43 research outputs found
Patient knowledge and its role in the management of coronary heart disease
No full textThis study examines the role that patient knowledge plays in helping patients to manage a chronic condition such as coronary heart disease (CHD). It asks two questions: firstly, what sources do CHD patients use when seeking knowledge about their condition, and what are their reasons for doing so? Secondly, do patients, in the course of managing their CHD, generate knowledge about the condition and its treatment? The study is based on a qualitative analysis of semi-structured interviews conducted with 34 patients with diagnosed CHD. It uses the grounded theory method.
The study makes a contribution to knowledge in a number of areas. Firstly, it shows that the patients interviewed obtain health information from a wide variety of sources, but prefer knowledge derived through personal interaction; their knowledge-seeking appears to be influenced by the quality of their relationship with their GP.
Secondly, it shows that these patients seek three distinct types of knowledge from different sources: expert knowledge from GPs and consultants; personalised practical knowledge from nurse specialists and cardiac trainers; ‘folk’ or common sense knowledge from close friends, family and other patients.
Thirdly, it identifies two examples of patient-generated knowledge that could help improve CHD management – firstly, the understanding that underpins patients’ self-generated home-made health records; secondly, the patient embodied understanding that their health knowledge does not determine their health behaviours where the benefits of such knowledge are deferred.
Fourthly, the study develops a theoretical model to explain how individual patient observations and practices can be converted into potentially valuable organisational knowledge.
Finally, four areas are identified where health benefits may be obtained through improving current knowledge management interventions aimed at CHD patients: by using technology to assist patient involvement; by personalising cardiac rehabilitation; through the reconfiguration of long-term clinical pathways; and through better co-ordination of treatment across primary and secondary care, and across clinical specialities.
As this is a qualitative study, the findings are theses, grounded in the words and actions of the patients studied. However, the new light shed on aspects of patient knowledge and the associated theoretical developments can help guide future study and encourage a re-evaluation of the effectiveness of knowledge management interventions aimed at chronic disease patients
A genetic variation map for chicken with 2.8 million single-nucleotide polymorphisms
No full textWe describe a genetic variation map for the chicken genome containing 2.8 million single-nucleotide polymorphisms (SNPs). This map is based on a comparison of the sequences of three domestic chicken breeds (a broiler, a layer and a Chinese silkie) with that of their wild ancestor, red jungle fowl. Subsequent experiments indicate that at least 90% of the variant sites are true SNPs, and at least 70% are common SNPs that segregate in many domestic breeds. Mean nucleotide diversity is about five SNPs per kilobase for almost every possible comparison between red jungle fowl and domestic lines, between two different domestic lines, and within domestic lines--in contrast to the notion that domestic animals are highly inbred relative to their wild ancestors. In fact, most of the SNPs originated before domestication, and there is little evidence of selective sweeps for adaptive alleles on length scales greater than 100 kilobases
Obesity indices and self-reported functional health in men and women in the EPIC-Norfolk
No full textTo investigate the association between two indices of obesity, BMI and waist-to-hip ratio (WHR), and self-reported physical and mental functional health
Antenatal Screening for Down Syndrome Using Serum Placental Growth Factor with the Combined, Quadruple, Serum Integrated and Integrated Tests
No full textPMCID: PMC3463523This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Incorporating DNA Sequencing into Current Prenatal Screening Practice for Down's Syndrome
No full textPMCID: PMC3604109This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Whole-genome analysis of diverse Chlamydia trachomatis strains identifies phylogenetic relationships masked by current clinical typing
No full textChlamydia trachomatis is responsible for both trachoma and sexually transmitted infections, causing substantial morbidity and economic cost globally. Despite this, our knowledge of its population and evolutionary genetics is limited. Here we present a detailed phylogeny based on whole-genome sequencing of representative strains of C. trachomatis from both trachoma and lymphogranuloma venereum (LGV) biovars from temporally and geographically diverse sources. Our analysis shows that predicting phylogenetic structure using ompA, which is traditionally used to classify Chlamydia, is misleading because extensive recombination in this region masks any true relationships present. We show that in many instances, ompA is a chimera that can be exchanged in part or as a whole both within and between biovars. We also provide evidence for exchange of, and recombination within, the cryptic plasmid, which is another key diagnostic target. We used our phylogenetic framework to show how genetic exchange has manifested itself in ocular, urogenital and LGV C. trachomatis strains, including the epidemic LGV serotype L2b
Paul, Antioch, and Jerusalem: a study in relationships and authority in earliest Christianity
No full textPaul's life and work, including his relationship with the Jerusalem church, were dynamic, rather than having been predetermined in his conversion. The Antiochene church was crucial to Paul's development, to a degree not previously appreciated. Little is known of the years following Paul's conversion, other than it was unsettled, and included travels and sojourns in Arabia, Damascus, Jerusalem, and Tarsus. The encounter with the Jerusalem church did not result in a stable relationship or social integration. It was at Antioch that Paul was first fully incorporated into a Christian community, from which he derived his dyadic identity, and later his apostolic commission. His relationship with the Jerusalem church consisted in corporate participation in the коιυυυία between the churches of Jerusalem and Antioch. In this context, Paul joined Barnabas in defending the Antiochene gospel of uncircumcision, and not his own theology or apostleship, at the Jerusalem conference. The Antioch incident resulted in Paul's separation from the Antiochene church, and exclusion from its коιυυυία with the Jerusalem church. His independent ministry followed, during which he developed his conception of apostleship independent of human authority, in which his self-identity is bound up with the gospel, in response to his isolation, and loss of dyadic identity and apostolic commission. Paul sought to end his isolation through reconciliation with the Antiochene church, and, through its коιυυυία, with the Jerusalem church. This was the object of the collection, but the crisis in Corinth delayed completion, requiring Paul to convey his offering separately. His implicit claim to коιυυυία accordingly became overt, and the collection became the basis, rather than a correlative obligation, of the relationship. This jeopardized the acceptability of Paul's overtures, and, while his reception is uncertain, the journey occasioned his arrest, and ended his missionary career
Modifiable lifestyle behaviors and functional health in the European Prospective Investigation into Cancer (EPIC)-Norfolk population study
No full textTo examine the association between modifiable lifestyle behaviors and functional health
Self-reported mental health-related quality of life and mortality in men and women in the European Prospective Investigation into Cancer (EPIC-Norfolk): a prospective population study
No full textTo explore the relationship between self-reported mental functional health and mortality
Lifestyle behaviours and quality-adjusted life years in middle and older age
No full textour findings support the view that modifiable lifestyle factors are an important component in health improvement
