The association between the measurement of adherence to anti-diabetes medicine and the HbA1c

BACKGROUND: Adherence to medicines is important in subjects with diabetes, as nonadherence is associated with an increased risk of morbidity and mortality. However, it is not clear whether there is an association between adherence to medicines and glycaemic control, as not all studies have shown this. One of the reasons for this discrepancy may be that, although there is a standard measure of glycaemic control i.e. HbA1c, there is no standard measure of adherence to medicines. Adherence to medicines can be measured either qualitatively by Morisky or non-Morisky methods or quantitatively using the medicines possession ratio (MPR). AIMS OF THE REVIEW: The aims of this literature review are (1) to determine whether there is an association between adherence to anti-diabetes medicines and glycaemic control, and (2) whether any such association is dependent on how adherence is measured. Methods A literature search of Medline, CINAHL and the Internet (Google) was undertaken with search terms; 'diabetes' with 'adherence' (or compliance, concordance, persistence, continuation) with 'HbA1c' (or glycaemic control). RESULTS: Twenty-three studies were included; 10 qualitative and 12 quantitative studies, and one study using both methods. For the qualitative methods measurements of adherence to anti-diabetes medicines (non-Morisky and Morisky), eight out of ten studies show an association with HbA1c. Nine of ten studies using the quantitative MPR, and two studies using MPR for insulin only, have also shown an association between adherence to anti-diabetes medicines and HbA1c. However, the one study that used both Morisky and MPR did not show an association. Three of the four studies that did not show a relationship, did not use a range of HbA1c values in their regression analysis. The other study that did not show a relationship was specifically in a low income population. CONCLUSIONS: Most studies show an association between adherence to anti-diabetes medicines and HbA1c levels, and this seems to be independent of method used to measure adherence. However, to show an association it is necessary to have a range of HbA1c values. Also, the association is not always apparent in low income populations.

Feminism and art in 2013 : a panel discussion

Brisbane-based artist and Founding Co-Director of LEVEL artist run initiative Courtney Coombs reports on a one day forum about Feminism and Art held at LEVEL on International Womens Day 2013. LEVEL is focused on providing opportunities for female visual artists and generating dialogue around gender and arts practice. To listen to podcasts from the event visit http://www.ciprecinct.qut.edu.au/archive/2013/feminism-art.jsp

Convergence of regenerative medicine and synthetic biology to develop standardized and validated models of human diseases with clinical relevance

In order to progress beyond currently available medical devices and implants, the concept of tissue engineering has moved into the centre of biomedical research worldwide. The aim of this approach is not to replace damaged tissue with an implant or device but rather to prompt the patient's own tissue to enact a regenerative response by using a tissue-engineered construct to assemble new functional and healthy tissue. More recently, it has been suggested that the combination of Synthetic Biology and translational tissue-engineering techniques could enhance the field of personalized medicine, not only from a regenerative medicine perspective, but also to provide frontier technologies for building and transforming the research landscape in the field of in vitro and in vivo disease models.

Focus on Form : J. J. Tikkanen, Giotto and Art Research in the 19th Century

My doctoral dissertation is on Johan Jakob Tikkanen (1857 1930), the first professor of art history in Finland, and his significance and methods in the context of late 19th and early 20th-century European art history. Tikkanen was one of the pioneering scholars in the field of medieval art research, and, along with Anton Springer, Heinrich Wölfflin, Aloïs Riegl, Adolfo Venturi, Franz Wickhoff, Julius von Schlosser, Aby Warburg, Emile Mâle and others, one of the scholars who defined art history as an independent academic discipline. Tikkanen s scholarly interests and his methods resemble those of many formalistically oriented German and Austrian art historians of his time. He became well known throughout Europe, mainly for his studies on illustrated medieval manuscripts. Tikkanen s dissertation, Der Malerische Styl Giotto s Versuch zu einer Characteristik Desselben, from 1884 was regarded in its day as the best form-analytical study on the painter. It has a central position in the present thesis, as it already included nearly all the methods that Tikkanen used and elaborated upon throughout his career. Giotto also gives a good perspective for comparing Tikkanen s ideas with a long art-historical tradition. Tikkanen was profoundly interested in artistic creativity. In his own words, he wanted to study das künstlerische Können , artistic ability, instead of das künstlerische Wollen or artistic will, which was an important theoretical issue in art history in the late 19th century. This starting point led him to the history of style and iconographical research. Along with the Danish art historian, Julius Lange, he was one of the first scholars who began to study the meaning of gestures and postures in art. In my dissertation I have emphasized the importance of Tikkanen s personal art education. I regard it as having influenced both his scholarly argumentation and his working methods. I have also written a short overview of the situation of art history in Finland and in Northern Countries before Tikkanen s time in order to give an idea of his scientific background. My thesis is a critical and historiographical study on J. J. Tikkanen s role in the development of art history and its methodology.

New Functional Biomaterials for Medicine and Healthcare

The book begins with an overview of the use of biomaterials in contemporary healthcare and the process of developing novel biomaterials; the key issues and challenges associated with the design of complex implantable systems are also highlighted. The book then reviews the main materials used in functional biomaterials, particularly their properties and applications. Individual chapters focus on both natural and synthetic polymers, metallic biomaterials, and bio-inert and bioactive ceramics.

Critical reckonings : Global art and art history after the West and Eurocentrism

Review of Paul Wood (2013), Western Art and the Wider World. Wiley-Blackwell : Chichester, United Kingdom.

Western medicine and Australian Indigenous healing practices

Most projects undertaken by government health organisations are formulated on values and beliefs about health and illness that are derived from Anglo/Celtic culture. Health beliefs differ between cultures and it has been identified that the differences in the Indigenous and non-Indigenous constructs of health impacts negatively on the effectiveness of mainstream healthcare provided to Indigenous peoples [2]. This implies that strategies that incorporate, or better still are derived from, Indigenous health beliefs have a greater potential to be effective. This article introduces a prospective survey project asking how western medicine and traditional treatments interface with each other.

The Science and Art of Light

Architecture today often is praised for its tectonics, floating volumes, and sensational, gravity-defying stunts of “starchitecture.” Yet, very so often there is a building that inspires descriptions of the sublime, the experiential, and the power of light and architecture to transcend our expectations. The new Meinel Optical Sciences Research Building, designed by Phoenix-based Richärd+Bauer for the University of Arizona, Tucson, is one of these architectural rarities. Already drawing comparisons to Louis Kahn's 1965 Salk Institute for Biological Studies in La Jolla, California, the indescribable quality of light that characterizes the best of Kahn's work also resonates in Richärd+Bauer's new building. Both an expansion and renovation of the existing College of Optical Sciences facilities, the Meinel building includes teaching and research laboratories, six floors of offices, discussion areas, conference rooms, and an auditorium. The new 47,000 square-foot cast-in-place concrete structure, wrapped on three-sides in copper-alloy panels, harmonizes with the largely brick vocabulary of the campus while reflecting the ethereal quality of the wide Arizona sky. The façade, however, is merely a prelude for what awaits inside—where light and architecture seamlessly combine to create moments of pure awe.

Dimensions of University Student Learning in Medicine and Pharmacy

Study orientations in higher education consist of various dimensions, such as approaches to learning, conceptions of learning and knowledge (i.e. epistemologies), self-regulation, and motivation. They have also been measured in different ways. The main orientations typically reported are reproducing and meaning orientations. The present study explored dimensions of study orientations, focusing in particular on pharmacy and medicine. New versions of self-report instruments were developed and tested in various contexts and in two countries. Furthermore, the linkages between study orientations and students epistemological development were explored. The context of problem-based (PBL) small groups was investigated in order to better understand how collaboration contributes to the quality of learning. The participants of Study I (n=66) were pharmacy students, who were followed during a three-year professionally oriented program in terms of their study orientations and epistemologies. A reproducing orientation to studying diminished during studying, whereas only a few students maintained their original level of meaning orientation. Dualism was found to be associated with a reproducing orientation. In Study II practices associated with deep and surface approaches to learning were measured in two differing ways, in order to better distinguish between what students believed to be useful in studying, and the extent to which they applied their beliefs to practice when preparing for examinations. Differences between domains were investigated by including a sample of Finnish and Swedish medical students (n=956) and a Finnish non-medical sample of university students (n=865). Memorizing and rote learning appeared as differing components of a surface approach to learning, while understanding, relating, and critical evaluation of knowledge emerged as aspects of a deep approach to learning. A structural model confirmed these results in both student samples. Study III explored a wide variety of dimensions of learning in medical education. Swedish medical students (n=280) answered the questionnaire. The deep approach to learning was strongly related to collaboration and reflective learning, whereas the surface approach was associated with novice-like views of knowledge and the valuing of certain and directly applicable knowledge. PBL students aimed at understanding, but also valued the role of memorization. Study IV investigated 12 PBL tutorial groups of students (n=116) studying microbiology and pharmacology in a medical school. The educational application was expected to support a deep approach to learning: Group members course grades in a final examination were related to the perceived functioning of the PBL tutorial groups. Further, the quality of cases that had been used as triggers for learning, was associated with the quality of small group functioning. New dimensions of study orientations were discovered. In particular, novel, finer distinctions were found within the deep approach component. In medicine, critical evaluation of knowledge appeared to be less valued than understanding and relating. Further, collaboration appeared to be closely related to the deep approach, and it was also important in terms of successful PBL studying. The results of the studies confirmed the previously found associations between approaches to learning and study success, but showed interesting context- and subgroup-related differences in this respect. Students ideas about the nature of knowledge and their approaches to learning were shown to be closely related. The present study expanded our understanding of the dimensions of study orientations, of their development, and their contextual variability in pharmacy and medicine.

Folk medicine and horticulture

The article discusses the uses of marine organisms in folk medicine and in horticulture in the Philippines. Commonly used marine organisms are the different varieties of seaweeds, sea urchin, sea cucumber, turtle, crocodile and fishes such as grouper and rabbitfish.

On the Relationship Between the Generalized Equality Classifier and ART 2 Neural Networks

In this paper, we introduce the Generalized Equality Classifier (GEC) for use as an unsupervised clustering algorithm in categorizing analog data. GEC is based on a formal definition of inexact equality originally developed for voting in fault tolerant software applications. GEC is defined using a metric space framework. The only parameter in GEC is a scalar threshold which defines the approximate equality of two patterns. Here, we compare the characteristics of GEC to the ART2-A algorithm (Carpenter, Grossberg, and Rosen, 1991). In particular, we show that GEC with the Hamming distance performs the same optimization as ART2. Moreover, GEC has lower computational requirements than AR12 on serial machines.

LUCIANO BERIO’S NATURALE: A STORY COMBINING FOLK MUSIC AND ART MUSIC

The study of a score by a serious performer is a fundamental step in the process of arriving at a knowledgeable and deeply informed approach to performing a piece of music. In order to obtain this knowledge numerous aspects of the score must be taken into consideration. It is the intent of this dissertation to gather and analyze the information concerning Naturale, a work written by Luciano Berio in 1985 for viola, percussion and recorded voice, based on Sicilian folk songs. All the aspects surrounding Naturale’s existence are taken into consideration in this study. First, it is important to reflect on Berio’s compositional style and traits, the manner in which he relates his works one to another, what he sees in folk music and his own personal desire to intertwine art music and folk music. For Berio Naturale is not an isolated venture into the realm of mixing folk music and his own avant-garde style; it is instead one of many works resulting from his long-standing relationship with folk music. Another essential aspect in this case is the study of Sicilian folk music itself, and the sources used by Berio to find the songs by which he was inspired. The work is examined section by section with figures showing both excerpts of Naturale as well as the original songs with their translations. An analysis containing harmonic, thematic and formal aspects of the score was developed in order to arrive at a better understanding of the structure and pacing of the piece. For this research the author went to Italy to conduct an interview with Maestro Aldo Bennici, the Sicilian violist for whom Naturale was composed. This interview helped in the discovery of two more songs used by Berio that have not to this point been identified in any other document. Bennici’s outstanding testimony portrayed the expressive character of this music and the evocative imagery behind this score. I hope to bring this knowledge to other performers, that they may fully understand and appreciate the unique beauty and power of Berio’s Naturale.

Symmetrical freedom quilts: the ethnomathematics of ways of communication, liberation, and art

Symmetrical Freedom Quilts may be considered as links between mathematics, history, ethnomathematics, and the art of quilting. A quilt theme is a pedagogical way to integrate mathematics, art, and history in an interdisciplinary approach. This article combines an ethnomathematical-historical perspective by elaborating a history project related to the Underground Railroad. This work will allow teachers to develop classroom projects that help students to better understand geometry, especially concepts of symmetry and transformations. One of the objectives of this project is to stimulate student’s creativity and interest, because quilts may be considered as cultural and mathematical expressions of student’s daily life.