Statistical analysis of the associations of hereditary factors with the risk of Type 1 diabetes and Diabetic Nephropathy based on the familial data collected through ascertaiment from population-based registers

In genetic epidemiology, population-based disease registries are commonly used to collect genotype or other risk factor information concerning affected subjects and their relatives. This work presents two new approaches for the statistical inference of ascertained data: a conditional and full likelihood approaches for the disease with variable age at onset phenotype using familial data obtained from population-based registry of incident cases. The aim is to obtain statistically reliable estimates of the general population parameters. The statistical analysis of familial data with variable age at onset becomes more complicated when some of the study subjects are non-susceptible, that is to say these subjects never get the disease. A statistical model for a variable age at onset with long-term survivors is proposed for studies of familial aggregation, using latent variable approach, as well as for prospective studies of genetic association studies with candidate genes. In addition, we explore the possibility of a genetic explanation of the observed increase in the incidence of Type 1 diabetes (T1D) in Finland in recent decades and the hypothesis of non-Mendelian transmission of T1D associated genes. Both classical and Bayesian statistical inference were used in the modelling and estimation. Despite the fact that this work contains five studies with different statistical models, they all concern data obtained from nationwide registries of T1D and genetics of T1D. In the analyses of T1D data, non-Mendelian transmission of T1D susceptibility alleles was not observed. In addition, non-Mendelian transmission of T1D susceptibility genes did not make a plausible explanation for the increase in T1D incidence in Finland. Instead, the Human Leucocyte Antigen associations with T1D were confirmed in the population-based analysis, which combines T1D registry information, reference sample of healthy subjects and birth cohort information of the Finnish population. Finally, a substantial familial variation in the susceptibility of T1D nephropathy was observed. The presented studies show the benefits of sophisticated statistical modelling to explore risk factors for complex diseases.

Compressible 2nd-order boundary-layers for 3-dimensional stagnation point flows with mass-transfer

All the second-order boundary-layer effects have been studied for the steady laminar compressible 3-dimensional stagnation-point flows with variable properties and mass transfer for both saddle and nodal point regions. The governing equations have been solved numerically using an implicit finite-difference scheme. Results for the heat transfer and skin friction have been obtained for several values of the mass-transfer rate, wall temperature, and also for several values of parameters characterizing the nature of stagnation point and variable gas properties. The second-order effects on the heat transfer and skin friction at the wall are found to be significant and at large injection rates, they dominate over the results of the first-order boundary layer, but the effect of large suction is just the opposite. In general, the second-order effects are more pronounced in the saddle-point region than in the nodal-point region. The overall heat-transfer rate for the 3-dimensional flows is found to be more than that of the 2-dimensional flows.

Laminar compressible boundary layers with vectored mass transfer

The paper studies the influence of vectored suction or injection on the flow and heat transfer at the stagnation point of a two-dimensional body (a cylinder) and an axisymmetric body (a sphere) with allowance for the effects of variable gas properties. The analysis is based on the boundary-layer equations in dimensionless form for the steady compressible fluid with variable properties in the stagnation region of a two-dimensional or an axisymmetric body with tangential and normal surface mass transfer under similarity requirements. It is shown that the variation of the density-viscosity product across the boundary layer has a strong effect on the skin friction and heat transfer. This gives rise to a point of inflection which can be removed by suction and by increasing the wall temperature. The skin friction and heat transfer are significantly affected by the pressure gradient parameter.

Cluster randomised-control trial for an Australian child protection education program: Study protocol for the Learn to be safe with Emmy and friends™

Background Child maltreatment has severe short-and long-term consequences for children’s health, development, and wellbeing. Despite the provision of child protection education programs in many countries, few have been rigorously evaluated to determine their effectiveness. We describe the design of a multi-site gold standard evaluation of an Australian school-based child protection education program. The intervention has been developed by a not-for-profit agency and comprises 5 1-h sessions delivered to first grade students (aged 5–6 years) in their regular classrooms. It incorporates common attributes of effective programs identified in the literature, and aligns with the Australian education curriculum. Methods/Design A three-site cluster randomised controlled trial (RCT) of Learn to be safe with Emmy and friends™ will be conducted with children in approximately 72 first grade classrooms in 24 Queensland primary (elementary) schools from three state regions, over a period of 2 years. Entire schools will be randomised, using a computer generated list of random numbers, to intervention and wait-list control conditions, to prevent contamination effects across students and classes. Data will be collected at baseline (pre-assessment), immediately after the intervention (post-assessment), and at 6-, 12-, and 18-months (follow-up assessments). Outcome assessors will be blinded to group membership. Primary outcomes assessed are children’s knowledge of program concepts; intentions to use program knowledge, skills, and help-seeking strategies; actual use of program material in a simulated situation; and anxiety arising from program participation. Secondary outcomes include a parent discussion monitor, parent observations of their children’s use of program materials, satisfaction with the program, and parental stress. A process evaluation will be conducted concurrently to assess program performance. Discussion This RCT addresses shortcomings in previous studies and methodologically extends research in this area by randomising at school-level to prevent cross-learning between conditions; providing longer-term outcome assessment than any previous study; examining the degree to which parents/guardians discuss intervention content with children at home; assessing potential moderating/mediating effects of family and child demographic variables; testing an in-vivo measure to assess children’s ability to discriminate safe/unsafe situations and disclose to trusted adults; and testing enhancements to existing measures to establish greater internal consistency.

Compressible magnetohydrodynamic boundary layer swirling nozzle and diffuser flows with a magnetic field

The flow, heat and mass transfer problem for boundary layer swirling flow of a laminar steady compressible electrically conducting gas with variable properties through a conical nozzle and a diffuser with an applied magnetic field has been studied. The partial differential equations governing the flow have been solved numerically using an implicit finite-difference scheme after they have been transformed into dimensionless form using the modified Lees transformation. The results indicate that the skin friction and heat transfer strongly depend on the magnetic field, mass transfer and variation of the density-viscosity product across the boundary layer. However, the effect of the variation of the density-viscosity product is more pronounced in the case of a nozzle than in the case of a diffuser. It has been found that large swirl is required to produce strong effect on the skin friction and heat transfer. Separationless flow along the entire length of the diffuser can be obtained by applying appropriate amount of suction. The results are found to be in good agreement with those of the local nonsimilarity method, but they differ quite significantly from those of the local similarity method.

Systematic review of interventions to improve the provision of information for adults with primary brain tumours and their caregivers

Background: Adults with primary brain tumors and their caregivers have significant information needs. This review assessed the effect of interventions to improve information provision for adult primary brain tumor patients and/or their caregivers. Methods: We included randomized or nonrandomized trials testing educational interventions that had outcomes of information provision, knowledge, understanding, recall, or satisfaction with the intervention, for adults diagnosed with primary brain tumors and/or their family or caregivers. PubMed, MEDLINE, EMBASE and Cochrane Reviews databases were searched for studies published between 1980 and June 2014. Results: Two randomized controlled, one non-randomized controlled, and 10 single group pre-post trials enrolled more than 411 participants. Five group, four practice/process change and four individual interventions assessed satisfaction (12 studies), knowledge (four studies) or information provision (2 studies). Nine studies reported high rates of satisfaction. Three studies showed statistically significant improvements over time in knowledge and two showed greater information was provided to intervention than control group participants, although statistical testing was not performed. Discussion: The trials assessed intermediate outcomes such as satisfaction, and only 4/13 reported on knowledge improvements. Few trials had a randomized controlled design and risk of bias was either evident or could not be assessed in most domains.

Effects of unilateral vocal fold paralysis treatment with fascia augmentation on airflow mechanics, tracheal sounds and voice acoustics

Data on the influence of unilateral vocal fold paralysis on breathing, especially other than information obtained by spirometry, are relatively scarce. Even less is known about the effect of its treatment by vocal fold medialization. Consequently, there was a need to study the issue by combining multiple instruments capable of assessing airflow dynamics and voice. This need was emphasized by a recently developed medialization technique, autologous fascia injection; its effects on breathing have not previously been investigated. A cohort of ten patients with unilateral vocal fold paralysis was studied before and after autologous fascia injection by using flow-volume spirometry, body plethysmography and acoustic analysis of breathing and voice. Preoperative results were compared with those of ten healthy controls. A second cohort of 11 subjects with unilateral vocal fold paralysis was studied pre- and postoperatively by using flow-volume spirometry, impulse oscillometry, acoustic analysis of voice, voice handicap index and subjective assessment of dyspnoea. Preoperative peak inspiratory flow and specific airway conductance were significantly lower and airway resistance was significantly higher in the patients than in the healthy controls (78% vs. 107%, 73% vs. 116% and 182% vs. 125% of predicted; p = 0.004, p = 0.004 and p = 0.026, respectively). Patients had a higher root mean square of spectral power of tracheal sounds than controls, and three of them had wheezes as opposed to no wheezing in healthy subjects. Autologous fascia injection significantly improved acoustic parameters of the voice in both cohorts and voice handicap index in the latter cohort, indicating that this procedure successfully improved voice in unilateral vocal fold paralysis. Peak inspiratory flow decreased significantly as a consequence of this procedure (from 4.54 ± 1.68 l to 4.21 ± 1.26 l, p = 0.03, in pooled data of both cohorts), but no change occurred in the other variables of flow-volume spirometry, body-plethysmography and impulse oscillometry. Eight of the ten patients studied by acoustic analysis of breathing had wheezes after vocal fold medialization compared with only three patients before the procedure, and the numbers of wheezes per recorded inspirium and expirium increased significantly (from 0.02 to 0.42 and from 0.03 to 0.36; p = 0.028 and p = 0.043, respectively). In conclusion, unilateral vocal fold paralysis was observed to disturb forced breathing and also to cause some signs of disturbed tidal breathing. Findings of flow volume spirometry were consistent with variable extra-thoracic obstruction. Vocal fold medialization by autologous fascia injection improved the quality of the voice in patients with unilateral vocal fold paralysis, but also decreased peak inspiratory flow and induced wheezing during tidal breathing. However, these airflow changes did not appear to cause significant symptoms in patients.

The impact of communication technologies on life and relationship satisfaction

Previous studies have shown a relationship between the use of communications technology and well-being, particularly mediated through its effect on personal relationships. However, there is some debate over whether this effect is positive or negative. The present study explored this issue further, examining whether the effect varies depending on the type of communications technology, and the nature of the personal relationship. An online survey was conducted with 3,421 participants in three countries (Australia, UK and US). It examined the use of ten communication methods, overall satisfaction with life and satisfaction with four different kinds of relationships (close and extended family, and close and distant friends). Results indicate that richer communication methods, which include non-verbal cues, were positively associated with both overall satisfaction with life and satisfaction with relationships. These methods included face-to-face communication, and phone and video calls. Conversely, more restricted methods, such as text messaging and instant messaging, were negatively associated with both variables. Social networking was negatively associated with overall satisfaction, but not with satisfaction with relationships. The strength of the association between a communications method and satisfaction with a relationship varied depending on the type of relationship, but whether it was positive or negative did not change.

Efficacy of family mediation and the role of family violence: Study protocol

Background Family law reforms in Australia require separated parents in dispute to attempt mandatory family dispute resolution (FDR) in community-based family services before court attendance. However, there are concerns about such services when clients present with a history of high conflict and family violence. This study protocol describes a longitudinal study of couples presenting for family mediation services. The study aims to describe the profile of family mediation clients, including type of family violence, and determine the impact of violence profiles on FDR processes and outcomes, such as the type and durability of shared parenting arrangements and clients’ satisfaction with mediated agreements. Methods A mixed method, naturalistic longitudinal design is used. The sampling frame is clients presenting at nine family mediation centres across metropolitan, outer suburban, and regional/rural sites in Victoria, Australia. Data are collected at pre-test, completion of mediation, and six months later. Self-administered surveys are administered at the three time points, and a telephone interview at the final post-test. The key study variable is family violence. Key outcome measures are changes in the type and level of acrimony and violent behaviours, the relationship between violence and mediated agreements, the durability of agreements over six months, and client satisfaction with mediation. Discussion Family violence is a major risk to the physical and mental health of women and children. This study will inform debates about the role of family violence and how to manage it in the family mediation context. It will also inform decision-making about mediation practices by better understanding how mediation impacts on parenting agreements, and the implications for children, especially in the context of family violence.

N-H center dot center dot center dot O and C-H center dot center dotcenter dot O interaction mimicry in the 1:1 molecular complexes of 5,5-diethylbarbituric acid with urea and acetamide

The analogy between N-H center dot center dot center dot O and C-H center dot center dot center dot O intermolecular interactions is studied with variable temperature (180-100 K) single crystal X-ray diffraction analysis.5,5-Diethylbarbituric acid (barbital) forms isostructural molecular complexes (co-crystals) with urea (1) and acetamide (2) that respectively contain these analogous interactions.The behaviour of these two interactions as a function of temperature is very similar. This indicates that the C-H center dot center dot center dot O bond in barbital acetamide plays a similar chemical and structural role as does the N-H center dot center dot center dot O bond in barbital urea. The close relationship between these interactions and their comparable nature is further adduced from the formation of a ternary solid solution (3) of barbital, urea and acetamide. The fact that the C-H center dot center dot center dot O interaction in barbital acetamide is weaker than the N-H center dot center dot center dot O interaction in barbital urea is shown by the fact that acetamide is under expressed and urea is over expressed with respect to the quantities of these substances present in solution prior to crystallization of these ternary crystals.

Boost Customer Loyalty with Online Support. The Case of Mobile Telecoms Providers.

The paper explores the effect of customer satisfaction with online supporting services on loyalty to providers of an offline core service. Supporting services are provided to customers before, during, or after the purchase of a tangible or intangible core product, and have the purpose of enhancing or facilitating the use of this product. The internet has the potential to dominate all other marketing channels when it comes to the interactive and personalised communication that is considered quintessential for supporting services. Our study shows that the quality of online supporting services powerfully affects satisfaction with the provider and customer loyalty through its effect on online value and enjoyment. Managerial implications are provided.

Compressible Boundary-Layer Swirling Flow in a Nozzle and a Diffuser With Highly Cooled Wall

The steady laminar compressible boundary-layer swirling flow with variable gas properties and mass transfer through a conical nozzle, and a diffuser with a highly cooled wall has been studied. The partial differential equations governing the nonsimilar flow have been transformed to a system of coordinates using modified Lees transformation. The resulting equations are transformed into coordinates having finite ranges by means of a transformation which maps an infinite region into a finite region. The ensuing equations are then solved numerically using an implicit finite-difference scheme. The results indicate that the variation of the density-viscosity product across the boundary layer and mass transfer have strong effect on the skin friction and heat transfer. Separationless flow along the entire length of the diffuser can be obtained by applying suction. The results are found to be in good agreement with those of the local nonsimilarity method but they differ appreciably from those of the local similarity method.

Unsteady laminar compressible swirling flow with massive blowing

THE study of swirling boundary layers is of considerable importance in many rotodynamic machines such as rockets, jet engines, swirl generators, swirl atomizers, arc heaters, etc. For example, the introduction of swirl in a flow acceleration device such as a nozzle in a rocket engine promises efficient mass flow control. In nuclear rockets, swirl is used to retain the uranium atoms in the rocket chamber. With these applications in mind, Back1 and Muthanna and Nath2 have obtained the similarity solutions for a low-speed three-dimensional steady laminar compressible boundary layer with swirl inside an axisymmetric surface of variable cross section. The aim of the present analysis is to study the effect of massive blowing rates on the unsteady laminar swirling compressible boundary-layer flow of an axisymmetric body of arbitrary cross section when the freestream velocity and blowing rate vary with time. The type of swirl considered here is that of a free vortex superimposed on the longitudinal flow of a compressible fluid with variable properties. The analysis is applicable to external flow over a body as well as internal flow along a surface. For the case of external flow, strong blowing can have significant use in cooling the surface of hypervelocity vehicles, particularly when ablation occurs under large aerodynamic or radiative heating, but there may not be such an important application of strong blowing in the case of internal flow. The governing partial differential equations have been solved numerically using an implicit finite difference scheme with a quasilinearization technique.3 High temperature gas effects, such as radiation, dissociation, and ionization, etc., are not investigated. The nomenclature is usually that of Ref. 4 and is listed in the full paper.

Three-dimensional laminar compressible boundary layers with large injection

The effect of large mass injection on the following three-dimensional laminar compressible boundary-layer flows is investigated by employing the method of matched asymptotic expansions: (i) swirling flow in a laminar compressible boundary layer over an axisymmetric surface with variable cross-section and (ii) laminar compressible boundary-layer flow over a yawed infinite wing in a hypersonic flow. The resulting equations are solved numerically by combining the finite-difference technique with quasi-linearization. An increase in the swirl parameter, the yaw angle or the wall temperature is found to be capable of bringing the viscous layer nearer the surface and reducing the effects of massive blowing.

Constraining complex aquifer geometry with geophysics (2-D ERT and MRS measurements) for stochastic modelling of groundwater flow

Stochastic modelling is a useful way of simulating complex hard-rock aquifers as hydrological properties (permeability, porosity etc.) can be described using random variables with known statistics. However, very few studies have assessed the influence of topological uncertainty (i.e. the variability of thickness of conductive zones in the aquifer), probably because it is not easy to retrieve accurate statistics of the aquifer geometry, especially in hard rock context. In this paper, we assessed the potential of using geophysical surveys to describe the geometry of a hard rock-aquifer in a stochastic modelling framework. The study site was a small experimental watershed in South India, where the aquifer consisted of a clayey to loamy-sandy zone (regolith) underlain by a conductive fissured rock layer (protolith) and the unweathered gneiss (bedrock) at the bottom. The spatial variability of the thickness of the regolith and fissured layers was estimated by electrical resistivity tomography (ERT) profiles, which were performed along a few cross sections in the watershed. For stochastic analysis using Monte Carlo simulation, the generated random layer thickness was made conditional to the available data from the geophysics. In order to simulate steady state flow in the irregular domain with variable geometry, we used an isoparametric finite element method to discretize the flow equation over an unstructured grid with irregular hexahedral elements. The results indicated that the spatial variability of the layer thickness had a significant effect on reducing the simulated effective steady seepage flux and that using the conditional simulations reduced the uncertainty of the simulated seepage flux. As a conclusion, combining information on the aquifer geometry obtained from geophysical surveys with stochastic modelling is a promising methodology to improve the simulation of groundwater flow in complex hard-rock aquifers. (C) 2013 Elsevier B.V. All rights reserved.