The effect of multiple chronic conditions on self-rated health, disability and quality of life among the older populations of Northern Ireland and the Republic of Ireland: a comparison of two nationally representative cross-sectional surveys

Objectives: Multimorbidity is common in the older population, but the impact of combinations of chronic conditions on disability and quality of life (QoL) is not well known. This analysis explores the effect of specific combinations of chronic diseases on disability, QoL and self-rated health (SRH).

Design: We used data from two population representative cross-sectional studies, the Northern Ireland Health and Social Wellbeing Survey (NIHSWS) 2005 and the Survey of Lifestyle, Attitudes and Nutrition (SLAN) 2007 (conducted in the Republic of Ireland).

Setting: Randomly selected community-living participants were interviewed at home.

Participants: A total of 6159 participants aged 50 years and older were included in the analysis.

Outcome measures: Chronic conditions were classified as cardiovascular disease, chronic pain,diabetes or respiratory disease. Interaction terms estimated by logistic regression were used to examine the effects of multiple chronic conditions on disability, SRH and QoL.

Results: Each chronic condition group was correlated with each of the others after adjusting for sociodemographic factors. Those from Northern Ireland were more likely to report a limitation in daily activities (45%) compared to those from the Republic of Ireland (21%). Each condition had an independent effect on disability, SRH and QoL, and those with multiple chronic conditions reported the worst outcomes. However, there were no statistically significant positive interactions between chronic condition groups with respect to any outcome.

Conclusions: Chronic conditions affect individuals largely independent of each other with respect to their effect on disability, SRH and QoL. However, a significant proportion of the population aged 50 years and over across the island of Ireland lives with multimorbidity,and this group is at the highest risk of disability, poor SRH and poor QoL.

Uma história do design do cartaz português do século XVII ao século XX

Constatada que foi uma lacuna na área da história do design gráfico português, a necessidade deste estudo surgiu naturalmente no sentido, se não de a colmatar pelo menos de a diminuir. Consequentemente, realizou-se a investigação desde o séc. XVII ao séc. XX. O trabalho baseou-se primeiramente na pesquisa de material, quer na Biblioteca Nacional de Portugal, quer na colecção de Madeira Luís em arquivo na Universidade de Aveiro. Foram ainda realizadas entrevistas a designers no sentido de obter um conhecimento maior sobre a prática de projecto, nomeadamente do projecto do cartaz. Foi selecionada uma amostra que se considerou representativa e criou-se uma base de dados no sentido de sistematizar os conteúdos que interessavam ser estudados. Essa amostra foi posteriormente objecto de uma selecção por parte de dez especialistas convidados. Paralelamente, analisaram-se os cartazes dessa selecção do ponto de vista do design utilizando como metodologia a aplicação do modelo triangular (autoria, tecnologia, programa) de Francisco Providência. Concluiu-se que a história do design do cartaz português é resultado de um conjunto de interacções que se prendem com os acontecimentos políticos, económicos, culturais que se devem mesclar com a prática projectual realçando a importância e a intervenção da autoria nesse processo. Importou revelar uma visão interna da disciplina narrada pela autoria. Considerando as hipóteses de investigação e a abordagem metodológica utilizada, foi possível obter uma perspectiva centrada no design sobre a história do design do cartaz português.

O Design, a Gestão e a Comunicação da Marca: Caso de estudo spryou

Dissertação apresentada ao Instituto Politécnico de Castelo Branco para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Design Gráfico pela Escola Superior de Artes Aplicadas do Instituto Politécnico de Castelo Branco em associação com a Faculdade de Arquitetura da Universidade de Lisboa.

Off-road sampling reveals a different grassland bird community than roadside sampling: implications for survey design and estimates to guide conservation

Grassland bird species continue to decline steeply across North America. Road-based surveys such as the North American Breeding Bird Survey (BBS) are often used to estimate trends and population sizes and to build species distribution models for grassland birds, although roadside survey counts may introduce bias in estimates because of differences in habitats along roadsides and in off-road surveys. We tested for differences in land cover composition and in the avian community on 21 roadside-based survey routes and in an equal number of adjacent off-road walking routes in the grasslands of southern Alberta, Canada. Off-road routes (n = 225 point counts) had more native grassland and short shrubs and less fallow land and road area than the roadside routes (n = 225 point counts). Consequently, 17 of the 39 bird species differed between the two route types in frequency of occurrence and relative abundance, measured using an indicator species analysis. Six species, including five obligate grassland species, were more prevalent at off-road sites; they included four species listed under the Canadian federal Species At Risk Act or listed by the Committee on the Status of Endangered Wildlife in Canada: Sprague’s Pipit (Anthus spragueii), Baird’s Sparrow (Ammodramus bairdii), the Chestnut-collared Longspur (Calcarius ornatus), and McCown’s Longspur (Rhynchophanes mccownii). The six species were as much as four times more abundant on off-road sites. Species more prevalent along roadside routes included common species and those typical of farmland and other human-modified habitats, e.g., the European Starling (Sturnus vulgaris), the Black-billed Magpie (Pica hudsonia), and the House Sparrow (Passer domesticus). Differences in avian community composition between roadside and off-road surveys suggest that the use of BBS data when generating population estimates or distribution models may overestimate certain common species and underestimate others of conservation concern. Our results highlight the need to develop appropriate corrections for bias in estimates derived from roadside sampling, and the need to design surveys that sample bird communities across a more representative cross-section of the landscape, both near and far from roads. 

Biased representation of disturbance rates in the roadside sampling frame in boreal forests: implications for monitoring design

The North American Breeding Bird Survey (BBS) is the principal source of data to inform researchers about the status of and trend for boreal forest birds. Unfortunately, little BBS coverage is available in the boreal forest, where increasing concern over the status of species breeding there has increased interest in northward expansion of the BBS. However, high disturbance rates in the boreal forest may complicate roadside monitoring. If the roadside sampling frame does not capture variation in disturbance rates because of either road placement or the use of roads for resource extraction, biased trend estimates might result. In this study, we examined roadside bias in the proportional representation of habitat disturbance via spatial data on forest “loss,” forest fires, and anthropogenic disturbance. In each of 455 BBS routes, the area disturbed within multiple buffers away from the road was calculated and compared against the area disturbed in degree blocks and BBS strata. We found a nonlinear relationship between bias and distance from the road, suggesting forest loss and forest fires were underrepresented below 75 and 100 m, respectively. In contrast, anthropogenic disturbance was overrepresented at distances below 500 m and underrepresented thereafter. After accounting for distance from road, BBS routes were reasonably representative of the degree blocks they were within, with only a few strata showing biased representation. In general, anthropogenic disturbance is overrepresented in southern strata, and forest fires are underrepresented in almost all strata. Similar biases exist when comparing the entire road network and the subset sampled by BBS routes against the amount of disturbance within BBS strata; however, the magnitude of biases differed. Based on our results, we recommend that spatial stratification and rotating panel designs be used to spread limited BBS and off-road sampling effort in an unbiased fashion and that new BBS routes be established where sufficient road coverage exists.

Methodologies for the generation of design summer years for building energy simulation using UKCP09 probabilitic climate projections

Design summer years representing near-extreme hot summers have been used in the United Kingdom for the evaluation of thermal comfort and overheating risk. The years have been selected from measured weather data basically representative of an assumed stationary climate. Recent developments have made available ‘morphed’ equivalents of these years by shifting and stretching the measured variables using change factors produced by the UKCIP02 climate projections. The release of the latest, probabilistic, climate projections of UKCP09 together with the availability of a weather generator that can produce plausible daily or hourly sequences of weather variables has opened up the opportunity for generating new design summer years which can be used in risk-based decision-making. There are many possible methods for the production of design summer years from UKCP09 output: in this article, the original concept of the design summer year is largely retained, but a number of alternative methodologies for generating the years are explored. An alternative, more robust measure of warmth (weighted cooling degree hours) is also employed. It is demonstrated that the UKCP09 weather generator is capable of producing years for the baseline period, which are comparable with those in current use. Four methodologies for the generation of future years are described, and their output related to the future (deterministic) years that are currently available. It is concluded that, in general, years produced from the UKCP09 projections are warmer than those generated previously. Practical applications: The methodologies described in this article will facilitate designers who have access to the output of the UKCP09 weather generator (WG) to generate Design Summer Year hourly files tailored to their needs. The files produced will differ according to the methodology selected, in addition to location, emissions scenario and timeslice.

Freshwater reserves in Australia : directions and challenges for the development of a comprehensive, adequate and representative system of protected areas

The establishment of a system of protected areas that samples all ecosystems, including freshwater environments, in a comprehensive, adequate and representative (CAR) manner is regarded as a cornerstone for the conservation of biodiversity. There have been few quantitative assessments of the comprehensiveness, adequacy and representativeness of freshwater reserves in Australia. This paper reviews and quantifies the effect of classification of freshwater ecosystems for conservation planning, the importance of reservation status and protection measures for developing a CAR reserve system, and aspects of reserve design for freshwater ecosystems. We propose a strategic and iterative process that incorporates these measures to assist in the efficient and effective development of freshwater reserve systems worldwide. However, the provision of suitable water regimes for freshwater reserves presents further ecological and political challenges, and even adequate reservation of freshwater ecosystems may not conserve constituent biodiversity without effective management.

Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian women

Objective:
To identify the prevalence and correlates of three types of pelvic pain (dysmenorrhoea, dyspareunia, and other chronic pelvic pain [CPP]) in a nationally representative sample of Australian women.

Design and setting:
The CPP survey was part of a broader national study of health and relationships. Computer-assisted telephone interviews were administered to a random sample of 8656 Australian households; 4366 women aged between 16 and 64 years were interviewed in 2004 and 2005. Eighteen of the more than 200 potential survey questions related to pelvic pain.

Main outcome measures:
Self-reports of dysmenorrhoea, dyspareunia, and any other CPP not associated with sexual intercourse or menstruation.

Results:
Data on 1983 women aged 16–49 years who were still menstruating and sexually active were analysed. Prevalences were 71.7% for dysmenorrhoea, 14.1% for dyspareunia and 21.5% for other CPP; 23.3% of women reported no pelvic pain of any kind. Severe pain was reported by 15.0% (95% CI, 13.0%–17.1%) of women with dysmenorrhoea, 7.8% (95% CI, 5.0%–11.9%) of women with dyspareunia and 20.0% (95% CI, 16.1%–24.6%) of women with other CPP. Just over a third (34.2%) of women who reported any pain had sought advice from a health professional. Women reporting CPP were also likely to report other health conditions, most notably depression and anxiety. There were clear associations between CPP and sexual difficulties, pregnancy and pregnancy outcomes.

Conclusions:
Rates of pelvic pain in Australian women are high. General practitioners need to be ready to discuss these issues with patients, particularly in relation to underlying anxiety and depression.

Common structural basis for central nervous system drug design

The main theme of this thesis is that there is a common structural basis for drugs acting on the central nervous system (CNS), and that this concept may be used to design new CNS-active drugs which have greater specificity and hence less side-effects. To develop these ideas, the biological basis of how drugs modify CMS neurotransmission is described, and illustrated using dopaminergic pathways. An account is then given of the use of physicochemical concepts in contemporary drug design. The complete conformational analysis of several antipsychotic drugs is used to illustrate some of these techniques in the development of a model for antipsychotic drug action. After reviewing current structure-activity studies in several classes of CNS drugs (antipsychotics, anti-depressants, stimulants, hal1ucinogens, anticonvulsants and analgesics), a hypothesis for a common structural basis of CNS drug action is proposed- This is based on a topographical comparison of the X-ray structures of eight representative CNS-active drugs, and consists of three parts: 1.there is a common structural basis for the activity of many different CNS-active drug classes; 2. an aromatic ring and a nitrogen atom are the primary binding groups whose topographical arrangement is fundamental to the activity of these drug classes; 3. the nature and placement of secondary binding determines different classes of CNS drug activity. A four-Point model for this common structural basis is then defined using 14- CNS-active drug structures that include the original eight used in proposing the hypothesis. The coordinates of this model are: R1 (0. 3.5, 0), R2 (0, -3.5, O), N (4.8. -0.3, 1.4), and R3 (6.3, 1.3, 0), where R1 and R2 represent the point locations of a hydrophobic interaction of the common aromatic ring with a receptor, and R3 locates the receptor point for a hydrogen bond involving the common nitrogen, N. Extended structures were used to define the receptor points R1, R2 and R3, and the complete conformational space of each of the 14 molecules was considered. It is then shoun that the model may be used to predict whether a given structure is likely to show CNS activity: a search over 1,000 entries in the current Merck Index shows a high probability (82%) of CNS activity in compounds fitting the structural model. Analysis of CNS neurotransmitters and neuropeptides shows that these fit the common model well. Based on the available evidence supporting chemical evolution, protein evolution, and the evolution of neurotransmitter functions, it is surmised that the aromatic ring/nitrogen atom pharmacophore proposed in the common model supports the idea of the evolution of CNS receptors and their neurotransmitters, possibly from an aromatic amine or acety1cho1ine acting as a primaeval communicating molecule. The third point in the hypothesis trilogy is then addressed. The extensive conformation-activity analyses that have resulted in well-defined models for five separate CNS drug classes are used to map out the locations of secondary binding groups relative to the common model for anti-psychotics, antidepressants, analgesics, anticholinergics, and anticonvulsants. With this information, and knowledge derived from receptor-binding data, it is postulated that drugs having specified activity could be designed. In order to generate novel structures having a high probability of CNS-activity, a process of drug design is described in which known CNS structures are superimposed topographically using the common model as a template. Atoms regarded as superfluous may be selectively deleted and the required secondary binding groups added in predicted locations to give novel structures. It is concluded that this process provides the basis for the rational design of new lead compounds which could further be optimized for potent and specific CNS activity.

Non-Deterministic Exploration through Parametric Design

This paper explores non-deterministic parametric modelling as a design tool. Specifically, it addresses the application of parametric variables to the generation of a conceptual bridge design and the use of repeatable discrete components to the conceptual form. In order to control the generation of the bridge form, a set of design variables based on the concept of a law curve have been developed.These design variables are applied and tested through interactive modelling and variation, driven by manipulating the law curve. Combining this process with the application and control of a repeatable element, known as a Representative Volumetric Element (RVE), allows for the development and exploration of a design solution that could not be achieved through the use of conventional computer modelling.The competition brief for the Australian Institute of Architects (AIA) ‘Dialectical Bridge’ has been used as a case study to demonstrate the use of non-deterministic parametric modelling as a design tool.The results of the experimentation with parametric variables, the law curve and representative volumetric elements (RVE) are presented in the paper.

Geometric and material constraints in parametric modelling : the design to fabrication process

Parametric modelling, commonly used in the automotive and aerospace industries, has recently been adopted in the architecture and construction fields. The ability to design small repeatable components and apply them to a larger governing surface geometry is one area of parametric modelling that has great design potential. This two level modelling control, of component and overall surface, can allow designers to explore new types of form generation subject to parametric constraints. This paper reports on the design to fabrication process using repeatable components over a governing or carrier surface. The paper reports on our study of the requirements and possible solutions for successfully controlling a repeatable element, known as a Representative Volumetric Element (RVE), using geometric parameters of a larger governing surface geometry and material properties. This modelling process, coupled with Rapid
Manufacturing (RM) and Computer Numerically Controlled (CNC) machines has the potential to significantly reduce the interface between design and fabrication.

Design earthquake ground motion prediction for Perth metropolitan area with microtremor measurements for site characterization

Perth is the largest city in Western Australia and home to three-quarters of the state's residents. In recent decades, there have been a lot of earthquake activities just east of Perth in an area known as the South-West Seismic Zone. Previous numerical results of site response analyses based on limited available geology information for PMA indicated that Perth Basin might amplify the bedrock motion by more than 10 times at some frequencies and at some sites. Hence, more detailed studies on site characterization and amplification are necessary. The microtremor method using spatial autocorrelation (SPAC) processing is a useful tool for gaining thickness and shear wave velocity (SWV) of sediments and has been adopted in many previous studies. In this study, the response spectrum of rock site corresponding to the 475-year return period for PMA is defined according to the probabilistic seismic hazard analysis (PSHA) based on the latest ground motion attenuation model of Southwest Western Australia. Site characterization in PMA is performed using two microtremor measurements, namely SPAC technique and H/V method. The clonal selection algorithm (CSA) is introduced to perform direct inversion of SPAC curves to determine the soil profiles of representative PMA sites investigated in this study. Using the simulated bedrock motion as input, the responses of the soil sites are estimated using numerical method based on the shear-wave velocity vs. depth profiles determined from the SPAC technique. The response spectrum of the earthquake ground motion on surface of each site is derived from the numerical results of the site response analysis, and compared with the respective design spectrum defined in the Australian Earthquake Loading Code. The comparison shows that the code spectra are conservative in the short period range, but may slightly underestimate the response spectrum at some long period range.

The level of representative underwriting and the underwriting costs of REIT SEOs

Purpose – The purpose of this paper is to investigate factors influencing the underwriting discount for US Real Estate Investment Trust (REIT) Seasoned Equity Offerings (SEOs).

Design/methodology/approach – The study provides new evidence on determinants of underwriting discounts with a comprehensive dataset of 783 US REIT SEOs from 1996 until June 2010. Ordinary least squares regressions are performed to estimate the effect of the level of representative underwriting along with other potential factors on underwriting discounts.

Findings – The study complements the well-documented notion of the economies of scale in SEO underwriting discounts. The equally (value) weighted underwriting discounts averaged 4.21 per cent (4.10 per cent) with a declining trend over time. The findings of this study show the statistically and economically significant negative effect of the level of representative underwriting on the underwriting discounts, as well as the significance of the structure of underwriting syndicate in determining the underwriting discounts. The findings suggest that issuers can minimize the costs of raising secondary equity capital by optimally allocating the underwriting business among the underwriters.

Originality/value – This paper adds to the international REIT SEO literature by exploring new evidence behind underwriting discounts. The study includes data before and after the REIT Modernization Act 1999 and during the recent global financial crisis period.

Enhancing and assessing group and team learning in architecture and related design contexts

EXECUTIVE SUMMARYTeamwork skills are essential in the design industry where practitioners negotiate often-conflicting design options in multi-disciplinary teams. Indeed, many of the bodies that accredit design courses explicitly list teamwork skills as essential attributes of design graduates e.g., the Australian Institute of Architects (AIA), Royal Institute of British Architects (RIBA), the National Council of Architectural Registration Boards (NCARB) of the United States and the Institution of Engineers, Australia (IEAust). In addition to the need to meet the demands of the accrediting bodies, there are many reasons for the ubiquitous use of teamwork assignments in design schools. For instance, teamwork learning is seen as being representative of work in practice where design is nearly always a collaborative activity. Learning and teaching in teamwork contexts in design education are not without particular challenges. In particular, two broad issues have been identified: first, many students leave academia without having been taught the knowledge and skills of how to design in teams; second, teaching, assessment and assignment design need to be better informed by a clear understanding of what leads to effective teamwork and the learning of teamwork skills. In recognition of the lack of a structured approach to integrating teamwork learning into the curricula of design programs, this project set out to answer three primary research questions: • How do we teach teamwork skills in the context of design? • How do we assess teamwork skills?• How do design students best learn teamwork skills?In addition, four more specific questions were investigated:1. Is there a common range of learning objectives for group-and-team-work in architecture and related design disciplines that will enable the teaching of consistent and measurable outcomes?2. Do group and team formation methods, learning styles and team-role preferences impact students’ academic and course satisfaction outcomes?3. What combinations of group-and-team formation methods, teaching and assessment models significantly improve learning outcomes?4. For design students across different disciplines with different learning styles and cultural origins, are there significant differences in performance, student satisfaction (as measured through questionnaires and unit evaluations), group-and-team working abilities and student participation?To elucidate these questions, a design-based research methodology was followed comprising an iterative series of enquiries: (a) A literature review was completed to investigate: what constitutes effective teamwork, what contributes to effectiveness in teams, what leads to positive design outcomes for teams, and what leads to effective learning in teams. The review encompassed a range of contexts: from work-teams in corporate settings, to professional design teams, to education outside of and within the design disciplines. The review informed a theoretical framework for understanding what factors impact the effectiveness of student design teams. (b) The validity of this multi-factorial Framework of Effectiveness in Student Design Teams was tested via surveys of educators’ teaching practices and attitudes, and of students’ learning experiences. 638 students and 68 teachers completed surveys: two pilot surveys for participants at the four partner institutions, which then informed two national surveys completed by participants from the majority of design schools across Australia. (c) The data collected provided evidence for 22 teamwork factors impacting team effectiveness in student design teams. Pedagogic responses and strategies to these 22 teamwork factors were devised, tested and refined via case studies, focus groups and workshops. (d) In addition, 35 educators from a wide range of design schools and disciplines across Australia attended two National Teaching Symposiums. The first symposium investigated the wider conceptualisation of teamwork within the design disciplines, and the second focused on curriculum level approaches to structuring the teaching of teamwork skills identified in the Framework.The Framework of Effectiveness in Student Design Teams identifies 22 factors impacting effective teamwork, along with teaching responses and strategies that design educators might use to better support student learning. The teamwork factors and teaching strategies are categorised according to three groups of input (Task Characteristics, Individual Level Factors and Team Level Factors), two groups of processes (Teaching Practice & Support Structures and Team Processes), and three categories of output (Task Performance, Teamwork Skills, and Attitudinal Outcomes). Eight of the 22 teamwork factors directly relate to the skills that need to be developed in students, one factor relates to design outputs, and the other thirteen factors inform pedagogies that can be designed for better learning outcomes. In Table 10 of Section 4, we outline which of the 22 teamwork factors pertain to each of five stakeholder groups (curriculum leaders, teachers, students, employers and the professional bodies); thus establishing who will make best use the information and recommendations we make. In the body of this report we summarise the 22 teamwork factors and teaching strategies informed by the Framework of Effectiveness in Student Design Teams, and give succinct recommendations arising from them. This material is covered in depth by the project outputs. For instance, the teaching and assessment strategies will be expanded upon in a projected book on Teaching Teamwork in Design. The strategies are also elucidated by examples of good practice presented in our case studies, and by Manuals on Teamwork for Teachers and Students. Moreover, the project website ( visited by representatives of stakeholder groups in Australia and Canada), is seeding a burgeoning community of practice that promises dissemination, critical evaluation and the subsequent refinement of our materials, tools, strategies and recommendations. The following three primary outputs have been produced by the project in answer to the primary research questions:1. A theoretical Framework of Effectiveness in Student Design Teams;2. Manuals on Teamwork for Teachers and Students (available from the website);3. Case studies of good/innovative practices in teaching and assessing teamwork in design;In addition, five secondary outputs/outcomes have been produced that provide more nuanced responses:4. Detailed recommendations for the professional accrediting bodies and curriculum leaders;5. Online survey data (from over 700 participants), plus Team Effectiveness Scale to determine the factors influencing effective learning and successful outputs for student design teams;6. A community of practice in policy, programs, practice and dialogue;7. A detailed book proposal (with sample chapter), submitted to prospective publishers, on Teaching Teamwork in Design; 8. An annotated bibliography (accessed via the project website) on learning, teaching and assessing teamwork.The project has already had an international impact. As well as papers presented in Canada and New Zealand, the surveys were participated in by six Canadian schools of architecture, whose teaching leaders also provided early feedback on the project aims and objectives during visits made to them by the project leader. In addition, design schools in Vancouver, Canada, and San Diego in the USA have already utilised the Teacher’s Manual, and in February 2014 the project findings were discussed at Tel Aviv University in a forum focusing on the challenges for sustainability in architectural education.

Considerations in light truck suspension design

The present work aims at to approach considerations of trucks suspension design. The proposal of the work consists of discussing the aspects related to the acting of the suspension and of factors that interact with the system through representative models of the dynamic behaviour of the vehicle ride when operating in total load and/or empty conditions. The importance of this work is to revise some procedures of suspension study in the sense of adapting them to the Brazilian reality, tends in view the importance of the design characterisation and adaptation to the typical roads of Brazil. Copyright © 2000 Society of Automotive Engineers, Inc.