The Attitudes about Complex Therapy Scale (ACTS) in Type 2 Diabetes and Cardiovascular Disease: Development, Validity and Reliability

Background: Type 2 diabetes is associated with cardiovascular disease, and patients with both conditions are prescribed complex medication regimens. Aim: The aim was to develop a reliable and valid measure of attitudes associated with the prescription and management of multiple medicines in patients with Type 2 diabetes and cardiovascular disease. Methods: Principal component analysis (PCA) and Cronbach alpha assessed the reliability of the Attitudes about Complex Therapy Scale (ACTS). Examinations of relationships with related measures inform concurrent validity. Questionnaires were sent to a cross-sectional sample of 480 people prescribed multiple medicines for co-morbid Type 2 diabetes. Results: Cronbach alpha was 0.76, indicating the scale had good internal reliability. PCA rotated a four factor model accounting for 37% of the variance. Four subscales identified; 1. Concerns about multiple medicines and increasing numbers of medicines; 2.Anxiety over missed medicines; 3. Desires to substitute medicines and reduce the number of medicines prescribed and; 4. Perceptions related to organising and managing complex therapy. The ACTS showed significant relationships with measures of anxiety, depression, general beliefs about medicines and self-efficacy. Also, the ACTS significantly correlated with adherence to medicines, showing good predictive validity. Conclusion: The ACTS was designed to assess negative attitudes towards complex therapy and multiple medication management. This tool could aid prescribing decisions and may identify people who are intentionally non-adherent to all or some of their medicines

Evolution of Fixed-End Strings and the Off-Shell Disk Amplitude

An exact integral expression is found for the amplitude of a Bosonic string with ends separated by a fixed distance $R$ evolving over a time $T$ between arbitrary initial and final configurations. It is impossible to make a covariant subtraction of a covariant quantity which would render the amplitude non-zero. It is suggested that this fact (and not the tachyon) is responsible for the lack of a continuum limit of regularized random-surface models with target-space dimension greater than one. It appears consistent, however, to remove this quantity by hand. The static potential of Alvarez and Arvis $V(R)$ is recovered from the resulting finite amplitude for $R>R_{c}$. For $R<R_{c}$, we find $V(R)=-\infty$, instead of the usual tachyonic result. A rotation-invariant expression is proposed for special cases of the off-shell disk amplitude. {\it None} of the finite amplitudes discussed are Nambu or Polyakov functional integrals, except through an unphysical analytic continuation. We argue that the Liouville field does not decouple in off-shell amplitudes, even when the space-time dimension is twenty-six.Comment: Latex file, 19 pages, no figure

Future Needs for Tribo-Corrosion Research and Testing

Tribo-corrosion is an emerging interdisciplinary subject that spans from basic research on the behavior of surfaces in mechanical contact in chemically active surroundings to the test methods needed to quantify its effects, and from the selection of materials for bio-implants to the minimization of surface degradation and wastage in advanced energy conversion systems. Such a diverse field brings with it many challenges in understanding, testing, standardization, and application to engineering practice. This paper summarizes a panel discussion and participant survey held at the Third International Symposium on Tribo-Corrosion in Atlanta, Georgia, USA, in April 2012. It reflects a sense of agreement on many of the key scientific challenges in the field and the fact that tribo-corrosion is still in its infancy in terms of broad industry recognition, education, and the ability of those who conduct tribo-corrosion research to connect their laboratory results and theories to applications. Some sub-fields, notably the bio-tribo-corrosion of medical implants, have witnessed active international research efforts, but the engineering community in many other important areas of technology may not yet be aware of the field despite numerous tribo-corrosion problems that may exist within their purview

The Impact of Macular Pigment Augmentation on Visual Performance in Normal Subjects: COMPASS

This study was conducted to investigate whether augmentation of macular pigment (MP) enhances visual performance (VP). 121 normal subjects were recruited. The active (A) group consumed 12 mg of lutein (L) and 1 mg of zeaxanthin (Z) daily. MP optical density (MPOD) was assessed by customized heterochromatic flicker photometry. VP was assessed as best corrected visual acuity (BCVA), mesopic and photopic contrast sensitivity (CS), glare disability, photostress, and subjective visual function. Subjects were assessed at baseline; 3; 6; 12 months (V1, V2, V3 and V4, respectively). Central MPOD increased significantly in the A group (p \u3c 0.05) but not in the placebo group (p \u3e 0.05). This statistically significant increase in MPOD in the A group was not, in general, associated with a corresponding improvement in VP (p \u3e 0.05, for all variables), with the exception of a statistically significant time/treatment effect in “daily tasks comparative analysis” (p = 0.03). At V4, we report statistically significant differences in mesopic CS at 20.7 cpd, mesopic CS at 1.5 cpd under high glare conditions, and light/dark adaptation comparative analysis between the lower and the upper MP tertile groups (p \u3c 0.05) Further study into the relationship between MP and VP is warranted, with particular attention directed towards individuals with low MP and suboptimal VP. Research highlights ► Identifying that macular pigment significantly increased in the active group. ► Less glare disability for subjects with high macular pigment. ► Improved mesopic contrast sensitivity for subjects with high macular pigment. ► Identifying the need for further research in subjects with low macular pigment

Patient perceptions of treatment and illness when prescribed multiple medicines for co-morbid type 2 diabetes

Illness and treatment perceptions are vital for people self-managing co-morbid conditions with associated cardiovascular disease, such as type 2 diabetes (T2D). However, perceptions of a co-morbid condition and the use of multiple medicines have yet to be researched. This study investigated the illness and treatment perceptions of people with co-morbid T2D. The Brief Illness Perception Questionnaire (repeated for T2D, hypertension, and hyperlipidemia) and the Beliefs about Medicines Questionnaire Specific Concerns Scales (repeated for Oral hypoglycemic agents, anti-hypertensive medicines, and statins) were sent to 480 people managing co-morbid T2D. Data on the number of medicines prescribed were collected from medical records. Significantly different perceptions were found across the illnesses. The strongest effect was for personal control; the greatest control reported for T2D. Illness perceptions of T2D differed significantly from perceptions about hyperlipidemia. Furthermore, illness perceptions of T2D also differed from perceptions of hypertension with the exception of perceptions of illness severity. Hypertension and hyperlipidemia shared similar perceptions about comprehensibility, concerns, personal control, and timeline. Significant differences were found for beliefs about treatment necessity, but no difference was found for treatment concerns. When the number of medicines was taken as a between-subjects factor, only intentional non-adherence, treatment necessity beliefs, and perceptions of illness timeline were accounted for. Co-morbid illness and treatment perceptions are complex, often vary between illnesses, and can be influenced by the number of medicines prescribed. Further research should investigate relationships between co-morbid illness and treatment perception structures and self-management practices

The Relationship Between Macular Pigment and Visual Performance

This study was designed to assess whether macular pigment optical density (MPOD) is associated with visual performance. One hundred and forty-two young healthy subjects were recruited. Macular pigment optical density and visual performance were assessed by psychophysical tests including best corrected visual acuity (BCVA), mesopic and photopic contrast sensitivity, glare sensitivity, photostress recovery time (PRT). Measures of central visual function, including BCVA and contrast sensitivity, were positively associated with MPOD (p \u3c 0.05, for all). Photostress recovery and glare sensitivity were unrelated to MPOD (p \u3e 0.05). A longitudinal, placebo-controlled and randomized supplementation trial will be required to ascertain whether augmentation of MPOD can influence visual performance

The Relationship Between Macular Pigment and Visual Performance

This study was designed to assess whether macular pigment optical density (MPOD) is associated with visual performance. One hundred and forty-two young healthy subjects were recruited. Macular pigment optical density and visual performance were assessed by psychophysical tests including best corrected visual acuity (BCVA), mesopic and photopic contrast sensitivity, glare sensitivity, photostress recovery time (PRT). Measures of central visual function, including BCVA and contrast sensitivity, were positively associated with MPOD (p \u3c 0.05, for all). Photostress recovery and glare sensitivity were unrelated to MPOD (p \u3e 0.05). A longitudinal, placebo-controlled and randomized supplementation trial will be required to ascertain whether augmentation of MPOD can influence visual performance