Soliciting additional concerns in the primary care consultation and the utility of a brief communication intervention to aid solicitation: A qualitative study

Objective To investigate the perspectives of general practitioners (GPs) on the practice of soliciting additional concerns (ACs) and the acceptability and utility of two brief interventions (prompts) designed to aid the solicitation. Methods Eighteen GPs participating in a feasibility randomised controlled trial were interviewed. Interviews were semi-structured and audio-recorded. Data were analysed using a Framework Approach. Results Participants perceived eliciting ACs as important for: reducing the need for multiple visits, identifying serious illness early, and increasing patient and GP satisfaction. GPs found the prompts easy to use and some continued their use after the study had ended to aid time management. Others noted similarities between the intervention and their usual practice. Nevertheless, soliciting ACs in every consultation was not unanimously supported. Conclusion The prompts were acceptable to GPs within a trial context, but there was disagreement as to whether ACs should be solicited routinely. Some GPs considered the intervention to aid their prioritisation efficiency within consultations. Practice implications Some GPs will find prompts which encourage ACs to be solicited early in the consultation enable them to better organise priorities and manage time-limited consultations more effectively.

A delphi study on health in future India

PIP: A delphi study was conducted to identify or envision health scenarios in India by the year 2000. Questionnaires consisting of 48 questions on 5 areas (diagnosis and therapy; family planning; pharmaceuticals and drugs; biochemical and biomedical research; health services) were mailed to 250 experts in India. 36 responded. Results were compiled and mailed back to the respondents for changes and comments. 17 people responded. Results of the delphi study shows that policy decisions with respect to compulsory family planning as well as health education at secondary school level will precede further breakthroughs in birth control technology. Non operation reversible sterilization procedures, immunological birth control, Ayurvedic medicines for contraception and abortion, and selection of baby's sex are all possible by 2000 thereafter. Complete eradication of infectious diseases, malnutrition and associated diseases is considered unlikely before 2000, as are advances in biomedical research. Changes in health services (e.g., significant increases in hospital beds and doctors, cheap bulk drugs), particularly in rural areas, are imminent, leading to prolonging of life expectancy to 70 years. Genetic engineering may provide significant breakthroughs in the prevention of malignancies and cardiac disorders. The India delphi study is patterned after a similar delphi study conducted in the U.S. by Smith, Kline and French (SKF) Laboratories in 1968. The SKF study was able to predict some breakthroughs with basic research which have been realized.

D-MG Tradeoff and Optimal Codes for a Class of AF and DF Cooperative Communication Protocols

Cooperative relay communication in a fading channel environment under the orthogonal amplify-and-forward (OAF), nonorthogonal and orthogonal selection decode-and-forward (NSDF and OSDF) protocols is considered here. The diversity-multiplexing gain tradeoff (DMT) of the three protocols is determined and DMT-optimal distributed space-time (ST) code constructions are provided. The codes constructed are sphere decodable and in some instances incur minimum possible delay. Included in our results is the perhaps surprising finding that the orthogonal and the nonorthogonal amplify-and-forward (NAF) protocols have identical DMT when the time durations of the broadcast and cooperative phases are optimally chosen to suit the respective protocol. Moreover our code construction for the OAF protocol incurs less delay. Two variants of the NSDF protocol are considered: fixed-NSDF and variable-NSDF protocol. In the variable-NSDF protocol, the fraction of time occupied by the broadcast phase is allowed to vary with multiplexing gain. The variable-NSDF protocol is shown to improve on the DMT of the best previously known static protocol when the number of relays is greater than two. Also included is a DMT optimal code construction for the NAF protocol.

The role of aesthetic style in the visual communication of climate change

Public apathy on the issue of Anthropogenic Climate Change (ACC) is widespread, with more than half of surveyed Australians and Britons in denial of the phenomenon. While much is known about media influences and strategies such as message framing, there is little in the way of research on the impact of designed visual communication. This study builds knowledge and challenges assumptions by employing a relational approach between ACC visual communications, the professionals producing them, and the members of society that these communications are attempting to influence, contributing knowledge to the fields of graphic design, science communication and social science.

A scientific approach to agent selection

The prioritisation of potential agents on the basis of likely efficacy is an important step in biological control because it can increase the probability of a successful biocontrol program, and reduce risks and costs. In this introductory paper we define success in biological control, review how agent selection has been approached historically, and outline the approach to agent selection that underpins the structure of this special issue on agent selection. Developing criteria by which to judge the success of a biocontrol agent (or program) provides the basis for agent selection decisions. Criteria will depend on the weed, on the ecological and management context in which that weed occurs, and on the negative impacts that biocontrol is seeking to redress. Predicting which potential agents are most likely to be successful poses enormous scientific challenges. 'Rules of thumb', 'scoring systems' and various conceptual and quantitative modelling approaches have been proposed to aid agent selection. However, most attempts have met with limited success due to the diversity and complexity of the systems in question. This special issue presents a series of papers that deconstruct the question of agent choice with the aim of progressively improving the success rate of biological control. Specifically they ask: (i) what potential agents are available and what should we know about them? (ii) what type, timing and degree of damage is required to achieve success? and (iii) which potential agent will reach the necessary density, at the right time, to exert the required damage in the target environment?

"Mut ei tää oo hei midsommarista!" - ruotsin kielen viestinnällinen suullinen harjoittelu yhteistoiminnallisten skeema- ja elaborointitehtävien avulla

Communicative oral practice in Swedish through collaborative schema-based and elaboration tasks The general aim of this study was to learn how to better understand foreign language communicative oral practice and to develop it as part of communicative language teaching. The language-specific aim was to study how Swedish was being practised communicatively and orally in a classroom context as part of the didactic teaching-studying-learning process, and how the students' communicative oral practice in Swedish was carried out through collaborative schema-based and elaboration tasks. The scientific problem of this study focused on the essence of foreign language communicative oral proficiency. The research questions were concerned with 1) the students' involvement in carrying out the given oral tasks; 2) the features of communication and interaction strategies; 3) thematic vocabulary, and 4) the students' experiences and conceptions of the communicative oral tasks used. The study consisted of two groups of students from a Helsinki-area school (a group of upper secondary school students, Swedish Level A, Courses 2 and 3, n=9; and a group of basic education students, Swedish Level B, Course 2, n=13). The study was carried out as a pedagogically oriented case study which included certain features of ethnographic research and where the students' teacher acted as a researcher of her own work. The communicative oral practice contained five different tasks. The research data were gathered through systematic observation, audio recordings and by a questionnaire. The data were analysed through ethnographic content analysis methods. The main research finding was that a good deal of social interaction, collaboration and communication took place between the students when involved in communicative oral practice in Swedish. The students took almost optimal advantage of the allocated training time. They mostly used Swedish when participating in interactional communication. Finnish was mostly used by the students when they were deciding how to carry out a given task, aiming at intersubjectivity or negotiating meaning. The students were relaxed when practising Swedish. They also asked for and gave linguistic help in the spirit of collaborative learning principles. This resulted in interaction between students that highlighted certain features of negotiation of meaning, scaffolding and collaborative dialogue. Asking for and giving help in language issues concentrated mainly on vocabulary, and only in a few cases on grammar or pronunciation. The students also needed the teacher as a mentor. As well, the students had an enjoyable time when practising, which was most often related to carrying out the oral tasks. The thematic vocabulary used by the students corresponded well to the thematic lexis that served as a basis for the practice. At its most efficient, this lexis was most evident when the basic education students were carrying out schema-based tasks. The students' questionnaire answers agreed with the research findings gained through systematic observation and the analysis of audio recordings. The communicative tasks planned by the teacher and implemented by the students were very much in line. The language-didactic theory as presented in this study and the research findings can be widely utilised in pre-service and in-service teacher education, as well as, more generally, when developing communicative language teaching. Key words: communicative oral practice; the Swedish language; foreign language; didactic teaching-studying-learning process; communicative language teaching; collaborative task; schema-based task; elaboration task.

Integrated Information and Communication Technology Strategies for Competitive Higher Education in Asia and the Pacific

Developing countries in Asia and the Pacific are rapidly reaching middle income economic status. Their competitive advantage is shifting from labor-intensive industries and natural resource-based economies to knowledge-based economies that innovate and create new products and services. Early adoption of information and communication technology (ICT) can allow countries to leapfrog over the traditional development pathway into production of knowledge-based products and services. Since higher education institutions (HEIs) are considered a primary engine of economic growth, adoption of ICT is imperative for securing competitive advantage. ICT is thought to be one of the fastest growing industries and is frequently heralded as a transforming influence on higher education systems globally and, consequently, is enhancing the competitive advantage of countries. It is increasingly becoming evident that an institution-wide ICT strategy covering all evolving functions of competitive HEIs is necessary. Such a system may be designed as an integrated platform but implemented in phases.

From garamut to mobile phone: Communication change in rural Papua New Guinea

This article presents the attitudinal response of rural villagers in Papua New Guinea to mobile telephony, based on a threshold study made during the early stages of its adoption. The research indicates that the introduction of mobile telecommunications has generally been viewed positively, with mobile phones affording social interaction with loved ones. Nonetheless, negative concerns have been strongly felt, notably financial costs and anxiety about mobile phones aiding in the coordination of extramarital liaisons and criminal activities. The communities investigated previously had scant access to modern communication technologies, some still using traditional means such as wooden slit drums, known locally as garamuts. The expansion of mobile network coverage has introduced into communal village life the capability to communicate dyadically and privately at a distance. Investigation into the adoption of mobile phones thus promotes understanding about traditional means of communication and notions of public and private interactions.

Status assessment of water use research in turf growth and maintenance.

The strategic objectives of Turf Australia (formerly the Turf Producers Association (TPA)) relating to water use in turf are to: • Source and collate information to support the case for adequate access to water for the Turf production and maintenance sectors and • Compile information generated into a convincing communication package that can be readily used by the industry in its advocacy programs (to government, regulators, media etc) More specifically, the turfgrass industry needs unbiased scientific evidence of the value of healthy grass in our environment. It needs to promote the use of adequate water even during drought periods to maintain quality turfgrass, which provides many benefits to the broader community including cooling the environment, saving energy and encouraging healthy lifestyles. The many environmental, social and health benefits of living turfgrass have been the subject of numerous investigations beyond the scope of this review. However further research is needed to fully understand the economic returns achievable by the judicious use of water for the maintenance of healthy turfgrass. Consumer education, backed by scientific evidence will highlight the “false economy” in allowing turfgrass to wither and die during conditions which require high level water restrictions. This report presents a review of the literature pertaining to research in the field of turf water use. The purpose of the review was to better understand the scope and nature of existing research results on turf water relations so that knowledge gaps could be identified in achieving the above strategic objectives of the TPA. Research to date has been found to be insufficient to compile a convincing communication package as described. However, identified knowledge gaps can now be addressed through targeted research. Information derived from targeted research will provide valuable material for education of the end user of turfgrass. Recommendations have been developed, based on the results of this desktop review. It was determined that future research in the field of turf irrigation needs to focus on a number of key factors which directly or indirectly affect the relationship between turfgrass and water use. These factors are: • Climate • Cultivar • Quality • Site use requirements • Establishment and management The overarching recommendation is to develop a strategic plan for turfgrass water relations research based around the five determinants of turf water use listed above. This plan should ensure research under these five categories is integrated into a holistic approach by which the consumer can be guided in species and/or cultivar choices as well as best management practices with respect to turfgrass water relations. Worsening drought cycles and limited supply of water for irrigation were the key factors driving every research project reviewed in this report. Subsidence of the most recent (or current) drought conditions in Australia should not be viewed by the turf industry as a reason to withdraw support or funding for research in this area. Drought conditions, limited domestic water availability and urban water restrictions will return in Australia albeit in 5, 10 or 20 years time and the turf industry has an opportunity to prepare for that time.

Holographic methods for the fabrication of various types of mirrors

A comprehensive set of new configurations for the holographic simulation of a wide variety of mirrors is described. These holographically simulated mirrors (HSMs) have been experimentally realized and their imaging performance has been studied.

The scientific basis and development of a matrix metalloproteinase (MMP) -8 specific chair-side test for monitoring of periodontal health and disease from gingival crevicular fluid

Matrix metalloproteinase (MMP) -8, collagenase-2, is a key mediator of irreversible tissue destruction in chronic periodontitis and detectable in gingival crevicular fluid (GCF). MMP-8 mostly originates from neutrophil leukocytes, the first line of defence cells which exist abundantly in GCF, especially in inflammation. MMP-8 is capable of degrading almost all extra-cellular matrix and basement membrane components and is especially efficient against type I collagen. Thus the expression of MMP-8 in GCF could be valuable in monitoring the activity of periodontitis and possibly offers a diagnostic means to predict progression of periodontitis. In this study the value of MMP-8 detection from GCF in monitoring of periodontal health and disease was evaluated with special reference to its ability to differentiate periodontal health and different disease states of the periodontium and to recognise the progression of periodontitis, i.e. active sites. For chair-side detection of MMP-8 from the GCF or peri-implant sulcus fluid (PISF) samples, a dip-stick test based on immunochromatography involving two monoclonal antibodies was developed. The immunoassay for the detection of MMP-8 from GCF was found to be more suitable for monitoring of periodontitis than detection of GCF elastase concentration or activity. Periodontally healthy subjects and individuals suffering of gingivitis or of periodontitis could be differentiated by means of GCF MMP-8 levels and dipstick testing when the positive threshold value of the MMP-8 chair-side test was set at 1000 µg/l. MMP-8 dipstick test results from periodontally healthy and from subjects with gingivitis were mainly negative while periodontitis patients sites with deep pockets ( 5 mm) and which were bleeding on probing were most often test positive. Periodontitis patients GCF MMP-8 levels decreased with hygiene phase periodontal treatment (scaling and root planing, SRP) and even reduced during the three month maintenance phase. A decrease in GCF MMP-8 levels could be monitored with the MMP-8 test. Agreement between the test stick and the quantitative assay was very good (κ = 0.81) and the test provided a baseline sensitivity of 0.83 and specificity of 0.96. During the 12-month longitudinal maintenance phase, periodontitis patients progressing sites (sites with an increase in attachment loss ≥ 2 mm during the maintenance phase) had elevated GCF MMP-8 levels compared with stable sites. General mean MMP-8 concentrations in smokers (S) sites were lower than in non-smokers (NS) sites but in progressing S and NS sites concentrations were at an equal level. Sites with exceptionally and repeatedly elevated MMP-8 concentrations during the maintenance phase were clustered in smoking patients with poor response to SRP (refractory patients). These sites especially were identified by the MMP-8 test. Subgingival plaque samples from periodontitis patients deep periodontal pockets were examined by polymerase chain reaction (PCR) to find out if periodontal lesions may serve as a niche for Chlamydia pneumoniae. Findings were compared with the clinical periodontal parameters and GCF MMP-8 levels to determine the correlation with periodontal status. Traces of C. pneumoniae were identified from one periodontitis patient s pooled subgingival plaque sample by means of PCR. After periodontal treatment (SRP) the sample was negative for C. pneumoniae. Clinical parameters or biomarkers (MMP-8) of the patient with the positive C. pneumoniae finding did not differ from other study patients. In this study it was concluded that MMP-8 concentrations in GCF of sites from periodontally healthy individuals, subjects with gingivitis or with periodontitis are at different levels. The cut-off value of the developed MMP-8 test is at an optimal level to differentiate between these conditions and can possibly be utilised in identification of individuals at the risk of the transition of gingivitis to periodontitis. In periodontitis patients, repeatedly elevated GCF MMP-8 concentrations may indicate sites at risk of progression of periodontitis as well as patients with poor response to conventional periodontal treatment (SRP). This can be monitored by MMP-8 testing. Despite the lower mean GCF MMP-8 concentrations in smokers, a fraction of smokers sites expressed very high MMP-8 concentrations together with enhanced periodontal activity and could be identified with MMP-8 specific chair-side test. Deep periodontal lesions may be niches for non-periodontopathogenic micro-organisms with systemic effects like C. pneumoniae and possibly play a role in the transmission from one subject to another.

Priority-oriented reservation multiple access scheme for data communication through satellites

A multi-access scheme is proposed for handling priority-based messages in data communication systems through satellites. The different schemes by which time slots are alloted by the satellite are based on a ‘priority index’. The performance characteristics of the system using these schemes under different traffic conditions are discussed.

Two Tools for Interprocess Communication in Distributed Data-Flow Systems

Abstract is not available.