Evaluating telemedicine: A focus on patient pathways

Evaluations of telemedicine have sought to assess various measures of effectiveness (e.g., diagnostic accuracy), efficiency (e.g., cost), and engagement (e.g., patient satisfaction) to determine its success. Few studies, however, have looked at evaluating the organizational impact of telemedicine, which involves technology and process changes that affect the way that it is used and accepted by patients and clinicians alike. This study reviews and discusses the conceptual issues in telemedicine research and proposes a fresh approach for evaluating telemedicine. First, we advance a patient pathway perspective, as most of the existing studies view telemedicine as a support to a singular rather than multiple aspects of a health care process. Second, to conceptualize patient pathways and understand how telemedicine impacts upon them, we propose simulation as a tool to enhance understanding of the traditional and telemedicine patient pathway

Living with the user: Design drama for dementia care through responsive scripted experiences in the home

Participation in forms of drama and narrative can provoke empathy and creativity in user-centred design processes. In this paper, we expand upon existing methods to explore the potential for responsive scripted experiences that are delivered through the combination of sensors and output devices placed in a home. The approach is being developed in the context of Dementia care, where the capacity for rich user participation in design activities is limited. In this case, a system can act as a proxy for a person with Dementia, allowing designers to gain experiences and insight as to what it is like to provide care for, and live with, this person. We describe the rationale behind the approach, a prototype system architecture, and our current work to explore the creation of scripted experiences for design, played out though UbiComp technologies.This research is funded by the Arts and Humanities Research Council UK, (AH/K00266X/1) and Horizon Digital Economy Research (RCUK grant EP/G065802/1)

The Musculoskeletal Physiotherapy of Australia position on pre-manipulative testing for the cervical spine

The MPA undertook a survey of its members in 1997 to determine their compliance with and opinion of the APA Protocol for Pre-Manipulative Testing of the Cervical Spine (Magarey et al 2000a, Magarey et al submitted-a). As a result of that survey and a comprehensive literature review, the MPA developed a new set of guidelines for premanipulative procedures for the cervical spine (Magarey et al 2000b, Magarey et al submitted-b)

Using cultural probes to inform the design of assistive technologies

This paper discusses the practical implications of applying cultural probes to drive the design of assistive technologies. Specifically we describe a study in which a probe was deployed with home-based carers of people with dementia in order to capture critical data and gain insights of integrating the technologies into this sensitive and socially complex design space. To represent and utilise the insights gained from the cultural probes, we created narratives based on the probe data to enhance the design of assistive technologies.This work was supported by the Arts and Humanities Research Council (AH/K00266X/1) and RCUK through the Horizon Digital Economy Research grant (EP/G065802/1)

Can a pseudo-symmetry solve the cosmological constant problem?

A general no-go theorem dampens hope that the cosmological constant problem can be solved by a local symmetry mechanism. The possibility is considered here that this no-go theorem can be avoided by a pseudo-symmetry. A simple macroscopic effective field theory is constructed which admits an enhanced pseudo-symmetry in the absence of a cosmological term. It is pointed out that this pseudo-symmetry is an exact classical invariance of superstrings. The conjecture that this pseudo-symmetry survives in the quantum theory has several interesting consequences.Comment: Changes in language (including new title), and assorted perestroika. One new consequence of conjecture. 10 pages, uuencoded Postscript file. To appear in Phys.Lett.

Natural Mass Generation for the Sterile Neutrino

We point out that there is a serious cosmological problem in the supersymmetric standard model if a sterile neutrino is responsible for the solar neutrino oscillation, and propose a possible solution to this problem. We show that our solution induces naturally a mass of order 10^{-4} eV for the sterile neutrino, which is deeply related to the mechanism of supersymmetry breaking.Comment: 8 pages, no figures, minor changes, reference adde

Resistant starch as a dietary intervention to limit the progression of diabetic kidney disease

Diabetes is the leading cause of kidney disease, and as the number of individuals with diabetes increases there is a concomitant increase in the prevalence of diabetic kidney disease (DKD). Diabetes contributes to the development of DKD through a number of pathways, including inflammation, oxidative stress, and the gut-kidney axis, which may be amenable to dietary therapy. Resistant starch (RS) is a dietary fibre that alters the gut microbial consortium, leading to an increase in the microbial production of short chain fatty acids. Evidence from animal and human studies indicate that short chain fatty acids are able to attenuate inflammatory and oxidative stress pathways, which may mitigate the progression of DKD. In this review, we evaluate and summarise the evidence from both preclinical models of DKD and clinical trials that have utilised RS as a dietary therapy to limit the progression of DKD

On the Solution to the Polonyi Problem with OO(10~TeV) Gravitino Mass in Supergravity

We study the solution to the Polonyi problem where the Polonyi field weighs as $O(10{\rm TeV})$ and decays just before the primordial nucleosynthesis. It is shown that in spite of a large entropy production by the Polonyi field decay, one can naturally explain the present value of the baryon-to-entropy ratio, $n_B/s \sim (10^{-10}-10^{-11})$ if the Affleck-Dine mechanism for baryogenesis works. It is pointed out, however, that there is another cosmological problem related to the abundance of the lightest superparticles produced by the Polonyi decay

Supersymmetry, Axions and Cosmology

Various authors have noted that in particular models, the upper bound on the axion decay constant may not hold. We point out that within supersymmetry, this is a generic issue. For large decay constants, the cosmological problems associated with the axion's scalar partner are far more severe than those of the axion. We survey a variety of models, both for the axion multiplet and for cosmology, and find that in many cases where the cosmological problems of the saxion are solved, the usual upper bound on the axion is significantly relaxed. We discuss, more generally, the cosmological issues raised by the pseudoscalar members of moduli multiplets, and find that they are potentially quite severe.Comment: 27 pages, published version, some discussions clarifie

Relaxing the Cosmological Moduli Problem

Typically the moduli fields acquire mass m =C H in the early universe, which shifts the position of the minimum of their effective potential and leads to an excessively large energy density of the oscillating moduli fields at the later stages of the evolution of the universe. This constitutes the cosmological moduli problem, or Polonyi field problem. We show that the cosmological moduli problem can be solved or at least significantly relaxed in the theories in which C >> 1, as well as in some models with C << 1.Comment: 9 pages, 3 Postscript figure