Screening for atrial fibrillation – a cross-sectional survey of healthcare professionals in primary care

Introduction: Screening for atrial fibrillation (AF) in primary care has been recommended; however, the views of healthcare professionals (HCPs) are not known. This study aimed to determine the opinions of HCP about the feasibility of implementing screening within a primary care setting. Methods: A cross-sectional mixed methods census survey of 418 HCPs from 59 inner-city practices (Nottingham, UK) was conducted between October-December 2014. Postal and web-surveys ascertained data on existing methods, knowledge, skills, attitudes, barriers and facilitators to AF screening using Likert scale and open-ended questions. Responses, categorized according to HCP group, were summarized using proportions, adjusting for clustering by practice, with 95% C.Is and free-text responses using thematic analysis. Results: At least one General Practitioner (GP) responded from 48 (81%) practices. There were 212/418 (51%) respondents; 118/229 GPs, 67/129 nurses [50 practice nurses; 17 Nurse Practitioners (NPs)], 27/60 healthcare assistants (HCAs). 39/48 (81%) practices had an ECG machine and diagnosed AF in-house. Non-GP HCPs reported having less knowledge about ECG interpretation, diagnosing and treating AF than GPs. A greater proportion of non-GP HCPs reported they would benefit from ECG training specifically for AF diagnosis than GPs [proportion (95% CI) GPs: 11.9% (6.8–20.0); HCAs: 37.0% (21.7–55.5); nurses: 44.0% (30.0–59.0); NPs 41.2% (21.9–63.7)]. Barriers included time, workload and capacity to undertake screening activities, although training to diagnose and manage AF was a required facilitator. Conclusion: Inner-city general practices were found to have adequate access to resources for AF screening. There is enthusiasm by non-GP HCPs to up-skill in the diagnosis and management of AF and they may have a role in future AF screening. However, organisational barriers, such as lack of time, staff and capacity, should be overcome for AF screening to be feasibly implemented within primary care

An effective all-atom potential for proteins

We describe and test an implicit solvent all-atom potential for simulations of protein folding and aggregation. The potential is developed through studies of structural and thermodynamic properties of 17 peptides with diverse secondary structure. Results obtained using the final form of the potential are presented for all these peptides. The same model, with unchanged parameters, is furthermore applied to a heterodimeric coiled-coil system, a mixed alpha/beta protein and a three-helix-bundle protein, with very good results. The computational efficiency of the potential makes it possible to investigate the free-energy landscape of these 49--67-residue systems with high statistical accuracy, using only modest computational resources by today's standards

Genomic and functional analyses of mycobacterium tuberculosis strains implicate ald in D-cycloserine resistance.

CAPRISA, 2016.Abstract available in PDF file

Peer Toy Play as a Gateway to Children’s Gender Flexibility: The Effect of (Counter)Stereotypic Portrayals of Peers in Children’s Magazines

Extensive evidence has documented the gender stereotypic content of children’s media, and media is recognized as an important socializing agent for young children. Yet, the precise impact of children’s media on the endorsement of gender-typed attitudes and behaviors has received less scholarly attention. We investigated the impact of stereotypic and counter-stereotypic peers pictured in children’s magazines on children’s gender flexibility around toy play and preferences, playmate choice, and social exclusion behavior (n = 82, age 4–7 years-old). British children were randomly assigned to view a picture of a peer-age boy and girl in a magazine playing with either a gender stereotypic or counter-stereotypic toy. In the stereotypic condition, the pictured girl was shown with a toy pony and the pictured boy was shown with a toy car; these toys were reversed in the counter-stereotypic condition. Results revealed significantly greater gender flexibility around toy play and playmate choices among children in the counterstereotypic condition compared to the stereotypic condition, and boys in the stereotypic condition were more accepting of gender-based exclusion than were girls. However, there was no difference in children’s own toy preferences between the stereotypic and counter-stereotypic condition, with children preferring more gender-typed toys overall. Implications of the findings for media, education, and parenting practices are discussed, and the potential for counterstereotypic media portrayals of toy play to shape the gender socialization of young children is explored

Polar amplification dominated by local forcing and feedbacks

The surface temperature response to greenhouse gas forcing displays a characteristic pattern of polar-amplified warming1,2,3,4,5, particularly in the Northern Hemisphere. However, the causes of this polar amplification are still debated. Some studies highlight the importance of surface-albedo feedback6,7,8, while others find larger contributions from longwave feedbacks4,9,10, with changes in atmospheric and oceanic heat transport also thought to play a role11,12,13,14,15,16. Here, we determine the causes of polar amplification using climate model simulations in which CO2 forcing is prescribed in distinct geographical regions, with the linear sum of climate responses to regional forcings replicating the response to global forcing. The degree of polar amplification depends strongly on the location of CO2 forcing. In particular, polar amplification is found to be dominated by forcing in the polar regions, specifically through positive local lapse-rate feedback, with ice-albedo and Planck feedbacks playing subsidiary roles. Extra-polar forcing is further shown to be conducive to polar warming, but given that it induces a largely uniform warming pattern through enhanced poleward heat transport, it contributes little to polar amplification. Therefore, understanding polar amplification requires primarily a better insight into local forcing and feedbacks rather than extra-polar processes