Evaluating Patient Preferences of Maintenance Therapy for the Treatment of Chronic Obstructive Pulmonary Disease: A Discrete Choice Experiment in the UK, USA and Germany.

Introduction: With increasing availability of different treatments for chronic obstructive pulmonary disease (COPD), we sought to understand patient preferences for COPD treatment in the UK, USA, and Germany using a discrete choice experiment (DCE). Methods: Qualitative research identified six attributes associated with COPD maintenance treatments: ease of inhaler use, exacerbation frequency, frequency of inhaler use, number of different inhalers used, side effect frequency, and out-of-pocket costs. A DCE using these attributes, with three levels each, was designed and tested through cognitive interviews and piloting. It comprised 18 choice sets, selected using a D-efficient experimental design. Demographics and disease history were collected and the final DCE survey was completed online by participants recruited from panels in the UK, USA and Germany. Responses were analyzed using mixed logit models, with results expressed as odds ratios (ORs). Results: Overall, 450 participants (150 per country) completed the DCE; most (UK and Germany, 97.3%; USA, 98.0%) were included in the final analysis. Based on relative attribute importance, avoidance of side effects was found to be most important (UK: OR 11.65; USA: OR 7.17; Germany: OR 11.45; all p<0.0001), followed by the likelihood of fewer exacerbations (UK: OR 2.22; USA: OR 1.63; Germany: OR 2.54; all p<0.0001) and increased ease of use (UK: OR 1.84; USA: OR 1.84; Germany: OR 1.60; all p<0.0001). Number of inhalers, out-of-pocket costs, and frequency of inhaler use were found to be less important. Preferences were relatively consistent across the three countries. All participants required a reduction in exacerbations to accept more frequent inhaler use or use of more inhalers. Conclusion: When selecting COPD treatment, individuals assigned the highest value to the avoidance of side effects, experiencing fewer exacerbations, and ease of inhaler use. Ensuring that patients' preferences are considered may encourage treatment compliance

Smart Exoskeleton Hand with Soft Electronics

Many people in the modern world suffer from a loss of hand and finger strength due to diseases in the muscle or nervous system such as ALS, Muscular Atrophy, and more. This problem has become more widespread with the surge of technology over the last 5-10 years. Therefore, we have created a smart exoskeleton hand with soft electronics that will allow people with less than average hand strength to perform daily activities. The exoskeleton device utilizes small, lightweight linear actuators to provide additional strength to the user’s fingers and the hand itself will be 3D-printed with ABS and PLA plastics to allow for a lower cost while maintaining the strength requirements. The smart exoskeleton also contains a feedback system that processes electromyogram (EMG) signals through a custom circuit in order to replicate the real time movement of the user. These signals are then saved as a data file and stored to allow physicians to analyze these signals and find trends of either reconstruction or deconstruction. This system is powered by two AA batteries and one 6V battery housed in a custom, 3D-printed battery pack. A small touch LCD screen has been installed to display the filtered signals from the EMG sensors attached to the users arm while also showing the current battery life of the device. All of these components incorporated into one system allow for a lightweight, portable design that provides the user with the ease of normal mobility.https://scholarscompass.vcu.edu/capstone/1148/thumbnail.jp

Smart Cities at Play: Lived Experiences, Emerging Forms of Playfulness, and Problems of Participation

In recent years, the notion of smart cities has become the focus of a growing body of research. To date, much of this attention has revolved around the technical aspect, with related concerns including the creation and implementation of suitable smart city technologies. What is notably missing from these discussions, however, is a consideration of the lived experience of supposedly \u27smart spaces\u27 and the extent to which physical and digital environments are currently producing new forms of play and playfulness that can be contextualized within this field. With this in mind, the purpose of our workshop is as follows. First, to provide a platform for researchers and practitioners to engage with these issues that often remain hidden when discussions solely focus on technology. Second, to develop a draft research agenda for challenges that will serve as a primer for future studies examining the topic

Student Learning Outcomes of an Interdisciplinary Fashion Event

The purposes of a cross-college fashion show held at a Mid-Atlantic university were to: a) provide a platform for developing or emergent professionals to display their career talents, b) provide an opportunity for students to work collaboratively across multiple creative disciplines, c) give students a holistic academic experience, and d) support undergraduate scholarships. Such an interdisciplinary event for students from various majors across a university may stimulate the growth of knowledge and motivate real-life applications

Local scales on curves and surfaces

In this paper, we extend our previous work on the study of local scales of a function to studying local scales on curves and surfaces. In the case of a function f, the local scales of f at x is computed by measuring the deviation of f from a linear function near x at different scales t's. In the case of a d-dimensional surface E, the analogy is to measure the deviation of E from a d-plane near x on E at various scale t's. We then apply the theory of singular integral operators on E to show useful properties of local scales. We will also show that the defined local scales are consistent in the sense that the number of local scales are invariant under dilation

Women's experiences of factors affecting treatment engagement and adherence in internet delivered behavioural activation for postnatal depression

ArticleCrown Copyright © 2014 Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).Introduction Women with postnatal depression (PND) face significant barriers to treatment that may be overcome by internet based delivery of treatment. Demand for a self-help internet postnatal treatment offered via a parenting site was high, but attrition rates were also high. Aims To gain patient perspectives on engagement and barriers to the Netmums' “Helping with Depression” treatment. Method Semi-structured interviews were conducted with 17 participants selected from the Netmums trial. Results Thematic analysis revealed motivators and barriers to treatment. Women reported that the flexibility and anonymity of internet interventions fit with their postnatal circumstances. They identified that the relevance of the intervention to their personal circumstances, expectations of motherhood, stigma about depression and motherhood, hopelessness about their ability to improve, previous negative experiences with treatment and treatment seeking, and a lack of practical and emotional support contributed to feelings of being overwhelmed. Women who felt more overwhelmed were more likely to discontinue treatment. Women suggested that support would reduce the impact of barriers and improve adherence. Discussion Open access, self-help internet interventions are acceptable to women with postnatal depression, but it is critical to provide tailoring and support to help overcome barriers and improve treatment adherence

Teachers’ pedagogical decision-making and influences on this when teaching students with severe intellectual disabilities

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this record.This article focuses on teachers’ pedagogical decision-making and influences on this decision-making when teaching students with severe intellectual disabilities. The research reported and discussed forms part of an international collaborative research project in the south west of England and Florida, US. The study is set within the broader socio-political context of inclusion, contributing a pedagogical dimension to other aspects of inclusion, such as placement, curriculum and accountability. Houssaye’s (2000) pedagogical interaction model is examined and adapted to situate and analyse teachers’ pedagogical decision-making, and influences on this, when teaching students with severe intellectual disabilities. The study shows a prominence and privileging of pedagogical decisions and influences around teacher-student pedagogical interactions over curriculum-teacher or curriculum-student pedagogical interactions. The implications of this emphasis are considered in the historical context of teaching and learning models and approaches for this group of learners.This article emerges from a collaborative international project between the University of Exeter and the University of South Florida, which was partly funded by the Global Academic Partnership (GAP) each institution is part of

Mineralogical sources of groundwater fluoride in Archaen bedrock/regolith aquifers: Mass balances from southern India and north-central Sri Lanka

STUDY REGION: The Maheshwaram and Waipally catchments of Andhra Pradesh, India, and the Plonnaruwa catchment of north-central Sri Lanka. STUDY FOCUS: The distribution of F across eight crystalline phases and between the bedrock and the regolith at eleven sites in three catchments is documented. Mineral contributions to F release during weathering and regolith development are quantified. NEW HYDROLOGICAL INSIGHTS FOR THE REGION: An estimate of weathering duration for the in situ regolith in Andhra Pradesh, 250-380 Ka, is close to a previous estimate for southern India. Partial or total destruction of the primary F-bearing bedrock minerals and consistent depletion of F in the remnant minerals result in a much reduced total F content in the regolith. Leaching experiments and field relationships, however, indicate a greater potential for F mobilisation to groundwater from the regolith than the bedrock. Schemes for managed aquifer recharge should beware the risk of mobilising additional F to groundwater

Improved fused silica fibres for the advanced LIGO monolithic suspensions

To further increase the sensitivity of the advanced LIGO (aLIGO) gravitational wave detectors, two major upgrades of the monolithic fused silica suspension are considered: a higher stress in the suspension fibres and a longer final suspension stage. One of the challenges for this upgrade will be producing thinner and longer fibres that can hold the test mass safely. We demonstrate that laser power fluctuations during the fibre fabrication process can produce diameter variations and potentially weak fibres. We present a laser intensity stabilisation technology for fused silica fibre fabrication using a camera system to monitor heating. Fibres fabricated with this new technique showed a 34% decrease in the interquartile range of measured breaking stress, which indicates that the application of intensity stabilisation technology can improve the statistical strength of fused silica fibres by tightening the spread of values. As the aLIGO detectors upgrade plan (A+) proposes to use thinner fibres, it is essential to enhance the performance of fused silica fibres