Multimorbidity: Technical Series on Safer Primary Care

No abstract available

Carbon and Hydrogen Isotopes as Tracers of Methane Dynamic in Wetlands

This work presents a review of the main processes leading to the production and sinking of methane in wetlands and how they affect the stable isotope composition of carbon and hydrogen. Isotope fractionation factors associated to diffusion, ebullition, bacterial oxidation, etc., have been gathered from relevant literature in an intent of providing researchers in this thematic with practical procedures and tools for the interpretation of experimental data. Also it is presented guidelines of the most reliable field and laboratory methods used at present for the correct sampling and analyzing methane in different stages of occurrence, as well the most common tools used in their interpretation. Each statement is fully referenced to a long updated list of publications.Fil: Sanci, Romina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Geocronología y Geología Isotopica. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Geocronología y Geología Isotopica; ArgentinaFil: Panarello, Hector Osvaldo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Geocronología y Geología Isotopica. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Geocronología y Geología Isotopica; Argentin

Toward Youth Friendly Services: A Survey of Young People in Primary Care

Background: The World Health Organization encourages the development of youth friendly services, yet little is known on how youth currently present in general practice. Objective: To describe the perspectives, expectations, and service receipt of young people presenting to family doctors to inform the development of youth friendly services. Design: Cross-sectional survey. Participants and measurements: Consecutive young people attending 26 randomly selected practices were recruited in the waiting rooms. Standardized instruments were used to interview them before their consultation. Results: Of 501 young people who were approached, 450 participated (91% participation rate). Most had respiratory (26%) or dermatological complaints (18%). When asked to assess their health status, 59% perceived they had neither a physical nor a mental illness. However, 43% stated they had fears about their health problem and 1 in 5 feared it could be life-threatening. Although only 10% presented with psychological complaints, 24% perceived they currently had a mental illness. The most common expectations were treatment (50%) and good communication (42%). Most youth were prescribed medication (60%), but 40% of those who received a prescription had not expected to receive a treatment. A follow-up appointment was offered to 57% of participants. Conclusions: This study identifies a gap between young people's perception of illness and their presentations to family doctors. It also highlights unexpected fears, and a mismatch between expectations and service receipt. These findings have implications for family medicine training and for clinical practice. They should inform the development of youth friendly service

Text message communication in primary care research: a randomized controlled trial

Background. Text message communication is increasingly used in clinical practice but rarely in research. Particularly in young people, this method of participation in primary care research appears both feasible and acceptable. However, previous experience shows that text messaging for research may lead to lower response rates. Aim. To test the hypothesis that text message communication in primary care research does not lead to lower response rates compared to a paper-based method. Methods. This randomized controlled trial took place in 26 randomly selected practices in Victoria, Australia. Consecutive patients aged 16-24 years attending general practice appointments were recruited as part of a larger study on patients' perspectives. Patients owning a mobile phone were randomized to receive a question about satisfaction with the consultation either by text message or on a card completed before leaving the practice. Logistic regression was used to estimate the effect on the response rate of using text message rather than the card method, adjusting for clustering within practices and for differences in baseline characteristics among participants. Results. In total, 402 of 409 eligible young people agreed to participate and were randomized to either receive a text message (n = 193) or a card enquiry (n = 209). The response rate was 80.2% [95% confidence interval (CI): 73.3-87.1%] with text message and 85.6% (95% CI: 79.6-91.7%) with the card. The adjusted odds of responding (odds ratio: 0.62; 95% CI: 0.30-1.27) were not significantly lower in the group using text messaging compared to the group using the card response method. Conclusion. These findings offer new perspectives for use of text message communication to gather information from patients in primary care researc

Comparative morphological differences between umbilical cords from chronic hypertensive and preeclamptic pregnancies.

To compare morphological changes in the umbilical cords from chronic hypertensive and preeclamptic patients having normal or pathological umbilical artery Doppler ultrasonographic results. Umbilical cords from 34 normotensive, 31 chronic hypertensive and 70 preeclamptic women with normal and abnormal Doppler flow velocity waveforms (FVW) at 35-40 gestational weeks were studied. Morphological changes in the umbilical cords were examined on formalin-fixed, paraffin-embedded sections. The total umbilical cord area, total vessel area, and wall thickness of umbilical vessels were measured in systematic random samples using unbiased stereology methods. An ANOVA test was used for statistical analysis. In the chronic hypertensive and preeclamptic groups with normal Doppler FVW, the thickness of the umbilical cord vessels remained nearly constant, whereas both the total area and the lumen area were reduced. These changes correlate with the histopathological findings, suggesting a mainly vasoconstrictive effect. By contrast, analysis of the preeclamptic group with pathologic Doppler FVW showed a comparable reduction of all parameters of the umbilical cord. Histopathological findings were related to smaller, contracted smooth muscle cells of the vessel wall, which is suggestive of a predominant hypoplastic mechanism. As a result of reduced uteroplacental perfusion, fetal hypoxia and intrauterine growth retardation become unavoidable in preeclampsia. The histopathological changes in the umbilical cord between the chronic hypertensive and preeclamptic patients depend on the Doppler results. In conclusion, the umbilical artery Doppler FVW indices provide good values for predicting intrauterine growth retardation in preeclamptic patients.</p

Safer Primary Care: Caring for People with Multiple Conditions

No abstract available

Factors Contributing to Reading Performance: An In-Depth Analysis of the “Boy Crisis”

This research used a quantitative study approach to investigate the “boy crisis” in Canada. Boy crisis advocates suggest that boys are being surpassed by girls on reading assessments and promote strategies to assist male students. A feminist framework was used in this study that allowed for an investigation and discussion of the factors that mediate between gender and success at reading comprehension, interpretation, and response to text without ignoring female students. Reading scores and questionnaire data compiled by the Pan-Canadian Assessment Program were used in this research, specifically the PCAP-13 2007 assessment of approximately 30,000 13-year-old students from all Canadian provinces and Yukon Territory (CMEC, 2008). Approximately 20,000 participants wrote the reading assessment, while 30,000 students completed the questionnaire responses. Predictor variables were tested using parametric tests such as independent samples t-test, one-way ANOVA, chi-square analysis, and Pearson r. Findings from this study indicate that although boys scored lower than girls on the PCAP-13 2007 reading assessment, factors were found to influence the reading scores of both male and female students to varying degrees. Socioeconomic status, perceptions of the reading material used in language arts classrooms, reading preference, reading interest, parental involvement, parental encouragement for reading, and self-efficacy were all found to affect the reading performance of boys and girls. Relationships between variables were also found and are discussed in this research. The analysis presented in this study allows parents, educators, and policy makers to begin to critically examine and re-evaluate boy crisis literature and offers suggestions on how to improve reading performance for all students of all socioeconomic backgrounds

Correlation Among Math Anxiety, Attitudes Toward Math, and Math Achievement in Grade 9 Students: Relationships Across Gender

This research evaluated (a) the correlation between math anxiety, math attitudes, and achievement in math and (b) comparison among these variables in terms of gender among grade 9 students in a high school located in southern Ontario. Data were compiled from participant responses to the Attitudes Toward Math Inventory (ATMI) and the Math Anxiety Rating Scale for Adolescents (MARS-A), and achievement data were gathered from participants’ grade 9 academic math course marks and the EQAO Grade 9 Assessment of Mathematics. Nonparametric tests were conducted to determine whether there were relationships between the variables and to explore whether gender differences in anxiety, attitudes, and achievement existed for this sample. Results indicated that math anxiety was not related to math achievement but was a strong correlate of attitudes toward math. A strong positive relationship was found between math attitudes and achievement in math. Specifically, self-confidence in math, enjoyment of math, value of math, and motivation were all positive correlates of achievement in math. Also, results for gender comparisons were nonsignificant, indicating that gender differences in math anxiety, math attitudes, and math achievement scores were not prevalent in this group of grade 9 students. Therefore, attitudes toward math were considered to be a stronger predictor of performance than math anxiety or gender for this group

Outcomes and costs of primary care surveillance and intervention for overweight or obese children: the LEAP 2 randomised controlled trial

addresses: Royal Children's Hospital, Murdoch Childrens Research Institute and University of Melbourne, Parkville, Vic 3052, Australia. [email protected]: PMCID: PMC2737607types: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov'tCopyright © 2009 by the BMJ Publishing Group Ltd. This articles was first published in: BMJ, 2009, Vol. 339, pp. b3308 -To determine whether ascertainment of childhood obesity by surveillance followed by structured secondary prevention in primary care improved outcomes in overweight or mildly obese children