Improving adherence to medication in stroke survivors (IAMSS): a randomised controlled trial: study protocol

Background: Adherence to therapies is a primary determinant of treatment success, yet the World Health Organisation estimate that only 50% of patients who suffer from chronic diseases adhere to treatment recommendations. In a previous project, we found that 30% of stroke patients reported sub-optimal medication adherence, and this was associated with younger age, greater cognitive impairment, lower perceptions of medication benefits and higher specific concerns about medication. We now wish to pilot a brief intervention aimed at (a) helping patients establish a better medication-taking routine, and (b) eliciting and modifying any erroneous beliefs regarding their medication and their stroke. Methods/Design: Thirty patients will be allocated to a brief intervention (2 sessions) and 30 to treatment as usual. The primary outcome will be adherence measured over 3 months using Medication Event Monitoring System (MEMS) pill containers which electronically record openings. Secondary outcomes will include self reported adherence and blood pressure. Discussion: This study shall also assess uptake/attrition, feasibility, ease of understanding and acceptability of this complex intervention. Trial Registration: Current Controlled Trials ISRCTN3827495

Prevalence of challenging behaviour in adults with intellectual disabilities, correlates, and association with mental health

Purpose of Review To summarise findings about the prevalence and correlates of challenging behaviour in adults with intellectual disabilities from robust research. We also describe findings on the interplay between challenging behaviour and mental health. Recent Findings Recent studies that have utilised psychometrically evaluated tools, with clear operational definitions, show similar findings on the prevalence of challenging behaviour of about 1 in every 5–6 adults known to services. We describe common correlates identified such as communication impairments, severity of intellectual disability, and living in institutional settings or congregate care. We also describe the complex and multifaceted relationship between challenging behaviour and mental health. Summary Based on recent studies, we propose a revised framework model to help understand challenging behaviour. We propose a number of areas where more research is required, particularly the development of risk tools clinicians can utilise in practice

Medication Persistence Rates and Factors Associated with Persistence in Patients Following Stroke: A Cohort Study

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Automated Calibration Technique for Predistortion Modulation Loops using Asynchronous Phase Detection

A novel calibration scheme for predistortion Σ∆ PLLs is proposed in this paper. In contrast to present calibration al gorithms this technique offers a digital representation of the high frequency phase characteristic. The architecture uses minimum chip area by synchronously sampling the data content of an asynchronous divider chain. Using this tech nique to detect the phase difference during a step response allows to determine the real loop gain within 7 µs with an accuracy better than 0.1%. Obtaining this, the deviation from the desired loop gain can be adjusted by a digitally controlled charge pump in order to derive the wanted loop transfer function. This is mandatory for predistortion mod ulation loops. The architecture is designed by systemthe oretical calculation of the loop behaviour and verified by mixed signal VHDL-AMS simulations

Spectral shaping by generalized transfer function design in frequency modulation ΣΔ synthesizers

A new straightforward ΣΔ-fractional-N modulation-loop design methodology is proposed in this paper. In contrast to present design approaches the closed loop transfer function can be used for pulse forming. An algorithm is presented which allows loop filter design based on the desired transfer function shaping. Using this technique, a closed loop modulation with low reference frequency for Bluetooth can be achieved without the need for predistortion. Using a 5th order loop filter, the ΣΔ modulator of order three will maintain the required noise specifications for the commonly used 13 MHz reference frequency. The resulting simulated total phase noise is as low as -111 dBc/Hz at 1.5 MHz and -132 dBc/Hz at 2.5 MHz

A quadricorrelator demodulator for a Bluetooth low-IF receiver

An analog quadricorrelator demodulator is presented. The short introduction to this demodulator is followed by a discussion about the important DC offsets question. To eliminate this, co-channel performance degrading aspect switches are added to the quadricorrelator architecture. System simulation results show how robust the demodulator becomes with this small modification to the structure