An adaptive real-time intelligent system to enhance self-care of chronic disease (ARISES)

Diabetes mellitus is an increasingly prevalent chronic metabolic condition characterised by impaired glucose homeostasis and raised blood glucose levels (hyperglycaemia). Broadly categorised as either type 1 (T1DM) or type 2 diabetes (T2DM), people with diabetes are largely responsible for self-managing their blood glucose levels. Despite the development of diabetes technologies such as real time continuous glucose monitoring (RT-CGM), many individuals are frequently exposed to iatrogenic low blood glucose levels (hypoglycaemia). Severe hypoglycaemia is associated with an increased risk of recurrent hypoglycaemia, impaired symptomatic awareness of hypoglycaemia, and potentially death if left untreated. This thesis affirmed the existing clinical impact of severe hypoglycaemia and its recurrent risk in a six-month analysis of severe hypoglycaemia attended by the London Ambulance Service NHS Trust (LAS). Fewer incidents of severe hypoglycaemia observed in a date matched repeat analysis during the 2020 COVID-19 lockdown suggested improved self-management possibly motivated by a proximal fear of hospitalisation and improved structure at home. Finally, a 12-week randomised control trial demonstrating a significant difference in time spent in hypoglycaemia <3mmol/L, is the first study to prove the immediate provision of RT-CGM significantly reduces the risk of recurrent hypoglycaemia. Moreover, it highlighted the impact of socioeconomic disparity as a barrier to effective hypoglycaemia risk modification. This guided the design of an adaptive real time intelligent system to enhance self-care of chronic disease (ARISES) aimed to deliver therapeutic and lifestyle decision support for people with T1DM. The ARISES graphic user interface (GUI) design was a collaborative process conceived in a series of focus group meetings including people with T1DM. Finally, a 12-week observational study using RT-CGM, a physiological sensor wristband, and a mobile diary app, allowed for a sub-analysis identifying measurable physiological parameters associated with current and impending hypoglycaemia in people with T1DM.Open Acces

Other Modernisms: Recording Diversity and Communicating History in Urban West Africa

Seminal publications on West African Architecture such as Kulterman’s New Architecture in Africa and the Architectural Review’s New Commonwealth Architecture came to define the African Modern Movement as it was understood internationally. This paper explores the specific context within which this new architecture developed and the actors that helped to shape it. Vaughan–Richards’ Ola–Oluwakitan House and Cubitt’s Elder Dempster Offices are analyzed in terms of their engagement with the socio-cultural context in which they were conceived, the site-specific Modernity of the former contrasting the corporate International Style response of the latter

Architecture scolaire et éducation en Afrique anglophone, xixe-xxe siècles

Nous présentons ici une brève analyse de l’architecture et du développement scolaires dans l’Afrique subsaharienne, en se référant plus particulièrement au Nigeria, l’ouest du continent et l’Afrique du Sud. Cet article se concentre sur la période des années cinquante aux années soixante-dix, c’est-à-dire avant et après l’indépendance. Nous suggérons que les programmes récents d’architecture scolaire se tournent vers les théories éducatives du passé, avec comme notion clef l’école publique au centre de la communauté et accessible à tous les citoyens.Presented here is a short analysis of educational design and development in sub-saharan Africa, with special reference to Nigeria, in West Africa and South Africa. The paper focuses on design developments in the 1950s-1970s, the pre and post independence period in Africa. It suggests that recent programmes in school design are returning to educational theories of the pasts, focusing on the state school being the centre of the community and accessible to all citizens.Unter besonderer Bezugnahme auf Nigeria, West- und Südafrika wird in diesem Beitrag eine kurze Analyse der Entwicklungslinien bei der Gestaltung von Bildungseinrichtungen in den südlich der Sahara gelegenen Teilen Afrikas vorgelegt. Dabei werden die Entwicklungen im Bereich des Designs in den 1950er bis 1970er Jahren, mithin in der Zeit vor und nach der Unabhängigkeit besonders in den Blick genommen. Er legt nahe, dass neuere Pläne zur Schulgestaltung wieder zu Bildungstheorien der Vergangenheit zurückkehren und die staatliche Schule als allen Bürgern zugänglicher Mittelpunkt des Gemeinwesens im Auge haben