1,990 research outputs found
The effect of sex differences on the subjective well-being of older widows and widowers
This investigation examined the relationship between sex and the subjective well-being of older widows and widowers. The main purpose of the study was to determine the effect of sex differences on the subjective well-being of the widowed. A second objective was to determine if some factors were of differential importance to the subjective well-being of the widowed according to sex. Drawing upon role theory propositions and propositions from social exchange theory, it was hypothesized that sex would have a significant effect on the subjective well-being of older widowed adults and that men would express lower subjective well-being. A second set of hypotheses stated that income adequacy would have a greater effect on the subjective well-being of the widower in comparison to the widow and that the frequency of social participation would affect the wellbeing of widows more so than widowers
The Use of Music Therapy Informed by Motivational Interviewing With College Student Drinkers to Invite âChange Talkâ
The effect of a single music therapy session informed by motivational interviewing on an individualâs readiness to change risky drinking behavior was investigated in 16 undergraduate college students, ages 18-24. Participants completed the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) prior to and following the one week following the single session. The SOCRATES assesses whether a person recognizes problems related to drinking, how ambivalent the person is to the idea of the change in behavior, and whether or not the person is taking any steps to change risky drinking behavior. Analyzing the scores of the 16 participants whose AUDIT scores were greater than 8, a Mann-Whitney U test on pre-post change scores by condition and examination of group means revealed that participants in the music therapy group were significantly more likely to report increased recognition of the need to change risky drinking behavior following the session than those in the control condition (U = 15.50, p = .08).
Further exploration of the use of music therapy informed by motivational interviewing, music therapy as a brief intervention, and music therapy with young adults may be warranted
Analysis of a hierarchial Bayesian method for quantitative trait loci
Simulations were performed to compare two methods that detect quantitative trait loci on
plant data. Karl Bromanâs interval mapping algorithm which uses only one observation value per
plant line was compared to a hierarchical Bayesian model that allows replicates into the analysis
and takes into account the variability within each plant line. The simulation study utilized the
genetic map of Bay-0 X Shahdara plant with 38 genetic markers on 5 chromosomes. It is shown
through these simulations that the hierarchical Bayesian model and Bromanâs interval mapping
algorithm are able to detect quantitative trait loci (QTL) when only a single location was chosen,
but the hierarchical model was more powerful when two locations were chosen. This work
shows that when analyzing plant replicates the variability within each line has a strong impact on
the success of the overall analyses
Media influence on deviant behavior in middle school students
In recent years, there has been growing concern over the possible influence of
aggressive and sexually-explicit media on children and teenagers (Gore, 1987). It is
believed that graphic depictions of violence, disrespect of women, and the glamorization
of drug use are fostering similar behavior in the school-aged population. This anti-social
subject matter is presented in movies, on television (programs and music videos), the
internet, in the lyrics of popular music, and in video games. A generation ago, families
would not have tolerated the sex and violence presented to children. The questions
remains, have the behavior problems of Americaâs youth increased over the past ten to
twenty years? And is there a correlation between an increase in media presentations of
sex and violence to children, and an increase in public tolerance or ignorance of graphic
adult themes presented to children?
This thesis addresses the possible effects of exposure to various forms of violent
and anti-social media as a significant factor contributing to anti-social and disruptive
behaviors in middle school students in the school setting. The thesis also provides an
overview of other factors identified in a review of relevant literature. These factors
include lack of familial support, poor self-esteem and external locus of control. In
addition, the thesis describes a study conducted with middle school students who have
varying disciplinary records. The results of this study indicate that negative media, as a
single factor, does not appear to be sufficient to account for anti-social or disruptive
behavior of these students at school
What to do with diabetes therapies when HbA1c lowering is inadequate:add, switch, or continue? A MASTERMIND study
This is the author accepted manuscript. The final version is available from BioMed Central via the DOI in this record.Background: It is unclear what to do when people with type 2 diabetes have had no or a
limited glycemic response to a recently introduced medication. Intra-individual HbA1c
variability can obscure true response. Some guidelines suggest stopping apparently
ineffective therapy, but no studies have addressed this issue.
Methods: In a retrospective cohort analysis using the UK Clinical Practice Research Datalink
(CPRD), we assessed the outcome of 55,530 patients with type 2 diabetes starting their
second or third non-insulin glucose lowering medication, with a baseline HbA1c >58mmol/mol
(7.5%). For those with no HbA1c improvement or a limited response at 6 months (HbA1c fall
<5.5mmol/mol [0.5%]) we compared HbA1c 12 months later in those who continued their
treatment unchanged, switched to new treatment, or added new treatment.
Results: An increase or a limited reduction in HbA1c was common, occurring in 21.9%
(12,168/55,230), who had a mean HbA1c increase of 2.5mmol/mol (0.2%). After this limited
response, continuing therapy was more frequent (n=9,308; 74%) than switching (n=1,177; 9%)
or adding (n=2,163; 17%). Twelve months later, in those who switched medication HbA1c fell
(-6.8mmol/mol [-0.6%], 95%CI -7.7, -6.0) only slightly more than those who continued
unchanged (-5.1 mmol/mol [-0.5%], 95%CI -5.5, -4.8). Adding another new therapy was
associated with a substantially better reduction (-12.4mmol/mol [-1.1%], 95%CI -13.1, -11.7).
Propensity score matched subgroups demonstrated similar results.
Conclusions: Where glucose lowering therapy does not appear effective on initial HbA1c
testing, changing agents does not improve glycemic control. The initial agent should be
continued with another therapy added.Medical Research Council (MRC)National Institute for Health Research (NIHR
Development of oedema is associated with an improved glycaemic response in patients initiating thiazolidinediones: a MASTERMIND study
Abstracts of the 51st EASD Annual Meeting, Stockholm, Sweden, 14â18 September 2015This is the author accepted manuscript. The final version is available from Springer VerlagBackground and aims: Oedema is a common and serious side effect of thiazolidinedione therapy. A stratified medicines approach would aim to give thiazolidinediones to patients likely to have a good glycaemic response but to not develop oedema. We investigated whether oedema was associated with glycaemic response to thiazolidinedione therapy.
Materials and methods: We retrospectively studied 11,459 patients initiating a thiazolidinedione from UK primary care data (Clinical Practice Research Datalink), and identified medical records of new oedema in the subsequent twelve months. Response was defined as change in HbA1c at twelve months and was adjusted for baseline HbA1c, baseline BMI,
gender and compliance (medication possession ratio). In secondary analyses we restricted oedema classification to patients with concomitant weight gain. As a comparison the same analysis was performed in 13,089 patients initiating a sulfonylurea.
Results: The 5% of patients with recorded oedema on thiazolidinediones had a mean (CI) 2.2 (1.1-3.2)mmol/mol greater fall in HbA1c (p3 kg (p<
0.001) and a 3.6 (1.8-5.4)mmol/mol greater fall when weight gain >5 kg (p3 kg (p=0.19).
Conclusion: Patients with Type 2 diabetes who develop oedema on initiating thiazolidinediones have an improved glycaemic response, and more severe oedema may be associated with greater reductions in HbA1c. An association between oedema and glycaemic response was not observed in patients initiating sulfonylureas. This supports glycaemic lowering and fluid retention being mediated by a common pathway of thiazolidinedione drug action.Supported by: MRC grant MR-K005707-
Patients who develop oedema on initiating thiazolidinedione therapy have an improved glycaemic response: a MASTERMIND study
Special Issue: Abstracts of the Diabetes UK Professional Conference 2015, ExCeL London, 11â13 March 2015This is the author accepted manuscript. The final version is available from WileyBackground/aim: Oedema is a common and serious side effect ofthiazolidinedione therapy. A stratified medicine approach wouldaim to give thiazolidinediones to patients likely to have a goodglycaemic response but not to develop oedema. We investigatedwhether oedema was associated with glycaemic response tothiazolidinedione therapy.Methods: We studied 10,486 patients initiating a thiazolidinedionefrom Clinical Practice Research Datalink (CPRD), and identifiedmedical records of oedema in the subsequent 12 months. Responsewas defined as change in HbA1c at 12 months and was adjusted forbaseline HbA1c, baseline body mass index, gender and adherence(medication possession ratio). In secondary analyses we restrictedoedema classification to patients with concomitant weight gain. As acomparison the same analysis was performed in 13,089 patientsinitiating a sulfonylurea.Results: The 3% of patients with recorded oedema onthiazolidinediones had a mean (confidence interval) 3 (1.7â4.3)mmol/mol greater fall in HbA1c (p 3kg (p 8kg (p 3kg (p=0.19).Conclusion: Patients with Type 2 diabetes who develop oedemaon initiating thiazolidinediones have an improved glycaemicresponse, and more severe oedema is associated with greaterHbA1c reduction. This supports glycaemic lowering andfluid retention being mediated by a common pathway ofthiazolidinedione drug action
Are the new drugs better? Changing UK prescribing of Type 2 diabetes medications and effects on HbA1c and weight, 2010 to 2016
This is the author accepted manuscript. The final version is available from Wiley via the DOI in this record.Aim: The availability of new glucoseâlowering drugs has changed UK National Institute of Clinical Excellence Type 2 diabetes guidelines, but there has been little evaluation of realâworld use of these drugs, or of the populationâlevel impact of their use. We examined changes in UK prescribing for patients starting secondâ and thirdâline medications, and populationâlevel trends in glycaemic response and weight change.
Methods: We extracted incident secondâ and thirdâline oral prescription records for patients with Type 2 diabetes in the UKârepresentative Clinical Practice Research Datalink, 2010 to 2016 (n = 68,902). Each year we calculated the proportion of each drug prescribed as the percentage of the total prescribed. We estimated annual mean sixâmonth HbA1c response and weight change using linear regression, standardised for clinical characteristics.
Results: Use of Dipeptidyl peptidaseâ4 (DPP4) inhibitors has increased markedly to overtake sulfonylureas as the most commonly prescribed secondâline drug in 2016 (43% vs 34% of total prescriptions compared with 18% v 59% in 2010). Use of sodiumâglucose coâtransporterâ2 (SGLT2) inhibitors has increased rapidly to 14% of secondâline and 27% of thirdâline prescriptions in 2016. Mean HbA1c response at six months was stable over time (2016: 13.5 (95% confidence interval 12.8, 14.1) mmol/mol vs 2010: 13.9 (13.6;14.2) mmol/mol, p = 0.21). We found mean weight loss at six months in 2016, in contrast to 2010 where there was mean weight gain (2016: â1.2 (â0.9; â1.5) kg vs 2010: +0.4 (+0.3; +0.5) kg, p < 0.001).
Conclusion: The pattern of drug prescribing to manage patients with Type 2 diabetes has changed rapidly in the United Kingdom. Increasing use of DPP4 inhibitors and SGLT2 inhibitors has not resulted in improved glycaemic control but has improved the body weight of patients starting secondâ and thirdâline therapy.
Acknowledgement: This abstract is submitted on behalf of the MASTERMIND consortium
Snapshot Provisioning of Cloud Application Stacks to Face Traffic Surges
Traffic surges, like the Slashdot effect, occur when a web application is overloaded by a huge number of requests, potentially leading to unavailability. Unfortunately, such traffic variations are generally totally unplanned, of great amplitude, within a very short period, and a variable delay to return to a normal regime. In this report, we introduce PeakForecast as an elastic middleware solution to detect and absorb a traffic surge. In particular, PeakForecast can, from a trace of queries received in the last seconds, minutes or hours, to detect if the underlying system is facing a traffic surge or not, and then estimate the future traffic using a forecast model with an acceptable precision, thereby calculating the number of resources required to absorb the remaining traffic to come. We validate our solution by experimental results demonstrating that it can provide instantaneous elasticity of resources for traffic surges observed on the Japanese version of Wikipedia during the Fukushima Daiichi nuclear disaster in March 2011.Les pics de trafic, tels que l'effet Slashdot, apparaissent lorsqu'une application web doit faire face un nombre important de requĂȘtes qui peut potentiellement entraĂźner une mise hors service de l'application. Malheureusement, de telles variations de traffic sont en gĂ©nĂ©ral totalement imprĂ©vues et d'une grande amplitude, arrivent pendant une trĂšs courte pĂ©riode de temps et le retour Ă un rĂ©gime normal prend un dĂ©lai variable. Dans ce rapport, nous prĂ©sentons PeakForecast qui est une solution intergicielle Ă©lastique pour dĂ©tecter et absorber les pics de trafic. En particulier, PeakForecast peut, Ă partir des traces de requĂȘtes reçues dans les derniĂšres secondes, minutes ou heures, dĂ©tecter si le systĂšme sous-jacent fait face ou non Ă un pic de trafic, estimer le trafic futur en utilisant un modĂšle de prĂ©diction suffisamment prĂ©cis, et calculer le nombre de ressources nĂ©cessaires Ă l'absorption du trafic restant Ă venir. Nous validons notre solution avec des rĂ©sultats expĂ©rimentaux qui dĂ©montrent qu'elle fournit une Ă©lasticitĂ© instantanĂ©e des ressources pour des pics de trafic qui ont Ă©tĂ© observĂ©s sur la version japonaise de Wikipedia lors de l'accident nuclĂ©aire de Fukushima Daiichi en mars 2011
Reflections on Teaching and Learning in Field Education: A Teacher-Scholar Model
The purpose of this brief article is to report an innovative attempt to promote high quality field education utilizing Specialized Field Education Units (SFEUs) while overcoming both the internal and external barriers noted above. This approach, an integrated field unit using a teacher-scholar model, has been implemented for the past five years by the joint field education programs of the North Carolina Agricultural and Technical State University and the University of North Carolina at Greensboro BSW and MSW programs. The results have been a higher level of full-time engagement in field education by full-time tenure-track faculty members, high student success as measured by achievement of CSWE competencies, and higher rates of faculty publication and funding for research programs
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