Medically unexplained symptoms: The need for effective communication and an integrated care strategy

Much is already known about medically unexplained symptoms (MUS) in terms of incidence, presentation and current treatment. What needs to be urgently addressed is a strategy for dealing with patients and their conditions, particularly when they do not fall neatly into medical frameworks or pathologies where the syndrome can be easily explained. This article will consider the provision of health and social care support for patients with MUS within an interprofessional education context. The author will contend that a sensitive and valued service for this large client group is dependent upon services without professional boundaries and practitioners with a clinical interest that can work together and agree an appropriate way forward in terms of care, support and strategic service provision. The article will support the idea that clear guidelines through the National Institute for Health and Care Excellence can offer clear clinical direction for practitioners working in primary and secondary care settings to work together interprofessionally to ensure a seamless and sensitive service for people with this condition.

What’s in a surname? Physique, aptitude, and sports type comparisons between Tailors and Smiths

Combined heredity of surnames and physique, coupled with past marriage patterns and trade-specific physical aptitude and selection factors, may have led to differential assortment of bodily characteristics among present-day men with specific trade-reflecting surnames (Tailor vs. Smith). Two studies reported here were partially consistent with this genetic-social hypothesis, first proposed by Bäumler (1980). Study 1 (N = 224) indicated significantly higher self-rated physical aptitude for prototypically strength-related activities (professions, sports, hobbies) in a random sample of Smiths. The counterpart effect (higher aptitude for dexterity-related activities among Tailors) was directionally correct, but not significant, and Tailor-Smith differences in basic physique variables were not significant. Study 2 examined two large datasets (Austria/Germany combined, and UK: N = 7001 and 20532) of men’s national high-score lists for track-and-field events requiring different physiques. In both datasets, proportions of Smiths significantly increased from light-stature over medium-stature to heavy-stature sports categories. The predicted counterpart effect (decreasing prevalences of Tailors along these categories) was not supported. Related prior findings, implicit egotism as an alternative interpretation of the evidence, and directions for further inquiry are discussed in conclusion.

A Communication and Resources Management Scheme to Support the Smart Grid Integration of Multiplayers Access to Resources Information

The increasing and intensive integration of distributed energy resources into distribution systems requires adequate methodologies to ensure a secure operation according to the smart grid paradigm. In this context, SCADA (Supervisory Control and Data Acquisition) systems are an essential infrastructure. This paper presents a conceptual design of a communication and resources management scheme based on an intelligent SCADA with a decentralized, flexible, and intelligent approach, adaptive to the context (context awareness). The methodology is used to support the energy resource management considering all the involved costs, power flows, and electricity prices leading to the network reconfiguration. The methodology also addresses the definition of the information access permissions of each player to each resource. The paper includes a 33-bus network used in a case study that considers an intensive use of distributed energy resources in five distinct implemented operation contexts.

Daily physical activities and sports in adult survivors of childhood cancer and healthy controls: a population-based questionnaire survey.

BACKGROUND: Healthy lifestyle including sufficient physical activity may mitigate or prevent adverse long-term effects of childhood cancer. We described daily physical activities and sports in childhood cancer survivors and controls, and assessed determinants of both activity patterns. METHODOLOGY/PRINCIPAL FINDINGS: The Swiss Childhood Cancer Survivor Study is a questionnaire survey including all children diagnosed with cancer 1976-2003 at age 0-15 years, registered in the Swiss Childhood Cancer Registry, who survived ≥5 years and reached adulthood (≥20 years). Controls came from the population-based Swiss Health Survey. We compared the two populations and determined risk factors for both outcomes in separate multivariable logistic regression models. The sample included 1058 survivors and 5593 controls (response rates 78% and 66%). Sufficient daily physical activities were reported by 52% (n = 521) of survivors and 37% (n = 2069) of controls (p<0.001). In contrast, 62% (n = 640) of survivors and 65% (n = 3635) of controls reported engaging in sports (p = 0.067). Risk factors for insufficient daily activities in both populations were: older age (OR for ≥35 years: 1.5, 95CI 1.2-2.0), female gender (OR 1.6, 95CI 1.3-1.9), French/Italian Speaking (OR 1.4, 95CI 1.1-1.7), and higher education (OR for university education: 2.0, 95CI 1.5-2.6). Risk factors for no sports were: being a survivor (OR 1.3, 95CI 1.1-1.6), older age (OR for ≥35 years: 1.4, 95CI 1.1-1.8), migration background (OR 1.5, 95CI 1.3-1.8), French/Italian speaking (OR 1.4, 95CI 1.2-1.7), lower education (OR for compulsory schooling only: 1.6, 95CI 1.2-2.2), being married (OR 1.7, 95CI 1.5-2.0), having children (OR 1.3, 95CI 1.4-1.9), obesity (OR 2.4, 95CI 1.7-3.3), and smoking (OR 1.7, 95CI 1.5-2.1). Type of diagnosis was only associated with sports. CONCLUSIONS/SIGNIFICANCE: Physical activity levels in survivors were lower than recommended, but comparable to controls and mainly determined by socio-demographic and cultural factors. Strategies to improve physical activity levels could be similar as for the general population.

Effects of computer-mediated communication and face-to-face communication on the quantity and quality of discourse produced by English as a second language students /

The effects oftwo types of small-group communication, synchronous computer-mediated and face-to-face, on the quantity and quality of verbal output were con^ared. Quantity was deiSned as the number of turns taken per minute, the number of Analysis-of-Speech units (AS-units) produced per minute, and the number ofwords produced per minute. Quality was defined as the number of words produced per AS-unit. In addition, the interaction of gender and type of communication was explored for any differences that existed in the output produced. Questionnaires were also given to participants to determine attitudes toward computer-mediated and face-to-face communication. Thirty intermediate-level students fi-om the Intensive English Language Program (lELP) at Brock University participated in the study, including 15 females and 15 males. Nonparametric tests, including the Wilcoxon matched-pairs test, Mann-Whitney U test, and Friedman test were used to test for significance at the p < .05 level. No significant differences were found in the effects of computer-mediated and face-to-face communication on the output produced during follow-up speaking sessions. However, the quantity and quality of interaction was significantly higher during face-to-face sessions than computer-mediated sessions. No significant differences were found in the output produced by males and females in these 2 conditions. While participants felt that the use of computer-mediated communication may aid in the development of certain language skills, they generally preferred face-to-face communication. These results differed fi-om previous studies that found a greater quantity and quality of output in addition to a greater equality of interaction produced during computer-mediated sessions in comparison to face-to-face sessions (Kern, 1995; Warschauer, 1996).

Communication and Economic Growth.

Overs the past millennium, each of the three centuries of most rapid demographic growth in the West Coincided with the diffusion of a new communications technology. This paper examines the hypothesis of Harold Innis (1894-1952) that there is two-way feeback between such innovations and economic growth.

Computer-mediated communication and time pressure induce higher cardiovascular responses in the preparatory and execution phases of cooperative tasks

Resumen tomado de la publicaci??n

World Englishes : implications for international communication and English language teaching.

El modelo del idioma inglés que se debe utilizar en las aulas ha sido durante mucho tiempo un tema de debate. Este texto describe las variedades mundiales de lengua inglesa, y discute las ventajas y desventajas de seleccionar una variedad determinada como segunda lengua desde el punto de vista de profesores y alumnos. Examina y evalúa nuevos conceptos tales como 'estándar', 'variedad', 'nativo' y 'hablante no nativo', para validar el papel desempeñado por los profesores de inglés multilingüe y multicultural, con el argumento de que las necesidades del contexto y el alumno deben determinar la variedad que se les enseñe. Viene acompañado de un CD de audio.