Glucocorticoid therapy for adrenal insufficiency: nonadherence, concerns and dissatisfaction with information

Objective: Appropriate self‐management of glucocorticoid therapy (GC) is crucial for patients with adrenal insufficiency (AI). We aimed to describe patients’ self‐reported nonadherence to GC, evaluate perceived doubts about need for GC, concerns about adverse effects, and dissatisfaction with information received about GC. Design: Cross‐sectional survey. Patients: Patients prescribed GC for AI (n = 81) from five European countries. Measurements: Online survey including the Medication Adherence Report Scale (MARS), Beliefs about Medicines Questionnaire© (BMQ Specific, adapted for AI) and Satisfaction with Information about Medicines Scale© (Prof Rob Horne; SIMS). Results: Most patients (85·2%) reported a degree of nonadherence to GC. The most frequent types of nonadherence concerned changing the timing of GC doses, for example taking a dose later in the day than advised (37·0%). Few patients doubted their personal need for daily GC, but most reported high concerns about GC including potential weight gain (50·6%), osteoporosis (53·6%) and the continuing risk of adrenal crisis (50·6%). Dissatisfaction with information about GC was frequent, with participants particularly dissatisfied with the amount of information they had received about potential problems with GC. People who expressed dissatisfaction with information about GC, and concerns about its adverse effects were also more likely to report nonadherence (P < 0·05). Conclusions: Nonadherence to treatment, concerns about potential adverse effects and dissatisfaction with the information provided about treatment were frequently reported by this European sample of AI patients. Many AI patients may need additional information about their GC and support to address concerns about GC and facilitate adherence

Nonlocal Cosmology

We explore nonlocally modified models of gravity, inspired by quantum loop corrections, as a mechanism for explaining current cosmic acceleration. These theories enjoy two major advantages: they allow a delayed response to cosmic events, here the transition from radiation to matter dominance, and they avoid the usual level of fine tuning; instead, emulating Dirac's dictum, the required large numbers come from the large time scales involved. Their solar system effects are safely negligible, and they may even prove useful to the black hole information problem.Comment: Expanded(!) version, to appear in Phys. Rev. Letter

Buoyant Venus station mission feasibility study for 1972 and 1973 launch opportunities. Volume 3 - Configuration definition. Part 1 - Configuration Final report

Configuration definitions for buoyant Venus station missions for 1972 - 1973 launch perio

Rippled Cosmological Dark Matter from Damped Oscillating Newton Constant

Let the reciprocal Newton 'constant' be an apparently non-dynamical Brans-Dicke scalar field damped oscillating towards its General Relativistic VEV. We show, without introducing additional matter fields or dust, that the corresponding cosmological evolution averagely resembles, in the Jordan frame, the familiar dark radiation -> dark matter -> dark energy domination sequence. The fingerprints of our theory are fine ripples, hopefully testable, in the FRW scale factor; they die away at the General Relativity limit. The possibility that the Brans-Dicke scalar also serves as the inflaton is favorably examined.Comment: RevTex4, 12 pages, 5 figures; Minor revision, References adde

Integrability of the N-body problem in (2+1)-AdS gravity

We derive a first order formalism for solving the scattering of point sources in (2+1) gravity with negative cosmological constant. We show that their physical motion can be mapped, with a polydromic coordinate transformation, to a trivial motion, in such a way that the point sources move as time-like geodesics (in the case of particles) or as space-like geodesics (in the case of BTZ black holes) of a three-dimensional hypersurface immersed in a four-dimensional Minkowskian space-time, and that the two-body dynamics is solved by two invariant masses, whose difference is simply related to the total angular momentum of the system.Comment: 15 pages, LaTeX, no figure

Entropy of gravitationally collapsing matter in FRW universe models

We look at a gas of dust and investigate how its entropy evolves with time under a spherically symmetric gravitational collapse. We treat the problem perturbatively and find that the classical thermodynamic entropy does actually increase to first order when one allows for gravitational potential energy to be transferred to thermal energy during the collapse. Thus, in this situation there is no need to resort to the introduction of an intrinsic gravitational entropy in order to satisfy the second law of thermodynamics.Comment: 9 pages, 4 figures. Major changes from previous version. We consider only thermodynamic entropy in this version. Published in PR

On the Ricci flow and emergent quantum mechanics

The Ricci flow equation of a conformally flat Riemannian metric on a closed 2-dimensional configuration space is analysed. It turns out to be equivalent to the classical Hamilton-Jacobi equation for a point particle subject to a potential function that is proportional to the Ricci scalar curvature of configuration space. This allows one to obtain Schroedinger quantum mechanics from Perelman's action functional: the quantum-mechanical wavefunction is the exponential of $i$ times the conformal factor of the metric on configuration space. We explore links with the recently discussed emergent quantum mechanics.Comment: To appear in the proceedings of DICE'08 (Castiglioncello, Italy, Sept. 2008), edited by H.-T. Elz

Synthesis And Characterization Of (pyNO−)2GaCl: A Redox-Active Gallium Complex

We report the synthesis of a gallium complex incorporating redox-active pyridyl nitroxide ligands. The (pyNO−)2GaCl complex was prepared in 85% yield via a salt metathesis route and was characterized by 1H and 13C NMR spectroscopies, X-ray diffraction, and theory. UV–Vis absorption spectroscopy and electrochemistry were used to access the optical and electrochemical properties of the complex, respectively. Our discussion focuses primarily on a comparison of the gallium complex to the corresponding aluminum derivative and shows that although the complexes are very similar, small differences in the electronic structure of the complexes can be correlated to the identity of the metal