enablement appeared to be associated with clinic settings but not doctors’ training background. Training in family medicine and a clinic environment that enables more patient doctor time might help in enhancing doctors’ empathy and enablement for chronic illness patients

    Finite N Index and Angular Momentum Bound from Gravity

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    We exactly compute the finite N index and BPS partition functions for N=4 SYM theory in a newly proposed maximal angular momentum limit. The new limit is not predicted from the superconformal algebra, but naturally arises from the supergravity dual. We show that the index does not receive any finite N corrections while the free BPS partition function does.Comment: 14 pages, v2: minor revisions, published versio

    Longitudinal changes in prospective memory and their clinical correlates at 1-year follow-up in first-episode schizophrenia

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    This study aimed to investigate prospective memory (PM) and the association with clinical factors at 1-year follow-up in first-episode schizophrenia (FES). Thirty-two FES patients recruited from a university-affiliated psychiatric hospital in Beijing and 17 healthy community controls (HCs) were included. Time- and event-based PM (TBPM and EBPM) performances were measured with the Chinese version of the Cambridge Prospective Memory Test (CCAMPROMPT) at baseline and at one-year follow-up. A number of other neurocognitive tests were also administered. Remission was determined at the endpoint according to the PANSS score _ 3 for selected items. Repeated measures analysis of variance revealed a significant interaction between time (baseline vs. endpoint) and group (FES vs. HCs) for EBPM (F(1, 44) = 8.8, p = 0.005) and for all neurocognitive components. Paired samples ttests showed significant improvement in EBPM in FES (13.1±3.7 vs. 10.3±4.8; t = 3.065, p = 0.004), compared to HCs (15.7±3.6 vs. 16.5±2.3; t = -1.248, p = 0.230). A remission rate of 59.4% was found in the FES group. Analysis of covariance revealed that remitters performed significantly better on EBPM (14.9±2.6 vs. 10.4±3.6; F(1, 25) = 12.2, p = 0.002) than non-remitters at study endpoint. The association between EBPM and 12-month clinical improvement in FES suggests that EBPM may be a potential neurocognitive marker for the effectiveness of standard pharmacotherapy. Furthermore, the findings also imply that PM may not be strictly a trait-related endophenotype as indicated in previous studies

    Regional coronary endothelial function is closely related to local early coronary atherosclerosis in patients with mild coronary artery disease: pilot study.

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    BACKGROUND: Coronary endothelial function is abnormal in patients with established coronary artery disease and was recently shown by MRI to relate to the severity of luminal stenosis. Recent advances in MRI now allow the noninvasive assessment of both anatomic and functional (endothelial function) changes that previously required invasive studies. We tested the hypothesis that abnormal coronary endothelial function is related to measures of early atherosclerosis such as increased coronary wall thickness. METHODS AND RESULTS: Seventeen arteries in 14 healthy adults and 17 arteries in 14 patients with nonobstructive coronary artery disease were studied. To measure endothelial function, coronary MRI was performed before and during isometric handgrip exercise, an endothelial-dependent stressor, and changes in coronary cross-sectional area and flow were measured. Black blood imaging was performed to quantify coronary wall thickness and indices of arterial remodeling. The mean stress-induced change in cross-sectional area was significantly higher in healthy adults (13.5%±12.8%, mean±SD, n=17) than in those with mildly diseased arteries (-2.2%±6.8%, P<0.0001, n=17). Mean coronary wall thickness was lower in healthy subjects (0.9±0.2 mm) than in patients with coronary artery disease (1.4±0.3 mm, P<0.0001). In contrast to healthy subjects, stress-induced changes in cross-sectional area, a measure of coronary endothelial function, correlated inversely with coronary wall thickness in patients with coronary artery disease (r=-0.73, P=0.0008). CONCLUSIONS: There is an inverse relationship between coronary endothelial function and local coronary wall thickness in patients with coronary artery disease but not in healthy adults. These findings demonstrate that local endothelial-dependent functional changes are related to the extent of early anatomic atherosclerosis in mildly diseased arteries. This combined MRI approach enables the anatomic and functional investigation of early coronary disease

    China’s emerging global role: dissatisfied responsible great power

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    China has (re)emerged as a great power in a world not of its own making. The distribution of power in major organisations and the dominant norms of international interactions are deemed to unfairly favour the existing Western powers, and at times obstruct China’s ability to meet national development goals. Nevertheless, engaging the global economy has been a key source of economic growth (thus helping to maintain regime stability), and establishing China’s credentials as a responsible global actor is seen as a means of ensuring continued access to what China needs. As an emerging great power that is also still in many respects a developing country, China’s challenge is to change the global order in ways that do not cause global instability or generate crises that would damage China’s own ability to generate economic growth and ensure political stability

    Strong, weak and flavor scalar triplets for the CDF Wjj anomaly

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    A model describing the 4.1\sigma\ Wjj anomaly observed by the CDF experiment at the Tevatron collider is introduced. It features new scalar particles which are charged both under the SU(3)_C and the SU(2)_L gauge groups and which couple to pairs of quarks. We introduce several identical replicas of the scalar multiplets in order to leave an unbroken U(3)_Q x U(3)_U x U(3)_D flavor symmetry to satisfy the constraints coming from flavor physics. We discuss the LHC reach on the new scalar resonances both in the resonant production channel (with the Wjj final state) and in the QCD pair production channel (with the 4j final state).Comment: 17 pages, 6 figures and 4 table

    Developments in synthesis, characterization, and application of large, high-quality CVD single crystal diamond

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    Single crystal diamond synthesis by microwave plasma chemical vapor deposition at rapid growth rate has considerably advanced in the past few years. Developments have been made in growth, optical quality, and mechanical properties. Of the various types of single crystal diamond that can be produced using these techniques, high quality single crystal CVD diamond can be routinely produced, and this material is playing an increasing role in research on materials under extreme conditions. This article highlights recent developments in single crystal CVD diamond synthesis and characterization, as well as various applications in high-pressure materials research.За останні кілька роки синтез монокристалів алмазу мікрохвильовим плазмовим хімічним осадженням з газової фази з високою швидкістю значно просунувся. Прогрес було досягнуто у рості, оптичних і механічних властивостях. З різних типів монокристалічного алмазу, що можна отримати з використанням цього методу, регулярно виробляють високоякісні монокристалічні CVD-алмази, і цей матеріал відіграє все більш важливу роль при дослідженні матеріалів в екстремальних умовах. У даній роботі висвітлено останні досягнення в синтезі монокристалічного CVD-алмазу і дослідженні його характеристик, а також його різне застосування у дослідженні матеріалів при високому тиску.За последние несколько лет синтез монокристаллов алмаза микроволновым плазменным химическим осаждением из газовой фазы с высокой скоростью значительно продвинулся. Прогресс был достигнут в росте, оптических и механических свойствах. Из различных типов монокристаллического алмаза, которые могут быть получены с использованием этого метода, регулярно производят высококачественные монокристаллы CVD-алмаза, и этот материал играет все более важную роль в исследовании материалов в экстремальных условиях. В этой работе осветлены последние разработки в синтезе монокристаллов CVD-алмаза и исследовании его характерист

    Transition Radiation Spectra of Electrons from 1 to 10 GeV/c in Regular and Irregular Radiators

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    We present measurements of the spectral distribution of transition radiation generated by electrons of momentum 1 to 10 GeV/c in different radiator types. We investigate periodic foil radiators and irregular foam and fiber materials. The transition radiation photons are detected by prototypes of the drift chambers to be used in the Transition Radiation Detector (TRD) of the ALICE experiment at CERN, which are filled with a Xe, CO2 (15 %) mixture. The measurements are compared to simulations in order to enhance the quantitative understanding of transition radiation production, in particular the momentum dependence of the transition radiation yield.Comment: 18 pages, 15 figures, submitted to Nucl. Instr. Meth. Phys. Res.

    Optical properties of the pseudogap state in underdoped cuprates

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    Recent optical measurements of deeply underdoped cuprates have revealed that a coherent Drude response persists well below the end of the superconducting dome. In addition, no large increase in optical effective mass has been observed, even at dopings as low as 1%. We show that this behavior is consistent with the resonating valence bond spin-liquid model proposed by Yang, Rice, and Zhang. In this model, the overall reduction in optical conductivity in the approach to the Mott insulating state is caused not by an increase in effective mass, but by a Gutzwiller factor, which describes decreased coherence due to correlations, and by a shrinking of the Fermi surface, which decreases the number of available charge carriers. We also show that in this model, the pseudogap does not modify the low-temperature, low-frequency behavior, though the magnitude of the conductivity is greatly reduced by the Gutzwiller factor. Similarly, the profile of the temperature dependence of the microwave conductivity is largely unchanged in shape, but the Gutzwiller factor is essential in understanding the observed difference in magnitude between ortho-I and -II YBa2_2Cu3_3Oy_y.Comment: 9 pages, 6 figures, submitted to Eur. Phys. J.
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