Designing a web-application to support home-based care of childhood CKD stages 3-5: Qualitative study of family and professional preferences

Background: There is a lack of online, evidence-based information and resources to support home-based care of childhood CKD stages 3-5. Methods. Qualitative interviews were undertaken with parents, patients and professionals to explore their views on content of the proposed online parent information and support (OPIS) web-application. Data were analysed using Framework Analysis, guided by the concept of Self-efficacy. Results: 32 parents, 26 patients and 12 professionals were interviewed. All groups wanted an application that explains, demonstrates, and enables parental clinical care-giving, with condition-specific, continously available, reliable, accessible material and a closed communication system to enable contact between families living with CKD. Professionals advocated a regularly updated application to empower parents to make informed health-care decisions. To address these requirements, key web-application components were defined as: (i) Clinical care-giving support (information on treatment regimens, video-learning tools, condition-specific cartoons/puzzles, and a question and answer area) and (ii) Psychosocial support for care-giving (social-networking, case studies, managing stress, and enhancing families' health-care experiences). Conclusions: Developing a web-application that meets parents' information and support needs will maximise its utility, thereby augmenting parents' self-efficacy for CKD caregiving, and optimising outcomes. Self-efficacy theory provides a schema for how parents' self-efficacy beliefs about management of their child's CKD could potentially be promoted by OPIS. © 2014 Swallow et al.; licensee BioMed Central Ltd

Investigating the transfer of toughness from rubber modified bulk epoxy polymers to syntactic foams

Syntactic foams are lightweight, high specific strength materials used in the aerospace and naval 10 industries. Their utility is limited by their brittleness. The epoxy polymer matrix in an epoxy/hollow 11 glass microsphere (GMS) syntactic foam was modified using carboxyl-terminated butadiene-acrylonitrile 12 (CTBN) rubber with the aim to increase fracture toughness. The microstructure and fracture properties 13 were investigated, and compared to CTBN modified bulk epoxy polymers. The formation of complex CTBN microstructures was responsible for the increase in fracture energy, from 193 J/m2 14 for the unmodified syntactic foam, to 296 J/m2 15 at 12 wt% CTBN modification. However, this increase is much smaller than for the CTBN modification of bulk epoxy polymers, where an increase from 101 J/m2 16 to 1112 J/m2 17 was measured for the same CTBN concentration. There is little toughness transfer from the 18 bulk epoxy polymers to the syntactic foams, attributable to small interstitial regions between the GMS, 19 restricting plastic zone size. A statistical approach to the analytical modelling of fracture energy in the 20 bulk epoxy polymers highlights the importance of considering the underlying distribution of rubber 21 particle and void sizes. The increase in fracture energy achieved in this work can increase the overall 22 usefulness of syntactic foams in structural applications

Commutativity and the emergence of classical objectivity

We examine how the ability of a system to redundantly proliferate relevant information about its pointer states is affected when it is coupled to multiple baths. To this end, we consider a system in contact with two baths: one—termed the accessible environment —which, on its own, induces a pure dephasing mechanism on the state of the system and satisfies the conditions for classical objectivity to be established. The second environment, which we dub as inaccessible, affects the system in two physically relevant ways. Firstly, we consider an interaction that commutes with the Hamiltonian describing the interaction between system and accessible bath. It thus also gives rise to dephasing of the system, albeit on different time scales. Secondly, we consider a thermalising interaction, which does not commute with the system-accessible environment Hamiltonian. While the former still allows the system to redundantly encode its state into the accessible environment, the latter degrades the correlations, eventually destroying them in the long-time limit, and thus leads to a loss of the conditions necessary for classical objectivity to be established. This sheds light on the role that commutativity between the various system-bath interaction terms plays when establishing the conditions for classical objectivity to be supported

Diabetes care and service access among elderly Vietnamese with type 2 diabetes

BACKGROUND: Vietnamese patients are disproportionately represented in type 2 diabetes mellitus statistics and also incur high rates of diabetes complications. This situation is compounded by limited access to health care. The aim of this project was to gain a deeper understanding of the difficulties Vietnamese patients experience when accessing services and managing their type 2 diabetes mellitus, and to identify factors that are important in promoting health service use. METHODS: Three focus groups with 15 Vietnamese participants with type 2 diabetes mellitus, 60 to >70 years of age, were conducted in Vietnamese. Open-ended questions were used and focussed on experiences of living with diabetes and access to healthcare services in the Inner Northwest Melbourne region. Audio recordings were transcribed and then translated into English. Data were analysed using a thematic analysis framework. RESULTS: Findings indicate four main themes, which together provide some insight into the experiences of living with diabetes and accessing ongoing care and support, for elderly Vietnamese with type 2 diabetes. Themes included: (1) the value of being healthy; (2) controlling diabetes; (3) staying healthy; and (4) improving services and information access. CONCLUSIONS: Participants in this study were encouraged to adhere to diabetes self-management principles, based largely on a fear of medical complications. Important aspects of healthcare access were identified as; being treated with respect, having their questions answered and having access to interpreters and information in Vietnamese. Attention to these details is likely to lead to improved access to healthcare services and ultimately to improve glycemic control and overall health status for this community

Mechanical and fracture performance of carbon fibre reinforced composites with nanoparticle modified matrices

The microstructure and fracture performance of carbon-fibre reinforced polymer (CFRP) composites with an epoxy resin cured with an anhydride hardener containing silica nanoparticles and/or polysiloxane core-shell rubber (CSR) particles was investigated in the current work. Double cantilever beam tests were performed in order to evaluate the fracture energy of the CFRP composites, while the single edge notched bend (SENB) specimen was employed to evaluate the fracture energy of the bulk polymers. Tests were conducted at room temperature and at -80°C. The transferability of the toughness from the bulk polymers to the fibre-composite systems is discussed, with an emphasis on elucidating the toughening mechanism