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Tri-Cornered Hat by Cathy Campbell
Welcome! You are browsing as a guestWould you like to see 6 projects made from this pattern and much more? create a free account What am I missing?
© 2012
Tri-Cornered Hat
This pattern is available for free.
This hat is fairly easy to work up and a great way to practice your I-cords and Kitchener's Stitch! (We also have versions of this hat in Cuddles and Mochi Plus.)
Pattern calls for double-pointed needles for entire hat. You can use a 16" circular needle instead for the body of the hat. Even though the circumference is 15", you are not working on the very tips of the needles so the circumference of the working part of the needles is actually about 15". You will still need at least 2 dpn's for working the Kitchener st and I-cords.
For more information, see: https://web.archive.org/web/20170216041512/http://st...

subset: commoncrawl


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- Home
- Your Heart
- Ask Dr. T
- Heart Healthy Living
- Professionals
- About Us
- Contact Us
This section will include a variety of recipes that will start with Breakfast and end with Desert at the other end of the day. Information about diets you can find elsewhere.
In addition to providing you with delicious food (I hope), the recipes will include nutritional information, such as calories, cholesterol, salt and other ingredients.
Ask Doctor T. Blog
I have been advised by my primary physician to schedule a cardiac catherization and possible stent placement procedure after having a Nuclear Stress Test with the following "Findings:
The study quality is excellent. There is no transient LV ischemic dilatation noted. The left ventricular...
I have a friend with internal defibulator. can I perform cpr and is it possible for me to get shocked if the debibulator is going off?


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The Cherokee
The Cherokee were originally living in North Carolina, Tennessee, Georgia, and Alabama. Andrew Jackson, the 7th president of the U.S., declared the Indians had to move off their land. Andrew Jackson forced the US to give up 20 million square miles of land for Indian reservations. The Cherokee were forced onto the reservations during the Westward Expansion. The Choctaw were the first to be removed from their land in 1831. The Cherokee started migrating in the 1800's along the Trail of Tears. The Trail of Tears was the trail that the Indians used to reach the reservations in Oklahoma. Approximately 4,000 people died from hunger or disease during their journey.
A famous chief in the Cherokee nation was John Ross. He was born in Turkey Town in Alabama on October 3, 1790. He spoke English because he attended a white man's school. He attended South West Point Academy located in Tennessee. During the War of 1812, John Ross fought with Andrew Jackson. Ross was the one who changed the Cherokee tribal government to a miniature republic. Each of the eight districts would send four representatives to the Cherokee national legislature. He dreamed the Cherokee would become a state of the U.S. named the State of the Cherokee. In Washington D.C., he fought against the Indian Removal Act. After the Indian Removal Act was passed, he led the Cherokee Indians along the Trail of Tears. He was elected chief of the united Cherokee nation after the Indians settled on the reservations. He died on August 1, 1866 in Washington D.C.
start at 14 seconds/end at 4:00
"A Brief History of the Trail of Tears." A Brief History of the Trail of Tears. N.p., n.d. Web. 21 Apr. 2014.


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You may remember last time, I posted a high resolution scan of the upcoming Louis Vuitton ad campaign this Fall. A while ago, I recieved a Newsletter from eLuxury and along with the newsletter comes a photo. Do you want to know what it is?
The photo I posted few day ago was in fact cropped and eLuxury sent me the fullest to the full scan of the photo for the ad campaign.. Here it is:
Before I saw this photo, I thought that the ad campaign was shot in a bridge, but hell I was wrong, it was shot in Universal Studios! I can't confirm it yet but the globe in the background really looks like the one in the Universal Studios Amusement Park in Florida. Haha.. Compare:
If you want to borrow any photos here in my post or anywhere in my blog, please do link back. It's just a simple way of saying thank you. Anyway, wanna recieve updates? You may want to ou may want to subscribe to the feed or register for updates by email.


text:
|Publication number
|Publication type
|Application number
|Publication date
|Feb 1, 2011
|Filing date
|Aug 25, 2006
|Priority date
|Feb 26, 2004
|Fee status
|Also published as
|Publication number
|Lars Gustaf Liljeryd, Ulf Frederik Magnusson
|Original Assignee
|Diabetes Tools Sweden Ab
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (17), Non-Patent Citations (1), Referenced by (15), Classifications (22), Legal Events (4)
|External Links: USPTO, USPTO Assignment, Espacenet
This application is a continuation of copending International Application No. PCT/EP2005/002006, filed Feb. 25, 2005, which designated the United States, and was not published in English and is incorporated herein by reference in its entirety.
1. Field of the Invention
The present invention relates to improved interpretation of noisy physiologic and biochemical signals by the use of filtering, prediction and trend analysis of patient data, and discloses a method and device and/or a computer program product that aims at improving motivation, self-control and self-management of patients having type 2-diabetes or diabetes-related disease. The invention monitors oxygen utilisation of the heart, thus physical condition and fitness, and indicates stimulants and drug abuse and psychological and emotional stress. The invention discloses the use of a painless, non-invasive surrogate measure for blood glucose, as well as blood glucose prediction by sparse blood sampling, and a metabolic performance indicator. The invention offers long-term, metabolic monitoring at low cost combined with ease of use, and creates patient awareness of metabolic system function relating to the disease in an intuitive way, needing very little effort by the user. Lower cost, a lower burden for the health care system, prolonged lifespan and increased quality of life for the patient may be gained from the use of the proposed invention.
2. Description of Prior Art
Physiologic and biochemical signals for example blood glucose sampling, blood pressure and other monitored signals of mammalians can be very noisy, having a high variance when sampled over time. It is therefore critical to reduce such noise before accurate interpretation of the data can be made. Further, biochemical signals are often invasive in nature and such measurements can be discomfortable, costly or complicated to apply. The proposed invention strives to improve accuracy in interpretation of such signals by the use of suitable filtering methods and to reduce discomfort and cost by the use of non-invasive surrogate measures.
Diabetes is increasing globally in epidemic proportions and stands for a massive cost burden of healthcare. Type 1-diabetes, stands for around 10% of all diabetes cases. Type 2-diabetes, therefore stands for around 90% of all diabetes cases, and is steadily increasing. In the United States alone, it is estimated that up to 7% of the population may have diabetes. 100 million individuals are overweight, thus at high risk for type 2-diabetes. If this trend continues, 100% of the US adult population will be obese in year 2030. Total yearly cost of diabetes in the US including indirect costs where 1997 estimated to approximate USD 100 billion. In Saudi Arabia it has been estimated that up to 25% of the population may have diabetes related disease. The World Health Organization (WHO) predicts an increase to 300 million diabetes patients worldwide by the year 2025. Various attempts have been made to reverse this global epidemic trend, but to date this has failed.
Type 1-diabetes, (earlier referred to as insulin dependent diabetes mellitus IDDM), is identified by irreversible beta-cell destruction, that usually results in absolute insulin deficiency. Type 2-diabetes, (earlier referred to as non-insulin dependent diabetes mellitus, NIDDM), is identified as a heterogeneous disorder believed to involve both genetic and environmental factors. Type 2-diabetes is to a great extent a lifestyle related disease where modern sedentary lifestyle in combination with poor eating habits is believed to be major sources of the problem. The type 2-diabetes patient typically does not require insulin treatment for survival. The typical symptoms of type 2-diabetes are: Thirst, frequent urination, drowsiness, fatigue, overweight, gustatory sweating, varying blurred vision, elevated blood sugar levels, acetone breath and sugar in the urine. An examination of the patient will quite typically reveal a sedentary lifestyle and a distinct preference for a diet high in saturated fats and refined carbohydrates.
Insulin resistance is a common metabolic abnormality that characterizes individuals with various medical disorders including type 2-diabetes and obesity and occurs in association with many cardiovascular and metabolic abnormalities. Insulin resistance is defined as the inability of the body to respond adequately to insulin. The Syndrome-X or Metabolic Syndrome, also named the Insulin Resistance Syndrome, is a cluster of metabolic and physiologic risk factors that predict the development of type 2-diabetes and related cardiovascular diseases. It is generally characterized by five major abnormalities; obesity, hypertension, insulin resistance, glucose intolerance and dyslipedaemia. The prevalence rate of the metabolic syndrome in western countries is 25-35%. Aging is generally associated with insulin resistance and deteriorating beta cell function and obesity with insulin resistance and hyperinsulinemia.
Diabetic autonomic neuropathy (DAN) is a serious and one of the most common complications of diabetes. Most type 2-diabetes patients die in cardiovascular diseases preceded by a deterioration of the functionality of the autonomic nervous system (ANS). This is seldom noticed at an early stage, making type 2-diabetes a "stealth" disease developing slowly over the years and is most often unnoticed by the patient until discovered at a late stage. DAN impairs the ability to conduct normal activities of daily living, lowers quality of life, and increases the risk of death. DAN affects many organ systems throughout the body e.g., gastrointestinal, genitourinary, and cardiovascular. DAN is a result of nerve fibre destruction and loss related to the "toxic" effects of elevated blood glucose levels. Intensive glycaemic control is therefore critical in preventing the onset and slowing the progression of DAN. ANS problems and DAN can successfully be detected by the assessment of heart rate variability (HRV) analysis.
Hypertension is a major health problem in the western population and associated to cardiovascular disease. Arterial stiffening may be both a cause and consequence of hypertension, however recent research suggests that arterial stiffening is the typical precursor to hypertension, and that arterial stiffening is likely to have a genetic basis. The majority of type 2-diabetes patients (over 50%) suffer from hypertension. It is therefore imperative to control the blood pressure of diabetic patients. In type 2-diabetes it is recommended to keep the blood pressure below 130/80 either by improving life-style or by medication or a combination of both.
Insulin resistance and type 2-diabetes are associated with changes in plasma lipoprotein levels. Up to 70% of patients with type 2-diabetes have lipid disorders. Coronary heart disease is the leading cause of death among patients with type 2-diabetes. Dyslipidemia, together with obesity, hypertension, and hyperglycemia contribute strongly to coronary heart disease. Even mild degrees of dyslipidemia may elevate coronary heart disease risk factors. As these risk factors are additive or even multiplicative, strategies for lifestyle improvement should not only focus on hyperglycemia but also on dyslipidemia. As dyslipidemia in type 2-diabetes usually show smaller and denser LDL-particles, which are more atherogenic, the target for cholesterol lowering should include very-low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) as well as lowering of elevated triglycerides (TG).
Mental stress, elevated blood-pressure and elevated heart rate are common problems of today's society. Modern work and lifestyle is less physically active where hi-tech related jobs often result in a sedentary lifestyle. High demand work with sustained high levels of stress is common and a negative effort/reward factor can contribute to stress induced disease. It is well known that mental stress can influence metabolism such as elevated blood-glucose levels as well as an increased systolic blood pressure and heart rate. Various stimulants such as caffeine, nicotine, alcohol, cocaine and amphetamine also increase systolic blood pressure and heart rate.
Modern type of diet, high in energy and fat content is associated with insulin resistance and related disorders. The exact aetiology of insulin resistance is however not clear. Genetic predisposition and environmental factors including quality and quantity of dietary fat, both contribute to development of an inability to adequately dispose plasma glucose at normal plasma insulin levels. Fast food outlets are gaining popularity due to high sugar, fat-rich and tasty food in combination with time-efficient eating. The increased consumption of fast-acting, high-energy carbon hydrates reflects in blood sugar overshoots and insulin overshoots followed by blood sugar undershoots and drowsiness, again demanding renewed intake of fast-acting carbon hydrates etc. This cyclic feedback is frequently pounding the metabolic regulatory system. Such transient excitation is believed in the long term to be harmful and contribute to insulin resistance and elevated insulin levels, the early start-up of the type 2-diabetes process. The above life-style related problems are currently creating health problems of a magnitude unheard of in the past.
Physical activity, thus aerobic fitness is the cornerstone in fighting type 2-diabetes related disease. It is a most important task to improve cardiovascular fitness by physical activity that increases the capability and efficiency of the heart to supply the cardiovascular system with oxygen as well as improve insulin sensitivity and oxygen uptake of the muscles. The heart functions like any muscle that it can be trained to become stronger and more efficient. A weight reduction by only 10% usually shows positive effects on blood glucose and lipid levels. In particular, it is important to reduce abdominal fat mass.
Physical activity and energy expenditure can be estimated in a variety of ways that do not constrain the patient during his normal daily activities. Different methods exist like pedometers, accelerometers, heart-rate meters etc. One popular method use a pedometer to calculate number of steps walked or approximate the calories so consumed by a simple formula. Others calculate energy expenditure in relation to body movement and acceleration by the use of single-axial, bi-axial or tri-axial accelerometers. Another method use pulse monitoring based on plethysmograps, (a device that shines light through a finger or earlobe to calculate heart rate and physical activity). One other popular device, a pulse watch, measures the EKG signal by the use of a chest-strap with electrodes and transmits the EKG pulses to a specially designed wrist-watch calculator, which can calculate calories consumed and other parameters related to physical activity. However the simplest way to quantify physical activity is to just roughly estimate the daily activity, for example on a scale from one to five, relating to the daily effort made and the intensity and duration of the physical activity performed. More elaborate calculation and reporting methods include the MET tables (metabolic equivalent) or formula, which is an accurate index of the intensity of physical activity. Modern inactive and sedentary lifestyle has opened up a large market for health gymnasiums and marketing of various health-related products, and physical training programs for the improvement of physical fitness. Despite this positive trend, type 2-diabetes related disease is rapidly increasing at an alarming rate.
It is difficult to motivate high-risk, overweight, sedentary and diabetes-prone individuals to change life style. Just informing the individual of the health-risks involved and the need of physical training and/or the need for corrected eating habits and/or de-stressing treatment is often not sufficient. Low fit individuals often do not feel comfortable by being examined by somebody else or being forced to exercise training in gymnasiums. It is common to find overweight individuals embarrassed by their low physical fitness level, and in order to avoid humiliation, refuse to join rehabilitation programmes. It is believed by the inventor that the only way to break such detrimental trend is to educate people by hands-on experience by the use of simple and intuitive tools to monitor their own metabolic function, preferably at home in private. The individual can then himself gain understanding of the problems involved and gain insight to what extent and intensity it is necessary to change lifestyle.
Self monitoring using a personal blood-glucose meter is usually necessary for type 1 insulin dependent diabetes mellitus (IDDM) patients in order to aid self-administration of insulin. However it is less common that blood-glucose monitoring is prescribed for patients with manifest or borderline type 2-diabetes. Self-monitoring using urine dipsticks for urine-glucose measurements are more or less obsolete today and seldom used due to the fact that the renal threshold varies individually over a wide range. In addition this method cannot measure glucose levels below the renal threshold, exhibits long delay and low sensitivity, and therefore the use of blood-glucose monitoring is preferred.
Recent research has reported some benefits of using a blood-glucose meter for BG-monitoring in connection with meals for patients with type 2-diabetes. The idea is to monitor pre-prandial and post-prandial glucose levels to gain knowledge of the metabolic effect of the meal on the patient. The patient can then learn by experience how the glucose level will raise post-prandially and give him feedback on the glucose variation relating to different types of food intake. The idea is to balance the food intake, where a reduction in refined fast acting carbohydrates will reduce post-prandial blood-glucose overshoots. Such overshoots are understood to cause long-term damage to the autonomic nervous system and eventually may lead to diabetes and diabetic neuropathy. Such form of self-monitoring is cumbersome and impractical to maintain and it is not uncommon that patients drop out of such test trials due to lack of motivation relating to the intensity of the method. Blood glucose meters and tools need to be carried around by the patient during the day and testing is sometimes disclosed in public when having a meal in a restaurant. Including such cumbersome procedures as part of a patient's long-term daily practice is not very likely to succeed. In addition the cost is not negligible according to the consumption of a number of blood-glucose sticks and a number of finger-puncturing lances during the day. In addition, although such test is minimally invasive in nature it can be painful and very uncomfortable to the patient. Further it gives little room for logic and intuitive interpretation of the results and it is therefore difficult to comprehend and administer for the patient in order to obtain a therapeutic goal, a serious disadvantage.
The World Health Organisation (WHO) and American Diabetes Association (ADA) has specified blood-glucose ranges and levels in order to differentiate between the different stages of diabetes. Fasting glucose concentrations that diagnose the symptomatic patient (WHO criteria, 1999) are shown below. Fasting sample glucose concentrations are in mmol/L:
Whole Blood
Manifest Diabetes Mellitus
Impaired glucose tolerance
Impaired fasting glucose
When assessing blood-glucose levels in the clinic, it is unfortunately quite common to overlook the existence of a strong biologic variability as well as an analytic variability. Thus substantial variability exists between observations that may be misinterpreted by the inexperienced physician resulting in reduced accuracy in grading and diagnosis of the disease.
When a blood sample is drawn in a clinic, a number of factors influence the accuracy of the measurement result such as:
Relating to the above uncertainties, it is believed by the inventor that blood-glucose monitoring under controlled conditions in the home, using a sufficiently accurate blood-glucose meter together with suitable post-processing and filtering methods, improves the accuracy of the diagnostic classification. This is believed by the inventor, to be superior compared to established clinical laboratory measurements and current praxis.
Although elevated insulin levels (hyperinsulinemia) appears in the bloodstream long before elevated blood glucose levels eventually manifest; yet a high glucose level remains the classic type 2-diabetes symptom classifier. Insulin levels are rarely, if ever, used as a diabetic risk marker or diagnostic tool except for clinical research purposes, a remarkable fact. Thus, a low blood glucose level does not preclude the presence of the disease.
Monitoring of oxygen saturation is common practice of patients under emergency treatments as well as in the operating theatre. Before the invention of the now widely used pulse-oximeter, (an instrument that monitors blood haemoglobin oxygen saturation using infrared light absorption), it was common practice to calculate the Rate-Pressure-Product (RPP) of the patient during surgery to establish the patients heart condition and oxygen utilization. The RPP (also called the Double Product) is a reasonably accurate measure of heart oxygen utilization and is derived by multiplying the systolic blood pressure by the heart rate (RPP=sBP�HR/100). After the introduction of the pulse oximeter, RPP has found little use today, but has some use in sports medicine indicating oxygen consumption of the heart during treadmill exercise tests etc. RPP also indicate stress and the use of stimulating drugs.
In order to ease the burden for the patient, the inventor declares that only fasting blood glucose sampling is necessary for accurate long term monitoring and treatment of type 2-diabetes related disease. Even sparsely sampled blood glucose measurements for example once a week may be sufficient, relating to an embodiment of the invention for an accurate prediction of daily BG. More intensive and cumbersome blood glucose monitoring like pre-and postprandial blood glucose measurements during the day is not deemed necessary as the fasting blood glucose level generally indicates the relative magnitude of postprandial blood glucose excursions. Thus a higher fasting blood glucose level is reflected in a higher postprandial blood glucose level and vice versa. This can be indicated by the use of multiple three-sample oral glucose tolerance OGTT tests sampled at 0 h, 1 h and 2 h during an intervention lifestyle improvement period see
In an additional embodiment of the invention, the BG level is predicted from preferably blood pressure and heart rate (Rate Pressure Product) alone, making painful finger pricking or painful invasive procedures unnecessary except for the initial calibration and set-up procedure of the predictor. In another embodiment of the invention, it offers less frequent need of painful finger pricking.
The proposed invention offers the patient an intuitive way to measure and analyse certain physiologic parameters such as for example intensity of physical activity, blood-glucose, blood pressure and heart rate. In addition important patient data such as lipid levels, total cholesterol, triglycerides, body temperature, weight, body mass index and the waist to hip ratio can be stored and processed. Following such measurements, data is processed and optimised using suitable filtering algorithms, and thereafter indicated to the patient in an intuitive manner for instant feedback of his behaviour, progress and results.
A preferred embodiment of the invention comprises the following steps:
From the above, it becomes clear that metabolic monitoring of diabetes related disease is essential in order to assess at least the current status of a subject. Dense sampling of vital biological parameters offers several advantages. The main advantage is that the subject is continuously made aware of his current status so his health condition does not deteriorate. An other advantage is that the subject continuously receives an overview over any changes or trends in his current status, which may for example relate to a lack of physical activity or a lack of good nutrition in the worse case, or sufficient physical activity and a well-controlled diet in the better case. Yet another important advantage is that the subject gets instantaneous feedback of his status and can adjust his lifestyle according to the developing trend. The prerequisite for efficient metabolic monitoring according to the invention is that the subject monitors vital biologic parameters. For example blood glucose levels, blood pressure and heart rate can be measured at wake-up in the morning and physical activity can be measured during the day etc.
Accurate blood glucose monitoring requires invasive measurements, although finger pricking may be considered as minimally invasive. Currently there is no other method that can compare in accuracy to an invasive measurement. A subject pricks his finger to sample a small amount of blood, which is subsequently examined in an analytical device, which outputs a blood glucose value. Even minimally invasive methods are costly, and often experienced as discomfortable and can thus have a negative impact on the patient and disease management.
It is an object of the present invention to provide an improved concept for indicating a health-related condition of a subject, which is easier to comprehend, offers lower running cost, is more comfortable and more motivating for the subject to use, compared to traditional methods.
In accordance with a first aspect, the invention provides an apparatus for indicating a health-related condition of a subject, having:
In accordance with a second aspect, the invention provides a method of indicating a health-related condition of a subject, the method including the steps of:
In accordance with a third aspect, the invention provides a computer program having a program code for performing a method of indicating a health-related condition of a subject, the method including the steps of:
The present invention strives to reduce discomfort and cost for the user by the introduction of new surrogate measures and prediction.
The present invention is based on the finding that a high accuracy invasive measurement method can be partly substituted by a surrogate non-invasive measurement method. The high accuracy invasive measurement method is typically represented by a costly, uncomfortable and "hard" measurement method, and where the non-invasive measurement method is a low-cost, comfortable and "soft" measurement method, relating to its impact on the subject.
The predictor generates densely sampled invasive data, based on sparsely sampled invasive data and densely sampled non-invasive data. Thus, the subject does not have to commit to painful finger pricking daily or as often as would be necessary in the prior art, but could revert to less frequent finger pricking as for example on a weekly basis. The subject only has to perform a simple and painless non-invasive blood pressure related measurement method on a for example daily basis, and this therefore does not have a large impact on the subject.
In another preferred embodiment, the predictor is fed with more than one biological quantity, which is derived from a non-invasive measurement.
In accordance with the present invention, the only prerequisite for the two measurements or biological quantities is that both measurements have a correlation to the health-related condition of the subject.
Further, the present invention strives to improve accuracy in the interpretation of noisy physiologic signals by the use of low-pass filtering methods for extraction of the useful signal variation and removal of non-useful signal variations.
These and other objects and features of the present invention will become clear from the following description taken in conjunction with the accompanying drawing, in which:
Depending on the specific implementation, the input interface obtains these samples of the biological quantity, which forms the raw sequence, by a manual input such as via a keyboard, by cable, radio, infra-red or other means from an analytical device, which for example analyses a blood sample to output a blood glucose value, blood pressure, heart rate, physical activity or any other biological quantity of interest, to an electronic buffer, memory or similar means within the input interface 20. Thus, one obtains, at the output of the input interface 20, the raw sequence as a sequence of samples, which can be input to a filter device 22 as indicated by an arrow 23 connecting block 20 and block 22.
Alternatively, or additionally, the raw sequence can also be input into a first processor 24 for processing the raw sequence to obtain a processed sequence, which is, after being processed by the processor 24, filtered in the filter device 22.
The first processor 24 may include a predictor, an interpolator or any other means, which is arranged to derive the processed sequence using the raw sequence output by block 20. In this connection, the first processor can also include, as will be outlined later, a combiner for combining two or more raw sequences to obtain a combined raw sequence, which can then be filtered by the filter device 22.
The filter 22 is arranged for filtering the raw sequence of samples or the processed sequence of samples derived from the raw sequence of samples to obtain a filtered sequence. It is to be noted here that the filter, which is preferably a low-pass filter, is configured for reducing the non-useful variation to obtain a filtered sequence, which has a stronger influence of the useful variation compared to the influence of the non-useful variation, or which can even be completely eliminated.
The apparatus further comprises an output interface 25 for outputting the filtered sequence or an enhanced sequence derived from the filtered sequence, wherein the output interface is arranged to output at least an increase indication, a decrease indication or a remain unchanged indication as a trend of the filtered sequence or the enhanced sequence, the trend being representative for a useful variation of the health-related condition of the subject. As it becomes clear from
With respect to the output interface 25, it is to be noted here that the trend indication can be, of course, a graphical display as shown in
Naturally, this can also be done by a sensory perceptive interface for example for the blind or deaf which outputs certain perceptive indications for indicating an increase, a decrease or a remain unchanged situation. Naturally, one can signal such an indication by mechanical means such as a sound or strong vibration for an increase, a week vibration for a decrease or a very weak vibration for a remain unchanged situation. Alternatively, the frequencies of the vibrations can be made different from each other for each indication. Alternatively, apart from vibration indication means, one can also use any other mechanical marking such as raising a key so that the raised key can be felt by a user compared to the situation, in which the key is not raised.
The present invention builds on the simple concept that "knowledge gives motivation" and encourages life-style improvement for the patient. The invention offers patient monitoring in a new way by the use of trend analysis, based on well-proven and traditional patient measurements, and presents new and improved ways of indicating patient status. Such improved information can be used by the patient and/or his doctor for treatment planning and follow-up. The invention motivates and educates the patient by the use of performance feedback, so he can make progress in his life-style modification.
In type 2-diabetes related disease, it is current practice for the doctor to inform the patient that a change of eating habits and lifestyle change is needed, but it is usually difficult for the patient to judge and comprehend the necessary level of change. It is often difficult to motivate the patient due to the "silent" nature of this disease. If the life-style modification is performed too aggressively, exhaustion and loss of motivation may result and the patient may give up. On the other hand, if it is not performed seriously enough, it will not have the desired effect. The benefit of the proposed invention is that the appropriate level of lifestyle change is clearly indicated to the patient in an intuitive way, thus avoiding discouraging over-efforts.
It is believed by the inventor that this, by the method indicated "just enough" level of approach, is the key to long-term motivation and success of rehabilitation. This is achieved using new multi-parameter physiological monitoring methods in combination with clear trend indications, thus encouraging self-control and rewarding the patient for good behaviour for the effort made, and give an negative indication when the patient fails to progress. Such instantaneous indication of performance feedback is far superior to, and in strict contrast to traditional medical practice using very long-term "feedback" given by the doctor on only a sparse per-visit basis.
The present invention describes a new method and/or a new device that needs a minimum of patient engagement and effort, where some patient parameters are frequently sampled, once a day or even once a week and other parameters are sampled less frequently. The frequently sampled parameters may easily be performed at bedside in the morning and no equipment or tools needs to be carried around during the day. The less frequently sampled patient parameters may be performed for example at the clinic.
Frequently sampled physiological patient parameters in a densely or sparsely manner, equidistant or non-equidistant sampled, may consist of:
Substantially less frequently sampled patient parameters can consist of:
When assessing blood-glucose levels at home it is important that the analytic variability of the measuring instrument is low and substantially less than the biological variability of the patient. Else the measurement will be meaningless. Unfortunately some personal-type blood-glucose meters have an unacceptably high analytic variability, making them less reliable and useful for accurate blood-glucose measurements. However some commercially available low-cost personal-type blood-glucose meters are found to be sufficiently accurate for reliable measurements of for example fasting BG, provided appropriate post processing of the data is performed. On the other hand if higher accuracy is wanted, for example two or more consecutive measurements within minutes can be performed, and subsequently averaged in a post-process. Multiple BG-meters can also be used in parallel to reduce variability and the results averaged. This can preferably be performed in clinical research when high accuracy is needed and has been used in the research to verify the proposed invention.
Due to the strong biologic variability of the blood glucose level in combination with some analytic variability of the blood glucose measuring instrument, substantial data scatter is experienced, making the noisy signal difficult to interpret. See
According to the above strong variability of BG, the inventor strongly believes that current diabetes criteria results in sub-optimum diagnosis and therefore needs to be revised. In order to make BG interpretation more accurate, low-pass filtering of multiple BG data is necessary. However, it is important not to filter the data too excessively, as this will reduce short-term variations and blunt the details of variation. Optimum filtration and avoidance of over-filtration can be obtained by residual analysis described later.
Although measurements of BG seem to be extremely noisy it cannot be characterized as white noise. For clarification one can take a look at the estimated autocorrelation function (acf) where dependence is obvious (see
Because of the inventor's measurement strategy, using three high quality BG-meters of the same brand, one can calculate the analytical error. This is being done by comparison of two BG meters at a time, which generates three approximately normal distributed cases with a standard deviation around 0,35 mmol/L (see
where the standard deviation σ is approximately the same for each comparison, which are three to the number (n). By the use of the statistical rule that the variance of two normal distributed data-series are additive, we get
√{square root over (2σ2)}≈0,35 (2)
Hence, the standard deviation of the mean values of the three meters used in the case study is approximately 0,14 mmol/L.
To achieve a clear trend presentation of the noisy data it is necessary to process the data with a low-pass filter, which can be done through spectral analysis. In
where H is a FIR low-pass filter in the frequency domain (see
ΔBG fd(t)=BG(t)−BG LP(fd)(t) (4)
For a certain cut-off frequency fd between 0 and 1 (discrete frequency). When fd increases from 0 to 1 we can calculate the mean of the squared residuals, where N is the length of the residual vector for each value of fd.
This will generate a curve describing the behavior of the residuals for different fd (see
The result of the LP-filtering using the chosen cut-off frequency in the frequency domain and time domain, are shown in
As an alternative one can perform similar filtering in the time-domain using convolution. Other types of low-pass filters may also be used by those skilled in the art.
Blood pressure can be measured at both arms and then low-pass filtered in order to reduce variance. Blood pressure can also be measured at the wrist, finger or other places. The Pulse-Wave-Transition-Time (PWTT) estimation can also be used to measure blood pressure. This estimates the blood pressure by measuring the pulse-wave transition time, starting from when the heart creates for example a EKG R-wave, to when the pulse-wave creates a light transmission difference due to changing blood pulse density, detected at a finger by a plethysmograph. In addition, from the systolic, diastolic and pulse data, it may be an advantage to calculate the Mean Arterial Pressure (MAP) and Pulse Pressure (PP) and present this data graphically.
In a similar manner, physical activity data is usually scattered due to large variations in daily activity or due to approximate estimations. It is therefore convenient to low-pass filter such data over time in a similar manner as above, as this makes the physical activity data easier to interpret. Physical activity can simply be estimated on an intensity scale where such scale can comprise the following grading of daily activities:
For more accurate estimation the MET (metabolic equivalent) can be used. 1 MET is equivalent to resting energy expenditure and light activity is <3 METS, moderate 3-5.9 METS, hard 6-8.9 METS or very hard >9 METS activity. MET activity tables are available to simplify calculation of calories burned (kcal), which is carried out by multiplying MET-value, weight and time elapsed. A cost-effective way of estimating physical activity is to use a pedometer. The activity data collected in the example graphs of the invention is using a pedometer that is used in combination with a built-in timer to calculate the approximate calories burned during the day or physical activity performed. It is practical to indicate energy expenditure as calories burned, as this is a commonly used and understandable term.
The heart rate data is also scattered due to large variations day to day. It is therefore convenient to low-pass filter such data in a similar manner as above, as this makes the heart rate data easier to interpret.
In an additional embodiment of the invention, systolic and diastolic blood pressure and heart rate is measured on a preferably daily basis in both arms. The data from both arms can then be averaged and low-pass filtered to reduce variability. The product of the systolic blood pressure and heart rate is calculated to obtain the Rate Pressure Product (RPP) in order to estimate the physical condition of the patient. RPP=Systolic BP*Heart rate/100. In addition to approximately indicate the oxygen utilization of the heart, the RPP reveals the presence of stimulating drugs like caffeine, nicotine, cocaine and amphetamine as well as mental and emotional stress. Thus the inventor teaches that the RPP is an important parameter to evaluate together with BG to establish the overall health-related condition of the patient. To achieve a trend presentation of RPP, as well as its separate components themselves, we can use a similar low-pass filter method, which produced the BG-trend. It may also be valuable for the physician to evaluate any blood pressure differences between the left and right arm, according to a separate long-term average of each arm.
In a similar manner, the morning blood pressure data at rest is scattered due to large variations day to day and in addition due to analytic variability. Having the patient or doctor to make single-spot blood pressure measurements does not seem very meaningful according to the large noise level that also exists in the BP-data. It is therefore necessary to low-pass filter such data, as this makes the blood pressure data more accurate and easier to interpret, see
By simultaneously comparing the indicated data from the physical activity and BG-level filtered in an abovementioned way, it can be seen that an improvement in physical activity results in reduction in blood glucose level such as the blood glucose level is inversely proportional to physical activity. However, extreme physical activity can under certain conditions actually have the opposite effect, raising the blood glucose level. Thus by simultaneously presenting such data indicated for example graphically to the patient, he or she can easily adopt his effort of physical activity and other life style related efforts to suite a predefined target goal. This can now be achieved in an accurate and intuitive way, not needing to over-exaggerate the effort made, but instead simply working towards the blood glucose, RPP and activity target goal in a timely manner day-by-day as indicated by the progress in the graphics, see
In another embodiment of the invention a new method is presented where the inventor has discovered that the RPP dynamics correlates well with the BG dynamics and in inverse proportion to the level of physical activity and thus RPP may be used to predict BG fluctuations and dynamics, see
In yet another embodiment of the invention the RPP can be used together with a predicting filter to calculate a surrogate measure for daily BG. This new BG prediction method can advantageously be used when it is not possible, impractical or felt painful and inconvenient by the patient to sample blood. Under such circumstances, BG measurements may be used only initially of the treatment or intervention period to calibrate the RPP predictor against the BG values. After such calibration is performed, the patient may revert to RPP measurements only, and take BG measurements for example only when visiting the doctor. In yet another embodiment of the invention, as described below, the BG-prediction filters are being updated on a sparse basis, for example once a week. Thus, initial training of the prediction filter first requires a data-sequence of densely sampled measurements. The length of this training sequence may be for example from one week to a month. Subsequently the prediction filter can be updated sparsely. The proposed prediction methods can be used to predict any signal x1 out of the signal x2, if a correlation is detected between x1 and x2 (note that x2 may be a combination of several measurement quantities).
Thus both BG and RPP can be used as an important indicators of improved self-control and life-style change in type 2-diabetes related disease. RPP shows a correlation to BG, and in particular under transitional phases of lifestyle changes, such as changing from sedentary lifestyle to a more active lifestyle or between varying intensity periods of physical activity. Thus the derivative of BG and derivative of RPP have a strong correlation (see
The present invention predicts daily BG from the RPP at a high accuracy from the use of only sparsely sampled blood samples. The prediction may be proceeded by two different approaches, ARX and FIR-Wiener. As mentioned before, prediction methods require a sequence of data for training. Such sparsely sampled BG values are used to update an advanced filter predictor. Thus for the patient that has traumatic sensations from blood sampling or finger pricking, such painful activities can be reduced to for example one sample per week and still accurate daily BG values can be predicted by the predictor from the sparingly sampled BG values. The system is identified using transfer functions together with BG, an input signal x and white noise. x can be a vector of one variable or a matrix of several variables. Examples of variables can be measurements such as Rate Pressure Product, Systolic Blood Pressure, Diastolic Blood Pressure, Pulse, Mean Arterial Pressure, Pulse Pressure or Physical Activity. This identification can be done since we are assuming that BG and x are partly affected by the same underlying parameters. Among these parameters we find for example physical activity, food habits, stress, virus and overweight. Therefore, we can present the system by the following hypothesis.
BG(t)=G(θ,q)x(t)+H(θ,q)e(t) (6)
which is a description of a linear system where the noise part e(t) is a stochastic white noise with E[e(t)]=0. In a wider sense, the system can be described by the principles of a black box (see
An important pre-process when a system is being identified, is to subtract the mean value. This is given by
where N is the number of measurements. There are several ways to estimate the transfer functions G(θ,q) and H(θ,q), where models like ARX, ARMAX, OE and Box-Jenkins can be mentioned. In this case ARX is discussed, which provides a straightforward prediction algorithm called linear regression. Box-Jenkins is the most complex model which the other models are being special cases of. Tests have shown minimum amount of differences between the different model-approaches.
The ARX-model can be written as
BG(t)+a 1 BG(t−1)+ . . . +a n
where the polynomial-coefficients can be collected and written as
θ=[a1 . . . an
Furthermore, equation 2 can be rewritten as
A(q)BG(t)=B(q)RPP(t−nk)+e(t) (10)
nk is the delay.
Given the optimal elements in the vector θ, old BG- and RPP values, it is possible to predict BG. The prediction is being calculated with knowledge of θ and the regression vector φ, containing old BG and RPP values.
φ(t)=[−BG(t−1) . . . −BG(t−n a) RPP(t−nk) . . . RPP(t−n k −n b+1)]T (12)
Note that the noise term e(t) is not a member of φ. Furthermore, the product of θ and φ provides the prediction
{circumflex over (B)}Ĝ(t|θ)=θTφ(t) (13)
In the example the predictor is designed as a one-step predictor, and becomes adaptive as it retrains for every prediction. Other step lengths of predictors and other types of predictors can be used by those skilled in the art.
For each calculation of θ at the time t−1, a guess or a prediction of BG(t) will be produced. Hence, at the time t it is possible to carry out the prediction error
ε(t,θ)=BG(t)−{circumflex over (BG)}(t|θ) (14)
For a training sequence of the length N we get the quadratic criteria
It is therefore straight forward to pick the θ, which gives
{circumflex over (θ)}N = arg
We have the prediction error
ε(t,θ)=BG(t)−θTφ(t) (17)
Hence, the quadratic criteria (11) can be written as
If RN is invertible, the formula can be written as
The last part of (19) is always zero if
θ={circumflex over (θ)}N =R N −1 f N (22)
and because RN is positive definite, this provides a minimum. Hence, the optimal minimized value of VN(θ) is given when equation (22) is fulfilled, because the rest of the terms are independent of θ. To improve this predictor one can use the information of residuals, which will be available when a true BG-sample is being taken. This residual can be weighted exponentially in order to be added to forthcoming predictions for improved amplitude tracking.
As an example,
As another prediction example one can implement a FIR-Wiener filter, which is a powerful predictor suppressing noise optimally. A variable describing future BG-samples can be written as (of course BG is just an example in this matter, one can replace BG with some other sparse sampled variable being correlated with the densely sampled variable). Hence, we create the predicted value BG as.
x k =BG(n+k) (23)
We create a vector containing BG- and RPP-measurements.
y=[BG(n) . . . BG(n−tM)RPP(n+k) . . . RPP(n−T+k)] (24)
where t is the number of old BG-values in and M is the testing interval of BG. T represents old values of RPP while k is the number of steps being predicted (k<M).
Further, we estimate a matrix containing auto-correlation functions and cross-correlation functions. In order to calculate these estimations we can use a sequence of known measurements, as a training sequence.
{circumflex over (R)}yy=E[yTy] (25)
We also estimate the cross-correlation
rxy=E[xkyT] (26)
Now the filter can be created as, (one for each prediction, k is an index of the prediction step)
h k ={circumflex over (R)} yy −1 r xy (27)
Which leads to the predicted value
{circumflex over (B)}Ĝ(n+k)=h k y T (28)
Analysis of the time series data for relevance should be performed and data dropouts or outliers above a threshold can be substituted using averages of neighbouring data. This is most important, as it is normal to sometimes forget to take measurements or sometimes make errors in manual interpretation of measurements. Long data dropouts may need to be interpolated in such situation when the subject has forgotten his device or when gone for a holiday etc. The linear interpolation is also an alternative to the linear regression prediction method. For example, if BG measurements are being taken once every week, the vector of known BG-data is a down sampled version of an every day sampled BG vector. This can be described as
BG M(n)=BG(nM) (29)
for any interpolation interval M days (or samples). The linear interpolation is then carried out by applying a straight line based on M−1 samples between the elements in BGM. As an example,
Further, in another embodiment of the invention it may be preferable to automatically switch between linear interpolation and prediction, based on the sequence of missing data. The appropriate point in time of the switch-over may be determined by residual analysis of past known data. The residuals are generated from two cases: Case 1 where linear interpolated data in a certain sequence are compared with raw data. Case 2 where predicted data in the very same sequence are compared with raw data. This is of course being done in the same interval/sequence providing useful comparison between the two cases. The goal is to keep the residuals as small as possible and therefore the switchover point may be determined where the mean of the squared residuals from two cases intersect.
The sum or factorisation of BG and RPP may be used as a metabolic performance indicator called the Metabolic Performance Index (MPI) by the inventor, an indicator that may span a number of abnormalities and disease, thus a clear indicator for the promotion of self control and life-style change in type 2-diabetes related disease, see
It is believed by the inventor that a metabolic monitoring and indication device according to the proposed invention will be a very valuable asset to the patient for self management as well as a new tool for the physician to clearly and accurately assess and follow up patient status, and as such can be used as a valuable treatment tool. A screen-shot of a version of the software product is shown in
As an alternative to new hardware development, standard proven technologies and mass-produced consumer medical monitoring instruments may be used for data collection where a computer program product and a computer (desk-top, lap-top, palm-top or smart-phone) can be used to collect, download, analyse and present the information in a practical and intuitive way. In addition, intelligent blood-glucose monitors can be built or intelligent combination apparatus of blood-glucose and blood pressure monitor including a microprocessor and accelerometer for physical activity and a screen for display. The present invention can be implemented both in software, hardware chips and DSPs, for various kinds of use, for computation, storage and/or transmission of the signals, analogue or digital.
The described embodiments are merely illustrative for the principles of the present invention. It is understood that modifications and variations of the arrangements and the details described herein will be apparent to others skilled in the art. It is the intent, therefore, to be limited only by the scope of the impending patent claims and not by the specific details presented by way of description and explanation of the embodiments herein.
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|U.S. Classification
|600/365, 600/347
|International Classification
|Cooperative Classification
|European Classification
|Nov 8, 2006
Owner name: DIABETES TOOLS SWEDEN AB, SWEDEN
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Effective date: 20060809
|Dec 11, 2006
Owner name: DIABETES TOOLS SWEDEN AB, SWEDEN
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:LILJERYD, LARS GUSTAF;MAGNUSSON, ULF FREDERIK;REEL/FRAME:018611/0156
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Owner name: DIABETES TOOLS SWEDEN AB, SWEDEN
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|Fee payment
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5 life-saving inventions that were developed in the country you least expected – S'pore
Top image from @theofficialariel's Instagram.
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1985 Rolls-Royce Silver Spur Base Tires
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- 1985 Rolls-Royce Silver Spur Base
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Product code: 6967
Despatched in 1-3 days.
Atro-Bath Oil contains the extract of freshly harvested Arnica montana flowers which helps to relieve tired, aching muscles. It also contains essential oils to help keep skin soft.
Helianthus annuus (Sunflower seed oil), Prunus dulcis (Sweet almond oil), Gaultheria procumbens (Wintergreen oil), lecithin, glyceryl cocoate/citrate/lactate, Pinus sylvestris (Pine oil), Arnica montana, alcohol, tocopherol (Vitamin E).No artificial colourings or preservatives.
Shake well before use. Add a capful (20ml) of Atro-Bath Oil to running water and fill your bath as usual. For maximum benefit s oak for 15-20 minutes.
If pregnant or breastfeeding, please seek professional healthcare advice before using this product.Do not use if you have broken skin.Avoid getting in your eyes. If you do, rinse well with cool, clean water.Be careful when getting out of the bath as it may be slippery. Clean bath after use.
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RC Amphibious Craft "Terrain Twister" COOL
- Sold for: Start Free Trial or Sign In to see what it's worth.
- Item Category: Toys, Dolls, Games & Puzzles
- Source: eBay
- Sold Date: Mar 07, 2009
- Channel: Auction House
Very lightly used. Run one time in the creek behind the house. Terrain Twister will operate in sand, on carpets, grass, snow, and even water. Dual screws are watertight and buoyant so the vehicle can float. Comes with charger, battery, and Remote. All you need to get going. Cool toy for all ages.


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DIY sneak peak...
Wednesday, September 29, 2010
Again, I'm just popping in quickly to show you what I picked up yesterday for the DIY project I mentioned earlier this week...
Two and a half deliciously fabulous metres of textured animal print adhesive paper! Stay tuned to find out where it will be living! Have a gorgeous day! x
Monday, September 27, 2010
I just wanted to pop in to say a quick hello whilst our friends and their 3 beautiful boys have popped out to grab an early dinner for the kids so us big kids can play once they go to bed! With a house full of guests I am also unsure how much time I will have to blog this week so thought I'd quickly stick my head in :) I know I have been a little slack on the blog front of late especially my 'Baking with Mrs Bouw' posts but I promise that after this week, we have nothing else planned (and no more guests) until of course, the arrival of our precious BB!
I admit I haven't been baking as regularly as I usually do, although I did bake a batch of my lemon curd cupcakes yesterday as they are a favourite of our visitors and I swear, hubby would marry one if I wasn't already his wife! Here's the recipe I posted back in March for anyone who hasn't already tried these little pieces of heaven!And it was also a good excuse to use our gorgeous new cake stand (that was a part of our wedding gifts) for the first time!
Hopefully I'll be back in the next day or so to share with you a DIY I have been meaning to tick off my list for quite some time! I hope you've had a brilliant start to the week! x
Friday, September 24, 2010
nn.pl fan•cies
1. The mental faculty through which whims, visions, and fantasies are summoned up; imagination, especially of a whimsical or fantastic nature.
2. An image or a fantastic invention created by the mind.
3. A capricious notion; a whim.
4. A capricious liking or inclination.
5. Critical sensibility; taste.
6. Amorous or romantic attachment; love.
This room!
(Image via: Liv Chic)
Especially the Paul Smith 'LOVE' Wall Hanging!These 'Puzzle Boards' by OOOMS Dutch Design Studio. How perfect for entertaining! I fell in love with Macarons when I visited Paris in 2008 BUT
I am yet to have had a go at making them... I need this book!
If it's good enough for Ms Alba it's good enough for me!
I still have to purchase a nappy bag for myself and BB and
I quite fancy the 'Charlie' by timi & leslie...
BUT which colour?!
Light brown...
Or black?
And lastly, I fancy watching the AFL Grand Final tomorrow with
my darling hubby who has been in South Africa all week!
Check out the bet we made (above) at the beginning
of the season... and for those of you who don't follow AFL,
the two teams I picked are in the final with Collingwood
the red hot favourites to win... Mr B is NOT happy! :P
a pie and sauce for lunch... yum!
Besides watching the game on Saturday, we will probably spend Sunday shopping (mostly for BB) as well as preparing for yet another lot of guests (friends of ours and their 3 young boys) who will be staying with us all of next week! Do you have any special plans?
Happy Friday my friends... and have a great w/e! x
Thursday, September 23, 2010
With like a billion followers I'm sure many of you are already big fans of Jen's work, but for those of you who are yet to discover her blogging and designing talents, please do yourself a favour and visit BOTH Jen's always inspiring blog and her gorgeous online store!
My goal is to eventually do a full 'Tour of my home' but with bits and pieces still to add to each room and more guests arriving next week, I may just wait until after BB is born (58 days until due date... and counting). AND I of course want to include BB's nursery (which is currently under works) but we all know this room will definitely have to wait until after the birth as BB's gender remains a surprise :P
A BIG thanks to Jen for sharing a snippet of our home with her lovely readers. To see the full post CLICK HERE!
Have a brilliant day! :) x
Tuesday, September 21, 2010
Well I can report that I did go to Ikea shortly after my post and boy was I disappointed with the rug in the flesh. The 'white' stripes were NOT white at all but rather a dirty cream colour and I also really disliked the texture which felt cheap and rough. I decided immediately that this was not the rug for us and the search continued... but with no further luck over the last 6 weeks, hubby and I headed back to Ikea last week (there aren't too many options here in KL) in hope to find something from the new 2011 collection. With a large space to work with it was difficult to find one large enough BUT here is what we came home with...
So, what do you think? Will it do the trick until we find 'The one'? x
Friday, September 17, 2010
To my precious little BB,
My last entry seems like so long ago and the days and weeks are passing by so very quickly now... I cannot believe that your due date is only 64 days away!!! You'll be very happy to know that after the confusion surrounding your gender and the shock of finding out you are the opposite sex to what we were originally told, it only took your Dad and me a day or so to adjust to the idea of a different you ... and now we cannot possibly imagine having anyone else! It's hard for you not to always be on our minds and we talk about you constantly. My days are filled with thoughts of you. I think about meeting you and holding you for the first time. About bringing you home with us and having you fill our world with so much more than we could ever imagine. I think about both the near and distant future and daydream about all that will be.
During your last scan we were graced with the presence of your Grandma and Puppa Bouw who just spent 12 days with us here in KL. I had organised as a surprise for them to attend our appointment and between you and I, they were more excited about this than their actual holiday or seeing your Dad and I... it's all about YOU baby... and rightfully so :) It was priceless to see their faces light up when you appeared on the screen... not to mention the fact that we had to practically lift your Puppa's jaw off the floor because he was so amazed by the whole experience... especially hearing your heartbeat! It was so nice to be able to share you with them and fuel all of our excitement a little more! AND yes, you are even more adorable than the last time we saw you!
Too adorable!!!
But as my excitement is growing, I must admit, so are my nerves. Your Mummy is an 'over thinker' at the best of times, but over the last few weeks I have been waking in the middle of the night (and not just to make several trips to relieve my bladder) but due to stupid, silly, crazy, pregnant baby dreams! I have had some beautifully vivid ones... my favourite was the one where your little face was so perfectly clear to me that when I woke I was so overcome with pride that we had created you and I knew I had just fallen even MORE in love with you. BUT then there are the dreams where I find myself going into your nursery over and over again to check that you are ok and still wrapped in your swaddle properly... and where you are so tiny when you are born that all the clothes I have bought for you are FAR too big and I wake with the urge to immediately jump online and purchase some smaller items just to be 'more prepared'... if there is such a thing?! I know these are only petty things but I have had the odd dream (well, more like nightmare) that I would rather not think or talk about. Surely I am not the only expectant mother to have these? And secretly, apart from my night visions, there are my real life anxieties which I suppose are also a natural thing to be feeling. Motherhood was something that I felt, from a very young age, I would be good at... and now with you on your way, I am hoping more than ever that I was right.
Talking about 'being prepared' my little one, your nursery is coming along SO nicely! I am absolutely thrilled with all of my purchases so far (most of which were made on Etsy) and I am having the best time creating this haven for you. Your Daddy and I continue to slowly tick things off our BB 'to do' list but it is amazing how much a little bubba such as yourself needs! The other thing that we have been working on is a 'list of names' for you! We think we have a shortlist although have both agreed that we will not decide on your name until we meet you! This is another thing I know I will be losing sleep over :P
Look at our 'outie'!
You have continued to be an absolute blessing during pregnancy and besides my emotions/occasional mood swings which can sometimes get the better of me (um hello I am after all human, or should I say female!) I am still feeling pretty damn great! Your constant kicking and wriggling remains the highlight of each day and it is incredible to feel your strength grow. Your little kicks are so powerful now, there is no need to even touch my tummy... all one has to do is look at our bump and they will clearly see the movements of your tootsies! You are already too cheeky and cute for words and have already brought us so much joy.
Taken 2 weeks ago- Mumma Bouw @ the beginning of week 30!
So my precious little BB, with only 9 weeks until your due date, I will be seeing you very soon... but until then, as always, I cannot wait until our next scan in two weeks time.
I love you my darling bubba...
Mummy xoxo
Wednesday, September 15, 2010
I thought I'd share a few pics of what we got up to!
so I organised for them to come along to my last scan which
was on the day they arrive. They LOVED being able to see BB
and hear the heartbeat as well as meet my Doc. For them,
this was a wonderful start to their holiday! :) We celebrated both Father's Day and my darling husband's
birthday on Sunday 5th September! Me and Dadda Bouw (on his birthday/Father's Day)
with our Baby Bouw bump at 7 months along! The 5 of us indulged in a 'free flow' champagne brunch
(minus the champagne for BB and I) where we ate
and drunk ourselves sick... in a good way of course :P On the Monday we made the trip back to Pangkor Island Beach Resort
(this is where hubby took me for my birthday back in May)...
Where we spent 4 days relaxing by the beach and pool... Soaking up the sun...
We did attempt to do some sight seeing in the local towns...
Although we didn't really like what we saw... check out the
roadside butcher... umm, not exactly hygienic!
We took them to the upmarket shopping malls as well as
the China Town Markets where they shopped up a storm
and absolutely LOVED the bargaining!
So there you have it, that's what I have been up to for the last fortnight! This week I look forward to catching up on all my blog reading as well as enjoying a public holiday here in KL tomorrow which means hubby gets another day off JOY! But for now I must run as I am off to get rooted... my hair roots that is :P
I'll be back tomorrow with a well-over-due 'Letter's to BB' entry!
Have a beautiful day :) x
Wednesday, September 1, 2010
Today I though I would share with you the work of Danny Roberts, a young and talented fashion artist based out of California. I came across Danny's work some time ago but was reminded of it whilst trawling through my computer archives. I remember being so impressed with his creativity and his ability to sketch such eye catching pieces. Even though his work is predominantly based on fashion, I think some of his artwork could easily fall into other categories of art, such as the following two...
I particularly like this piece...
And this one, titled Masked love.
Danny has also been lucky enough to collaborate with many fashion designers and artists including Lancome, Forever 21 and Gwen Stefani...
A sketch of the Alexa Chung on the cover of Vogue.
Pretty great hey!
Happy hump day :) x


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About Beth
I love animals and am passionate about dogs, as a dog owner I know how inportant it is that your dog is well looked after while you go away and how much of your time away can be spent worrying about them!
My own dog - Skylos, is a rescue and she loves other dogs; so its great for her to have dogs around.
I work part time doing shift work and am due to start uni in September. I can also provide an up to date DBS certificate, as it is important to know that you can trust the person that is looking after your pets.
- Property type: House
- Resident dogs: One
- Outdoor space: Terrace / Patio
- I have a car for emergencies
- I can administer oral medications


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2015 BMW 320i
MSRP$32,950 Invoice$30,815
- 24 City
- 36 Hwy
- Seating5
- Fuel TypeGas
- Cargo368 L (13 cu.ft.)
- Horsepower180 hp
Estimated Monthly Payment
*Disclaimer: Estimated Monthly Payment is based on MSRP shown, 5% interest rate and the term displayed (24, 36, 48, 60, 72, 84 months) and is for illustrative purposes only. This calculation reflects amounts in U.S. Dollars rounded to the nearest whole dollar. Estimated monthly payments DO NOT include license, doc, emissions, or other possible fees.
All loan figures are based upon non-commercial usage and are subject to credit approval from an independent lending source. Actual down payment and resulting monthly payments may vary depending upon type and use of vehicle, regional lender requirements, and the strength of your credit. Check with your dealer for exact monthly payment.
|24 mo
|36 mo
|48 mo
|60 mo
|72 mo
|84 mo
2015 BMW 3 Series Buyer's Guide
The Merriam-Webster dictionary defines "benchmark" as something one can use to judge the quality or level of other similar things. When it comes to entry-level small luxury cars with sporting overtones, the word is defined as the BMW 3 Series. Going all the way back to the days of its predecessor, the BMW 2002 and its antecedents, BMW's lithe sport sedan has been universally acclaimed for its combination of strong build quality, outstanding driving characteristics, and the ability to seat four people while doing so. Nothing less than a sports car with a back seat, BMW raised the expectations of all other sporty cars with its outstanding execution of this model. If you're looking for a car you'll never tire of driving, look no farther.
What's the difference between trims?2015 BMW 3 Series 320i
- 17-inch wheels
- Dual automatic climate control
- Leatherette upholstery
- iDrive infotainment interface with 6.5-inch LCD display
- Wood trim
- Power adjustable front seats
- Split folding rear seat
- Heated side mirrors
- Diesel engine
- Wood trim
- Power adjustable front seats
- Split folding rear seat
- Heated side mirrors
- 18-inch rims
- Adaptive HID headlights
- Sunroof
- LED lighting
- 18-inch rims
- Adaptive HID headlights
- Sunroof
- LED lighting
- Hybrid engine
- Adaptive cruise control
- 8.8-inch LCD display
- Sport suspension system
- M Driving Dynamics control
What makes it move?
BMW's sedans offer a choice of rear- or all wheel drive, six-speed manual transmissions, and optional eight-speed automatic transmissions. The base engine is a 180-horsepower, 2.0-liter turbocharged four-cylinder with 200 ft-lbs of torque. The next rung up is a 240-horsepower version of the four-cylinder with 255 ft-lbs of torque. The diesel offering is a turbocharged 2.0-liter four with 180 horsepower and 280 ft-lbs of torque. The "big" engine is a 300-horsepower inline six-cylinder with 300 ft-lbs of torque. All are exceptionally smooth running and efficient.
Why buy the 2015 BMW 3 Series?
The primary reason to buy a BMW 3 Series sedan is for the sheer unalloyed joy of feeling one with your automobile. First of all, BMW automobiles are the smoothest cars on the road. They do everything with a grace and fluidity you'll be hard pressed to find in any other product—even those renowned for smoothness. Further, the 3 Series cars endow their drivers with quick acceleration, determined roadholding, a supple ride, reasonable fuel economy, and more than a heaping helping of style. If you're looking for a small luxury sedan with enjoyable driving manners, test-driving any one of the brilliantly responsive engines fitted to these delightful automobiles is definitely in order. If you really love driving, nothing else in this category solidly compares.


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- Description
The Pelican VersaBrite™ 2250 Deluxe Flashlight Kit is made of tough polycarbonate resin allowing it to withstands chemicals, water, and corrosion. This rugged, small yet powerful flashlight also includes a clip to make it hands free. Clip it on your coat, shirt pocket or hat and allow your hands to be free to focus, align, or use your telescope hand control. The pivoting head head lets you to aim light where you need it. Just twist to turn on. The VersaBrite™ 2250 is packaged with 2 AA alkaline cells, head strap, hook and loop, magnet, and 2 night vision discs.
Red and green night vision discs are essential requirements for an astronomy flashlight. Traditional red light preserves night vision however can be difficult to read by, particularly when you're looking at a full color star atlas. For this reason a green disc is also included which not only preserves your night vision but also allows for higher contrast and for our eye to read color better.
- Additional Information
Additional Information
SKU BK-PL-2250C Manufacturer Pelican Warranty Lifetime Warranty
- Reviews
- Included Items
Included Items
- Pelican VersaBrite Flashlight with White LED Bulb
- Green Color Gel Insert Disc
- Red Color Gel Insert Disc
- (2) AA Batteries
- Strap
- Adhesive Velcro
- Questions & Answers
Product QuestionsNo questions yet. Be the first to ask the question!
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