Development and evaluation of a screening tool to identify people with diabetes at increased risk of medication problems relating to hypoglycaemia and medication non-adherence

Abstract Aims: To develop and evaluate a screening tool to identify people with diabetes at increased risk of medication problems relating to hypoglycaemia and medication non-adherence. Methods: A retrospective audit of attendances at a diabetes outpatient clinic at a public, teaching hospital over a 16-month period was conducted. Logistic regression was undertaken to examine risk factors associated with medication problems relating to hypoglycaemia and medication non-adherence and the most predictive set of factors comprise the Diabetes Medication Risk Screening Tool. Evaluating the tool involved assessing sensitivity and specificity, positive and negative predictive values, cut-off scores, inter-rater reliability, and content validity. Results: The Diabetes Medication Risk Screening Tool comprises seven predictive factors: age, living alone, English language, mental and behavioural problems, comorbidity index score, number of medications prescribed, and number of high-risk medications prescribed. The tool has 76.5% sensitivity, 59.5% specificity, and has a 65.1% positive predictive value, and a 71.8% negative predictive value. A score of 27 or more out of 62 was associated with high-risk of a medication problem. The inter-rater reliability of the tool was high (κ = 0.79, 95% CI 0.75 - 0.84) and the content validity index was 99.4%. Conclusion: The Diabetes Medication Risk Screening Tool has good psychometric properties and can proactively identify people with diabetes at greatest risk of medication problems relating to hypoglycaemia and medication non-adherence.

Novel conducting polymer films and coated textiles

This research developed non-hazardous methods for coating wool with conductive polymers for thermal and anti-static clothing. Conductive polymers are black in colour, thus the synthesis of new conductive polymers was required to produce coloured or fluorescent conductive textile. Cross-linked conductive polymers were also synthesised to increase their durability.

Doppler radar in respiratory monitoring : detection and analysis

This paper presents the preliminary results of our work in detecting respiration using Doppler Radar in the 2.7 GHz operating band. We demonstrate the capability of Doppler Radar in capturing breathing patterns under various breathing forms such as normal breathing, fast breathing, as well as different rate of inhale and exhale. From the captured signals, respiration rate was obtained using Fast Fourier Transform and validated. The proposed approach could potentially be used in number of applications involving breathing rate and breathing pattern analysis via non-contact methods.

Non-smooth optimization methods for computation of the conditional value-at-risk and portfolio optimization

We examine numerical performance of various methods of calculation of the Conditional Value-at-risk (CVaR), and portfolio optimization with respect to this risk measure. We concentrate on the method proposed by Rockafellar and Uryasev in (Rockafellar, R.T. and Uryasev, S., 2000, Optimization of conditional value-at-risk. Journal of Risk, 2, 21-41), which converts this problem to that of convex optimization. We compare the use of linear programming techniques against a non-smooth optimization method of the discrete gradient, and establish the supremacy of the latter. We show that non-smooth optimization can be used efficiently for large portfolio optimization, and also examine parallel execution of this method on computer clusters.

Comparing probability and non-probability sampling methods in ecstasy research : implications for the internet as a research tool

The usage of Ecstasy and related drug (ERD) has increasingly been the focus of epidemiological and other public health-related research. One of the more promising methods is the use of the Internet as a recruitment and survey tool.However, there remain methodological concerns and questions about representativeness. Three samples of ERD users in Melbourne, Australia surveyed in 2004 are compared in terms of a number of key demographic and drug use variables. The Internet, face-to-face, and probability
sampling methods appear to access similar but not identical groups of ERD users. Implications and limitations of the study are noted and future research is recommended.

Offering fragile X syndrome carrier screening: a prospective mixed-methods observational study comparing carrier screening of pregnant and non-pregnant women in the general population

Article focus
▪ This article is a protocol of a study that involves offering fragile X syndrome carrier screening to pregnant and non-pregnant women in the general population. We are undertaking a programme evaluation approach using mixed methods to collect data about informed decisionmaking and predictors of test uptake, with a focus on psychosocial measures. We are also undertaking an economic appraisal.

Towards global benchmarking of food environments and policies to reduce obesity and diet-related non-communicable diseases : design and methods for nation-wide surveys

Introduction: 

A review of methods and tools to assess the implementation of government policies to create healthy food environments for preventing obesity and diet-related non-communicable diseases

BACKGROUND: Policies to create healthy food environments are recognized as critical components of efforts to prevent obesity and diet-related non-communicable diseases. There has not been a systematic review of existing methods and tools used to assess the implementation of these government policies. The purpose of this study was to review methods and tools used for assessing the implementation of government policies to create healthy food environments. The study conducted a systematic literature search. Multiple databases as well as the grey literature were searched. All study designs and review papers on assessing the implementation of government policies to create healthy food environments were included. A quality assessment of the methods and tools identified from relevant studies was carried out using the following four criteria: comprehensiveness, relevance, generalizability and feasibility. This quality assessment was completed by two independent reviewers. RESULTS: The review identified 52 studies across different policy areas, levels and settings. Self-administered questionnaires and policy checklists were most commonly applied to assess the extent of policy implementation, whereas semi-structured interviews were most commonly used to evaluate the implementation process. Measures varied widely, with the existence of policy implementation the aspect most commonly assessed. The most frequently identified barriers and facilitators for policy implementation were infrastructure support, resources and stakeholder engagement. The assessment of policy implementation on food environments was usually undertaken in combination with other policy areas, particularly nutrition education and physical activity. Three tools/methods were rated 'high' quality and 13 tools/methods received 'medium' quality ratings. CONCLUSIONS: Harmonization of the available high-quality methods and tools is needed to ensure that assessment of government policy implementation can be compared across different countries and settings and over time. This will contribute to efforts to increase government accountability for their actions to improve the healthiness of food environments.

Methods of construction of OWA operators from data

This paper investigates the problem of obtaining the weights of the ordered weighted aggregation (OWA) operators from observations. The problem is formulated as a restricted least squares and uniform approximation problems. We take full advantage of the linearity of the problem. In the former case, a well known technique of non-negative least squares is used. In a case of uniform approximation, we employ a recently developed cutting angle method of global optimisation. Both presented methods give results superior to earlier approaches, and do not require complicated nonlinear constructions. Additional restrictions, such as degree of orness of the operator, can be easily introduced

Research methods in sales ethics: a review of the empirical literature

From a review of the empirical sales ethics literature, this paper reports findings about some of the research methods used to investigate the decision-making of sales practitioners under ethical conditions. The review identifies that several of the methodological deficiencies raised by previous reviewers of the literature have not been adequately addressed by subsequent researchers. The paper primarily reviews quantitative research studies because of their prevalence in the empirical sales ethics literature, and because studies similar to these have contributed much to marketing ethics theory. This discussion also focuses on sampling and data collection methods, the treatment of respondent and non-response bias, the use of instruments and scales, and the application of the scenario technique. Some suggestions are made that would improve the research methods in each of these areas.

Implementation of novel methods of global and nonsmooth optimization : GANSO programming library

We discuss the implementation of a number of modern methods of global and nonsmooth continuous optimization, based on the ideas of Rubinov, in a programming library GANSO. GANSO implements the derivative-free bundle method, the extended cutting angle method, dynamical system-based optimization and their various combinations and heuristics. We outline the main ideas behind each method, and report on the interfacing with Matlab and Maple packages.

Changing risk behaviours for non-communicable disease in New Zealand working men - is workplace intervention effective?

Aims. To evaluate the effectiveness of a health promotion
programme targeting dietary behaviours and physical
activity among male hourly-paid workers and to explore
demographic and attitudinal influences on dietary patterns
at baseline.
Methods. A controlled field trial compared workers at one
intervention and one control worksite. The intervention
comprised nutrition displays in the cafeteria and monthly
30-minute workshops for six months. Key outcome
measures at six and twelve-months were self-reported
dietary and lifestyle behaviours, nutrition knowledge, body
mass index (BMI), waist circumference and blood pressure.
Results. 132 men at the intervention site and 121 men at the
control site participated in the study and a high retention rate
(94% at 6-months and 89% at 12-months) was achieved. At
baseline, 40% of the total sample (253) were obese, 30% had
elevated blood pressure, 59% indicated an excessive fat intake
and 92% did not meet the recommended vegetable and fruit
intake. The intervention reduced fat intake, increased
vegetable intake and physical activity, improved nutrition
knowledge and reduced systolic blood pressure when
compared to the control site. There was no difference in
change in mean BMI or waist circumference. Reduction in
BMI was associated with reduction in fat intake.
Discussion. Low intensity workplace intervention can
significantly improve reported health behaviours and
nutrition knowledge although the impact on more
objective measures of risk was variable. A longer duration
or more intensive intervention may be required to achieve
further reduction in risk factors.

Academics' experiences of teaching Australian 'non-local' courses in Hong Kong

This paper reports on some research from an ARC funded project conducted by the authors into the ways in which Australian universities establish collaborations with partners in Hong Kong and Papua New Guinea to offer courses in those countries. The research used principally qualitative methods (interviews, observations, document collection and analysis) to develop case-studies of a range of partnerships in Hong Kong. The project commenced in 1999 and is in its final stages. The paper discusses the experiences of staff who developed, administered and taught courses offered in Hong Kong by Australian institutions in partnership with a local provider. It presents and discusses findings on their reasons for working 'off-shore' in Hong Kong, their engagement with local staff and students, and their experience of Hong Kong students' coping with Australian curricula, pedagogies and assessment.

Is growth inhibited in non-elite competitive female gymnasts?

PURPOSE
We asked: 1) is statural growth inhibited in non-elite competitive female gymnasts?; and 2) if growth is reduced, is the effect similar for legs and spine?

METHODS
Height(Ht), sitting height(StHt) and leg length(LL) were measured in gymnasts and controls at baseline and every 12 mths for 2 yrs. Pubertal status was assessed by Tanner stage. Gymnasts were from USGF levels 4–10 and trained 7.5 to 22.5 hrs/wk. Age-adjusted Z-scores were determined for gymnasts on the anthropometric measures and based on linear regression analyses of data for 45 controls.

RESULTS
At baseline, pre-(N=40), peri-(N=16) and post-pubertal(N=11) gymnasts were shorter than controls(-0.9 to -1.3 SD, p < 0.01). In pre- and peri-pubertal gymnasts, this was due to a reduction in StHt (-0.8 to -1.3 SD) and LL (-0.8 to -1.1 SD)(p < 0.01). In post-pubertal gymnasts, StHt (-0.8 SD) was reduced (p < 0.05). No differences were observed in z-score deficits between pubertal groups, nor were there any differences in StHt and LL deficits. During 12 mths follow-up in 39 gymnasts, deficits in Ht z-scores were reduced further in pre-pubertal gymnasts (-0.2 SD, p < 0.001) due to a greater increase in the deficit in LL (-0.3 SD, p < 0.001). While the magnitude of z-score deficits for peri-pubertal gymnasts remained unchanged, Ht z-scores improved in post-pubertal gymnasts(+0.2SD, p < 0.05) due primarily to an increase in StHt (+0.4 SD, p < 0.01). Similar results were found in 16 gymnasts followed for 2 yrs.

CONCLUSION
Although small size may relate to self-selection for gymnastics, some non-elite female gymnasts may experience attenuated growth during early puberty due mainly to reduced leg growth. The increased growth observed in post-pubertal gymnasts is consistent with catch-up growth associated with delayed maturation.