General practice-recorded depression and antidepressant use in young people with newly diagnosed Type 1 diabetes: a cohort study using the Clinical Practice Research Datalink

Aims - To investigate whether young people with Type 1 diabetes have an increased rate of depression andantidepressant use and whether their risk varies by age group, time from diabetes diagnosis, calendar period ofdiagnosis or complications status. Methods - A cohort of incident cases of patients with Type 1 diabetes diagnosed before 35 years of age (n = 5548) wasidentified within the Clinical Practice Research Datalink and individually age and sex matched with up to two controlsubjects without diabetes (n = 10 657). Patients with depression were identified through general practice-recordeddepression codes and antidepressant prescriptions. Cox regression models gave hazard ratios for depression in peoplewith Type 1 diabetes compared with control subjects. Results - People with Type 1 diabetes were twice as likely to have a record of antidepressant use and generalpractice-diagnosed depression as their matched control subjects (hazard ratio 2.08, 95% CI 1.73–2.50, P < 0.001).These associations varied by time from diagnosis, with marked increases observed within the first 5 years of diagnosis(hazard ratio 2.14, 95% CI 1.51–3.03, P < 0.001), and by age at diabetes diagnosis, with excesses noted even in the 10-to 19-year age group (hazard ratio 1.45, 95% CI 1.06–1.98, P = 0.02). Conclusions - This population-based study shows that people with Type 1 diabetes have higher rates of generalpractice-recorded depression and antidepressant use. The excess is present within 5 years of diabetes diagnosis,suggesting psychological input for patients is warranted in the early years of their condition.

Neurophobia among general practice trainees: The evidence, perceived causes and solutions

Introduction

As general practice (GP) is the main source of referrals to neurologists, neurology education for GP trainees is important. We investigated the existence of neurophobia, contributing factors and potential prevention strategies among GP trainees.

In a questionnaire survey interest, knowledge, confidence and perceived difficulty in neurology were compared with different medical specialties. Reasons for difficulty with neurology, postgraduate neurology education experience, learning methods and suggested teaching improvements were examined.

Of 205 GP trainees, 118 (58%) completed the questionnaire. Threshold analyses justified categorical intervals for the Likert responses. Trainees recorded poorer knowledge (p < 0.001), less confidence (p < 0.001) and more perceived difficulty (p < 0.001) with neurology than with any other medical specialty. GP trainees had less interest in neurology than any other medical specialty (Duncan test, p < 0.001). There was a similar gradation in difficulty and confidence perception across medical specialties. Hospital and community-based neurology teaching was graded as “poor” or “very poor” by over 60% of GP trainees. There were multiple perceived causes of neurophobia, including neuroanatomy and poor quality teaching. More organised clinical teaching and referral guidance were suggested to address GP neurophobia.

Neurophobia is common among GP trainees in Northern Ireland. GP trainees have clear and largely uniform ideas on improving their neurology education. GP training posts should reflect the importance of neurology within the GP curriculum.

An analysis of the attitudes of dental patients attending general dental practice in Galway

AIM: To describe the patterns of dental attendance and attitudes towards tooth loss of general dental practice patients in Galway.

OBJECTIVES: 1. To determine the pattern of adult dental attendance in general practices in Galway; and, 2. To examine the oral health attitudes of these patients.

METHOD: Questionnaires were distributed to 311 consecutive adult patients in the waiting rooms of ten general dental practices in Galway, which were randomly selected from the telephone directory.

RESULTS: A total of 254 of the 311 questionnaires distributed were fully completed, returned and included in the results, giving a response rate of 81.7%. A total of 59% of dentate participants attended their dentist for annual or biannual examinations compared to 23% of edentate patients. Some 10.5% of medical card holders and 0.5% of non-medical card holders were edentulous.

CONCLUSIONS: The data from the survey indicated that medical card holders in Galway were more likely to be edentulous than nonmedical card holders. Edentate patients were less likely to be regular dental attenders than dentate patients.

General practitioners’ perceptions of the barriers and solutions to good quality palliative care in dementia

The general practitioner (GP) is in a pivotal position to initiate and adapt care for their patients living with dementia. This study aimed to elicit GPs' perceptions of the potential barriers and solutions to the provision of good-quality palliative care in dementia in their practices. A postal survey of GPs across Northern Ireland was conducted with open-ended items soliciting for barriers in their practices and possible solutions; 40.6% (138/340) were returned completed. Barriers to palliative care in dementia were perceived to be a dementia knowledge deficit for healthcare staff and the public, a resource shortfall within the GP practice and community, poor team coordination alongside inappropriate dementia care provision, and disagreements from and within families. These findings have significant implications for educators and clinicians as enhanced dementia education and training were highlighted as a strong agenda for GPs with the suggestions of dementia awareness programmes for the public.

Towards a general framework for information fusion

Depending on the representation setting, different combination rules have been proposed for fusing information from distinct sources. Moreover in each setting, different sets of axioms that combination rules should satisfy have been advocated, thus justifying the existence of alternative rules (usually motivated by situations where the behavior of other rules was found unsatisfactory). These sets of axioms are usually purely considered in their own settings, without in-depth analysis of common properties essential for all the settings. This paper introduces core properties that, once properly instantiated, are meaningful in different representation settings ranging from logic to imprecise probabilities. The following representation settings are especially considered: classical set representation, possibility theory, and evidence theory, the latter encompassing the two other ones as special cases. This unified discussion of combination rules across different settings is expected to provide a fresh look on some old but basic issues in information fusion.

Absolute Magnitudes of Pan-STARRS 1 Asteroids

It is well known that the absolute magnitudes (H) in the MPCORB and ASTORB orbital element catalogs suffer from a systematic offset. Juric at al. (2002) found 0.4 mag offset in the SDSS data and detailed light curve studies of WISE asteroids by Pravec et al. (2012) revealed size-dependent offsets of up to 0.5 mag. The offsets are thought to be caused by systematic errors introduced by earlier surveys using different photometric catalogs and filters. The next generation asteroid surveys provide an order of magnitude more asteroids and well-defined and calibrated magnitudes. The Pan-STARRS 1 telescope (PS1) has observed hundreds of thousands asteroids, submitted more than 2 million detections to the Minor Planet Center (MPC) and discovered almost 300 NEOs since the beginning of operations in late 2010. We transformed the observed apparent magnitudes of PS1-detected asteroids from the gP1,rP1,iP1,yP1,zP1 and wP1-bands into Johnson photometric system by assuming the mean S and C-type asteroid color (Fitzsimmons 2011 - personal communication, Schlafly et al. 2012, Magnier et al. 2012 - in preparation) and calculated the absolute magnitude (H) in the V-band and its uncertainty (Bowell et al., 1989) for more than 200,000 known asteroids having on average 6.7 detections per object. The H error with respect to the MPCORB catalog revealed a mean offset of -0.49+0.30 mag in good agreement with published values. We will also discuss the statistical and systematical errors in H and slope parameter G.

Physical Characterisation of Fast-Rotating Near-Earth Asteroids

We present VLT+VISIR mid-IR observations of fast-rotating near-Earth asteroids. Diameters and albedos are determined with thermal models. These NEAs may have unusual surface properties, e.g. from regolith transport/stripping due to the YORP effect.

Absolute magnitudes and slope parameters of Pan-STARRS PS1 asteroids -preliminary results

We present the study of absolute magnitude (H) and slope parameter (G) of 170,000 asteroids observed by the Pan-STARRS1 telescope during the period of 15 months within its 3-year all-sky survey mission. The exquisite photometry with photometric errors below 0.04 mag and well-defined filter and photometric system allowed to derive H and G with statistical and systematic errors. Our new approach lies in the Monte Carlo technique simulating rotation periods, amplitudes, and colors, and deriving most-likely H, G and their systematic errors. Comparison of H_M by Muinonen's phase function (Muinonen et al., 2010) with the Minor Planet Center database revealed a negative offset of 0.22±0.29 meaning that Pan-STARRS1 asteroids are fainter. We showed that the absolute magnitude derived by Muinonen's function is systematically larger on average by 0.14±0.29 and by 0.30±0.16 when assuming fixed slope parameter (G=0.15, G_{12}=0.53) than Bowell's absolute magnitude (Bowell et al., 1989). We also derived slope parameters of asteroids of known spectral types and showed a good agreement with the previous studies within the derived uncertainties. However, our systematic errors on G and G_{12} are significantly larger than in previous work, which is caused by poor temporal and phase coverage of vast majority of the detected asteroids. This disadvantage will vanish when full survey data will be available and ongoing extended and enhanced mission will provide new data.