1,721,016 research outputs found
High phenotypic diversity correlated with genomic variation across the European Batrachochytrium salamandrivorans epizootic.
Full text linkRecognizing the influence of pathogen diversity on infection dynamics is crucial for mitigating emerging infectious diseases. Characterising such diversity is often complex, for instance when multiple pathogen variants exist that interact differently with the environment and host. Here, we explore genotypic and phenotypic variation of Batrachochytrium salamandrivorans (Bsal), an emerging fungal pathogen that is driving declines among an increasing number of European amphibian species. For thirteen isolates, spanning most of the known temporal and geographical Bsal range in Europe, we mapped phenotypic diversity through numerous measurements that describe varying reproductive rates in vitro across a range of temperatures. Bsal isolates are revealed to have different thermal optima and tolerances, with phenotypic variation correlating with genomic diversity. Using a mechanistic niche model of the fire salamander (Salamandra salamandra) as an example, we illustrate how host steady-state body temperature and Bsal thermal range variation may influence pathogen growth through space and time across Europe. Our combined findings show how the identity of emergent pathogen variants may strongly influence when and which host populations are most at risk
The challenge of communication in interpreted consultations in diabetes care: a mixed methods study
Full text linkBackground: the experience of diabetes care for individuals from minority ethnic groups, particularly individuals of Bangladeshi origin, shows they are at a significant disadvantage.Aim: to identify the challenges of interpreted consultations for healthcare providers and to explain the disadvantage experienced by patients from minority groups who have diabetes.Design and setting: comparison of 12 interpreted consultations with 24 consultations involving fluent English speakers in four primary healthcare centres in Tower Hamlets, east London, UK.Method: content analysis of video recordings of routine diabetes review consultations in primary care, involving 36 patients, nine nurses or healthcare assistants, and six interpreters.Result: interpreted consultations were as long as same-language consultations but patients said less. The incidence of misunderstandings was similar but patients in interpreted consultations asked fewer questions. Indicators of social distance in interpreted consultations included less humour and less discussion of the patient’s feelings or personal circumstances. Patients in interpreted consultations were less likely to raise issues unrelated to diabetes, to discuss their own ideas about health, or to talk about clinical parameters. Providers commonly addressed English-speaking patients directly but usually addressed patients through interpreters using the third person. Interpreters sometimes changed the meaning or did not translate speech, and they added their own comments.Conclusion: the findings explain some of the known problems of diabetes care for individuals from ethnic minorities. Effective training for interpreters and care providers is needed to reduce social distance and to facilitate patients’ involvement in self-managemen
Improving ethnic monitoring for telephone-based healthcare: a conversation analytic study
Full text linkThis final article is available for use under the terms of the Creative Commons Attribution Non-Commercial 2.0 Licence; see http://bmjopen.bmj.co
Moral mediation in interpreted health care consultations
No full textThis paper reports on the moral work done in routine diabetes review consultations in primary care with nurses. Consultations with fluent English speakers are compared with consultations where an interpreter was present, largely involving patients of Bangladeshi origin. The study setting was Tower Hamlets in London, where type 2 diabetes is particularly common. Existing research has shown some dissatisfaction with diabetes care amongst Bangladeshi patients, and studies of care providers in other locations suggest that they at times experience the care of this group as particularly challenging. Through analysis of video-recorded consultations recorded in 2010–2011 we shed light on possible reasons for these difficulties. The 12 non-English speakers often experienced difficulties in raising issues that concerned them, particularly if their interpreter did not translate their utterance because it was deemed to be unrelated to diabetes. These difficulties were not shared by the 24 fluent English speakers, who also found it easier to convey a positive moral reputation and to excuse behaviour that deviated from recommended self-management practices. Interpreters at times also acted as moral mediators. For example, where a participant in the consultation made statements that appeared to convey a negative moral judgement of an other participant, these would often go untranslated. Probably, neither health care providers nor patients are fully aware of the nature of their communication difficulties. Given this, interpreters possess considerable power to influence matters. Understanding the moral work of consultations is important in explaining the findings of other studies showing difficulties in the provision of diabetes care to people with limited English language skill
Response to: Teaching sociology to undergraduate medical students
No full textUnderstanding the social basis of health and medicine and the contexts of clinical care are essential components of good medical practice. This includes the ways in which social factors such as class, ethnicity and gender influence health outcomes and how people experience health, illness and health care.In our Guide we describe what sociology is and what it brings to medicine, beginning with the nature of the “sociological imagination”. Sociological theory and methods are reviewed in order to explain and illustrate the role of sociology in the context of undergraduate medical education. Reference is made to the 2016 report ‘A Core Curriculum for Sociology in UK Undergraduate Medical Education’ by Collett and colleagues. Teaching and student learning are discussed in terms of organisation and delivery, with an emphasis on practice. Sections are included on assessment, feedback to students, evaluating teaching, faculty development, challenges for teaching sociology, and the value of a “community of practice” for sociology teachers in medical education
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
It was the worst of times, it was the BeSST of times: the stirring of medical students’ sociological imagination in 2020
No full textVariations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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