Long-term risk factor control after a cardiac rehabilitation programme

This study examined the hypothesis that Phase II cardiac rehabilitation participants (CRP) had better long-term risk factor control, self-rated perception of health and return to work rates than non-participants (NP) between 18 and 36 months post myocardial infarction (MI). It was a comparative study in a 550 bed hospital.

Approximately half of both groups did not achieve a total cholesterol (TC) of 5.5mmol/L or less. Compared with NP, CRP were significantly more likely to have a TC<=6.5mmol/L (7% vs. 28%) (p=0.006). NP with TC>6.5mmol/L were significantly less likely to be on treatment (p=0.002). CRP were more likely to regularly exercise than NP (79% vs. 61%) (p=0.038). The success rate for blood pressure targets, return to work rates and self-rated perception of health were similar in both groups.

In conclusion, CRP had better long-term control of some risk factors than NP. The study provides comparative longer term patient outcomes after an Australian cardiac rehabilitation (CR) programme and forms the basis for further outcome measurement.

Depression, anxiety and self-care behaviours of young adults with Type 2 diabetes: results from the International Diabetes Management and Impact for Long-term Empowerment and Success (MILES) Study.

Young adults with Type 2 diabetes have higher physical morbidity and mortality than other diabetes sub-groups, but differences in psychosocial outcomes have not yet been investigated. We sought to compare depression and anxiety symptoms and self-care behaviours of young adults with Type 2 diabetes with two matched control groups.

Establishment of temperature control scheme for microbioreactor operation using integrated microheater

This paper presents design and fabrication of a microbioreactor platform, and implementation of two temperature control methods (i.e. on-off and PID) and their performance evaluation on the microbioreactor platform (working volume ~300 μL). The temperature of the microbioreactor content is controlled by using a subminiature heater placed underneath the microbioreactor and is measured with a miniature Pt 100 sensor. The microbioreactor is also integrated with a magnetic stirring capacity and a water evaporation control scheme. Programs for the two temperature control methods are written in LabVIEW software and implemented by interfacing them with a data acquisition card. It is shown that by implementing on–off and PID temperature control methods, the temperature of the microbioreactor content can be tightly controlled with an accuracy of approximately ±0.5 °C of the set point values. Both control methods also provide a good response and settling time values (i.e. around 2 min). Contrary to the on/off control method, the PID control method requires no adjustments whenever the set-point values are modified. The PID temperature control method works well for the entire tested range.

Fuzzy logic controller and cascade inverter for direct torque control of IM

In this paper, a five-level cascaded H-bridge multilevel inverters topology is applied on induction motor control known as direct torque control (DTC) strategy. More inverter states can be generated by a five-level inverter which improves voltage selection capability. This paper also introduces two different control methods to select the appropriate output voltage vector for reducing the torque and flux error to zero. The first is based on the conventional DTC scheme using a pair of hysteresis comparators and look up table to select the output voltage vector for controlling the torque and flux. The second is based on a new fuzzy logic controller using Sugeno as the inference method to select the output voltage vector by replacing the hysteresis comparators and lookup table in the conventional DTC, to which the results show more reduction in torque ripple and feasibility of smooth stator current. By using Matlab/Simulink, it is verified that using five-level inverter in DTC drive can reduce the torque ripple in comparison with conventional DTC, and further torque ripple reduction is obtained by applying fuzzy logic controller. The simulation results have also verified that using a fuzzy controller instead of a hysteresis controller has resulted in reduction in the flux ripples significantly as well as reduces the total harmonic distortion of the stator current to below 4 %.

Chaotic synchronization of time-delay coupled Hindmarsh–Rose neurons via nonlinear control

Chaotic synchronization of two time-delay coupled Hindmarsh–Rose neurons via nonlinear control is investigated in this paper. Both the intrinsic slow current delay in a single Hindmarsh–Rose neuron and the coupling delay between the two neurons are considered. When there is no control, chaotic synchronization occurs for a limited range of the coupling strength and the time-delay values. To obtain complete chaotic synchronization irrespective of the time-delay or the coupling strength, we propose two nonlinear control schemes. The first uses adaptive control for chaotic synchronization of two electrically coupled delayed Hindmarsh–Rose neuron models. The second derives the sufficient conditions to ensure a complete synchronization between master and slave models through appropriate Lyapunov–Krasovskii functionals and the linear matrix inequality technique. Numerical simulations are carried out to show the effectiveness of the proposed methods.

Introduced birds in urban remnant vegetation : does remnant size really matter?

Introduced birds are a pervasive and dominant element of urban ecosystems. We examined the richness and relative abundance of introduced bird species in small (1–5 ha) medium (6–15 ha) and large (>15 ha) remnants of native vegetation within an urban matrix. Transects were surveyed during breeding and non-breeding seasons. There was a significant relationship between introduced species richness and remnant size with larger remnants supporting more introduced species. There was no significant difference in relative abundance of introduced species in remnants of different sizes. Introduced species, as a proportion of the relative abundance of the total avifauna (native and introduced species), did not vary significantly between remnants of differing sizes. There were significant differences in the composition of introduced bird species between the different remnant sizes, with large remnants supporting significantly different assemblages than medium and small remnants. Other variables also have substantial effects on the abundance of introduced bird species. The lack of significant differences in abundance between remnant sizes suggests they were all equally susceptible to invasion. No patches in the urban matrix are likely to be unaffected by introduced species. The effective long-term control of introduced bird species is difficult and resources may be better spent managing habitat in a way which renders it less suitable for introduced species (e.g. reducing areas of disturbed ground and weed dominated areas).

A technology of study applied in marketing education and supported by self-determination theory

The aim of this study is to assess whether universities are meeting the needs of marketing students in their specific university function of providing knowledge and knowledge processes. This viewpoint is not meant to overlook the university role as a civilizing agent in a constant search for truth (McKenna 2001), but the focus for this study (based as it is in a Faculty of Business and Law) is toward graduates entering the corporate world. Therefore, graduates with suitable discipline knowledge and reasoning skills, in this context, must be able to meet the needs of the corporate marketing sector. Extending this backward to the role of the university, this study is by default seeking to establish if universities are meeting the needs of the corporate sector. A comparison is made between marketing classes using a specific technology of study called an autarchic system, and those classes not using this method. As part of this analysis the study investigates the application of self-determination theory and psychological needs satisfaction. The basic needs scale, comprising of two constructs; Control and Caring was adapted and used to evaluate students' perception of subjects using autarchic study system and those not utilising this methodology.

The VISA-A questionnaire: a valid and reliable index of the clinical severity of Achilles tendinoplasty

Background: There is no disease specific, reliable, and valid clinical measure of Achilles tendinopathy. Objective: To develop and test a questionnaire based instrument that would serve as an index of severity of Achilles tendinopathy. Methods: Item generation, item reduction, item scaling, and pretesting were used to develop a questionnaire to assess the severity of Achilles tendinopathy. The final version consisted of eight  questions that measured the domains of pain, function in daily living, and sporting activity. Results range from 0 to 100, where 100 represents the perfect score. Its validity and reliability were then tested in a population of non-surgical patients with Achilles tendinopathy (n = 45), presurgical patients with Achilles tendinopathy (n = 14), and two normal control populations (total n = 87). Results: The VISA-A questionnaire had good test-retest (r = 0.93), intrarater (three tests, r = 0.90), and interrater (r = 0.90) reliability as well as good stability when compared one week apart (r = 0.81). The mean (95% confidence interval) VISA-A score in the non-surgical patients was 64 (59–69), in presurgical patients 44 (28–60), and in control subjects it exceeded 96 (94–99). Thus the VISA-A score was higher in non-surgical than presurgical patients (p = 0.02) and higher in control subjects than in both patient populations (p<0.001). Conclusions: The VISA-A questionnaire is reliable and displayed construct validity when means were compared in patients with a range of severity of Achilles tendinopathy and control subjects. The continuous numerical result of the VISA-A questionnaire has the potential to provide utility in both the clinical setting and research. The test is not designed to be diagnostic. Further studies are needed to determine whether the VISA-A score predicts prognosis.

Interaction of exercise and diet on GLUT-4 protein and gene expression in type I and type II rat skeletal muscle

We determined the interaction of exercise and diet on glucose transporter (GLUT-4) protein and mRNA expression in type I (soleus) and type II [extensor digitorum longus (EDL)] skeletal muscle. Forty-eight Sprague Dawley rats were randomly assigned to one of two dietary conditions: high-fat (FAT, n =24) or high-carbohydrate (CHO, n =24). Animals in each dietary condition were allocated to one of two groups: control (NT, n =8) or a group that performed 8 weeks of treadmill running (4 sessions week^–1 of 1000 m @ 28 m min^–1 , RUN, n =16). Eight trained rats were killed after their final exercise bout for determination of GLUT-4 protein and mRNA expression: the remainder were killed 48 h after their last session for measurement of muscle glycogen and triacylglycerol concentration. GLUT-4 protein expression in NT rats was similar in both muscles after 8 weeks of either diet. However, there was a main effect of training such that GLUT-4 protein was increased in the soleus of rats fed with either diet (P < 0.05) and in the EDL in animals fed with CHO (P < 0.05). There was a significant diet–training interaction on GLUT-4 mRNA, such that expression was increased in both the soleus (100% ↑P < 0.05) and EDL (142% ↑P < 0.01) in CHO-fed animals. Trained rats fed with FAT decreased mRNA expression in the EDL (↓ 45%, P < 0.05) but not the soleus (↓ 14%, NS). We conclude that exercise training in CHO-fed rats increased both GLUT-4 protein and mRNA expression in type I and type II skeletal muscle. Despite lower GLUT-4 mRNA in muscles from fat-fed animals, exercise-induced increases in GLUT-4 protein were largely preserved, suggesting that control of GLUT-4 protein and gene expression are modified independently by exercise and diet.

The creation of effective learners using an autarchic study method

The aim of this study is to assess whether universities are meeting the needs of marketing students and consequently the needs of the corporate marketing sector. A comparison is made between marketing classes using a specific technology of study called an autarchic system, and those classes not using this method. As part of this analysis the study investigates the application of self-determination theory and psychological needs  satisfaction. The basic needs scale, comprising two constructs; Control and Caring was adapted and used to evaluate students' perception of subjects using autarchic study system and those not utilising this methodology. The study used a multi-method approach consisting of a literature review, a qualitative phase involving in-depth interviews with marketing teaching staff and focus groups with marketing students and a survey of students. An adapted version of the basic psychological needs scale was included in a questionnaire that was administered to a convenience sample of 441 students. ANOVAlMANOVA and descriptive statistics were used to analyse the data. The pedagogy used in a conventional university setting is detailed and contrasted with the autarchic learning system. Findings strongly indicate students become far more able as learners when they have the knowledge of the types of learning barriers, they are coached to recognise the barrier when it occurs and apply the appropriate remedy as researched in this paper. These findings are of interest to educators, students, and industry as all sectors face significant social and financial losses because individuals are unable to duplicate instructions, maintain currency and plan tactically and strategically.

The relation between decentralised structure, budgetary participation and organisational commitment : the moderating role of managers' value orientation towards innovation

Reports the results of a study which investigated the moderating role of managers’ value orientation towards innovation (VOI) on the relationships between managers’ organisational commitment and two management control features – decentralised organisational structure and budgetary participation. Data for the study were collected from 116 managers in manufacturing firms. The results indicate that managers’ VOI has a significant moderating effect on the relationships between the two management control features and managers’ organisational commitment. The results reveal that the relationships are stronger for managers with high VOI than for managers with low VOI. These results have implications for enhancing managers’ organisational commitment through the design of management control systems appropriate for the extent of innovative work values promoted by organisations.

Strain sensors with adjustable sensitivity by tailoring the microstructure of graphene aerogel/PDMS nanocomposites

Strain sensors with high elastic limit and high sensitivity are required to meet the rising demand for wearable electronics. Here, we present the fabrication of highly sensitive strain sensors based on nanocomposites consisting of graphene aerogel (GA) and polydimethylsiloxane (PDMS), with the primary focus being to tune the sensitivity of the sensors by tailoring the cellular microstructure through controlling the manufacturing processes. The resultant nanocomposite sensors exhibit a high sensitivity with a gauge factor of up to approximately 61.3. Of significant importance is that the sensitivity of the strain sensors can be readily altered by changing the concentration of the precursor (i.e., an aqueous dispersion of graphene oxide) and the freezing temperature used to process the GA. The results reveal that these two parameters control the cell size and cell-wall thickness of the resultant GA, which may be correlated to the observed variations in the sensitivities of the strain sensors. The higher is the concentration of graphene oxide, then the lower is the sensitivity of the resultant nanocomposite strain sensor. Upon increasing the freezing temperature from −196 to −20 °C, the sensitivity increases and reaches a maximum value of 61.3 at −50 °C and then decreases with a further increase in freezing temperature to −20 °C. Furthermore, the strain sensors offer excellent durability and stability, with their piezoresistivities remaining virtually unchanged even after 10 000 cycles of high-strain loading−unloading. These novel findings pave the way to custom design strain sensors with a desirable piezoresistive behavior.

The presidential persona paradox of Barack Obama : man of peace or war president?

On a wave of hope and rousing talk of building global bridges, President Barack Obama won office in 2008, in part on a pledge to end the wars in Afghanistan and Iraq and to close the Guantanamo Bay detention facility. In contrast to his predecessor, who launched America into long, costly and ineffectual wars, Obama was seen to be more of a dove than a hawk. However, at the end of his two-term tenure America has been in a state of foreign belligerence for all eight years, making Obama the longest serving U.S. war president in history.The political persona of Obama as a dove originated with his opposition to the 2003 intervention in Iraq while he was still a senator. This was then cemented early in his presidency with his 2009 speech in Cairo, which seemed to signal a profound and optimistic realignment of America’s intentions towards the Middle East and its peoples. This speech was a watershed in defining his political persona and was instrumental in his being the only U.S. president to be awarded a Nobel Peace Prize while still in office. However, during his term the underlying political landscape of the Middle East changed significantly, with the withdrawal from then return to Iraq, the nuclear agreement with Iran, the increasingly chaotic legacy of the Arab Spring, the continued impasse of the Israel-Palestinian peace, the disintegration of Yemen and Libya and the rise of the Islamic State as the new threat in the political vacuum of northern Iraq and eastern Syria, and a resurgent Russian role in the region. All of these have provided novel challenges to Washington and a president attempting to live up to the positivity of his early days in office.At the end of his presidency Obama is faced with a public burned by the disappointments of the Iraq and Afghanistan campaigns and the new entanglements in the Middle East. This paper seeks to offer insights into the juxtaposition of Obama’s political persona and reality, as well as exploring what his political legacy might really be.

Glycaemic control and long-term outcomes following transition from modified intensive insulin therapy to conventional glycaemic control

This retrospective observational cohort study compared glycaemic control and long-term outcomes following transition from a modified intensive insulin therapy (mIIT) regimen to conventional glycaemic control (CGC) in adult patients admitted to a tertiary adult general intensive care unit, during two 24-month periods, before and after the publication of the Normoglycemia in Intensive Care Evaluation and Surviving Using Glucose Algorithm Regulation (NICE-SUGAR) trial. The before NICE-SUGAR cohort received mIIT (target glycaemic ranges 4.4 to 7.0 mmol/l), while the after NICE-SUGAR cohort received CGC (target glycaemic range 7.1 to 9.0 mmol/l). A total of 5202 patients were included in the study. With transition from mIIT to CGC, the mean time-weighted glucose increased from 6.94 mmol/l to 8.2 mmol/l (P <0.0001). A similar increase was observed in other glycaemic indices (mean, highest and lowest glucose values, P <0.0001 for all). The adjusted 90-day odds ratio for mortality decreased by 47% with transition from mIIT to CGC (odds ratio 1.47 (95% confidence interval, 1.22 to 1.78) (P <0.0001). The rate of severe and moderate hypoglycaemia also decreased from 1.2 to 0.4% (P=0.004) and from 23.3 to 5.9% (P <0.0001), respectively. mIIT was associated with an increased risk of moderate and severe hypoglycaemia compared to CGC (odds ratio 3.1 (1.51 to 6.39) (P=0.002), 6.29 (5.1 to 7.75) (P <0.0001)). Changes in recommended glycaemic control were translated into practice, with increased glycaemic indices and decreased rates of severe and moderate hypoglycaemia after the introduction of CGC. The associated decrease in 90-day mortality suggests mIIT was not superior to CGC, despite a lower hypoglycaemia rate than in previous IIT trials. Our findings support the continued use of CGC.

Long-term effects of calcium-vitamin-D3-fortified milk on bone geometry and strength in older men

The long-term effects of calcium and vitamin D supplementation on bone material and structural properties in older men are not known. The aim of this study was to examine the effects of high calcium (1000 mg/day)- and vitamin-D3 (800 IU/day)-fortified milk on cortical and trabecular volumetric BMD (vBMD) and bone geometry at the axial and appendicular skeleton in men aged over 50 years. One hundred and eleven men who were part of a larger 2-year randomized controlled trial had QCT scans of the mid-femur and lumbar spine (L1–L3) to assess vBMD, bone geometry and indices of bone strength [polar moment of inertia (Ipolar)]. After 2 years, there were no significant differences between the milk supplementation and control group for the change in any mid-femur or L1–L3 bone parameters for all men aged over 50 years. However, the mid-femur skeletal responses to the fortified milk varied according to age, with a split of ≤62 versus >62 years being the most significant for discriminating the changes between the two groups. Subsequent analysis revealed that, in the older men (>62 years), the expansion in mid-femur medullary area was 2.8% (P < 0.01) less in the milk supplementation compared to control group, which helped to preserve cortical area in the milk supplementation group (between group difference 1.1%, P < 0.01). Similarly, for mid-femur cortical vBMD and Ipolar, the net loss was 2.3 and 2.8% less in the milk supplementation compared to control group (P < 0.01 and <0.001, respectively). In conclusion, calcium–vitamin-D3-fortified milk may represent an effective strategy to maintain bone strength by preventing endocortical bone loss and slowing the loss in cortical vBMD in elderly men.