Randomised controlled trial of pharmacist-led patient counselling in controlling hypoglycaemic attacks in older adults with type 2 diabetes mellitus (ROSE-ADAM): A study protocol of the SUGAR intervention

Introduction Hypoglycaemia is one of the most serious adverse effects of diabetes treatment. Older adults are at the highest risk to develop hypoglycaemia. Several studies have established the important positive role of educational interventions on achieving glycaemic control and other clinical outcomes, however, there is still a lack in studies that evaluate the impact of such type of interventions on hypoglycaemia risk in elderly patients with type 2 diabetes. The purpose of this research is to evaluate the effectiveness of pharmacist-led patient counselling on reducing hypoglycaemic attacks in older adults with type 2 diabetes mellitus. Methods and analysis: This study is an open-label, parallel controlled randomised trial, which will be conducted in the outpatient clinics at the largest referral hospital in the north of Jordan. Participants who are elderly (age ≥ 65 years), diagnosed with type 2 diabetes mellitus, and taking insulin, sulfonylurea, or any three anti-diabetic medications will be randomly assigned to intervention (SUGAR Handshake) and control (usual care) groups. The SUGAR Handshake participants will have an interactive, individualised, medications-focused counselling session reinforced with a pictogram and a phone call at week six of enrolment. The primary outcome measure is the frequency of total hypoglycaemic events within 12 weeks of follow up. Secondary outcomes include the frequency of asymptomatic, symptomatic, and severe hypoglycaemic events, hypoglycaemia incidence, and time to the first hypoglycaemic attack. We will also conduct a nested qualitative study for process evaluation

A history of music education in New Zealand state primary and intermediate schools 1878-1989.

Music education has been part of the New Zealand curriculum since the nineteenth century yet it has not been perceived as a "mainstream" subject in the school curriculum. This research examines how music has been perceived in the curriculum, and looks at the effectiveness of the teacher in implementing music education programmes during the existence of the Department of Education between 1878 and 1989. While the Education Act of 1877 established the Department of Education, in practical terms the Department only started to function in 1878 and ceased to exist in 1989. External events such as the two economic depressions of the 1890s and the early 1930s, and the two World Wars, had a deleterious effect on music education development. In the local political arena there was inconsistency in attitudes towards the subject that further inhibited growth. The majority of immigrants during the nineteenth century were from Britain. A review of the sight singing movement in England is included in chapter one to determine why singing dominated school music in the New Zealand curriculum. In 1928 the syllabus changed from "singing" to "music." This reflected a wider concept of musical activity, including musical appreciation, movement and the playing of musical instruments. The 1920s represented an era of many new initiatives in school music, dominated by the appointment of the first Supervisor of School Music, E. Douglas Tayler. The subsequent appointments of four British music lecturers to the four Training Colleges augured well for school music. Broadcasts to schools programmes that featured prominently in the lives of many New Zealand school pupils, had begun life with Tayler's music programmes in 1931. The appointment of the National Adviser of Music, W.H. Walden Mills in 1958 represented another important milestone in music education, since no-one had held this position on a national level since Tayler's resignation 27 years earlier. Walden Mills' influence was manifest in the appointments of District Music Advisers during the 1960s who provided a much needed support service to teachers. Further developments in music education occurred during the 1970s with the implementation of special music programmes in certain schools, including the Music Teacher Scheme (MT scheme) and the composers in schools scheme. During the 1970s and 1980s awareness of other cultures became an integral part of school music programmes, and contemporary music of all kinds became an acceptable part of the school environment. Two significant events that reflected changing attitudes towards music education were the publication of the Tait Report in 1970 and the Ritchie Report in 1980. A CD accompanies the thesis giving examples of school songs published in various song books used in New Zealand schools between 1878 and 1980

Characterizations of scalars in Banach algebras

D.Phil

Geometry of the spectral semidistance in Banach algebras

summary:Let $A$ be a unital Banach algebra over $\mathbb C$, and suppose that the nonzero spectral values of $a$ and $b\in A$ are discrete sets which cluster at $0\in \mathbb C$, if anywhere. We develop a plane geometric formula for the spectral semidistance of $a$ and $b$ which depends on the two spectra, and the orthogonality relationships between the corresponding sets of Riesz projections associated with the nonzero spectral values. Extending a result of Brits and Raubenheimer, we further show that $a$ and $b$ are quasinilpotent equivalent if and only if all the Riesz projections, $p(\alpha ,a)$ and $p(\alpha ,b)$, correspond. For certain important classes of decomposable operators (compact, Riesz, etc.), the proposed formula reduces the involvement of the underlying Banach space $X$ in the computation of the spectral semidistance, and appears to be a useful alternative to Vasilescu's geometric formula (which requires the knowledge of the local spectra of the operators at each $0\not =x\in X$). The apparent advantage gained through the use of a global spectral parameter in the formula aside, various methods of complex analysis can then be employed to deal with the spectral projections; we give examples illustrating the usefulness of the main results