176 resultados para Local expertise


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We report the occurrence of four red macroalgae new to Europe. Two species were unambiguously determined to the species level with a DNA barcoding approach, while the remaining two species could only be assigned to a genus. Gelidium vagum was found in the Oosterschelde estuary (the Netherlands). Gracilariopsis chorda, Chondracanthus sp. and Solieria sp. were found in the Gulf of Morbihan in Brittany (France); Solieria sp. was also subsequently observed in the Thau Lagoon (France). Gelidium vagum and Gracilariopsis chorda are species originating from the north-western Pacific, around the Japanese archipelago. Phylogenetic analyses also show a likely Pacific origin for Chondracanthus sp. and Solieria sp. Three of these species are likely to have been introduced after 2008, indicating some active transport pathways between the Pacific and the north-eastern Atlantic. These findings also underline the importance of consistent and continuous local expertise (versus rapid assessment) in early warning systems.

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Achalasia is a neurodegenerative motility disorder of the oesophagus resulting in deranged oesophageal peristalsis and loss of lower oesophageal sphincter function. Historically, annual achalasia incidence rates were believed to be low, approximately 0.5-1.2 per 100000. More recent reports suggest that annual incidence rates have risen to 1.6 per 100000 in some populations. The aetiology of achalasia is still unclear but is likely to be multi-factorial. Suggested causes include environmental or viral exposures resulting in inflammation of the oesophageal myenteric plexus, which elicits an autoimmune response. Risk of achalasia may be elevated in a sub-group of genetically susceptible people. Improvement in the diagnosis of achalasia, through the introduction of high resolution manometry with pressure topography plotting, has resulted in the development of a novel classification system for achalasia. This classification system can evaluate patient prognosis and predict responsiveness to treatment. There is currently much debate over whether pneumatic dilatation is a superior method compared to the Heller's myotomy procedure in the treatment of achalasia. A recent comparative study found equal efficacy, suggesting that patient preference and local expertise should guide the choice. Although achalasia is a relatively rare condition, it carries a risk of complications, including aspiration pneumonia and oesophageal cancer. The risk of both squamous cell carcinoma and adenocarcinoma of the oesophagus is believed to be significantly increased in patients with achalasia, however the absolute excess risk is small. Therefore, it is currently unknown whether a surveillance programme in achalasia patients would be effective or cost-effective.

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Genetic data from polymorphic microsatellite loci were employed to estimate paternity and maternity in a local population of nine-banded armadillos (Dasypus novemcinctus) in northern Florida. The parentage assessments took advantage of maximum likelihood procedures developed expressly for situations when individuals of neither gender can be excluded a priori as candidate parents. The molecular data for 290 individuals, interpreted alone and in conjunction with detailed biological and spatial information for the population, demonstrate high exclusion probabilities and reasonably strong likelihoods of genetic parentage assignment in many cases; low mean probabilities of successful reproductive contribution to the local population by individual armadillo adults in a given year; and statistically significant microspatial associations of parents and their offspring. Results suggest that molecular assays of highly polymorphic genetic systems can add considerable power to assessments of biological parentage in natural populations even when neither parent is otherwise known.

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First-order time remaining until a moving observer will pass an environmental element is optically specified in two different ways. The specification provided by global tau (based on the pattern of change of angular bearing) requires that the element is stationary and that the direction of motion is accurately detected, whereas the specification provided by composite tau (based on the patterns of change of optical size and optical distance) does not require either of these. We obtained converging evidence,for our hypothesis. that observers are sensitive to composite tau in four experiments involving, relative judgments of, time to, passage with forced-choice methodology. Discrimination performance was enhanced in the presence of a local expansion component, while being unaffected when the detection of the direction of heading was impaired. Observers relied on the information carried in composite tau rather than on the information carried in its constituent components. Finally, performance was similar under conditions of observer motion and conditions of object motion. Because composite tau specifies first-order time remaining for a large number of situations, the different ways in which it may be detected are discussed.

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The paper has three main aims. First, to trace – through the pages of the Journal – the changing ways in which lay understandings of health and illness have been represented during the 1979-2002 period. Second, to say something about the limits of lay knowledge (and particularly lay expertise) in matters of health and medicine. Third, to call for a re-assessment of what lay people can offer to a democratised and customer sensitive system of health care and to attempt to draw a boundary around the domain of expertise. In following through on those aims, the author calls upon data derived from three current projects. These latter concern the diagnosis of Alzheimer’s disease in people with Down’s syndrome; the development of an outcome measure for people who have suffered a traumatic brain injury; and a study of why older people might reject annual influenza vaccinations. Key words: Lay health beliefs, lay expertise, Alzheimer’s, Traumatic Brain Injury, Vaccinations