Le rôle de la qualité alimentaire dans la prévention du déclin de l’autonomie fonctionnelle chez les personnes âgées atteintes du diabète type II faisant partie de la cohorte NuAge

La population mondiale est en train de vieillir. Le vieillissement augmente le risque des pertes de la force musculaire (FM), du diabète type II (T2D) et du déclin de la capacité fonctionnelle (CF). Indépendamment de l’âge, les personnes âgées diabétiques ont un risque accru des pertes de la FM et du déclin de la CF comparées aux non-diabétiques. La nutrition est un facteur déterminant d’un vieillissement optimal et joue un rôle primordial dans la prise en charge du diabète, minimise les pertes de FM et peut moduler le déclin de la CF. De plus, l’activité physique (AP) offre des bénéfices semblables à ceux de la nutrition. Ainsi, l’objectif principal de cette thèse est de déterminer le rôle de la qualité alimentaire (QA) dans le maintien de la CF chez les personnes âgées diabétiques vivant dans la communauté, par le biais des analyses secondaires réalisées sur la base de données de la cohorte NuAge. En vue de la réalisation de cet objectif, une caractérisation de plusieurs variables en lien avec la CF était nécessaire. Ainsi, une description globale de l’alimentation des personnes âgées diabétiques fut effectuée. Ensuite, chacun des articles présentés a testé un objectif spécifique chez ces personnes âgées diabétiques, afin de : 1) déterminer si la QA seule, ou combinée à l’AP est associée au maintien des forces musculaires (FM) ; 2) déterminer si la QA seule, ou combinée à l’AP est associée à la prévention du déclin de la CF ; et 3) examiner l’association entre la suffisance en apports énergétique et protéique et le maintien des FM et la CF. De plus, l’association entre la QA, l’AP et la performance physique (PP) a été examinée. Cette thèse de doctorat est la première à examiner le rôle de la QA dans la CF chez la population âgée diabétique. En particulier, les résultats ont montré que la population diabétique de NuAge se caractérise par une bonne alimentation globale et de bonnes habitudes alimentaires, avec des apports en macronutriments conformes aux recommandations nutritionnelles. Néanmoins, ces participants devraient augmenter leurs apports en micronutriments qui étaient inférieurs aux recommandations chez la majorité. En outre, aucune association significative n’a été observée entre la QA seule et le maintien des FM, ni le déclin de la PP et la CF. Cependant, la QA combinée à l’AP a été associée aux FM des membres supérieurs. Spécifiquement, les hommes diabétiques ayant une bonne QA combinée à une stabilité de l’AP pendant les trois ans de suivi ont subi des pertes minimes de la FM comparés aux autres. Toutefois, aucune association n’a été observée pour les FM des membres inférieurs. De plus, la QA combinée à l’AP n’était associée ni à la PP ni à la CF chez ces participants. Finalement, les analyses ont démontré que la suffisance en apports énergétiques et protéiques est associée au maintien de la CF. En effet, un apport en énergie égal ou supérieur à 30 kcal/kg poids corporel a minimisé le déclin de la CF comparativement à un apport inférieur à 30 kcal/kg chez les hommes, alors que les femmes ayant un apport protéique égal ou supérieur à 1g/kg poids corporel ont subi un déclin minime de la CF comparées à celles ayant des apports en protéines inférieurs à 1g/kg. Enfin, il a été démontré qu’un apport suffisant en protéines a minimisé les pertes de FM des membres inférieurs chez les femmes diabétiques de la cohorte NuAge. Collectivement, les résultats de cette thèse fournissent des données probantes indiquant qu’une bonne QA, des apports suffisants en énergie et en protéines et une bonne pratique de l’AP sont nécessaires afin de minimiser les pertes de la FM reliées au vieillissement et accélérées par la présence du diabète et par la suite maintenir la CF des personnes âgées diabétiques. Cependant, d’autres études seront nécessaires pour confirmer ces résultats.

Marketplace forces and the history of retailing : The cycle of control

This paper traces the history of store (retailer-controlled) and national (manufacture controlled)brands; identifies the key historical characteristics of the past 200 years of marketing history;describes the four main time periods of U.S. retail marketing (1800 - 2000); and comments on the most likely developments within the current phases of brand marketing. Will the future focus on technology and new forms of communications? The Internet exemplifies an unconventional retailing environment, with etailer numbers growing rapidly. The central proposition of this paper is that a "cycle of control" - a pattern of marketing developments within the history of retailing and national marketing communications - Can indicate the success of marketing strategies in the future.

Project diagnostics : assessing the condition of projects and identifying poor health combing forces

In many cases, construction projects do not achieve the objectives that the project participants set for them. If participants could better understand how their project is performing overall, at various stages of its delivery, then the opportunities to achieve project success would almost certainly be greater. This paper documents a method of assessing the status of a project, at a point in its design or construction phase, or after completion. The status is assessed in terms of up to seven (7) key success factors. Any evidence of less than adequate performance in these performance areas is scrutinised to seek out the root causes of why this situation is happening. Using these identified root causes of under performance, general suggestions can then be made as to how to return the project to good health. A software package that assists in assessing the status of the project has been developed. The package is currently being calibrated before commercial release.

The measurement of applied forces during anterior single rod correction of adolescent idiopathic scoliosis

Adolescent idiopathic scoliosis (AIS) is the most common form of spinal deformity in paediatrics, prevalent in approximately 2-4% of the general population. While it is a complex three-dimensional deformity, it is clinically characterised by an abnormal lateral curvature of the spine. The treatment for severe deformity is surgical correction with the use of structural implants. Anterior single rod correction employs a solid rod connected to the anterior spine via vertebral body screws. Correction is achieved by applying compression between adjacent vertebral body screws, before locking each screw onto the rod. Biomechanical complication rates have been reported as high as 20.8%, and include rod breakage, screw pull-out and loss of correction. Currently, the corrective forces applied to the spine are unknown. These forces are important variables to consider in understanding the biomechanics of scoliosis correction. The purpose of this study was to measure these forces intra-operatively during anterior single rod AIS correction.

Correlating vehicle forces and track profile

A research project was conducted at Queensland University of Technology on the relationship between the forces at the wheel-rail interface in track and the rate of degradation of track. Data for the study was obtained from an instrumented vehicle which ran repeatedly over a section of Queensland Rail's track in Central Queensland over a 6-month period. The wheel-rail forces had to be correlated with the elements of roughness in the test track profile, which were measured with a variety of equipment. At low frequencies, there was strong correlation between forces and profile, as expected, but diminishing correlation as frequencies increased.

AFM study of forces between silicon oil and hydrophobic - hydrophylic surfaces in aqueous solutions

An investigation has been made of the interactions between silicone oil and various solid substrates immersed in aqueous solutions. Measurements were made using an atomic force microscope (AFM) using the colloid-probe method. The silicone oil drop is simulated by coating a small silica sphere with the oil, and measuring the force as this coated sphere is brought close to contact with a flat solid surface. It is found that the silicone oil surface is negatively charged, which causes a double-layer repulsion between the oil drop and another negatively charged surface such as mica. With hydrophilic solids, this repulsion is strong enough to prevent attachment of the drop to the solid. However, with hydrophobic surfaces there is an additional attractive force which overcomes the double-layer repulsion, and the silicone oil drop attaches to the solid. A "ramp" force appears in some, but not all, of the data sets. There is circumstantial evidence that this force results from compression of the silicone oil film coated on the glass sphere.

Health law : scope, sources and forces

• For the purposes of this chapter, “health law” encapsulates regulation of the medical and health professions, the administration of health services and the maintenance of public health to the extent that it is connected to the provision of health services. • There are diverging views as to whether health law can be regarded as a discrete “area of law”. • Health law draws on other areas of law such as tort law, criminal law and family law. It is also draws upon other disciplines, most notably medical and health ethics. • Social and economic forces have influenced the development and direction of health law, and these forces may become even more influential as the century develops. • The increasingly globalised world has implications for Australia’s health systems and raises questions and creates commitments in respect of the international community. • Technological developments, including in respect of treatment, diagnosis and information management, create ongoing challenges for health law. • Patient rights, human rights and consumerism are increasingly key drivers in the development of health law. • Health law is significant to contemporary Australian society because of the gravity of the topics that fall within its ambit, its social relevance to so many aspects of human existence and endeavour, the important role it plays in protecting the vulnerable, and the extent to which it engages with fundamental principles of justice.

Distribution of forces during fulcrum bending radiographs on adolescent idiopathic scoliosis patients

At the Mater Children’s Hospital, approximately 80% of patients presenting with Adolescent Idiopathic Scoliosis requiring corrective surgery receive a fulcrum bending radiograph. The fulcrum bending radiograph provides a measurement of spine flexibility and a better indication of achievable surgical correction than lateral-bending radiographs (Cheung and Luk, 1997; Hay et al 2008). The magnitude and distribution of the corrective force exerted by the bolster on the patient’s body is unknown. The objective of this pilot study was to measure, for the first time, the forces transmitted to the patient’s ribs through the bolster during the fulcrum bending radiograph.

Decoupled trajectory planning for a submerged rigid body subject to dissipative and potential forces

This paper studies the practical but challenging problem of motion planning for a deeply submerged rigid body. Here, we formulate the dynamic equations of motion of a submerged rigid body under the architecture of differential geometric mechanics and include external dissipative and potential forces. The mechanical system is represented as a forced affine-connection control system on the configuration space SE(3). Solutions to the motion planning problem are computed by concatenating and reparameterizing the integral curves of decoupling vector fields. We provide an extension to this inverse kinematic method to compensate for external potential forces caused by buoyancy and gravity. We present a mission scenario and implement the theoretically computed control strategy onto a test-bed autonomous underwater vehicle. This scenario emphasizes the use of this motion planning technique in the under-actuated situation; the vehicle loses direct control on one or more degrees of freedom. We include experimental results to illustrate our technique and validate our method.

Altering heavy vehicle air suspension dynamic forces by modifying air lines

An experimental programme in 2007 used three air suspended heavy vehicles travelling over typical urban roads to determine whether dynamic axle-to-chassis forces could be reduced by using larger-than-standard diameter longitudinal air lines. This paper presents methodology, interim analysis and partial results from that programme. Alterations to dynamic measures derived from axle-to-chassis forces for the case of standard-sized longitudinal air lines vs. the test case where larger longitudinal air lines were fitted are presented and discussed. This leads to conclusions regarding the possibility that dynamic loadings between heavy vehicle suspensions and chassis may be reduced by fitting larger longitudinal air lines to air-suspended heavy vehicles. Reductions in the shock and vibration loads to heavy vehicle suspension components could lead to lighter and more economical chassis and suspensions. This could therefore lead to reduced tare and increased payloads without an increase in gross vehicle mass.