A High Statistics Search for Ultra-High Energy Gamma-Ray Emission from Cygnus X-3 and Hercules X-1

We have carried out a high statistics (2 Billion events) search for ultra-high energy gamma-ray emission from the X-ray binary sources Cygnus X-3 and Hercules X-1. Using data taken with the CASA-MIA detector over a five year period (1990-1995), we find no evidence for steady emission from either source at energies above 115 TeV. The derived upper limits on such emission are more than two orders of magnitude lower than earlier claimed detections. We also find no evidence for neutral particle or gamma-ray emission from either source on time scales of one day and 0.5 hr. For Cygnus X-3, there is no evidence for emission correlated with the 4.8 hr X-ray periodicity or with the occurrence of large radio flares. Unless one postulates that these sources were very active earlier and are now dormant, the limits presented here put into question the earlier results, and highlight the difficulties that possible future experiments will have in detecting gamma-ray signals at ultra-high energies.Comment: 26 LaTeX pages, 16 PostScript figures, uses psfig.sty to be published in Physical Review

Persuasive by design: a model and toolkit for designing evidence-based interventions

Despite increased interest in applying psychological theory to the practice of designing behavioral change interventions, design professionals often lack adequate knowledge and resources to do so. In this paper, we present a tool to help professionals in the creative industries design evidence-based health interventions, the Persuasive by Design model. This paper describes the contents and application of the model as well as plans for further development and testing

Using feedback from persuasive technologies to disrupt and change habitual behavior: a review of current literature.

Habitual behavior is often hard to change because of a lack of self-monitoring skills. Digital technologies offer an unprecedented chance to facilitate self-monitoring by delivering feedback on undesired habitual behavior. This review analyzed the results of 72 studies in which feedback from digital technology attempted to disrupt and change undesired habits. A vast majority of these studies found that feedback through digital technology is an effective way to disrupt habits, regardless of target behavior or feedback technology used. Unfortunately, methodological issues limit our confidence in the findings of all but 14 of the 50 studies with quantitative measurements in this review. Furthermore, only 4 studies tested for (and only 3 of those 4 found) sustained habit change, and it remains unclear how feedback from digital technology is moderated by receiver states and traits, as well as feedback characteristics such as feedback sign, comparison, tailoring, modality, frequency, timing and duration. We conclude with recommendations for new research directions

Current reference devices for hollow instrument loads as defined in standards are not a valid steam penetration test

In hospitals steam sterilization is an important aspect of infection prevention. Testing of steam penetration is a necessity. In some cases a hollow helix shaped Process Challenge (PCD) device is suggested as steam penetration test for hollow instruments. Since the introduction of these hollow A, hollow load, helix, or helix shaped PCD in standards, discussions about the use of these PCD s are ongoing. Conclusive experimental data on these hollow PCD s was not found in the literature. For the present study a strictly defined helix shaped PCD «reference» device was manufactured. Its performance was tested in a small (11 l) and a large (342 l) test steam sterilizer and compared with the minimum requirements for steam penetration defined in the ISO standards. It was found that this device does not fulfill these minimum requirements. Also these results indicate that hollow A or helix PCD s as presently defined in standards should not be used as steam penetration test in steam sterilization processes. Consequently, PCD s tested against this reference PCD or standard will also not meet the requirements for steam penetration. These PCD s should therefore not be used as steam penetration test for hollow instruments

Innovation in Pain Rehabilitation Using Co-Design Methods During the Development of a Relapse Prevention Intervention: Case Study

Background: Many intervention development projects fail to bridge the gap from basic research to clinical practice. Instead of theory-based approaches to intervention development, co-design prioritizes the end users' perspective as well as continuous collaboration between stakeholders, designers, and researchers throughout the project. This alternative approach to the development of interventions is expected to promote the adaptation to existing treatment activities and to be responsive to the requirements of end users.Objective: The first objective was to provide an overview of all activities that were employed during the course of a research project to develop a relapse prevention intervention for interdisciplinary pain treatment programs. The second objective was to examine how co-design may contribute to stakeholder involvement, generation of relevant insights and ideas, and incorporation of stakeholder input into the intervention design.Methods: We performed an embedded single case study and used the double diamond model to describe the process of intervention development. Using all available data sources, we also performed deductive content analysis to reflect on this process.Results: By critically reviewing the value and function of a co-design project with respect to idea generation, stakeholder involvement, and incorporation of stakeholder input into the intervention design, we demonstrated how co-design shaped the transition from ideas, via concepts, to a prototype for a relapse prevention intervention.Conclusions: Structural use of co-design throughout the project resulted in many different participating stakeholders and stimulating design activities. As a consequence, the majority of the components of the final prototype can be traced back to the information that stakeholders provided during the project. Although this illustrates how co-design facilitates the integration of contextual information into the intervention design, further experimental testing is required to evaluate to what extent this approach ultimately leads to improved usability as well as patient outcomes in the context of clinical practice