Ways of using evidence-based medicine in general practice

General practitioners wanting to practise evidence-based medicine (EBM) are constrained by time factors and the great diversity of clinical problems they deal with. They need experience in knowing what questions to ask, in locating and evaluating the evidence, and in applying it. Conventional searching for the best evidence can be achieved in daily general practice. Sometimes the search can be performed during the consultation, but more often it can be done later and the patient can return for the result. Case-based journal clubs provide a supportive environment for GPs to work together to find the best evidence at regular meetings. An evidence-based literature search service is being piloted to enhance decision-making for individual patients. A central facility provides the search and interprets the evidence in relation to individual cases. A request form and a results format make the service akin to pathology testing or imaging. Using EBM in general practice appears feasible. Major difficulties still exist before it can be practised by all GPs, but it has the potential to change the way doctors update their knowledge.

Changes in the ways of life of farmers in the northwest of Portugal after 1980

ABSTRACT This study analyzes the changes from 1980s in the lifestyles of families of pluriactive and exclusively agricultural farmers in the northwest of Portugal caused by the income arising from the migration of at least one member of the family to another country in the European Union and the narrowing of the labor and consumer markets among the villages, towns and cities. The theoretical framework used to analyze the changes in the way of life of the pluriactive farmers was based on Giddens' theory of structuration, which denies both the absolute determinism of the structure on the subject and the freedom of unrestrained action of these same subjects. The study was carried out with the application of a survey to 78 farmers, divided into "pluriactive" and "exclusively agricultural" farmers. The findings pointed out to a greater aquisition of modes of urban life by pluriactive farmers compared with the exclusively agricultural farmers and showed a generational bias in this process of acculturation.

Malaria serology: performance of six Plasmodium falciparum antigen extracts and of three ways of determining serum titers in IgG and IgM-ELISA

The study evaluated six Plasmodium falciparum antigen extracts to be used in the IgG and IgM enzyme-linked immunosorbent assays (ELISA), for malaria diagnosis and epidemiological studies. Results obtained with eighteen positive and nine negative control sera indicated that there were statistically significant differences among these antigen extracts (Multifactor ANOVA, p< 0.0001). Urea, sodium deoxycholate and Zwittergent antigen extracts performed better than did the three others, their features being very similar for the detection of IgG antibodies. Urea, alkaline and sodium deoxycholate antigen extracts proved to be better than the others for the detection of IgM antibodies. A straight line relationship was found between the optical densities (or their respective log 10) and the log 10 of antibody dilutions, with a very constant slope. Thus serum titers could be determined by direct titration and by two different equations, needing only one serum dilution. For IgM antibody detections, log 10 expression gave results that better correlated with direct titration (95% Bonferroni). For IgG antibody detections, the titer differences were not significant. The reproducibility of antibody titers and antigen batches was also evaluated, giving satisfactory results.

Sex determination: why so many ways of doing it?

Sexual reproduction is an ancient feature of life on earth, and the familiar X and Y chromosomes in humans and other model species have led to the impression that sex determination mechanisms are old and conserved. In fact, males and females are determined by diverse mechanisms that evolve rapidly in many taxa. Yet this diversity in primary sex-determining signals is coupled with conserved molecular pathways that trigger male or female development. Conflicting selection on different parts of the genome and on the two sexes may drive many of these transitions, but few systems with rapid turnover of sex determination mechanisms have been rigorously studied. Here we survey our current understanding of how and why sex determination evolves in animals and plants and identify important gaps in our knowledge that present exciting research opportunities to characterize the evolutionary forces and molecular pathways underlying the evolution of sex determination.

Maladies auto-immunes neuromusculaires: diagnostic et prise en charge [Dysimmune neuromuscular disorders: diagnostic challenges and new ways of management].

This review describes some dysimmune neuromuscular disorders and their recent management: syndrome of peripheral nerve hyperexcitability (treatment of cramps, immunosuppressors); Guillain-Barré syndrome (new mechanisms and consensus treatment); chronic inflammatory demyelinating polyradiculoneuropathy (new indication for the use of pulse dexamethasone, new scores of activity); importance of subcutaneous immunoglobulin in multifocal motor neuropathy and of infusions of rituximab in myasthenia gravis; new entities in myositis and their treatment.

Suffering and the ways of being human : an interview with Arthur Kleinman

Artikkelin tekijämerkintönä virheellisesti Johan Lindqvist

Potential utilization ways of recovered chemical products from digestate

The study evaluates the potential application of chemical substances, obtained from biogas plants` by-products. Through the anaerobic digestion process with biogas the large amount of digestate is produced. This digestate mainly consists on the organic matter with the high concentration of nutrients such as nitrogen and phosphorus. During ammonia stripping and phosphorus precipitation the products- ammonia water, ammonium sulfate, ammonium nitrate, ferrous phosphate, aluminum phosphate, calcium phosphate and struvite can be recovered. These chemicals have potential application in different industrial sectors. According to Finnish market and chemicals properties, the most perspective industrial applications were determined. Based on the data, obtained through the literature review and market study, the ammonia water was recognized as a most perspective recovered substances. According to interview provided among Finnish companies, ammonia water is used for flue gas treatment in SNCR technology. This application has a large scale in the framework of Finnish industrial sectors. As well nitrogen with phosphorous can be used as a source of nutrients in the biological wastewater treatment plants of paper mills.

Mythology as a key to historical ways of thinking

Kirjallisuusarvostelu

Do new ways of working foster work engagement?

Resumen tomado de la publicaci??n

Ways of doing : students explore their everyday and classroom processes.

Recurso para que los estudiantes lleguen a trazar sus propios procesos mentales, sus esquemas, sus sistemas de representación, y así ayudarles a construir un nuevo cuerpo de conocimientos profesionales, investigados por los mismos estudiantes. Basado en gran medida en principios humanistas, ofrece más de cien actividades destinadas a animar a los alumnos a pensar, hablar y escribir en inglés sobre áreas que, probablemente, nunca han discutido en su lengua materna. Las actividades, que son adecuadas para una variedad de niveles y edades, se ocupan de: examen de los patrones y procesos de los estudiantes en su vida cotidiana tanto en la exploración de la lengua materna como de la lengua extranjera; dinámica de grupo; formas de aprendizaje; la corrección y la retroalimentación. También hay una sección especial en el desarrollo del profesor.

Prospective elementary school teachers' ways of making sense of mathematical problem posing. 'Modos en que futuros profesores de primaria dan sentido a la invención de problemas matemáticos'.

Resumen basado en el de la publicación