Statin prescription initiation and lifestyle behaviour: a primary care cohort study

BACKGROUND: Statin prescribing and healthy lifestyles contribute to declining cardiovascular disease mortality. Recent guidelines emphasise the importance of giving lifestyle advice in association with prescribing statins but adherence to healthy lifestyle recommendations is sub-optimal. However, little is known about any change in patients' lifestyle behaviours when starting statins or of their recall of receiving advice. This study aimed to examine patients' diet and physical activity (PA) behaviours and their recall of lifestyle advice following initiation of statin prescribing in primary care.

METHOD: In 12 general practices, patients with a recent initial prescription of statin therapy, were invited to participate. Those who agreed received a food diary by post, to record food consumed over 4 consecutive days and return to the researcher. We also telephoned participants to administer brief validated questionnaires to assess typical daily diet (DINE) and PA level (Godin). Using the same methods, food diaries and questionnaires were repeated 3 months later. At both times participants were asked if they had changed their behaviour or received advice about their diet or PA.

RESULTS: Of 384 invited, 122 (32 %) participated; 109 (89.3 %) completed paired datasets; 50 (45.9 %) were male; their mean age was 64 years. 53.2 % (58/109) recalled receiving lifestyle advice. Of those who did, 69.0 % (40/58) reported having changed their diet or PA, compared to 31.4 % (16/51) of those who did not recall receiving advice. Initial mean daily saturated fat intake (12.9 % (SD3.5) of total energy) was higher than recommended; mean fibre intake (13.8 g/day (SD5.5)), fruit/vegetable consumption (2.7 portions/day (SD1.3)) and PA levels (Godin score 7.1 (SD13.9)) were low. Overall, although some individuals showed evidence of behaviour change, there were no significant changes in the proportions who reported high or medium fat intake (42.2 % v 49.5 %), low fibre (51.4 % v 55.0 %), or insufficient PA (80.7 % v 83.5 %) at 3-month follow-up.

CONCLUSION: Whilst approximately half of our cohort recalled receiving lifestyle advice associated with statin prescribing this did not translate into significant changes in diet or PA. Further research is needed to explore gaps between people's knowledge and behaviours and determine how best to provide advice that supports behaviour change.

Development of sustainable, innovative and energy-efficient concrete, based on the integration of all-waste materials: SUS-CON panels for building applications

The building sector requires the worldwide production of 4 billion tonnes of cement annually, consuming more than 40% of global energy and accounting for about 8% of the total CO2 emissions. The SUS-CON project aimed at integrating waste materials in the production cycle of concrete, for both ready-mixed and pre-cast applications, resulting in an innovative light-weight, ecocompatible and cost-effective construction material, made by all-waste materials and characterized by enhanced thermal insulation performance and low embodied energy and CO2. Alkali activated “cementless” binders, which have recently emerged as eco-friendly construction materials, were used in conjunction with lightweight recycled aggregates to produce sustainable concrete for a range of applications. This paper presents some results from the development of a concrete made with a geopolymeric binder (alkali activated fly ash) and aggregate from recycled mixed plastic. Mix optimisation was achieved through an extensive investigation on production parameters for binder and aggregate. The mix recipe was developed for achieving the required fresh and hardened properties. The optimised mix gave compressive strength of about 7 MPa, flexural strength of about 1.3 MPa and a thermal conductivity of 0.34 W/mK. Fresh and hardened properties were deemed suitable for the industrial production of precast products. Precast panels were designed and produced for the construction of demonstration buildings. Mock-ups of about 2.5 x 2.5 x 2.5 m were built at a demo park in Spain both with SUS-CON and Portland cement concrete, monitoring internal and external temperatures. Field results indicate that the SUS-CON mock-ups have better insulation. During the warmest period of the day, the measured temperature in the SUS-CON mock-ups was lower.

A multi vector energy analysis for interconnected power and gas systems

This paper presents the first multi vector energy analysis for the interconnected energy systems of Great Britain (GB) and Ireland. Both systems share a common high penetration of wind power, but significantly different security of supply outlooks. Ireland is heavily dependent on gas imports from GB, giving significance to the interconnected aspect of the methodology in addition to the gas and power interactions analysed. A fully realistic unit commitment and economic dispatch model coupled to an energy flow model of the gas supply network is developed. Extreme weather events driving increased domestic gas demand and low wind power output were utilised to increase gas supply network stress. Decreased wind profiles had a larger impact on system security than high domestic gas demand. However, the GB energy system was resilient during high demand periods but gas network stress limited the ramping capability of localised generating units. Additionally, gas system entry node congestion in the Irish system was shown to deliver a 40% increase in short run costs for generators. Gas storage was shown to reduce the impact of high demand driven congestion delivering a reduction in total generation costs of 14% in the period studied and reducing electricity imports from GB, significantly contributing to security of supply.

An energy based force prediction method for UD-CFRP orthogonal machining

The machining of carbon fiber reinforced polymer (CFRP) composite presents a significant challenge to the industry, and a better understanding of machining mechanism is the essential fundament to enhance the machining quality. In this study, a new energy based analytical method was developed to predict the cutting forces in orthogonal machining of unidirectional CFRP with fiber orientations ranging from 0° to 75°. The subsurface damage in cutting was also considered. Thus, the total specific energy for cutting has been estimated along with the energy consumed for forming new surfaces, friction, fracture in chip formation and subsurface debonding. Experiments were conducted to verify the validity of the proposed model.