Therapeutic Inertia in the Pharmacologic Treatment of Type 2 Diabetes Mellitus: Investigation of Causes and Recommendations for Change

Diabetes mellitus (DM) is a pervasive chronic condition and a serious global health issue. Type 2 diabetes mellitus (T2DM) comprises approximately 90-95% of all DM cases (Centers for Disease Control and Prevention [CDC], 2022). The prevalence of T2DM has risen rapidly over time; in fact, the number of adults diagnosed with T2DM over the past 20 years has more than doubled (CDC, 2022). T2DM currently affects an estimated 462 million people globally (equal to 6.28% of the world’s population), including more than one out of every 10 Americans (American Diabetes Association [ADA], 2018; CDC, 2022; Khan et al., 2020). In Washington state specifically, DM is the seventh leading cause of death (Washington State Department of Health [WADOH], 2018). As of 2018, one out of every 11 Washington adults have DM, and an estimated 33.7% of Washington\u27s adult population have prediabetes (CDC, 2018; WADOH, 2018)

Recent Trends in Chloride and Total Dissolved Solids in Silurian Wells in the Southwest Water Planning Group Region: Indicators of Groundwater Contamination within the Silurian Dolomite Aquifer

The objective of this study was to assess whether chloride (Cl-) and total dissolved solids (TDS) concentrations have continued to increase since 2005 in the Silurian shallow bedrock aquifer in the Southwest Water Planning Group (SWPG) region of Illinois (Will, Kendall, and Grundy Counties). Previous research has indicated that Cl- and TDS concentrations have been increasing in Will County since the 1960s as a result of road salt runoff. Analysis of new data indicates that several community supply wells in the SWPG region that are finished in the Silurian dolomite aquifer show increasing Cl- and TDS concentrations. The median increase in Cl- concentrations was 2.5 mg/L per year, with a maximum of 10.4 mg/L per year. The most affected wells were in the northwestern part of Will County. Deeper wells tended to have lower concentrations. Some of the wells that were sampled over short time frames showed extreme variability, which suggests that contaminated water recharges seasonally and that there is minimal mixing in the aquifers. As was shown in previous studies in the Chicago region, urbanization can seriously degrade the groundwater quality of unconfined aquifers. Increasing Cl- concentrations in the region indicate that road salt runoff is reaching the Silurian dolomite aquifer, even to depths greater than 300 feet. Therefore, recharge from the surface is reaching the dolomite aquifer, passing through any till and sand and gravel layers above it. This connectivity between the land surface and the dolomite aquifer shows the vulnerability of the aquifer to surface contamination and the need to protect it.published or submitted for publicationis peer reviewedOpe

Perspectives on the application of technology to enhance learning in an undergraduate nursing degree programme

This paper discusses concepts and practice relating to the use of computer-based technologies for enhancing learning. It draws on examples from a UK nursing degree programme

Occurrence and Removal of Pharmaceutical and Hormone Contaminants in Rural Wastewater Treatment Lagoons

With an increasing population in rural areas, the use of pharmaceuticals and personal care products (PPCPs) and naturally produced steroid hormones is also increasing. However, rural wastewater treatment plants were not specifically designed to remove PPCPs or hormones. Are these compounds being removed from water supplies? If they are, how effectively are they being removed and which treatment process is most effective? Samples from a rural wastewater treatment plant in Illinois were collected at each stage of the treatment process. Samples were taken twice, in September and November 2011. In addition, one sample each from upstream and downstream of the effluent discharge was taken in September. All the same samples were taken in November with the addition of a sample from the Mackinaw River downstream of the small stream to which the wastewater effluent discharges. Samples were extracted and analyzed in the lab for PPCPs and hormones via a new method developed by ISTC researchers. Results were published in Li et al (2013). Science of the Total Environment 445-446, 22-28. https://doi.org/10.1016/j.scitotenv.2012.12.035Ope

Usability of Food and Beverage Packs in Hospital - Experiences from the Renal Ward

Abstract presented at The 21st IAPRI World Conference on Packaging, 19-22 June 2018, Zhuhai, Chin

Concave Switching in Single and Multihop Networks

Switched queueing networks model wireless networks, input queued switches and numerous other networked communications systems. For single-hop networks, we consider a {($\alpha,g$)-switch policy} which combines the MaxWeight policies with bandwidth sharing networks -- a further well studied model of Internet congestion. We prove the maximum stability property for this class of randomized policies. Thus these policies have the same first order behavior as the MaxWeight policies. However, for multihop networks some of these generalized polices address a number of critical weakness of the MaxWeight/BackPressure policies. For multihop networks with fixed routing, we consider the Proportional Scheduler (or (1,log)-policy). In this setting, the BackPressure policy is maximum stable, but must maintain a queue for every route-destination, which typically grows rapidly with a network's size. However, this proportionally fair policy only needs to maintain a queue for each outgoing link, which is typically bounded in number. As is common with Internet routing, by maintaining per-link queueing each node only needs to know the next hop for each packet and not its entire route. Further, in contrast to BackPressure, the Proportional Scheduler does not compare downstream queue lengths to determine weights, only local link information is required. This leads to greater potential for decomposed implementations of the policy. Through a reduction argument and an entropy argument, we demonstrate that, whilst maintaining substantially less queueing overhead, the Proportional Scheduler achieves maximum throughput stability.Comment: 28 page

Sensible Salting in the Chicago Region

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PPCPs in Karst Groundwater in Southwestern Illinois

In May 2014, Wei Zheng, along with collaborators Walt Kelly (Illinois State Water Survey), Steve Taylor (Illinois Natural History Survey), and Sam Panno (Illinois State Geological Survey), received a one-year grant for a project titled “Pharmaceuticals and Personal Care Products (PPCPs) in Karst Groundwater in Southwestern Illinois,” allowed them to continue their work on groundwater contamination in karst regions of the state and expand to look at veterinary hormones.Prairie Research Institute’s Matching Research Awards ProgramOpe