Comparison of estimates and calculations of risk of coronary heart disease by doctors and nurses using different calculation tools in general practice: cross sectional study

OBJECTIVE: To assess the effect of using different risk calculation tools on how general practitioners and practice nurses evaluate the risk of coronary heart disease with clinical data routinely available in patients' records. DESIGN: Subjective estimates of the risk of coronary heart disease and results of four different methods of calculation of risk were compared with each other and a reference standard that had been calculated with the Framingham equation; calculations were based on a sample of patients' records, randomly selected from groups at risk of coronary heart disease. SETTING: General practices in central England. PARTICIPANTS: 18 general practitioners and 18 practice nurses. MAIN OUTCOME MEASURES: Agreement of results of risk estimation and risk calculation with reference calculation; agreement of general practitioners with practice nurses; sensitivity and specificity of the different methods of risk calculation to detect patients at high or low risk of coronary heart disease. RESULTS: Only a minority of patients' records contained all of the risk factors required for the formal calculation of the risk of coronary heart disease (concentrations of high density lipoprotein (HDL) cholesterol were present in only 21%). Agreement of risk calculations with the reference standard was moderate (kappa=0.33-0.65 for practice nurses and 0.33 to 0.65 for general practitioners, depending on calculation tool), showing a trend for underestimation of risk. Moderate agreement was seen between the risks calculated by general practitioners and practice nurses for the same patients (kappa=0.47 to 0.58). The British charts gave the most sensitive results for risk of coronary heart disease (practice nurses 79%, general practitioners 80%), and it also gave the most specific results for practice nurses (100%), whereas the Sheffield table was the most specific method for general practitioners (89%). CONCLUSIONS: Routine calculation of the risk of coronary heart disease in primary care is hampered by poor availability of data on risk factors. General practitioners and practice nurses are able to evaluate the risk of coronary heart disease with only moderate accuracy. Data about risk factors need to be collected systematically, to allow the use of the most appropriate calculation tools.

A class of perfect fluids in general relativity

This thesis is concerned with exact solutions of Einstein's field equations of general relativity, in particular, when the source of the gravitational field is a perfect fluid with a purely electric Weyl tensor. General relativity, cosmology and computer algebra are discussed briefly. A mathematical introduction to Riemannian geometry and the tetrad formalism is then given. This is followed by a review of some previous results and known solutions concerning purely electric perfect fluids. In addition, some orthonormal and null tetrad equations of the Ricci and Bianchi identities are displayed in a form suitable for investigating these space-times. Conformally flat perfect fluids are characterised by the vanishing of the Weyl tensor and form a sub-class of the purely electric fields in which all solutions are known (Stephani 1967). The number of Killing vectors in these space-times is investigated and results presented for the non-expanding space-times. The existence of stationary fields that may also admit 0, 1 or 3 spacelike Killing vectors is demonstrated. Shear-free fluids in the class under consideration are shown to be either non-expanding or irrotational (Collins 1984) using both orthonormal and null tetrads. A discrepancy between Collins (1984) and Wolf (1986) is resolved by explicitly solving the field equations to prove that the only purely electric, shear-free, geodesic but rotating perfect fluid is the Godel (1949) solution. The irrotational fluids with shear are then studied and solutions due to Szafron (1977) and Allnutt (1982) are characterised. The metric is simplified in several cases where new solutions may be found. The geodesic space-times in this class and all Bianchi type 1 perfect fluid metrics are shown to have a metric expressible in a diagonal form. The position of spherically symmetric and Bianchi type 1 space-times in relation to the general case is also illustrated.

Drug information in general practice pharmacy

The drug information sources currently available to general practice pharmacists have been identified. The use of and attitudes to these sources were assessed as well as the perceived information needs of practising pharmacists. The special requirements of women pharmacists and pharmacists working part-time were studied. The relationship of the medical representative as an information source for pharmacists was evaluated. Participation in continuing education programmes as a vital means of ensuring current information awareness and knowledge for the practising profession has been considered. Investigations were mainly pursued by questionnaire survey, while computer facilities were used for the processing and the analyses of data. The desirability of collated and evaluated information from one or more independent authoritative sources has been discussed. The increasing advisory role of the general practice pharmacist and the needs of the patient and potential customer have been discussed, with projections for the pharmacist's future health care contribution.

Looking back or looking forward in corpus linguistics:what can the last 20 years suggest about the next?

Starting with a description of the software and hardware used for corpus linguistics in the late 1980s to early 1990s, this contribution discusses difficulties faced by the software designer when attempting to allow users to study text. Future human-machine interfaces may develop to be much more sophisticated, and certainly the aspects of text which can be studied will progress beyond plain text without images. Another area which will develop further is the study of patternings involving not just single words but word-relations across large stretches of text.

The science and technology of corpus, and corpus for science and technology

Corpus Linguistics is a young discipline. The earliest work was done in the 1960s, but corpora only began to be widely used by lexicographers and linguists in the late 1980s, by language teachers in the late 1990s, and by language students only very recently. This course in corpus linguistics was held at the Departamento de Linguistica Aplicada, E.T.S.I. de Minas, Universidad Politecnica de Madrid from June 15-19 1998. About 45 teachers registered for the course. 30% had PhDs in linguistics, 20% in literature, and the rest were doctorandi or qualified English teachers. The course was designed to introduce the use of corpora and other computational resources in teaching and research, with special reference to scientific and technological discourse in English. Each participant had a computer networked with the lecturer’s machine, whose display could be projected onto a large screen. Application programs were loaded onto the central server, and telnet and a web browser were available. COBUILD gave us permission to access the 323 million word Bank of English corpus, Mike Scott allowed us to use his Wordsmith Tools software, and Tim Johns gave us a copy of his MicroConcord program.

‘Wir stehen fest zusammen/Zu Kaiser und zu Reich!’: Nationalism Among Germans in Britain, 1871–1918

German unification in 1871 triggered a wave of enthusiasm for the fatherland amongst German migrants worldwide. Britain was no exception. National confidence and coherence received a boost through the new symbols of ‘Kaiser’ and ‘Reich’. From the 1880s onwards, more and more militaristic and chauvinistic undertones could be heard. Local branches of German patriotic and militaristic pressure groups were founded in Britain. Support for Germany’s ‘new course’ of colonialist expansion and its ambitious naval programme was, however, not confined to right–wing groups but permeated ethnic life in general. Religion and nationalism stood in a symbiotic relationship; some German academics lecturing at British universities displayed chauvinistic attitudes; social clubs were increasingly dominated by an atmosphere of ‘Reich’–nationalism. After the outbreak of war, public expressions of pro–German attitudes did not disappear and were one of numerous factors contributing to Germanophobia within the host society.

Reacting and responding in TESOL Quarterly:a generic analysis of procedure and purpose in intertextual critical exchanges

A key feature of ‘TESOL Quarterly’, a leading journal in the world of TESOL/applied linguistics, is its ‘Forum’ section which invites ‘responses and rebuttals’ from readers to any of its articles. These ‘responses or rebuttals’ form the focus of this research. In the interchanges between readers reacting to earlier research articles in TESOL Quarterly and authors responding to the said reaction I – examine the texts for evidence of genre-driven structure, whether shared between both ‘reaction’ and ‘response’ sections, or peculiar to each section, and attempt to determine the precise nature of the intended communicative purpose in particular and the implications for academic debate in general. The intended contribution of this thesis is to provide an analysis of how authors of research articles and their critics pursue their efforts beyond the research article which precipitated these exchanges in order to be recognized by their discourse community as, in the terminology of Swales (1981:51), ‘Primary Knowers’. Awareness of any principled generic process identified in this thesis may be of significance to practitioners in the applied linguistics community in their quest to establish academic reputation and in their pursuit of professional development. These findings may also be of use in triggering productive community discussion as a result of the questions they raise concerning the present nature of academic debate. Looking beyond the construction and status of the texts themselves, I inquire into the kind of ideational and social organization such exchanges keep in place and examine an alternative view of interaction. This study breaks new ground in two major ways. To the best of my knowledge, it is the first exploration of a bipartite, intertextual structure laying claim to genre status. Secondly, in its recourse to the comments of the writers’ themselves rather than relying exclusively on the evidence of their texts, as is the case with most studies of genre, this thesis offers an expanded opportunity to discuss perhaps the most interesting aspects of genre analysis – the light it throws on social ends and the role of genre in determining the nature of current academic debate as it here emerges.

Advanced education and training in bioenergy in Europe

The paper explains how bioenergy education and training is growing in Europe. Employment estimates are included for renewable energy in general, and bioenergy in particular, to highlight the need for a broadly based education and training programme that is essential to build a knowledgeable workforce that can drive Europe's growing bioenergy sector. The paper reviews current provisions in bioenergy at Masters and PhD levels across the 27 members of the EU (EU27) plus Norway and Switzerland. This identifies a very active and expanding bioenergy education provision. 65 English-language Masters Courses in bioenergy (either focussing completely on bioenergy or with significant bioenergy content or specialisation) were identified. 231 providers of PhD studies in bioenergy were found.Masters Course offerings have grown rapidly across Europe during the last five years, but where data is available, enrolment has been quite low suggesting that there is an oversupply of courses and that course organisers are being optimistic in their projections. Existing provisions in Europe at Masters and PhD levels are clearly more than sufficient for short term needs, but further work is needed to evaluate the take-up rate and the content and focus of the provisions. To ensure talented graduates are attracted to these programmes, better promotion, stronger links with the research community and industry, and increased collaboration among course providers are needed. Short Courses of two to five days are an excellent way of meeting post-experience training needs but require further growth and development to serve the needs of the bioenergy community. © 2011 Elsevier Ltd.

Special issue:key debates in the translation of advertising material

Much has been written about the marketing aspects of promotional material in general, and several scholars (particularly in linguistics) have addressed questions relating to the structure and function of advertisements, focusing on images, rhetorical structure, semiotic functions, discourse features and audio-visual media, amongst other aspects of the genre. Not much, on the other hand, has been written within translation studies about the complexities involved in the transfer of an advertising message. Contributors to this volume explore various interdependent aspects of the interlingual and intercultural transfer of an advertising message. They emphasize features of culture specificity, of multi-medial semiotic interaction, of values and stereotypes, and most importantly, they recommend strategies and approaches to assist translators. Topics covered include a critique of the Western-based approach to advertising in the context of the Far East; different perceptions of the concept of cleanliness in advertising texts in Italy, Russia and the UK; the Walls Cornetto strategy of internationalization of product appeal, followed by localization; the role of the translator in recreating appeal in different lingua-cultural contexts; what constitutes 'Italianness' in advertisements for British consumers; and strategies for repackaging France as a tourist destination.

An introduction to forensic linguistics:language in evidence

From the accusation of plagiarism in The Da Vinci Code, to the infamous hoaxer in the Yorkshire Ripper case, the use of linguistic evidence in court and the number of linguists called to act as expert witnesses in court trials has increased rapidly in the past fifteen years. An Introduction to Forensic Linguistics: Language in Evidence provides a timely and accessible introduction to this rapidly expanding subject. Using knowledge and experience gained in legal settings – Malcolm Coulthard in his work as an expert witness and Alison Johnson in her work as a West Midlands police officer – the two authors combine an array of perspectives into a distinctly unified textbook, focusing throughout on evidence from real and often high profile cases including serial killer Harold Shipman, the Bridgewater Four and the Birmingham Six. Divided into two sections, 'The Language of the Legal Process' and 'Language as Evidence', the book covers the key topics of the field. The first section looks at legal language, the structures of legal genres and the collection and testing of evidence from the initial police interview through to examination and cross-examination in the courtroom. The second section focuses on the role of the forensic linguist, the forensic phonetician and the document examiner, as well as examining in detail the linguistic investigation of authorship and plagiarism. With research tasks, suggested reading and website references provided at the end of each chapter, An Introduction to Forensic Linguistics: Language in Evidence is the essential textbook for courses in forensic linguistics and language of the law.