1,720,968 research outputs found
General practitioners, generalism and the new genetics : qualitative and quantitative studies of general practitioners' response to the implications of genetic advances in breast cancer for their roles
No full textPolicy-makers, clinical geneticists and the Royal College of General Practitioners recognise general practitioners will identify patients with genetic susceptibility to common cancers. They recommend most patients' enquires about genetic susceptibility to common cancers, such as breast cancer, should be managed by general practitioners (GPs). Since the ratio of consultant geneticists to general practitioners is roughly 500 to one general practitioners will necessarily have a role. This research explores GPs' ideas of their role and their responses to roles identified for them by policy-makers and experts. I used qualitative and quantitative methods. Grounded theory guided open-ended interviews with a purposive sample of GPs. Interviews explored GPs' ideas, beliefs and experiences of genetic medicine in general, and more specifically, in relation to breast cancer. As data collection and analysis proceeded a theoretical sample (selection guided by the emerging analysis) was generated to explore categories further, and to test the integrity and credibility of the emerging analysis. Two core themes were identified: 1) genetics in the generalist context, which included appropriate generalist intervention, the ethical dilemmas implicit in the therapeutic gap and the familial-hereditary distinction in primary care, and 2) the implications for the generalist identity, including the potential marginalisation of generalism. The category familial-hereditary distinction was used to construct a hypothesis and a questionnaire which was applied to a random sample of 200 GPs in the Wessex area. A descriptive statistical analysis and factor analysis of the questionnaire data supported the findings of the qualitative study. Both studies revealed inconsistencies between policy-makers' and GPs' definitions of general practitioners' role in implementing genetic advances. General practitioners' emphasised the need to build on current practice, whereas policy-makers focused on transforming practice to include new and specialised roles.</p
Anti-DNA antibodies-structure and function
No full textExpression of monoclonal anti-DNA antibodies in vitro can be used to study the relationships between molecular structure, binding properties and pathogenicity. Bacterial and yeast systems can be used to produce antibody fragments such as Fab. The yields are potentially sufficient to allow structural studies such as crystallization, but purification of the anti-DNA Fab from the bacterial periplasm may be challenging. Mammalian cell expression systems produce lower yields, but the products are whole antibodies, which can be used in assays of pathogenicity. This article describes some recent experiments in which bacterial and mammalian systems were used to study human monoclonal anti-DNA antibodies. Light chain sequence motifs were found to be important both in binding to antigens and in determining pathogenicity of the antibodies in severe combined immunodeficiency mice. The distribution of B cell subpopulations is disturbed in patients with systemic lupus erythematosus (SLE). These patients, like those with infectious mononucleosis, have an overall B cell lymphopenia but an increased frequency of plasmablasts/early plasma cells in their blood. Some of these early plasma cells belong to clones that have rearranged the V(H) gene V4-34. There is a selective rise in immunoglobulins encoded by this gene in both infectious mononucleosis and SLE
Cohort study of informal carers of first-time stroke survivors: a profile of health and social changes in the first year of care giving
No full textInformal carers underpin community care policies. An initial cohort of 105 informal live-in carers of new stroke patients from the South Coast of England was followed up before discharge, six weeks after discharge and 15 months after stroke with face-to-face interviews assessing physical and psychological health, and social wellbeing. The carer cohort was compared to a cohort of 50 matched non-carers over the same time period. Carer distress was common (37–54%), started early on in the care-giving experience and continued until 15 months after stroke. Carers were 2.5 times as likely as non-carers to have significant psychological distress. Presence of early distress predicted 90% of those significantly distressed 15 months after stroke. Female carers were likely to develop distress earlier than male carers and in anticipation of the care-giving situation. Male carers developed similar levels of distress but only once the care-giving situation became reality. Further research is needed to establish ways to screen for psychological distress early after onset of caregiving, to find ways to tailor proven support interventions to the individual carer, and to evaluate the effect of early detection and support provision on later carer distress
Why do general practitioners prescribe antibiotics for sore throat? Grounded theory interview study
No full textObjectives: to understand why general practitioners prescribe antibiotics for some cases of sore throat and to explore the factors that influence their prescribing.Design: grounded theory interview study.Setting: general practice.Participants: 40 general practitioners: 25 in the maximum variety sample and 15 in the theoretical sample.Results: general practitioners are uncertain which patients will benefit from antibiotics but prescribe for sicker patients and for patients from socioeconomically deprived backgrounds because of concerns about complications. They are also more likely to prescribe in pressured clinical contexts. Doctors are mostly comfortable with their prescribing decisions and are not prescribing to maintain the doctor-patient relationship.Conclusions: general practitioners have reduced prescribing for sore throat in response to research and policy initiatives. Further interventions to reduce prescribing would need to improve identification of patients at risk of complications and be workable in busy clinical situations
Who cares for the carers? The district nurse perspective
No full textBackground. Community care of elderly and disabled people is increasing. Primary care teams are expected to provide support to the informal carers essential for its success.Objective. To explore district nurse (DN) views about roles of the primary care team and what is needed for support of informal carers.Method. A qualitative analysis of open-ended questions contained in a larger postal questionnaire.Results. DNs viewed improved respite care, general support and information provision as priorities for supporting carers, and lack of resources and access as the main reasons why they could not be more active. They thought other team members might be better placed to take that role. GPs were seen as key members of the primary care team providing services, actively identifying carers and co-ordinating other services and team members.Conclusion. DNs identified several areas of support for carers that could be improved: respite, information provision and general support services. They did not feel able to be pro-active in support of informal carers themselves and viewed the GP in that role as a central co-ordinator of care and services
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
Variations 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
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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