Prescribing for weight loss in primary care: evidence from a population based study

Background Taking antiobesity medication can be a cost effective way to lose weight. Uptake is determined in part by a General Practitioner's decision to prescribe weight loss medication and, in part, by patient preference. It is probable that the latter may indicate a patient's readiness to lose weight.


Methods Analysis of cross-sectional data (from February 2003 to March 2011) from a population based prescribing database (~1.75 million people) using an adjusted Poisson regression.


Results The number of antiobesity medications increased from 23.4 per 1000 population in 2004 to 30.7 per 1000 population in 2010 and was three times higher in female than in male subjects. Against this background, a marked seasonal variation in the number of antiobesity medications dispensed was evident (p<0.001), peaking in June/July with a trough in December/January (±8.0% peak to trough). The seasonal component was stronger in female subjects, ±11.2% peak to trough, compared with ±3.5% for male subjects.


Conclusions Obese patients, particularly women, increase their uptake of weight loss medication in the months leading up to the summer holiday period. The period prior to the summer may represent a time that health professionals could promote increased participation of obese patients in weight loss programmes.

Channel Time Allocation PSO for Gigabit Multimedia Wireless Networks

This article introduces a resource allocation solution capable of handling mixed media applications within the constraints of a 60 GHz wireless network. The challenges of multimedia wireless transmission include high bandwidth requirements, delay intolerance and wireless channel availability. A new Channel Time Allocation Particle Swarm Optimization (CTA-PSO) is proposed to solve the network utility maximization (NUM) resource allocation problem. CTA-PSO optimizes the time allocated to each device in the network in order to maximize the Quality of Service (QoS) experienced by each user. CTA-PSO introduces network-linked swarm size, an increased diversity function and a learning method based on the personal best, Pbest, results of the swarm. These additional developments to the PSO produce improved convergence speed with respect to Adaptive PSO while maintaining the QoS improvement of the NUM. Specifically, CTA-PSO supports applications described by both convex and non-convex utility functions. The multimedia resource allocation solution presented in this article provides a practical solution for real-time wireless networks.

Power allocation strategies across N orthogonal channels for single-relay networks at both source and relay

We consider a wireless relay network with one source, one relay and one destination, where communications between nodes are preformed over N orthogonal channels. This, for example, is the case when orthogonal frequency division multiplexing is employed for data communications. Since the power available at the source and relay is limited, we study optimal power allocation strategies at the source and relay in order to maximize the overall source-destination capacity. Depending on the availability of the channel state information at both the source and relay or only at the relay, power allocation is performed at both the source and relay or only at the relay. Considering different setups for the problem, various optimization problems are formulated and solved. Some properties of the optimal solution are also proved.

Secure Transmission with Optimal Power Allocation in Untrusted Relay Networks

We consider the problem of secure transmission in two-hop amplify-and-forward untrusted relay networks. We analyze the ergodic secrecy capacity (ESC) and present compact expressions for the ESC in the high signal-to-noise ratio regime. We also examine the impact of large scale antenna arrays at either the source or the destination. For large antenna arrays at the source, we confirm that the ESC is solely determined by the channel between the relay and the destination. For very large antenna arrays at the destination, we confirm that the ESC is solely determined by the channel between the source and the relay.

Counselling for sight loss: Using systematic case study research to build a client informed practice model

There is compelling evidence to suggest that acquired sight loss negatively impacts on emotional well-being. Despite increasing recognition of the need to provide emotional support for people with sight loss, we still do not fully understand what counselling interventions help and why they help. The aim of this study was to examine the process and outcome of counselling for a 70-year-old client who had experienced complete, irreversible, post-operative sight loss in order to gain a deeper understanding of client-defined helpful aspects of therapy. A Hermeneutic Single-Case Efficacy Design study was undertaken having received ethical approval from the University's Research Ethics Committee. The client received six sessions of counselling from a vision-impaired counsellor working within a pluralistic framework. Measures were completed by the client at every session, as well as at pre-and post-counselling. All sessions were recorded and transcribed. The client also participated in pre-and post-counselling interviews. Data formed a rich case record that was analysed by a quasi-judicial enquiry team. Results suggested that this was a successful outcome case. Client-defined helpful aspects of therapy were (1) feeling understood; (2) being able to express emotions around the loss of sight; (3) finding a new identity; (4) finding ways to cope with fear, loss, dependency, and other people's perceptions; (5) exploring the possibility of a positive future without sight; (6) making sense of things; and (7) finding ways to become more socially connected. Relevant therapeutic tasks are proposed, and four key aspects of therapy are identified, which may have implications for the development of a practice model.

Loss of Synaptic Connectivity, Particularly in Second Order Neurons Is a Key Feature of Diabetic Retinal Neuropathy in the Ins2Akita Mouse

Retinal neurodegeneration is a key component of diabetic retinopathy (DR), although the detailed neuronal damage remains ill-defined. Recent evidence suggests that in addition to amacrine and ganglion cell, diabetes may also impact on other retinal neurons. In this study, we examined retinal degenerative changes in Ins2^Akita diabetic mice. In scotopic electroretinograms (ERG), b-wave and oscillatory potentials were severely impaired in 9-month old Ins2^Akita mice. Despite no obvious pathology in fundoscopic examination, optical coherence tomography (OCT) revealed a progressive thinning of the retina from 3 months onwards. Cone but not rod photoreceptor loss was observed in 3-month-old diabetic mice. Severe impairment of synaptic connectivity at the outer plexiform layer (OPL) was detected in 9-month old Ins2Akita mice. Specifically, photoreceptor presynaptic ribbons were reduced by 25% and postsynaptic boutons by 70%, although the density of horizontal, rod- and cone-bipolar cells remained similar to non-diabetic controls. Significant reductions in GABAergic and glycinergic amacrine cells and Brn3a+ retinal ganglion cells were also observed in 9-month old Ins2^Akita mice. In conclusion, the Ins2^Akita mouse develops cone photoreceptor degeneration and the impairment of synaptic connectivity at the OPL, predominately resulting from the loss of postsynaptic terminal boutons. Our findings suggest that the Ins2^Akita mouse is a good model to study diabetic retinal neuropathy.

Polarization retention loss in PbTiO3 ferroelectric films due to leakage currents

The relationship between retention loss in single crystal PbTiO3 ferroelectric thin films and leakage currents is demonstrated by piezoresponse and conductive atomic force microscopy measurements. It was found that the polarization reversal in the absence of an electric field followed a stretched exponential behavior 1-exp[-(t/k)(d)] with exponent d>1, which is distinct from a dispersive random walk process with d <. The latter has been observed in polycrystalline films for which retention loss was associated with grain boundaries. The leakage current indicates power law scaling at short length scales, which strongly depends on the applied electric field. Additional information of the microstructure, which contributes to an explanation of the presence of leakage currents, is presented with high resolution transmission electron microscopy analysis.

Power-Capped DVFS and Thread Allocation with ANN Models on Modern NUMA Systems

Abstract—Power capping is an essential function for efficient power budgeting and cost management on modern server systems. Contemporary server processors operate under power caps by using dynamic voltage and frequency scaling (DVFS). However, these processors are often deployed in non-uniform memory
access (NUMA) architectures, where thread allocation between cores may significantly affect performance and power consumption. This paper proposes a method which maximizes performance under power caps on NUMA systems by dynamically optimizing two knobs: DVFS and thread allocation. The method selects the optimal combination of the two knobs with models based on artificial neural network (ANN) that captures the nonlinear effect of thread allocation on performance. We implement
the proposed method as a runtime system and evaluate it with twelve multithreaded benchmarks on a real AMD Opteron based NUMA system. The evaluation results show that our method outperforms a naive technique optimizing only DVFS by up to
67.1%, under a power cap.