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Over the last decades, many diffuse-interface Navier-Stokes Cahn-Hilliard (NSCH) models with non-matching densities have appeared in the literature. These models claim to describe the same physical phenomena, yet they are distinct from one another. The overarching objective of this work is to bring all of these models together by laying down a unified framework of NSCH models with non-zero mass fluxes. Our development is based on three unifying principles: (1) there is only one system of balance laws based on continuum mixture theory that describes the physical model, (2) there is only one natural energy-dissipation law that leads to quasi-incompressible NSCH models, (3) variations between the models only appear in the constitutive choices. The framework presented in this work now completes the fundamental exploration of alternate non-matching density NSCH models that utilize a single momentum equation for the mixture velocity, but leaves open room for further sophistication in the energy functional and constitutive dependence., Ship Hydromechanics and Structures

One of the major challenges in finite element methods is the mitigation of spurious oscillations near sharp layers and discontinuities known as the Gibbs phenomenon. In this article, we propose a set of functionals to identify spurious oscillations in best approximation problems in finite element spaces. Subsequently, we adopt these functionals in the formulation of constraints in an effort to eliminate the Gibbs phenomenon. By enforcing these constraints in best approximation problems, we can entirely eliminate over- and undershoot in one dimensional continuous approximations, and significantly suppress them in one- and higher-dimensional discontinuous approximations., Comment: Preprint, 41 pages, 16 figures

The prototypical diffuse-interface model that describes multi-component flows is the Navier-Stokes Cahn-Hilliard model (NSCH). Over the last decades many NSCH models have appeared that claim to describe the same physical phenomena, yet are distinct from one another. In a recent article [M.F.P. ten Eikelder, K.G. van der Zee, I. Akkerman, and D. Schillinger, Math. Mod. Meth. Appl. S. 33, pp 175-221, 2023.] we have established a unified framework of virtually all NSCH models. The framework reveals that there is only a single consistent NSCH model that naturally emanates from the underlying mixture theory. In the current article we present, verify and validate this novel consistent NSCH model by means of numerical simulation. To this purpose we discretize a divergence-free velocity formulation of the NSCH model using divergence-conforming isogeometric spaces. We compare computations of our consistent model to results of existing models from literature. The predictive capability of the numerical methodology is demonstrated via three-dimensional computations of a rising bubble and the contraction of a liquid filament that compare well with experimental data., Comment: preprint, 27 pages

ObjectivePatient-provider communication about complementary health approaches can support diabetes self-management by minimizing risk and optimizing care. We sought to identify sociodemographic and communication factors associated with disclosure of complementary health approaches to providers by low-income patients with diabetes.MethodsWe used data from San Francisco Health Plan's SMARTSteps Program, a trial of diabetes self-management support for low-income patients (n=278) through multilingual automated telephone support. Interviews collected use and disclosure of complementary health approaches in the prior month, patient-physician language concordance, and quality of communication.ResultsAmong racially, linguistically diverse participants, half (47.8%) reported using complementary health practices (n=133), of whom 55.3% disclosed use to providers. Age, sex, race/ethnicity, nativity, education, income, and health literacy were not associated with disclosure. In adjusted analyses, disclosure was associated with language concordance (AOR=2.21, 95% CI: 1.05, 4.67), physicians' interpersonal communication scores (AOR=1.50, 95% CI: 1.03, 2.19), shared decision making (AOR=1.74, 95% CI: 1.33, 2.29), and explanatory-type communication (AOR=1.46, 95% CI: 1.03, 2.09).ConclusionSafety net patients with diabetes commonly use complementary health approaches and disclose to providers with higher patient-rated quality of communication.Practice implicationsPatient-provider language concordance and patient-centered communication can facilitate disclosure of complementary health approaches.

ObjectivePatient-provider communication about complementary health approaches can support diabetes self-management by minimizing risk and optimizing care. We sought to identify sociodemographic and communication factors associated with disclosure of complementary health approaches to providers by low-income patients with diabetes.MethodsWe used data from San Francisco Health Plan's SMARTSteps Program, a trial of diabetes self-management support for low-income patients (n=278) through multilingual automated telephone support. Interviews collected use and disclosure of complementary health approaches in the prior month, patient-physician language concordance, and quality of communication.ResultsAmong racially, linguistically diverse participants, half (47.8%) reported using complementary health practices (n=133), of whom 55.3% disclosed use to providers. Age, sex, race/ethnicity, nativity, education, income, and health literacy were not associated with disclosure. In adjusted analyses, disclosure was associated with language concordance (AOR=2.21, 95% CI: 1.05, 4.67), physicians' interpersonal communication scores (AOR=1.50, 95% CI: 1.03, 2.19), shared decision making (AOR=1.74, 95% CI: 1.33, 2.29), and explanatory-type communication (AOR=1.46, 95% CI: 1.03, 2.09).ConclusionSafety net patients with diabetes commonly use complementary health approaches and disclose to providers with higher patient-rated quality of communication.Practice implicationsPatient-provider language concordance and patient-centered communication can facilitate disclosure of complementary health approaches.

Purpose: Examine social support’s association with seven individual chronic illness self-management behaviors: two healthy “lifestyle” behaviors (physical activity, diet) and five more highly skilled and diabetes-specific (medical) behaviors (checking feet, oral medication adherence, insulin adherence, self-monitored blood glucose, primary care appointment attendance).

Patient empowerment through self-management education is central to improving the quality of diabetes care and preventing Type 2 Diabetes. Although national programs exist, there is no EU-wide strategy for diabetes self-management education, and patients with limited literacy face barriers to effective self-management. The Diabetes Literacy project, initiated with the support of the European Commission, aims to fill this gap. The project investigates the effectiveness of diabetes self-management education, targeting people with or at risk of Type 2 Diabetes in the 28 EU Member States, as part of a comprehensive EU-wide diabetes strategy. National diabetes strategies in the EU, US, Taiwan, and Israel are compared, and diabetes self-management programs inventorized. The costs of the diabetes care pathway are assessed on a per person basis at national level. A comparison is made of the (cost)-effectiveness of different methods for diabetes self-management support, and the moderating role of health literacy, organization of the health services, and implementation fidelity of education programs are considered. Web-based materials are developed and evaluated by randomized trials to evaluate if interactive internet delivery can enhance self-management support for people with lower levels of health literacy. The 3-year project started in December 2012. Several literature reviews have been produced and protocol development and research design are in the final stages. Primary and secondary data collection and analysis take place in 2014. The results will inform policy decisions on improving the prevention, treatment, and care for persons with diabetes across literacy levels.

Purpose: Examine social support’s association with seven individual chronic illness self-management behaviors: two healthy “lifestyle” behaviors (physical activity, diet) and five more highly skilled and diabetes-specific (medical) behaviors (checking feet, oral medication adherence, insulin adherence, self-monitored blood glucose, primary care appointment attendance).

Reducing symptom burden is paramount at the end-of-life, but typically considered secondary to risk factor control in chronic disease, such as diabetes. Little is known about the symptom burden experienced by adults with type 2 diabetes and the need for symptom palliation. To examine pain and non-pain symptoms of adults with type 2 diabetes over the disease course - at varying time points before death and by age. Survey follow-up study. 13,171 adults with type 2 diabetes, aged 30-75 years, from Kaiser Permanente, Northern California, who answered a baseline symptom survey in 2005-2006. Pain and non-pain symptoms were identified by self-report and medical record data. Survival status from baseline was categorized into ≤ 6, > 6-24, or alive > 24 months. Mean age was 60 years; 48 % were women, and 43 % were non-white. Acute pain was prevalent (41.8 %) and 39.7 % reported chronic pain, 24.6 % fatigue, 23.7 % neuropathy, 23.5 % depression, 24.2 % insomnia, and 15.6 % physical/emotional disability. Symptom burden was prevalent in all survival status categories, but was more prevalent among those with shorter survival, p < .001. Adults ≥ 60 years who were alive > 24 months reported more physical symptoms such as acute pain and dyspnea, whereas participants < 60 years reported more psychosocial symptoms, such as depressed mood and insomnia. Adjustment for duration of diabetes and comorbidity reduced the association between age and pain, but did not otherwise change our results. In a diverse cohort of adults with type 2 diabetes, pain and non-pain symptoms were common among all patients, not only among those near the end of life. However, symptoms were more prevalent among patients with shorter survival. Older adults reported more physical symptoms, whereas younger adults reported more psychosocial symptoms. Diabetes care management should include not only good cardiometabolic control, but also symptom palliation across the disease course.

Reducing symptom burden is paramount at the end-of-life, but typically considered secondary to risk factor control in chronic disease, such as diabetes. Little is known about the symptom burden experienced by adults with type 2 diabetes and the need for symptom palliation. To examine pain and non-pain symptoms of adults with type 2 diabetes over the disease course - at varying time points before death and by age. Survey follow-up study. 13,171 adults with type 2 diabetes, aged 30-75 years, from Kaiser Permanente, Northern California, who answered a baseline symptom survey in 2005-2006. Pain and non-pain symptoms were identified by self-report and medical record data. Survival status from baseline was categorized into ≤ 6, > 6-24, or alive > 24 months. Mean age was 60 years; 48 % were women, and 43 % were non-white. Acute pain was prevalent (41.8 %) and 39.7 % reported chronic pain, 24.6 % fatigue, 23.7 % neuropathy, 23.5 % depression, 24.2 % insomnia, and 15.6 % physical/emotional disability. Symptom burden was prevalent in all survival status categories, but was more prevalent among those with shorter survival, p < .001. Adults ≥ 60 years who were alive > 24 months reported more physical symptoms such as acute pain and dyspnea, whereas participants < 60 years reported more psychosocial symptoms, such as depressed mood and insomnia. Adjustment for duration of diabetes and comorbidity reduced the association between age and pain, but did not otherwise change our results. In a diverse cohort of adults with type 2 diabetes, pain and non-pain symptoms were common among all patients, not only among those near the end of life. However, symptoms were more prevalent among patients with shorter survival. Older adults reported more physical symptoms, whereas younger adults reported more psychosocial symptoms. Diabetes care management should include not only good cardiometabolic control, but also symptom palliation across the disease course.

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The use of coolants during the welding of 2000 series aluminum alloys was investigated in an attempt to improve the properties of fusion welds in these alloys. The general premises behind this experimentation were that cooling combined with minimal welding heat inputs should narrow the heat-affected zones and should increase the quenching rates in both the weld bead and heat-affected zone. It was believed that beneficial effects on weld properties might be obtained in this way. A metallographic study of welds made with and without coolants indicated these postulates to be true. Weld heat-affected zones and zones of eutectic and grain boundary melting were narrowed, and dendritic structure in weld beads was refined when coolants were used. In addition, joint efficiencies of 90% or better were obtained for 2014-T6 sheet without solution treatment and both with and without artificial aging after welding. Joint efficiencies exceeding 85% were also obtained for 2024-T86 sheet without postweld solution treatment., Pub. in Welding Journal (U. S.) v42 Research Suppl. Jun 1963. Presented at the AWS National Meeting held in Milwaukee, Wis., Oct 1-4, 1962.