Restoration of self-awareness of hypoglycemia in adults with long-standing type 1 diabetes: hyperinsulinemic-hypoglycemic clamp substudy results from the HypoCOMPaSS trial.

OBJECTIVE: Impaired awareness of hypoglycemia (IAH) and defective counterregulation significantly increase severe hypoglycemia risk in type 1 diabetes (T1D). We evaluated restoration of IAH/defective counterregulation by a treatment strategy targeted at hypoglycemia avoidance in adults with T1D with IAH (Gold score ≥4) participating in the U.K.-based multicenter HypoCOMPaSS randomized controlled trial. RESEARCH DESIGN AND METHODS: Eighteen subjects with T1D and IAH (mean ± SD age 50 ± 9 years, T1D duration 35 ± 10 years, HbA1c 8.1 ± 1.0% [65 ± 10.9 mmol/mol]) underwent stepped hyperinsulinemic-hypoglycemic clamp studies before and after a 6-month intervention. The intervention comprised the HypoCOMPaSS education tool in all and randomized allocation, in a 2 × 2 factorial study design, to multiple daily insulin analog injections or continuous subcutaneous insulin infusion therapy and conventional glucose monitoring or real-time continuous glucose monitoring. Symptoms, cognitive function, and counterregulatory hormones were measured at each glucose plateau (5.0, 3.8, 3.4, 2.8, and 2.4 mmol/L), with each step lasting 40 min with subjects kept blinded to their actual glucose value throughout clamp studies. RESULTS: After intervention, glucose concentrations at which subjects first felt hypoglycemic increased (mean ± SE from 2.6 ± 0.1 to 3.1 ± 0.2 mmol/L, P = 0.02), and symptom and plasma metanephrine responses to hypoglycemia were higher (median area under curve for symptoms, 580 [interquartile range {IQR} 420-780] vs. 710 [460-1,260], P = 0.02; metanephrine, 2,412 [-3,026 to 7,279] vs. 5,180 [-771 to 11,513], P = 0.01). Glycemic threshold for deterioration of cognitive function measured by four-choice reaction time was unchanged, while the color-word Stroop test showed a degree of adaptation. CONCLUSIONS: Even in long-standing T1D, IAH and defective counterregulation may be improved by a clinical strategy aimed at hypoglycemia avoidance.

Awareness of energy drink intake guidelines and associated consumption practices: a cross-sectional study

BACKGROUND: Despite concern regarding harms of energy drink (ED) consumption, no research has been conducted to determine awareness and compliance with ED intake guidelines displayed on product packaging in Australia (a novel approach internationally).

METHODS: A convenience sample of 1922 people completed an online survey. Participants reported their knowledge of maximum recommended daily ED intake according to Australian guidelines.

RESULTS: Guideline awareness was reported by 38, 23 and 19 % of past year consumers, lifetime, and non-consumers, respectively. Amongst past year consumers, 'accurate estimators' reported greater ED intake and were more likely to exceed intake guidelines and consume alcohol mixed with ED (AmED). After controlling for demographics and frequency of use, guideline awareness predicted increased likelihood of exceeding guidelines in ED sessions, but was not associated with exceeding ED guidelines in AmED sessions.

CONCLUSIONS: Australia is considered to have the most stringent regulatory approach to EDs internationally. However, advisory statements are not associated with greater awareness and compliance with intake guidelines. Failure to comply with standards for efficacious product labelling, and absence of broader education regarding guidelines, needs to be addressed.

Enhancing English language learners’ text understanding through metaphor awareness

 The study examined awareness of metaphor as a tool to enhance English language learners’ understanding of texts with embedded metaphors. Findings revealed that an enhanced awareness of metaphor, as indicated by greater use of the metalanguage of metaphor, longer turns conversation and reflective journals, helped them get deeper text meaning.

April 2007: Stress Awareness Month

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A situation awareness interface for a bi-wheeled industrial hovercraft: design, development and evaluation

The intention of this thesis is to develop a prototype interface that enables an operator to control a bi-wheeled industrial hovercraft that will work within a fusion power plant if the automation system fails. This fusion power plant is part of the ITER project a conjoint effort of various industrialized countries to develop cleaner sources of energy. The development of the interface prototype will be based on situation awareness concepts, which provide a means to understand how human operators perceive the world around, then process that information and make decisions based on the knowledge that they already have and the projected knowledge of the reactions that will occur in the world in response to the actions the operator makes. Two major situation awareness methods will be used, GDTA as a means to discover the requirements the interface needs to solve, and SAGAT to conduct the evaluation on the three interfaces. This technique can isolate the differences an operator has in situation awareness when presented with relevant information given by each of the three interfaces that were built for this thesis. Where the first interface presents the information within the operator’s focal point of view in a pictorial style, the second interface shows the same information within the same point of view has the first interface but only shows it in a textual manner. While the third interface shows the relevant information in the operator’s peripheral field of view. Also SAGAT can provide insight on the question to know if providing the operator with feed-forward information about the stoppage distances of the bi-wheeled industrial hovercraft has any effect on the operator’s decision making.

Hudumia: a platform to support spontaneous volunteers' situational awareness, coordination and safety underemergency scenarios

Spontaneous volunteers always emerge under emergency scenarios and are vital to a successful community response, yet some uncertainty subsists around their role and its inherent acceptance by official entities under emergency scenarios. In our research we have identified that most of the spontaneous volunteers do have none or little support from official entities, hence they end up facing critical problems as situational awareness, safety instructions and guidance, motivation and group organization. We argue that official entities still play a crucial role and should change some of their behaviors regarding spontaneous volunteerism. We aim with this thesis to design a software architecture and a framework in order to implement a solution to support spontaneous volunteerism under emergency scenarios along with a set of guidelines for the design of open information management systems. Together with the collaboration from both citizens and emergency professionals we have been able to attain several important contributions, as the clear identification of the roles taken by both spontaneous volunteers and professionals, the importance of volunteerism in overall community response and the role which open collaborative information management systems have in the community volunteering efforts. These conclusions have directly supported the design guidelines of our software solution proposal. In what concerns to methodology, we first review literature on technologies support to emergencies and how spontaneous volunteers actually challenge these systems. Following, we have performed a field research where we have observed that the emerging of spontaneous volunteer’s efforts imposes new requirements for the design of such systems, which leaded to the creation of a cluster of design guidelines that supported our software solution proposal to address the volunteers’ requirements. Finally we have architected and developed an online open information management tool which has been evaluated via usability engineering methods, usability user tests and heuristic evaluations.

Air pollution and citizen awareness

Includes bibliography

The importance of citizen awareness in controlling air pollution in metropolitan areas of Latin America: the theoretical framework

Includes bibliography

Citizen awareness and air pollution: the case of Mexico City

Includes bibliography

Citizen awareness and air pollution: the case of São Paulo Metropolitan Region

Includes bibliography

Citizen awareness and air pollution: the case of Santiago

Includes bibliography

Citizen awareness and air pollution in three Latin American cities: São Paulo, Santiago and Mexico City. Comparative analysis

Includes bibliography

Methodology of the project Enhancement of citizen awareness for the formulation of air pollution control policies in three metropolitan areas of Latin America: Mexico City, Santiago and São Paulo

Includes bibliography