In this work, methylmethacrylate, MMA was polymerized by ATRP method to obtain low molecular weight living polymers. The initiator was p-toluenesulfonylchloride and catalyst ligand complex system were CuCl-4,4&rsquo / dimethyl 2,2&rsquo / bipyridine. Polymers with controlled molecular weight were obtained. The polymer chains were shown by NMR investigation to be mostly syndiotactic. The molecular weight and molecular weight distribution of some polymer samples were measured by GPC method. The K and a constants in [h]=K Ma equation were measured as 9.13x10-5 and 0.74, respectively. FT-IR and X-Ray results showed regularity in polymer chains. The molecular weight-Tg relations were verified from results of molecular weight-DSC results.

In this thesis the design of a MMIC vector modulator operating in 9GHz-10GHz band is investigated and performed. Sub-sections of the vector modulator are 4-port (4.8dB) 1200 phase shift relative to the dedicated port power splitter, digitally controlled variable gain amplifier and the in phase power combiner. Alternative methods are searched in order to implement the structure properly in the given frequency band. The final design is appropriate for MMIC structure. 4-port (4.8dB) 1200 phase shift relative to the dedicated port power splitter is studied. The performance is simulated and optimized first on Microwave Office, then on Advanced Design System (ADS) tools. Various methods to design a digitally controlled variable gain amplifier are studied. The final topology is simulated and optimized on ADS tool. An in phase power combiner is designed. The performance of the combiner is simulated and optimized on ADS tool. Lumped element models are replaced with CASWELL H-40 models to achieve a MMIC structure and a layout is drawn. The finalized vector modulator is simulated and optimized on ADS tool. Key words: MMIC, Vector Modulator, Digitally Controlled Variable Gain Amplifier, Layout

Antibiotic use is a vital method for the treatment of most diseases involving bacterial infections. Unfortunately, in certain cases these agents are not effective in treatments against diseases for either some limitation in antibiotic usage because of the side effects or some distribution problems caused by physiological or pathological barriers in the body. Such problems are thought to be minimized by development of controlled release systems which involve implantation of antibiotic loaded polymeric systems directly to the site of infection. Present study involves Vancomycin, a very strong antibiotic with a wide spectrum of activity, and two biocompatible and biodegradable polymers, poly(3-hydroxybutyrate-co-3-valerate) PHBV and poly(L-lactide-co-glycolide) PLGA, in the construction of rod shaped controlled release systems designed for the aim of local treatment of osteomyelitis. Vancomycin carrying rods of either PHBV 8 or PLGA (50:50) polymers were prepared by the use of cold paste and hot extrusion methods in two different loading ratios (2:1 and 1:1 P:V). In situ release kinetics of each type of rod was determined by spectrophotometric measurement of vancomycin concentration. For determination of drug content of the controlled release rods initially and at the end of the release experiments, extraction and IR (infrared) studies were carried out. The efficacy of the system was measured in vitro on the bacterial strain, B. subtilis. Characterization of the rods was made by the use of stereomicroscopy and SEM (scanning electron microscopy). In situ release results of the controlled Vancomycin release formulations revealed that for both polymer types, hot extrusion process enabled the formation of a more compact system that provided slower release of the agent compared to the cold paste method. With the combined effect of variable loading proportion and polymer type the most prolonged release was obtained by PHBV rods having 2:1, P:V, ratio (prepared by hot extrusion method). In general, the release kinetics from the rods obeyed the Fickian diffusion kinetics except for PLGA rods prepared by cold paste method with 1:1 and 2:1 (P:V) loading ratios, which had a first order rate of drug release. According to in vitro bioactivity assays, all the groups effectively inhibited bacterial growth with the first day release samples. On the seventh day, however, only two cold paste samples, PHBV:Vancomycin 1:1 and PLGA:Vancomycin 1:1 had drug content barely sufficient for MEC while the others were in the ineffective range. The IR and grinding-extraction studies proved that Vancomycin was still present within the rods after a ten day release period. The PHBV rods with 2:1 (P:V) ratio prepared by hot extrusion method seem to be the most promising drug delivery system in terms of providing prolonged release as an implantable drug delivery system for the treatment of bacterial infections of the bone, namely osteomyelitis.

Barley protein based microcapsules (1-5µm) incorporating fish oil/β-carotene were successfully prepared. Well suspended solid microcapsules, rather than emulsions, were able to form after high pressure emulsifying process. These wet-status microcapsules could be turned into dry powder by a spray drying process. The microcapsules demonstrated spherical shape and high loading capacity. Oxidative stability tests under accelerated conditions and in food formulations suggest barley proteins are effective microencapsulation materials to protect fish oil against oxidation. Microcapsule degradation and bioactive compound release behaviors were studied in the simulated gastro-intestinal tract. The data revealed that nano-encapsulations (20-30nm) were formed as a result of enzymatic degradation of microcapsule bulk matrix in the simulated gastric tract. These nano-encapsulations delivered β-carotene to a simulated human intestinal tract intact, where they were degraded by pancreatic enzymes and steadily released the β-carotene. These uniquely structured microcapsules may provide a new strategy to develop target delivery systems for nutraceuticals / Food Science and Technology

Conventional free-radical miniemulsion polymerization has been well studied since early 1970s. Conventional free-radical miniemulsion polymerizations have inherent limitations associated with uncontrolled free-radical polymerization mechanism. The goal of this work is to develop a variety of unconventional miniemulsion polymerization techniques by applying new polymerization techniques (typically in solution or bulk) to miniemulsion systems to overcome their inherent limitations and extend the application of free-radical miniemulsion polymerization. This work focused on the exploration of kinetic and mechanistic aspects of unconventional miniemulsion polymerizations. First, enzyme initiated free-radical miniemulsion polymerization, in contrast with those conventional chemical initiated miniemulsion polymerization, is demonstrated for the first time as an answer to the challenges associated with using the hydrophobic of vinyl monomers in aqueous enzymatic reactions. A procedure for enzyme initiated free-radical miniemulsion polymerization was formulated and stable poly(styrene) latexes were successfully synthesized. The kinetics of enzyme initiated free-radical miniemulsion polymerization and the effect of reaction conditions on the polymerization was elucidated. Second, RAFT miniemulsion polymerization of hydrophobic monomers was performed in CSTR trains and the transient states, previously identified by others in our group, were elucidated. Next, RAFT miniemulsion polymerization of a partially water soluble monomer was studied. RAFT miniemulsion polymerizations of gamma-methyl-alpha-methylene-gamma-butyrolactone, a partially water soluble lactone monomer derived from renewable sources, was successfully formulated. Homogeneous nucleation was found to play an important role in the free-radical "miniemulsion" homopolymerization of MeMBL. By using styrene as a comonomer, the RAFT miniemulsion polymerizations of MeMBL and styrene were well controlled and narrowly distributed copolymers of MeMBL/styrene were produced. Following the study of the partially water monomer, RAFT inverse miniemulsion polymerization was proposed for the polymerization of hydrophilic monomers. The kinetics of RAFT inverse miniemulsion polymerization of acrylamide exhibited the typical behavior of controlled polymerizations up to high conversions. The effects of reaction parameters on the polymerization rate and particle size were investigated. The dominant locus of radical generation for particle nucleation and the fate of desorbed monomeric radicals in inverse miniemulsion polymerizations were evaluated. Finally in this work, conclusions and implications are presented and ideas for future work are suggested.

Objectives. Ascertain if there has been a secular trend in 3-months prevalence of casually reported back pain. Evaluate if such back pain predicts concurrent health as well as future sick leave, disability pension, hospitalization and survival. Study differences in diagnostic assessment and labelling between physicians. Evaluate if a comprehensive manual therapy programme reduces sickness absence. Materials and methods. Combined population samples from 1973 to 2003 with a total of 12,891 observations with self-reported back pain and covariates. 7,074 of these individuals were followed for an average of 8.5 years and outcomes were self-reported health as well as official register data on sick leave, disability pension, hospitalisation and mortality. The Gotland Low Back Pain Study, a randomised controlled trial with participation of two general practitioners and two orthopaedic surgeons treating 160 patients with acute/subacute low back pain, with 10 weeks diagnostic evaluation and treatment and a two-year follow up. Results. Back pain prevalence increased 16% per ten years (OR 1.16, 95%CI 1.11-1.22). Back pain was negatively associated with self-rated health (p<0.0001), increased the risk of disability pension (p<0.002), and hospital admissions (p<0.0005), but not number of days in hospital, sick leave or mortality. General practitioners used terms from manual medicine and reported more pseudoradicular pain, while orthopaedic surgeons used non-specific pain labels, reported more true radicular pain and used more x-ray examinations. Among those on sick leave at baseline, manual therapy patients showed faster return to work (HR 1.62, 95%CI 1.006–2.60) and a lower point-prevalence of sick leave than reference patients at end of treatment period (ratio 0.35, 95% CI 0.13–0.97) but not after two years. Conclusions. There was a strong secular trend towards increase in self-reported back pain from 1973 to 2003. Such pain had a negative effect on some of the health outcomes and does not appear to be harmless. Physicians from different specialities labelled the condition differently. The manual therapy programme proved to be more effective than the established treatment regarding return to work.

The aim of this research was to compare the pain experience of cardiac surgical patients who attended the Acute Pain Service (APS) education program with cardiac surgical patients who did not attend the APS. The participants of both groups, pain levels, consumption of total analgesia, anxiety levels, satisfaction with pain management, ratios of self-administered bolus doses and failed attempts on Patient Controlled Analgesia (PCA) device and their length of hospital stay were compared. The findings indicated no statistical significant differences between the two groups being investigated in relation to pain levels, total analgesia consumed, anxiety levels, satisfaction with pain management, total demands and delivery attempts on the PCA and their length of hospital stay. The clinical mplications are significant. The preoperative pain management education program provided by APS clinical nurses for cardiac surgical patients does not have the positive outcomes expected.

This doctoral portfolio presents two separate but related research study reports on ‘self-care practices of adults with poorly controlled diabetes in Malaysia’. It is comprised of five sections. Section one which is the introduction begins with a general discussion on diabetes mellitus (henceforth referred to as diabetes), a common, growing, serious and costly health problem. The importance of self-care in the management of diabetes and its many disabling long-term complications are emphasised. This is followed by a specific discussion of diabetes in Malaysia - its prevalence, the quality of care, cost and the need for research to uncover new information to improve the care provided to Malaysians with diabetes. Section two is the report on the first research study that investigates the four cornerstones of diabetes self-care practices, namely: dietary intakes, medication adherence, physical activity and self-monitoring of blood glucose in Malaysian adults with poorly controlled diabetes. It also explores the factors that influence these self-care practices. Section three is the report on the second research study that assessed the efficacy of an out-patient diabetes educational program based on a self-efficacy theoretical approach to improve firstly, self-care practices and secondly, clinical outcomes of adults with poorly controlled diabetes in Malaysia. It also identified some of the factors that facilitate or impede such a programme in the Malaysian context. Section four integrates the findings of the two related research studies - the first defining the problem and the second providing possible solutions in the Malaysian context. It points out limited diabetes knowledge on self-care can compromise or create problems regarding self-care practices for Malaysians with poor glycaemic control. It also identifies possible areas of research that can uncover new knowledge that may improve the quality of diabetes care and enhance the quality of life of Malaysian with diabetes. Section five includes publication originating from this work. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1374559 / Thesis (D.Nurs.) -- University of Adelaide, School of Population Health and Clinical Practice, 2009

The efficacy of cognitive-behavioural therapy (CBT) in the treatment of child anxiety disorders has been well established in the literature, with on average, just over 50% of children becoming free of their primary anxiety diagnosis immediately following treatment (James et al., 2008). Despite the existence of these efficacious treatments, up to two thirds of children with anxiety do not receive assistance for their difficulties (Essau et al., 2002). The reasons for this are varied, and include lack of available therapists or services, long waiting lists, high therapy costs and stigma associated with therapy. Computer- and internet-based interventions represent a modern alternative for delivering CBT interventions that may be more appealing and accessible to a greater proportion of children with anxiety. Various forms of computer-assisted therapies have been investigated, including palmtop computers, desktop computers, virtual reality and online programs. Although computerised interventions have demonstrated promise in the treatment of adult anxiety, they have only recently received interest in the child literature. Specifically, there are very few controlled trials evaluating the efficacy of computer- and internet-based interventions for childhood psychological disorders, including anxiety disorders. The present research involved the initial development and subsequent testing of an entirely internet-based, CBT intervention for child anxiety disorders. BRAVE-ONLINE was developed as an internet adaptation of The BRAVE Program, a clinic-based program which has demonstrated efficacy in the treatment of childhood anxiety. The online intervention is a therapist-mediated program, in which children and parents receive email and telephone assistance from a therapist throughout treatment. BRAVE-ONLINE is an interactive program consisting of 10 child and 6 parent sessions to be completed by families in their own home. Following the development of BRAVE–ONLINE, the first study of this thesis included a randomised control trial to investigate the efficacy of the internet-based intervention (NET) compared to a waitlist control (WL). Seventy-three children aged between 7 and 12 years, diagnosed with separation anxiety disorder, social phobia, generalised anxiety disorder or specific phobia were randomly allocated to NET and WL conditions. Treatment effects were evaluated at 10-14 weeks post-assessment and 6-month follow-up, using multiple outcome measures including a diagnostic interview, clinician ratings of severity, parent and child questionnaires. Results indicated that at post-assessment, 30% of NET participants in the completer sample (22.5% in the Intent-to-Treat (ITT) sample) no longer met criteria for their primary anxiety diagnosis, compared to 10% of WL participants. Significant gains were also evident for clinician severity ratings, global assessments of functioning, and several questionnaire measures. However, results also indicated that children and parents were slow to progress through therapy, such that a large proportion of families had not completed all treatment sessions at the post-assessment point. For this reason, 6-month follow-up may present a better indication of treatment efficacy. Indeed, at 6-month follow-up, treatment gains were improved upon such that 75% of children in the completer sample (52.5% in the ITT sample) no longer met criteria for their primary anxiety disorder. Reductions in severity ratings, global assessments of functioning and child and parent self-report measures were also improved upon at 6-month follow-up. Further, the online intervention was found to be highly acceptable to families and was associated with only minimal rates of attrition. The second study of this thesis aimed to explore factors associated with treatment outcome for the online intervention. Factors of interest included demographic factors (age, gender, income and educational background), treatment expectancy, initial symptom severity, program compliance and pre-treatment diagnostic comorbidity. Specifically, this study investigated the extent to which each of these factors predicted the improvement made by children on global assessments of functioning (CGAS) at 6-month follow-up. Results indicated that only some of these factors were directly associated with treatment outcome. Although treatment expectancy predicted compliance with the program, it was not associated with treatment outcome. Baseline severity also did not predict treatment outcome. Contrary to expectation, levels of program compliance by children negatively predicted outcome, such that children who were more compliant with the program showed fewer improvements in overall functioning. Parent compliance did not predict treatment outcome. A significant relationship was evident between diagnostic comorbidity (number of pre-treatment anxiety diagnoses) and treatment outcome, such that higher baseline comorbidity predicted poorer functioning on the CGAS at 6-month follow-up. None of the demographic factors were associated with treatment outcome. Overall, the findings of this research suggest that a CBT intervention delivered entirely over the internet was associated with reductions in indicators of anxiety at post-assessment, compared to a WL control, particularly for the completer sample. Further, these reductions were improved upon at 6-month follow-up, with a substantial proportion of children becoming free of their primary anxiety diagnosis. The results also indicated that the online intervention might not be as effective for children suffering from multiple anxiety disorders. The effects of program compliance were somewhat surprising and possible explanations are offered. Although these results are promising, conclusions should be regarded as tentative until further trials are conducted and the online intervention is compared with clinic-based treatments. Limitations of this research and areas for future research are discussed.

This thesis uses the International Classification of Functioning, Disability and Health (ICF) model (World Health Organisation, 2001) to explore the multidimensional presentation of strengths and problems in young people with cystic fibrosis (CF), firstly examining its theoretical “fit” to the health condition, and secondly using it to characterise the performance of those with CF. Few studies in the literature demonstrate such an holistic approach to the physiotherapy assessment and management of this population. It was expected that this description of performance would provide a framework for identifying key areas for physiotherapy exercise intervention. This then formed the basis for further studies to examine the effect of a targeted exercise program (compared to current exercise practice) on inpatient outcomes, as well as on outcomes of outpatient management. The position paper included provides theoretical support for the ICF model as an appropriate tool in the management of young people with CF. Building on this, Study 1 explored the practical utility of the ICF model for describing the presentation of young inpatients and outpatients with CF. Eighty-four participants with CF were recruited as a consecutive series who satisfied selection criteria to provide a cross-sectional view at younger (7-12 years, n=51) and older (13-17 years, n=33) ages. Musculoskeletal, respiratory and physiological measures represented the body structures and functions domain, the six-minute walk test and jump tests were included in the activities domain, and participation was described by the Cystic Fibrosis Questionnaire–Revised Version and Fels Physical Activity Questionnaire. Contextual factors were also considered (age, gender, inpatient/outpatient status). In this exploratory study, performance of this population was compared to normative data where available. Also, correlations between measures within and between ICF domains were examined as suggested by the model itself. Finally, effects of contextual factors on performance were investigated using univariate analysis of variance. This first study and the position paper support the ICF model as an effective tool for describing performance of young people with CF, and for investigating functional relationships within and between domains. Results showed significant differences in this population compared to normative data, and interrelationships were identified within and between ICF domains. Between inpatients and outpatients in the specified age groups, there was a statistically significant difference in means for a number of measures, whereby inpatients displayed consistently poorer mean scores than outpatients, with this effect significantly stronger in the older age group. The application of the ICF model was useful for highlighting areas to target in physiotherapy exercise intervention, and for substantiating selected measures to assess the program’s effectiveness across domains. Study 2 was a randomised controlled trial with blinded assessor, which investigated the effectiveness of a 10-14 day inpatient-based exercise program (the Cystic Fibrosis: Fitness Challenge) (CF:FC) tailored for young people with CF (7-17 years). The CF:FC program (n=15) included exercise strategies based on recommendations from previous work in the field, and from findings from Study 1. This program included a portable exercise package (FitKitTM) designed to be adaptable to limited space environments such as at the hospital bedside, important when inpatients with CF are isolated according to infection control procedures. Participants in the control program (n=16) received the current exercise practice provided for young people with CF at a tertiary hospital, which included mainly aerobic-type activities to affect airway clearance. Performance on study measures (scoped within the framework of the ICF model, presented in Study 1) were compared pre- and post-intervention (admission and completion of the inpatient exercise program) between the groups. This trial showed significant improvements for participants in both groups from admission to discharge for a range of measures, including respiratory function, muscle strength and quality of life measures. Participants in the intervention group showed significantly greater improvements for some measures, for example: ankle dorsiflexor strength, six-minute walk distance and perception of their respiratory status. The continuation of the intervention and control programs into the outpatient setting was the focus of Study 3. The FitKitTM was provided for the intervention group, incorporating strategies to enhance adherence including a physical activity log (PAL) and internet-based follow-up. The control home exercise program consisted of the current practice provided on discharge. Interestingly, the control group improved significantly in hip abductor strength and six-minute walk distance during the outpatient period, whereas the intervention group sustained the improvements gained in the inpatient period but generally showed no further significant improvement. When the change from inpatient admission to outpatient follow-up was considered, it was apparent that greater improvements during the inpatient period provided a ‘buffer’ to accommodate for possible deteriorations in function in the outpatient phase. Issues regarding adherence to exercise programs during the outpatient period are discussed. This thesis confirms the usefulness of the ICF model for describing young people with CF, guiding assessment and review processes to achieve comprehensive management, and strengthening the evidence-base for targeted physiotherapy exercise intervention. A novel, tailored exercise program is introduced which is effective during inpatient periods, and provides a maintenance effect during outpatient periods, but strategies to enhance adherence during outpatient periods require further investigation.