Established cardiovascular disease and CVD risk factors in a primary care population of middle-aged Irish men and women

Contemporary Irish data on the prevalence of major cardiovascular disease (CVD) risk factors are sparse. The primary aims of this study were (1) to estimate the prevalence of major cardiovascular disease risk factors, including Type 2 Diabetes Mellitus, in the general population of men and women between the ages of 50 and 69 years; and (2) to estimate the proportion of individuals in this age group at high absolute risk of cardiovascular disease events on the basis of pre-existing cardiovascular disease or as defined by the Framingham equation. Participants were drawn from the practice lists of 17 general practices in Cork and Kerry using stratified random sampling. A total of 1018 people attended for screening (490 men, 48%) from 1473 who were invited, a response rate of 69.1%. Cardiovascular disease risk factors and glucose intolerance are common in the population of men and women aged between 50 and 69 years. Almost half the participants were overweight and a further quarter met current international criteria for obesity, one of the highest recorded prevalence rates for obesity in a European population sample. Forty per cent of the population reported minimal levels of physical activity and 19% were current cigarette smokers. Approximately half the sample had blood pressure readings consistent with international criteria for the diagnosis of hypertension, but only 38% of these individuals were known to be hypertensive. Eighty per cent of the population sample had a cholesterol concentration in excess of 5 mmol/l. Almost 4% of the population had Type 2 Diabetes Mellitus, of whom 30% were previously undiagnosed. A total of 137 participants (13.5%) had a history or ECG findings consistent with established cardiovascular disease. Of the remaining 881 individuals in the primary prevention population, a total of 20 high-risk individuals (19 male) had a risk of a coronary heart disease event 30% over ten years according to the Framingham risk equation, giving an overall population prevalence of 2.0% (95% CI 1.3 - 3.0). At a risk level 20% over ten years, an additional 91 individuals (8.9%) were identified. Thus a total of 24.4% of the population were at risk either through pre-existing CVD (13.5%) or an estimated 10-year risk exceeding 20% according to the Framingham risk equation (10.9%). Thus a substantial proportion of middle-aged men are at high risk of CVD. The findings emphasise the scale of the CVD epidemic in Ireland and the need for ongoing monitoring of risk factors at the population level and the need to develop preventive strategies at both the clinical and societal level.

Optimisation of Smart Grid performance using centralised and distributed control techniques

A massive change is currently taking place in the manner in which power networks are operated. Traditionally, power networks consisted of large power stations which were controlled from centralised locations. The trend in modern power networks is for generated power to be produced by a diverse array of energy sources which are spread over a large geographical area. As a result, controlling these systems from a centralised controller is impractical. Thus, future power networks will be controlled by a large number of intelligent distributed controllers which must work together to coordinate their actions. The term Smart Grid is the umbrella term used to denote this combination of power systems, artificial intelligence, and communications engineering. This thesis focuses on the application of optimal control techniques to Smart Grids with a focus in particular on iterative distributed MPC. A novel convergence and stability proof for iterative distributed MPC based on the Alternating Direction Method of Multipliers is derived. Distributed and centralised MPC, and an optimised PID controllers' performance are then compared when applied to a highly interconnected, nonlinear, MIMO testbed based on a part of the Nordic power grid. Finally, a novel tuning algorithm is proposed for iterative distributed MPC which simultaneously optimises both the closed loop performance and the communication overhead associated with the desired control.