Acceptance of Health Services on Mobile Phones: A Study of Consumer Perceptions

CONTEXT: Mobile phones are a popular technology capable of portable computing and data access. These features could be helpful for delivering health care services. OBJECTIVE: This study examined health consumers' perceptions of mobile phone health services and their intentions to adopt the technology. DESIGN: Participants viewed a presentation introducing mobile phone services for interacting with health professionals, taking health actions, delivering health information, and managing health care services. Afterwards, semi-structured interviews inquired about their perceptions and acceptance of the technology. ANALYSIS: Qualitative analysis identified emerging themes from interview transcripts. PARTICIPANTS: Forty adult health consumers who were healthy individuals or patients with chronic health conditions - additionally, they had experience with health services delivered through information technology, or they did not. RESULTS: All participants intended to use the technology: thirty were ready to adopt immediately, while ten intended to adopt later upon the need or when particular conditions were met. Among all respondents, sixteen were interested in adopting a selection of the services only. Diverse motivations and pathways may shape health consumers' adoption decision. However, the general process has potential adopters considering their health status and health environment, their personality, and the perceived helpfulness of the technology. Helpfulness was determined by reflection upon positive and negative perceptions of the technology and consideration of usability and safety. Participants had positive impressions that the technology supports healthy behaviors and fosters quality and efficiency of care. There were also preferences for mobile and digital health services. Furthermore, participants believed the technology could support health information behaviors. The negative perceptions were concerns that the technology requires immense resources and skills, is stressful to use, neglects the social dimension of health care, and threatens the quality of care. Consequently, there was interest in the development of safe, responsive, and inclusive mobile health systems. Implementation of mobile phone health services should respond to health consumers' interests and concerns. CONCLUSION: Health consumers are interested in using mobile phone health services

Is Engagement Alone Sufficient to Ensure “Active Learning”?

“Active Learning” is commonly defined as any instructional method that engages students in the learning process. However, active learning encompasses a broad range of educational methods and its impact on learning outcomes has been variable. In 2015, our IM clerkship redesigned its half-day learning sessions from a largely passive didactic style of lecturing to more active learning approaches. We further revised the curriculum in 2016 to further convert the sessions to primarily case based learning led by a faculty or resident. The goal of our intervention was to increase the Self-Reported Engagement Measure (STOBE) of each didactic session and improve educational outcomes

MEMS-Based Communications Systems for Space-Based Applications

As user demand for higher capacity and flexibility in communications satellites increases, new ways to cope with the inherent limitations posed by the prohibitive mass and power consumption, needed to satisfy those requirements, are under investigation. Recent studies suggest that while new satellite architectures are necessary to enable multi-user, multi-data rate, multi-location satellite links, these new architectures will inevitably increase power consumption, and in turn, spacecraft mass, to such an extent that their successful implementation will demand novel lightweight/low power hardware approaches. In this paper, following a brief introduction to the fundamentals of communications satellites, we address the impact of micro-electro-mechanical systems (MEMS) technology, in particular micro-electro-mechanical (MEM) switches to mitigate the above mentioned problems and show that low-loss/wide bandwidth MEM switches will go a long way towards enabling higher capacity and flexibility space-based communications systems

Role of CED-4 in the activation of CED-3

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62523/1/388728a0.pd

The Ketamine Side Effect Tool (KSET):A comprehensive measurement-based safety tool for ketamine treatment in psychiatry

Objectives: On a background of the rapidly expanding clinical use of ketamine and esketamine for treatment of depression and other conditions, we examined safety monitoring, seeking to identify knowledge gaps relevant to clinical practice. Methods: An international group of psychiatrists discussed the issue of safety of ketamine and esketamine and came to a consensus on key safety gaps. Results: There is no standard safety monitoring for off-label generic ketamine. For intranasal esketamine, each jurisdiction providing regulatory approval may specify monitoring. Treatment is often provided beyond the period for which safety has been demonstrated, with no agreed framework for monitoring of longer term side effects for either generic ketamine or intranasal esketamine. Limitations: The KSET has established face and content validity, however it has not been validated against other measures of safety. Conclusions: We recommend the Ketamine Side Effect Tool (KSET) as a comprehensive safety monitoring tool for acute and longer term side effects

Familial pulmonary alveolar proteinosis caused by mutations in CSF2RA

Primary pulmonary alveolar proteinosis (PAP) is a rare syndrome characterized by accumulation of surfactant in the lungs that is presumed to be mediated by disruption of granulocyte/macrophage colony-stimulating factor (GM-CSF) signaling based on studies in genetically modified mice. The effects of GM-CSF are mediated by heterologous receptors composed of GM-CSF binding (GM-CSF-Rα) and nonbinding affinity-enhancing (GM-CSF-Rβ) subunits. We describe PAP, failure to thrive, and increased GM-CSF levels in two sisters aged 6 and 8 yr with abnormalities of both GM-CSF-Rα–encoding alleles (CSF2RA). One was a 1.6-Mb deletion in the pseudoautosomal region of one maternal X chromosome encompassing CSF2RA. The other, a point mutation in the paternal X chromosome allele encoding a G174R substitution, altered an N-linked glycosylation site within the cytokine binding domain and glycosylation of GM-CSF-Rα, severely reducing GM-CSF binding, receptor signaling, and GM-CSF–dependent functions in primary myeloid cells. Transfection of cloned cDNAs faithfully reproduced the signaling defect at physiological GM-CSF concentrations. Interestingly, at high GM-CSF concentrations similar to those observed in the index patient, signaling was partially rescued, thereby providing a molecular explanation for the slow progression of disease in these children. These results establish that GM-CSF signaling is critical for surfactant homeostasis in humans and demonstrate that mutations in CSF2RA cause familial PAP

"The extreme penalty of the law": mercy and the death penalty as aspects of state power in colonial Nyasaland, c. 1903-47

Open access article.Capital punishment was the pinnacle of the colonial judicial system and its use of state violence, but has previously been neglected as a topic of historical research in Africa. This article is based on the case files and legal records of over 800 capital trials – predominantly for murder – dating between 1900 and 1947. It outlines the functioning of the legal system in Nyasaland and the tensions between “violence” and “humanitarianism” in the use and reform of the death penalty. Capital punishment was a political penalty as much as a judicial punishment, with both didactic and deterrent functions: it operated through mercy and the sparing of condemned lives as well as through executions. Mercy in Nyasaland was consistent with colonial political objectives and cultural values: it was decided not only on the facts of cases, but according to British conceptions of “justice”, “order”, “criminality”, and “African” behaviour. This article analyses the use of mercy in Nyasaland to provide a lens on the nature of colonial governance, and the tensions between African and colonial understandings of violence.Arts and Humanities Research Council (UK) and the Beit Fund, University of Oxfor

Neuroprotective Action of Cycloheximide Involves Induction of Bcl-2 and Antioxidant Pathways

The ability of the protein synthesis inhibitor cycloheximide (CHX) to prevent neuronal death in different paradigms has been interpreted to indicate that the cell death process requires synthesis of “killer” proteins. On the other hand, data indicate that neurotrophic factors protect neurons in the same death paradigms by inducing expression of neuroprotective gene products. We now provide evidence that in embryonic rat hippocampal cell cultures, CHX protects neurons against oxidative insults by a mechanism involving induction of neuroprotective gene products including the antiapoptotic gene bcl-2 and antioxidant enzymes. Neuronal survival after exposure to glutamate, FeSO4, and amyloid β-peptide was increased in cultures pretreated with CHX at concentrations of 50–500 nM; higher and lower concentrations were ineffective. Neuroprotective concentrations of CHX caused only a moderate (20–40%) reduction in overall protein synthesis, and induced an increase in c-fos, c-jun, and bcl-2 mRNAs and protein levels as determined by reverse transcription–PCR analysis and immunocytochemistry, respectively. At neuroprotective CHX concentrations, levels of c-fos heteronuclear RNA increased in parallel with c-fos mRNA, indicating that CHX acts by inducing transcription. Neuroprotective concentrations of CHX suppressed accumulation of H2O2 induced by FeSO4, suggesting activation of antioxidant pathways. Treatment of cultures with an antisense oligodeoxynucleotide directed against bcl-2 mRNA decreased Bcl-2 protein levels and significantly reduced the neuroprotective action of CHX, suggesting that induction of Bcl-2 expression was mechanistically involved in the neuroprotective actions of CHX. In addition, activity levels of the antioxidant enzymes Cu/ Zn-superoxide dismutase, Mn-superoxide dismutase, and catalase were significantly increased in cultures exposed to neuroprotective levels of CHX. Our data suggest that low concentrations of CHX can promote neuron survival by inducing increased levels of gene products that function in antioxidant pathways, a neuroprotective mechanism similar to that used by neurotrophic factors

Archaeology, Architecture, and the Postcolonial Critique

Peer reviewe