The development of an innovative mobile phone app for type 1 diabetes alcohol education

Introduction Social media is being increasingly used to try and engage young people with their healthcare issues. However, most mobile diabetes applications (Apps) do not include personalised patient education, a key facet of diabetes self-management. We sought the views and ideas of young people with type 1 diabetes to enable the design of innovative new Apps which might help to improve their quality of life. This project highlights an innovative, patient-centric approach to the development and production of a health based mobile App concerning diabetes education about alcohol. Methods Data collected by semi-structured, in-depth qualitative interviews (n=9) of people with type 1 diabetes aged 18-21. Interviews were transcribed and loaded onto the qualitative data analysis tool NVivo. Baseline data analysis was undertaken to locate potential ideas for mobile App development, with suggestions chosen needing to reflect interviewee requirements and to meet clinic goals. Results Interviewees suggested that they would find a guide which could be accessed via a mobile device about alcohol limits and the effects of alcohol on their diabetes particularly useful on a night out. An App about alcohol and diabetes, ‘Start Safe, Stay Safe’, was developed with further input from young people with type 1 diabetes and clinic staff. Summary In developing a mobile App about alcohol and diabetes, we have shown how young people with type 1 diabetes can participate effectively in the design and implementation of new technology which they can then use to improve their quality of life

Reconsidering your perceptions: exploring the lifeworld of a young person with type 1 diabetes

Introduction Views of young people with type 1 diabetes are vital in developing quality services, yet research on their lifestyle and use of web and mobile technology to support their condition is sparse. We aimed to develop a deeper understanding of the perspective of a young person with type 1 diabetes and construct a picture of their lifeworld. Methods Data collected by semi-structured, in-depth qualitative interviews (n=9) of people with type 1 diabetes aged 18-21. Interviews were transcribed and loaded onto the qualitative data analysis tool NVivo. Results A number of themes emerged, including: • The effects of technology on living with diabetes. • Use of social media, mobile phones and Apps to obtain information and support. • Feelings about the health services they used. We also uncovered several interesting issues that concern patients in this age group: • Understanding the isolation that young people might feel at this age. • Personal attitudes to type 1 diabetes and initiating improvement. • Fear, discomfort and being seen as different. • Why we might embrace and show negative views of the condition. • Rethinking the use of Facebook. Summary We obtained a deeper and more empathetic understanding of the feelings of young people with type 1 diabetes, and the issues that are important to them. This data will be used to look at local services, producing more effective systems for support and self-management which take into account the feelings of patients and make them more likely to engage with technology

Why haven’t YOU thought of that? Over 15 great mobile app ideas for improving the quality of life of a young person with type 1 diabetes

Introduction The use of mobile devices to look up health-related information is of increasing importance to young people, who have a radically different view of technology than either their parents or practitioners. We explored what young people with type 1 diabetes required from social media and mobile technology by seeking their views and ideas, enabling the eventual design of innovative new tools to help them engage with health services and their own health in their preferred manner. Methods Data collected by semi-structured, in-depth qualitative interviews (n=9) of people with type 1 diabetes aged 18-21. Interviews were transcribed and loaded onto the qualitative data analysis tool NVivo. Baseline data analysis was then undertaken to locate potential ideas for mobile App development. Results Over fifteen innovative new ideas for mobile Apps not currently available were suggested including: • Twitter - contacting other people with type 1 diabetes, an emergency link for contacting the health service and receiving direct messages from clinic staff which would help to personalise diabetes care. • Hypoglycaemia awareness - advice on what to do for friends, family and colleagues who might come into contact with the participant. • Illness information. • News/information on existing/new diabetes technology. Summary We have explored what young people with type 1 diabetes want from social media and mobile technology, so that the design and implementation of new technology to help self-management is more patient-centred, more likely to be used and more likely to improve quality of life

Meanwhile use as performance - rehearsing and performing community in temporary spaces

This paper explores the use of performance theory as a framework to conceptualise temporality and opportunity in a design research project examining community use of meanwhile spaces. Meanwhilehas developed as a term to describe the use of temporarily available space, typically due to stalled building projects or business failure. Growth of the meanwhile sector led the researchers to question how more social and community value could be gained from these spatial opportunities. Performance theory, with its emphasis on dynamic temporality was proposed as a framework that might provide for the conceptual shifts that would enable a sector that traditionally seeks permanent and long term development to make the most from these temporary opportunities. A design research study that included a practical intervention was undertaken. This paper reflects on the relationship between theory and practice in the project

Mode-switching: a new technique for electronically varying the agglomeration position in an acoustic particle manipulator

Acoustic radiation forces offer a means of manipulating particles within a fluid. Much interest in recent years has focussed on the use of radiation forces in microfluidic (or “lab on a chip”) devices. Such devices are well matched to the use of ultrasonic standing waves in which the resonant dimensions of the chamber are smaller than the ultrasonic wavelength in use. However, such devices have typically been limited to moving particles to one or two predetermined planes, whose positions are determined by acoustic pressure nodes/anti-nodes set up in the ultrasonic standing wave. In most cases devices have been designed to move particles to either the centre or (more recently) the side of a flow channel using ultrasonic frequencies that produce a half or quarter wavelength over the channel, respectively.It is demonstrated here that by rapidly switching back and forth between half and quarter wavelength frequencies – mode-switching – a new agglomeration position is established that permits beads to be brought to any arbitrary point between the half and quarter-wave nodes. This new agglomeration position is effectively a position of stable equilibrium. This has many potential applications, particularly in cell sorting and manipulation. It should also enable precise control of agglomeration position to be maintained regardless of manufacturing tolerances, temperature variations, fluid medium characteristics and particle concentration

Innovative mobile technology alcohol education for young people with type 1 diabetes.

Views of young people with type 1 diabetes are vital in developing quality services and improving health-related quality of life (HRQoL), yet research on their lifestyle and use of web and mobile technology to support their condition and in non-health related areas is sparse. The aim of this research was to develop an insight into young people’s current use of web and mobile technology and its potential impact on HRQoL by constructing an in-depth picture of their day-to-day experiences, exploring how they made use of technology in their lives and in relation to their condition and treatment – then, building something to help them. Data were collected by semi-structured, in-depth qualitative interviews (n=9) of young people with type 1 diabetes and aged 18–21 years. Interviews were transcribed and loaded onto NVivo for theme identification. Data analysis was also undertaken during initial interviews (n=4) to locate potential ideas for technical development. Latter interviews (n=5) assisted in the iterative sociotechnical design process. Three suggestions for improvement were taken forward for prototyping with one – an alcohol education guide – being developed into a clinically approved app. This article documents the procedures and sociotechnical design principles involved in the creation of a patient-centric app. It provides an innovative example of how education with the aim of improving HRQoL can be designed in a way which meets the needs of a particular group and values and encourages their input to assist in the creative process, while at the same time conforming to clinical guidelines

Counselling in primary care : a systematic review of the evidence

Primary objective: To undertake a systematic review which aimed to locate, appraise and synthesise evidence to obtain a reliable overview of the clinical effectiveness, cost-effectiveness and user perspectives regarding counselling in primary care. Main results: Evidence from 26 studies was presented as a narrative synthesis and demonstrated that counselling is effective in the short term, is as effective as CBT with typical heterogeneous primary care populations and more effective than routine primary care for the treatment of non-specific generic psychological problems, anxiety and depression. Counselling may reduce levels of referrals to psychiatric services, but does not appear to reduce medication, the number of GP consultations or overall costs. Patients are highly satisfied with the counselling they have received in primary care and prefer counselling to medication for depression. Conclusions and implications for future research: This review demonstrates the value of counselling as a valid choice for primary care patients and as a broadly effective therapeutic intervention for a wide range of generic psychological conditions presenting in the primary care setting. More rigorous clinical and cost-effectiveness trials are needed together with surveys of more typical users of primary care services

Modelling of Physical Ageing in starch using the TNM equation

Gelatinised wheat starch, freeze dried and equilibrated at different RH, was aged at different temperatures and for different times. The Tool–Narayanaswamy–Moynihan (TNM) model was used to describe the ageing for all samples under all conditions. Three TNM parameters: x, Dh⁄ and A were determined experimentally using, respectively, the peak shift method (x) and the dependency of T0f (the limiting value of Tf) on the cooling rate (Dh⁄ and A). The non-linearity parameter x and the non exponential parameter b were also estimated by optimising a fit of the experimental normalised specific heat at different ageing times and temperatures to curves generated using the TNM model. The TNM model successfully described the normalised experimental data. It was found that the intermolecular forces were strong and the relaxation times depended more strongly on the glass structure than the glass temperature. The hydration level of the starch had a direct impact of the breadth of the relaxation time distribution. A dependency of the non-linearity parameter x on ageing temperature (peak shift method) was observed. This suggests that physical ageing is more complex than is described by TNM formalism

Abdominal cancer symptoms: evaluation of the impact of a regional public awareness campaign.

Objective: A regional ‘Be Clear on Cancer’ (BCoC) campaign developed by Public Health England aimed to promote public awareness of key abdominal cancer symptoms in people aged 50 years and over. Methods: Data were analysed for metrics at different stages in the patient care pathway including public awareness, GP attendance and referrals, to cancer diagnosis. Results: There was significantly higher recognition of the BCoC abdominal campaign in the campaign region compared to the control area (Post Campaign/Control, n = 401/406; 35% vs. 24%, p [less than] 0.05). The campaign significantly improved knowledge of ‘bloating’ as a symptom (p = 0.03) compared to pre-campaign levels. GP attendances for abdominal symptoms increased significantly by 5.8% (p = 0. 03), although the actual increase per practice was small (average 16.8 visits per week in 2016 to 17.7 in 2017). Urgent GP referrals for suspected abdominal cancer increased by 7.6%, compared to a non-significant change (0.05%) in the control area. For specific abdominal cancers, the number diagnosed were similar to or higher than the median in the campaign area but not in the control area in people aged 50 and over: colorectal (additional n = 61 cancers), pancreatic (additional n = 102) and stomach cancers (additional n = 17). Conclusions: This campaign had a modest impact on public awareness of abdominal cancer symptoms, GP attendances and cancers diagnosed

Habitat-specific invertebrate responses to hydrological variability, anthropogenic flow alterations, and hydraulic conditions

This is an Open Access Article. It is published by Wiley under the Creative Commons Attribution 4.0 Unported Licence (CC BY). Full details of this licence are available at: http://creativecommons.org/licenses/by/4.0/© 2019 The Authors. Freshwater Biology Published by John Wiley & Sons Ltd. Quantifying ecological responses to river flow regimes is a key scientific approach underpinning many environmental flow (e-flow) strategies. Incorporating habitat-scale influences (e.g. substrate composition and organic matter cover) within e-flow frameworks has the potential to provide a broader understanding of the causal mechanisms shaping instream communities, which may be used to guide river management strategies. In this study, we examined invertebrate communities inhabiting three distinct habitat groups (HGs—defined by coarse substrates, fine sediments, and the fine-leaved macrophyte Ranunculus sp.) across four rivers (each comprising two study sites) within a single catchment. We tested the structural and functional responses of communities inhabiting different HGs to three sets of flow-related characteristics: (1) antecedent hydrological (discharge—m3/s) variability; (2) antecedent anthropogenic flow alterations (percentage of discharge added to or removed from the river by human activity); and (3) proximal hydraulic conditions (characterised by the Froude number). The former two were derived from groundwater model daily time series in the year prior to the collection of each invertebrate sample, while the latter was collected at the point of sampling. While significant effects of hydrological and anthropogenic flow alteration indices were detected, Froude number exerted the greatest statistical influence on invertebrate communities. This highlights that habitat-scale hydraulic conditions to which biota are exposed at the time of sampling are a key influence on the structure and function of invertebrate communities. Mixed-effect models testing invertebrate community responses to flow-related characteristics, most notably Froude number, improved when a HG interaction term was incorporated. This highlights that different mineralogical and organic habitat patches mediate ecological responses to hydraulic conditions. This can be attributed to HGs supporting distinct taxonomic and functional compositions and/or providing unique ecological functions (e.g. flow refuges), which alter how instream communities respond to hydraulic conditions. While the individual importance of both flow and small-scale habitat effects on instream biota has been widely reported, this study provides rare evidence on how their interactive effects have a significant influence on riverine ecosystems. These findings suggest that river management strategies and e-flow frameworks should not only aim to create a mosaic of riverine habitats that support ecosystem functioning, but also consider the management of local hydraulic conditions within habitat patches to support specific taxonomic and functional compositions