Patients' attitudes towards, and information needs in relation to, nurse prescribing in rheumatology

Aims and objectives: To assess the level of confidence that rheumatology patients would have in nurse prescribing, the effects on likely adherence and particular concerns that these patients have. In addition, given that information provision has been cited as a potential benefit of nurse prescribing, the present study assessed the extent to which these patients would want an explanation for the selected medicine, as well as which types of information should be included in such an explanation. Background: Nurse prescribing has been successfully implemented in the UK in several healthcare settings. Existing research has not addressed the effects on patients' confidence and likely adherence, nor have patients' information needs been established. However, we know that inadequate medicines information provision by health professionals is one of the largest causes of patient dissatisfaction. Methods: Fifty-four patients taking disease-modifying drugs for inflammatory joint disease attending a specialist rheumatology clinic self-completed a written questionnaire. Results: Patients indicated a relatively high level of confidence in nurse prescribing and stated that they would be very likely to take the selected medication. The level of concern was relatively low and the majority of concerns raised did not relate to the nurse's status. Strong support was expressed for the nurse providing an explanation for medicine choice. Conclusion: This research provides support for the prescription of medicines by nurses working in the area of rheumatology, the importance of nurses providing a full explanation about the selected medicines they prescribe for these patients and some indication as to which categories of information should be included. Relevance to clinical practice: Rheumatology patients who have not yet experienced nurse prescribing are, in general, positive about nurses adopting this role. It is important that nurses provide appropriate information about the prescribed medicines, in a form that can be understood.

Using the web graph to influence application behaviour

The Web's link structure (termed the Web Graph) is a richly connected set of Web pages. Current applications use this graph for indexing and information retrieval purposes. In contrast the relationship between Web Graph and application is reversed by letting the structure of the Web Graph influence the behaviour of an application. Presents a novel Web crawling agent, AlienBot, the output of which is orthogonally coupled to the enemy generation strategy of a computer game. The Web Graph guides AlienBot, causing it to generate a stochastic process. Shows the effectiveness of such unorthodox coupling to both the playability of the game and the heuristics of the Web crawler. In addition, presents the results of the sample of Web pages collected by the crawling process. In particular, shows: how AlienBot was able to identify the power law inherent in the link structure of the Web; that 61.74 per cent of Web pages use some form of scripting technology; that the size of the Web can be estimated at just over 5.2 billion pages; and that less than 7 per cent of Web pages fully comply with some variant of (X)HTML.

Largest connected component of a star graph with faulty vertices

In order to make a full evaluation of an interconnection network, it is essential to estimate the minimum size of a largest connected component of this network provided the faulty vertices in the network may break its connectedness. Star graphs are recognized as promising candidates for interconnection networks. This article addresses the size of a largest connected component of a faulty star graph. We prove that, in an n-star graph (n >= 3) with up to 2n-4 faulty vertices, all fault-free vertices but at most two form a connected component. Moreover, all fault-free vertices but exactly two form a connected component if and only if the set of all faulty vertices is equal to the neighbourhood of a pair of fault-free adjacent vertices. These results show that star graphs exhibit excellent fault-tolerant abilities in the sense that there exists a large functional network in a faulty star graph.

The influence of organic acids in relation to acid deposition in controlling the acidity of soil and stream waters on a seasonal basis

Much uncertainty still exists regarding the relative importance of organic acids in relation to acid deposition in controlling the acidity of soil and surface waters. This paper contributes to this debate by presenting analysis of seasonal variations in atmospheric deposition, soil solution and stream water chemistry for two UK headwater catchments with contrasting soils. Acid neutralising capacity (ANC), dissolved organic carbon (DOC) concentrations and the Na:Cl ratio of soil and stream waters displayed strong seasonal patterns with little seasonal variation observed in soil water pH. These patterns, plus the strong relationships between ANC, Cl and DOC, suggest that cation exchange and seasonal changes in the production of DOC and seasalt deposition are driving a shift in the proportion of acidity attributable to strong acid anions, from atmospheric deposition, during winter to predominantly organic acids in summer.

Nocturnal ranging behaviour of urban hedgehogs, Erinaceus europaeus, in relation to risk and reward

Urban areas have both positive and negative influences on wildlife. For terrestrial mammals, one of the principle problems is the risk associated with moving through the environment whilst foraging. In this study, we examined nocturnal patterns of movement of urban-dwelling hedgehogs (Erinaceus europaeus) in relation to (i) the risks posed by predators and motor vehicles and (ii) nightly weather patterns. Hedgehogs preferentially utilised the gardens of semi-detached and terraced houses. However, females, but not males, avoided the larger back gardens of detached houses, which contain more of the habitat features selected by badgers. This difference in the avoidance of predation risk is probably associated with sex differences in breeding behaviour. Differences in nightly movement patterns were consistent with strategies associated with mating behaviour and the accumulation of fat reserves for hibernation. Hedgehogs also exhibited differences in behaviour associated with the risks posed by humans; they avoided actively foraging near roads and road verges, but did not avoid crossing roads per se. They were, however, significantly more active after midnight when there was a marked reduction in vehicle and foot traffic. In particular, responses to increased temperature, which is associated with increased abundance of invertebrate prey, were only observed after midnight. This variation in the timing of bouts of activity would reduce the risks associated with human activities. There were also profound differences in both area ranged and activity with chronological year which warrant further investigation.

The relation between content and structure in language production: an analysis of speech errors in semantic dementia

In order to explore the impact of a degraded semantic system on the structure of language production, we analysed transcripts from autobiographical memory interviews to identify naturally-occurring speech errors by eight patients with semantic dementia (SD) and eight age-matched normal speakers. Relative to controls, patients were significantly more likely to (a) substitute and omit open class words, (b) substitute (but not omit) closed class words, (c) substitute incorrect complex morphological forms and (d) produce semantically and/or syntactically anomalous sentences. Phonological errors were scarce in both groups. The study confirms previous evidence of SD patients’ problems with open class content words which are replaced by higher frequency, less specific terms. It presents the first evidence that SD patients have problems with closed class items and make syntactic as well as semantic speech errors, although these grammatical abnormalities are mostly subtle rather than gross. The results can be explained by the semantic deficit which disrupts the representation of a pre-verbal message, lexical retrieval and the early stages of grammatical encoding.

Relation between neuronal morphology and electrophysiology in the Kainate lesion model of Alzheimer's Disease

This paper describes a computational and statistical study of the influence of morphological changes on the electrophysiological response of neurons from an animal model of Alzheimer's Disease (AD). We combined experimental morphological data from rat hippocampal CA1 pyramidal cells with a well-established model of active membrane properties. Dendritic morphology and the somatic response to simulated current clamp conditions were then compared for cells from the control and the AD group. The computational approach allowed us to single out the influences of neuromorphology on neuronal response by eliminating the effects of active channel variability. The results did not reveal a simple relationship between morphological changes associated with AD and changes in neural response. However, they did suggest the existence of more complex than anticipated relationships between dendritic morphology and single-cell electrophysiology.

Specialization of right temporo-parietal junction for mentalizing and its relation to social impairments in autism

Over the last 25years, "mindblindness" (deficits in representing mental states) has been one of the primary explanations behind the hallmark social-communication difficulties in autism spectrum conditions (ASC). However, highlighting neural systems responsible for mindblindness and their relation to variation in social impairments has remained elusive. In this study we show that one of the neural systems responsible for mindblindness in ASC and its relation to social impairments is the right temporo-parietal junction (RTPJ). Twenty-nine adult males with ASC and 33 age and IQ-matched Controls were scanned with fMRI while making reflective mentalizing or physical judgments about themselves or another person. Regions of interest within mentalizing circuitry were examined for between-group differences in activation during mentalizing about self and other and correlations with social symptom severity. RTPJ was the only mentalizing region that responded atypically in ASC. In Controls, RTPJ was selectively more responsive to mentalizing than physical judgments. This selectivity for mentalizing was not apparent in ASC and generalized across both self and other. Selectivity of RTPJ for mentalizing was also associated with the degree of reciprocal social impairment in ASC. These results lend support to the idea that RTPJ is one important neural system behind mindblindness in ASC. Understanding the contribution of RTPJ in conjunction with other neural systems responsible for other component processes involved in social cognition will be illuminating in fully explaining the hallmark social-communication difficulties of autism.

Real estate capital flows and transitional economies

reign real estate capital was a major source of financing domestic property market office construction in Central Europe after the fall of the Berlin Wall in 1989. During the 1990s, over 800 office buildings were either newly constructed or refurbished in Budapest, Prague and Warsaw. The primary focus of this analysis is explaining the spatial construction and redevelopment patterns of the post-1989 office buildings in these cities. Secondarily, we analyze the correlation of foreign direct investment flows to annual construction of office buildings. We seek to explain the location of new or refurbished office buildings in the central business district (CBD) or in non-CBD locations in terms of the effect of time, size of property and other variables, and test whether there is a positive correlation relationship of foreign direct investment flows and new office construction or refurbishment. Integrating relevant foreign direct investment (FDI), economic geography and property theories in the research, the authors attempt to bridge existing gaps in the literature.