Designing Behavior Change Support Systems Targeting Blood Donation Behavior

While blood is crucial for many surgeries and patient treatments worldwide, it cannot be produced artificially. Fulfilling the demand for blood products on average days is already a major challenge in countries like South Africa and Ghana. In these countries, less than 1 % of the population donates blood and most of the donations come from first-time donors who do not return. Sufficient new, first-time and even lapsed donors must be motivated to donate regularly. This study argues that blood donation behavior change support systems (BDBCSS) can be beneficially applied to support blood donor management in African countries. In this study, the design science research (DSR) approach is applied in order to derive generic design principles for BDBCSS and instantiate the design knowledge in prototypes for a blood donation app and a chatbot. The design principles were evaluated in a field study in South Africa. The results demonstrate the positive effects of BDBCSS on users’ intentional and developmental blood donation behavior. This study contributes to research and practice by proposing a new conceptualization of blood donation information systems support and a nascent design theory for BDBCSS that builds on behavioral theories as well as related work on blood donation information systems. Thus, the study provides valuable implications for designing preventive health BCSS by stating three design principles for a concrete application context in healthcare

On the value of foreign PhDs in the developing world: Training versus selection effects

This paper compares the career effects of overseas and domestic PhD training for scientists working in an emerging economy, South Africa. Variations in scientific achievements of South African academics may arise because those who attend \better" PhD programmes receive better training, but it may also be because good students select into good universities. We examine selection and training effects for four tiers of South African and two tiers of foreign universities. Those who received PhDs from universities in industrialized countries tend to be more productive than those whose PhDs were locally granted, but universities from industrialized countries do not necessarily provide better training than local universities. Pure selection effects contribute to career outcomes nearly as much as training effects. When looking at training in isolation, PhDs from top South African universities produce a similar quantity and quality research output to those from leading universities in the developed world

Comorbidities Associated with Large Abdominal Aortic Aneurysms

BACKGROUND: Abdominal aortic aneurysm has become increasingly important owing to demographic changes. Some other diseases, for example, cholecystolithiasis, chronic obstructive pulmonary disease, and hernias, seem to co-occur with abdominal aortic aneurysm. The aim of this retrospective analysis was to identify new comorbidities associated with abdominal aortic aneurysm. METHODS: We compared 100 patients with abdominal aortic aneurysms and 100 control patients. Their preoperative computed tomographic scans were examined by two investigators independently, for the presence of hernias, diverticulosis, and cholecystolithiasis. Medical records were also reviewed. Statistical analysis was performed using univariate analysis and multiple logistic regression analysis. RESULTS: The aneurysm group had a higher frequency of diverticulosis (p = 0.008). There was no significant difference in the occurrence of hernia (p = 0.073) or cholecystolithiasis (p = 1.00). Aneurysm patients had a significantly higher American Society of Anesthesiology score (2.84 vs. 2.63; p = 0.015) and were more likely to have coronary artery disease (p < 0.001), congestive heart failure (p < 0.001), or chronic obstructive pulmonary disease (p < 0.001). Aneurysm patients were more likely to be former (p = 0.034) or current (p = 0.006) smokers and had a significantly higher number of pack years (p < 0.001). Aneurysm patients also had a significantly poorer lung function. In multivariate analysis, the following factors were associated with aneurysms: chronic obstructive pulmonary disease (odds ratio, OR = 12.24; p = 0.002), current smoking (OR = 4.14; p = 0.002), and coronary artery disease (OR = 2.60; p = 0.020). CONCLUSIONS: Our comprehensive analysis identified several comorbidities associated with abdominal aortic aneurysms. These results could help to recognize aneurysms earlier by targeting individuals with these comorbidities for screening

Changebots - Designing Chatbots to Support Blood Donor Behaviour Change

Even though blood products cannot be produced artificially, but are important for many surgeries and treatments, less than 1 \% of the population donates blood in countries like South Africa or Ghana. Therefore, efficient and successful blood donor mobilisation and management are important. We argue that a chatbot offers easy access to information for all types of donors and can support the transition of non-, first-time or lapsed donors to regular donors. By applying the design science research methodology, we have developed a chatbot for all donor types in South Africa and Ghana. We performed two design cycles, collaborating with experts from three blood services and grounding our research on existing and derived behavioural change models. The chatbot was positively evaluated in two workshops that included focus group discussions and online surveys

Chatblood - Towards designing chatbots for blood donors

Healthcare systems worldwide depend on volunteer blood donations to secure surgeries and treatments for patients. Stochastic demands and donations as well as a short shelf-life of blood products impose additional challenges. In order to adequately match demand and supply, it is crucial for blood donation centres to call in donors at the right time, reach non-donors, and motivate first-time and lapsed donors to donate regularly (again). While often websites offer information to new donors and sometimes apps provide access to appointment systems for regular donors, for example, we argue that chatbots offer an easy and anonymous access to information for all. As an addition to apps and websites they could help to reach more people to become blood donors. Applying the design science research methodology, we present design principles for blood donation chatbots. In an online survey with 213 participants, we analysed the applicability of chatbots for different use cases

The regulation and catalytic mechanism of the NADP-malic enzyme from tobacco leaves

The non-photosynthetic NADP-malic enzyme EC 1.1.1.40 (NADP-ME), which catalyzes the oxidative decarboxylation of L-malate and NADP+ to produce pyruvate and NADPH, respectively, and which could be involved in plant defense responses, was isolated from Nicotiana tabacum L. leaves. The mechanism of the enzyme reaction was studied by the initial rate method and was found to be an ordered sequential one. Regulation possibilities of purified cytosolic NADP-ME by cell metabolites were tested. Intermediates of the citric acid cycle (a-ketoglutarate, succinate, fumarate), metabolites of glycolysis (pyruvate, phosphoenolpyruvate, glucose-6-phosphate), compounds connected with lipogenesis (coenzyme A, acetyl-CoA, palmitoyl-CoA) and some amino acids (glutamate, glutamine, aspartate) did not significantly affect the NADP-ME activity from tobacco leaves. In contrast, macroergic compounds (GTP, ATP and ADP) were strong inhibitors of NADP-ME; the type of inhibition and the inhibition constants were determined in the presence of the most effective cofactors (Mn2+ or Mg2+), required by NADP-ME. Predominantly non-competitive type of inhibitions of NADP-ME with respect to NADP+ and mixed type to L-malate were found

Webcam technology on neonatal wards—examining the objective and subjective workload of nurses: a combined observational and survey study

BackgroundThis study was conducted to estimate the additional objective and perceived workload of nurses resulting from the use of webcams. The successful implementation of webcam technology into routine care requires an analysis to prevent adverse events of increased nursing workload.MethodsThe study took place on three neonatal wards in two University Hospitals in Germany. In the first Hospital, the study was conducted from February to July 2021; in the second one it was conducted between June and November 2021. Data were collected using a combined approach of a standardised diary questionnaire study and passive observations. The participants were accompanied in their daily work and their activities were recorded 65 nurses participated.Results2,031 h were observed in 1,630 observation blocks. In 14.74% of the observation blocks webcam activities were detected. The extent to which the nurses had webcam-related additional workloads was rated as no additional workload in 82.16% of the daily questionnaires (n = 1,026).ConclusionThe observed low workload due to the webcams is in line with the nurses’ perception. The observational data revealed, on a number of different analysis levels, that a limited additional workload was generated. There was no decrease in activity performance observed and no clear indication for interruptions due to the webcam-related activities for the nurses. However, it is important to raise awareness about the individual workload levels for the successful implementation. Additional education programs can be provided for nurses.Trial registrationThe Neo-CamCare study is registered at the German Clinical Trials Register. DRKS-ID: DRKS00017755

Manual lymphatic drainage and quality of life in patients with lymphoedema and mixed oedema: a systematic review of randomised controlled trials.

PURPOSE: To assess the impact of manual lymphatic drainage (MLD) on the health-related quality of life (HRQoL) of adults with lymphoedema or mixed oedema, through a systematic review of randomised controlled trials (RCTs). METHODS: MEDLINE, EMBASE, PsycINFO, CENTRAL, the Cochrane Database of Systematic Reviews and ClinicalTrials.gov were searched to identify RCTs evaluating HRQoL after a MLD intervention compared to non-MLD interventions (PROSPERO 2016:CRD42016042255). We extracted the effect of the interventions on the HRQoL (primary outcome) as well as data on volume and functional changes, and adverse events when available (secondary outcomes). RESULTS: Eight studies were eligible. The studies were heterogeneous in the aetiology of oedema, schemes of MLD applied, additional treatments offered with MLD, length of follow-up, instruments used to assess HRQoL and interventions offered to the control group. Five studies included patients with breast cancer-related arm lymphoedema; one study reported increased HRQoL among patients randomised to the MLD group. The two RCTs that involved patients with leg mixed oedema due to chronic venous insufficiency did not find between-group differences in the overall HRQoL. One trial included patients with hand oedema from systemic sclerosis and showed higher HRQoL in the group that received MLD. No studies reported reductions in HRQoL, or severe adverse events after MLD. The small numbers of patients analysed in all studies may have resulted in lack of power to detect between-group differences in HRQoL. CONCLUSIONS: The effect of MLD on the HRQoL of patients with chronic oedema is unclear

Effect of salt on the growth and metabolism of Glycine max

Soybean plants cultivated with 50, 100 and 200 mM of NaCl, revealed that root growth was less affected by salinity than shoots. Salinity led to a reduction in leaf area and an increase in water content of the roots. These factors could contribute to the adaptation of the plant, improving its hydration. Although nitrate and free amino acid levels were reduced by salt treatment in roots, protein content of leaves was not altered. Salinity led to alterations in xylem amino acid composition, with increases in Ser, Ala, Gaba and Pro and a decrease in Asn. Similar changes were seen for Asn and Ser in roots together with a much stronger increase in Gaba. It is suggested that the decline in Asn reflects its conversion to Ala and Gaba (via Glu) in the roots while the increase in Pro and Gaba could be related to the adaptation of the plant to salinity.80981