Lifestyle risk factor modification in midlife women with type 2 diabetes : theoretical modelling of perceived barriers

Objective: The aim of this paper is to propose a ‘Perceived barriers and lifestyle risk factor modification model’ that could be incorporated into existing frameworks for diabetes education to enhance lifestyle risk factor education in women. Setting: Diabetes education, community health. Primary argument: ‘Perceived barriers’ is a health promotion concept that has been found to be a significant predictor of health promotion behaviour. There is evidence that women face a range of perceived barriers that prevent them from engaging in healthy lifestyle activities. Despite this, current evidence based models of diabetes education do not explicitly incorporate the concept of perceived barriers. A model of risk factor reduction that incorporates ‘perceived barriers’ is proposed. Conclusion: Although further research is required, current approaches to risk factor reduction in type 2 diabetes could be enhanced by identification and goal setting to reduce an individual’s perceived barriers.

Prevalence of swallowing difficulties and medication modification in customers of community pharmacists

Background People may alter their solid oral medication dosage forms to make it easier to swallow. However, modification of solid medication dosage forms can lead to adverse effects, and people may alter the dosage forms without informing the health professionals involved in their care. Aim To estimate the prevalence of swallowing difficulties and medication dosage form modification among community pharmacy consumers, and to investigate consumer views, attitudes and interactions with health professionals regarding such issues. Method Consumers were recruited from five community pharmacies in Brisbane, Australia and invited to participate in a structured interview. Results A total of 369 consumers participated in the study. Overall, 16.5% of people reported experiencing swallowing difficulties, and 10.6% of all respondents reported modifying medication dosage forms. Almost half (44.2%) of those surveyed did not think there would be issues with modifying medication dosage forms. Some consumers would not seek advice from health professionals if they experienced swallowing problems and/or would not seek advice from health professionals before modifying their medication dosage forms, regardless of their thoughts about any problems associated with this practice. Conclusion Some consumers appeared to be accustomed to modifying medication dosage forms, even when there was no apparent or obvious need. People were also reluctant to seek advice from health professionals regarding swallowing difficulties, or modifying medication dosage forms. Health professionals must be assertive in educating consumers about swallowing problems, and medication dosage form modification.

Bearing capacity factor N-c under phi=0 condition for piles in clays

Bearing capacity factor N-c for axially loaded piles in clays whose cohesion increases linearly with depth has been estimated numerically under undrained (phi=0) condition. The Study follows the lower bound limit analysis in conjunction With finite elements and linear programming. A new formulation is proposed for solving an axisymmetric geotechnical stability problem. The variation of N-c with embedment ratio is obtained for several rates of the increase of soil cohesion with depth; a special case is also examined when the pile base was placed on the stiff clay stratum overlaid by a soft clay layer. It was noticed that the magnitude of N-c reaches almost a constant value for embedment ratio greater than unity. The roughness of the pile base and shaft affects marginally the magnitudes of N-c. The results obtained from the present study are found to compare quite well with the different numerical solutions reported in the literature.

Safe to crush? A pilot study into solid dosage form modification in aged care

Aims To observe medication solid dosage form modification in aged care facilities (ACFs), and assess staff levels of self-perceived knowledge of medication modification and the types of resources available to them. Method Observation of medication rounds in a convenience sample of Australian Capital Territory ACFs and assessment of staff knowledge of dosage form modification and available resources. Results From 160 observations across six medication rounds, 29 residents had a total of 75 medications modified by the nursing staff prior to administration, with 32% of these instances identified as inappropriate. The methods used for crushing and administration resulted in drug mixing, spillage and incomplete dosing. The staff reported adequate resources; however, a lack of knowledge on how to locate and use these resources was evident. Conclusions Improved staff training on how to use available resources is needed to reduce the observed high incidence of inappropriate medication crushing.

Prevalence of swallowing difficulties and medication modification in community pharmacy customers

Community pharmacies are in the prime position to provide information to patients who have difficulties swallowing medication.

Prevalence of swallowing difficulties and medication modification in customers of community pharmacists

BACKGROUND: People may alter their solid oral medication dosage forms to make it easier to swallow. However, modification of solid medication dosage forms can lead to undesirable effects, and people may alter the dosage forms without informing the health professionals involved in their care. AIM: To estimate the prevalence of swallowing difficulties and medication modification amongst community pharmacy consumers, and to investigate consumer views, attitudes, and interactions with health professionals regarding such issues. METHODS: Consumers were recruited from five community pharmacies in Brisbane, Queensland and invited to participate in a structured interview. RESULTS: A total of 369 consumers participated in the study. Overall, 16.5% of people reported experiencing swallowing difficulties, and 10.6% of all respondents reported modifying medication dosage forms. Almost half (44.2%) of those surveyed did not think there would be issues with modifying medication dosage forms. Some consumers would not seek advice from health professionals if they experienced swallowing problems and/or would not seek advice from health professionals before modifying their medication dosage forms, regardless of their thoughts about any problems associated with this practice. CONCLUSION: Some consumers appeared to be accustomed to modifying medication dosage forms, even when there was no apparent or obvious need. People were also reluctant to seek advice from health professionals regarding swallowing difficulties, or modifying medication dosage forms. Health professionals must be assertive in educating consumers about swallowing problems, and medication dosage form modification.

Design of laterally loaded piles in clays based on cone penetration test data: a reliability-based approach

The behaviour of laterally loaded piles is considerably influenced by the uncertainties in soil properties. Hence probabilistic models for assessment of allowable lateral load are necessary. Cone penetration test (CPT) data are often used to determine soil strength parameters, whereby the allowable lateral load of the pile is computed. In the present study, the maximum lateral displacement and moment of the pile are obtained based on the coefficient of subgrade reaction approach, considering the nonlinear soil behaviour in undrained clay. The coefficient of subgrade reaction is related to the undrained shear strength of soil, which can be obtained from CPT data. The soil medium is modelled as a one-dimensional random field along the depth, and it is described by the standard deviation and scale of fluctuation of the undrained shear strength of soil. Inherent soil variability, measurement uncertainty and transformation uncertainty are taken into consideration. The statistics of maximum lateral deflection and moment are obtained using the first-order, second-moment technique. Hasofer-Lind reliability indices for component and system failure criteria, based on the allowable lateral displacement and moment capacity of the pile section, are evaluated. The geotechnical database from the Konaseema site in India is used as a case example. It is shown that the reliability-based design approach for pile foundations, considering the spatial variability of soil, permits a rational choice of allowable lateral loads.

Trajectory sensitivity modification in optimal linear systems

A new procedure for reducing trajectory sensitivity for the optimal linear regulator is described. The design is achieved without increase in the order of optimization and without the feedback of trajectory sensitivity. The procedure is also used in the input signal design problem for linear system identification by interpreting it as increasing trajectory sensitivity with respect to parameters to be estimated.

Vertical uplift resistance of circular plate anchors in clays under undrained condition

The vertical uplift resistance of circular plate anchors, embedded horizontally in a clayey stratum whose cohesion increases linearly with depth, has been obtained under undrained (phi = 0) condition. The axi-symmetric static limit analysis formulation in combination with finite elements proposed recently by the authors has been employed. The variation of the uplift factor (F,) with changes in the embedment ratio (H/B) has been computed for several rates of increases of soil cohesion with depth. It is noted that in all the cases, the magnitude of F-c increases continuously with depth up to a certain value of H-cr/B beyond which the uplift factor becomes essentially constant. The proposed static limit analysis formulation is seen to provide acceptable results even for the two other simple chosen axi-symmetric problems.

Bauer Method of MVDR Spectral Factorization for Pitch Modification in the Source Domain

In our earlier work [1], we employed MVDR (minimum variance distortionless response) based spectral estimation instead of modified-linear prediction method [2] in pitch modification. Here, we use the Bauer method of MVDR spectral factorization, leading to a causal inverse filter rather than a noncausal filter setup with MVDR spectral estimation [1]. Further, this is employed to obtain source (or residual) signal from pitch synchronous speech frames. The residual signal is resampled using DCT/IDCT depending on the target pitch scale factor. Finally, forward filters realized from the above factorization are used to get pitch modified speech. The modified speech is evaluated subjectively by 10 listeners and mean opinion scores (MOS) are tabulated. Further, modified bark spectral distortion measure is also computed for objective evaluation of performance. We find that the proposed algorithm performs better compared to time domain pitch synchronous overlap [3] and modified-LP method [2]. A good MOS score is achieved with the proposed algorithm compared to [1] with a causal inverse and forward filter setup.

Stability of an unsupported vertical circular excavation in clays under undrained condition

By using the axisymmetric finite elements static limit analysis formulation, proposed recently by the authors, the stability numbers (gamma H/c(o)) for an unsupported vertical circular excavation in clays, whose cohesion increases with depth, have been determined under undrained condition; gamma = unit weight, H., height of the excavation and c(o) = cohesion along ground surface. The results are obtained for various values of H/b and m; where b = the radius of the excavation and m = a non-dimensional parameter which accounts for the rate of the increase of cohesion with depth. The values of the stability numbers increase continuously both with increases in H/b and m. The results obtained in this study compare well with those available in literature.(C) 2009 Elsevier Ltd. All rights reserved.

Wide Ranged La Modification in CCTO Ceramics Through Sol-Gel: Effect on Microstructure and Dielectric Properties

Sol-Gel method was employed to synthesize pure and wide ranged La-modified CaCu3Ti4O12 ceramics using mixed acetate-nitrate-alcoxide individual metal-ion precursors. SEM pictures revealed that grain size monotonously decreases with the extent of La incorporation. All the prepared ceramics manifested dielectric constant in the range similar to 10(3)-10(4). Dielectric loss was found to decrease with La incorporation and got optimized for 20% La3+ while retaining its high dielectric constant which may be industrially important. Room temperature Impedance spectroscopy suggested that decrease in grain resistance is responsible for reduction in dielectric loss according to Internal Barrier Layer Capacitor (IBLC) model.

Structural and Optical Modification in Bi doped As40S60 Thin Films.

The influence of substitution of Bi atom instead of S atoms on the structural and optical properties of thin films of As40S60 are reported. The density is found to be increased with the addition Bi heavy metal into As2S3. The amorphous to polycrystalline structure of the bulk sample is observed for Bi more than 7%. The glass transition temperature is found to be decreased with addition of Bi. The absorption edge shifts to shorter wavelength, thereby decreasing optical band gap of BixAs(40)S(60-x) (x= 0,2 and 4% here) film. The optical parameter change is discussed from the stand point of chemical bonds formed in the films and related to the defect states produced due to incorporation of Bi atoms in place of chalcogenide S atoms.