Experiences of Diagnosis, Symptoms, and Use of Reliever Inhalers in Patients With Asthma and Concurrent Inducible Laryngeal Obstruction or Breathing Pattern Disorder: Qualitative Analysis of a UK Asthma Online Community.

BACKGROUND: Breathing pattern disorders (BPDs) and inducible laryngeal obstruction (ILO) cause similar symptoms to asthma, including dyspnea and chest tightness, with an estimated prevalence of up to one-fifth of patients with asthma. Both conditions can be comorbid with asthma, and there is evidence that they are misdiagnosed and mistreated as asthma. OBJECTIVE: This study aims to explore whether the symptoms of ILO and BPD were topics of discussion in a UK asthma online health community and patient experiences of diagnosis and treatment, in particular their use of reliever inhalers. METHODS: A qualitative thematic analysis was performed with posts from an asthma community between 2018 and 2022. A list of key ILO or BPD symptoms was created from the literature. Posts were identified using the search terms "blue inhaler" and "breath" and included if describing key symptoms. Discussion threads of included posts were also analyzed. RESULTS: The search retrieved a total of 1127 relevant posts: 1069 written by 302 users and 58 posted anonymously. All participants were adults, except 2 who were parents writing about their children. Sex and age were only available for 1.66% (5/302; 3 females and 2 males) and 9.93% (30/302) of participants (27 to 73 years old), respectively. The average number of posts written by each participant was 3.54 (range 1-63). Seven participants wrote >20 posts each. Participants experiencing undiagnosed ILO or BPD symptoms, whether or not comorbid with asthma, expressed frustration with the "one-size-fits-all" approach to diagnosis, as many felt that their asthma diagnosis did not fully explain symptoms. Some suspected or were formally diagnosed with BPD or ILO, the latter reporting relief on receiving a diagnosis and appropriate management. Participants showed awareness of their inappropriate salbutamol use or overuse due to lack of effect on symptoms. BPD and ILO symptoms were frequently comorbid with asthma. The asthma online community was a valuable resource: engagement with peers not only brought comfort but also prompted action with some going back to their clinicians and reaching a diagnosis and appropriate management. CONCLUSIONS: Undiagnosed ILO and BPD symptoms and lack of effects of asthma treatment were topics of discussion in an asthma online community, caused distress and frustration in participants, and affected their relationship with health care professionals, showing that patients experiencing BPD and ILO have unmet needs. Clinicians' education on BPD and ILO diagnosis and management, as well as increased access to appropriate management options, such as respiratory physiotherapy and speech and language therapy, are warranted particularly in primary care. Qualitative evidence that engagement with the online community resulted in patients taking action going back to their clinicians and reaching a diagnosis of ILO and BPD prompts future research on online peer support from an established online health community as a self-management resource for patients

Anti-bunched photons from a lateral light-emitting diode

We demonstrate anti-bunched emission from a lateral-light emitting diode. Sub-Poissonian emission statistic, with a g$^{(2)}$(0)=0.7, is achieved at cryogenic temperature in the pulsed low-current regime, by exploiting electron injection through shallow impurities located in the diode depletion region. Thanks to its simple fabrication scheme and to its modulation bandwidth in the GHz range, we believe our devices are an appealing substitute for highly-attenuated lasers in existing quantum-key-distribution systems. Our devices outperform strongly-attenuated lasers in terms of multi-photon emission events and can therefore lead to a significant security improvement in existing quantum key distribution systems

Surface-acoustic-wave driven planar light-emitting device

Electroluminescence emission controlled by means of surface acoustic waves (SAWs) in planar light-emitting diodes (pLEDs) is demonstrated. Interdigital transducers for SAW generation were integrated onto pLEDs fabricated following the scheme which we have recently developed. Current-voltage, light-voltage and photoluminescence characteristics are presented at cryogenic temperatures. We argue that this scheme represents a valuable building block for advanced optoelectronic architectures

Exploring the types of social support exchanged by survivors of pediatric stroke and their families in an online peer support community: a qualitative thematic analysis (Preprint)

Background: Pediatric stroke is relatively rare, under researched and there is little awareness of its occurrence in wider society. There is a paucity of literature on effectiveness of interventions to improve rehabilitation and services available to survivors. Access to online health communities through the internet may be a means of support for pediatric stroke patients and their families during recovery, however little research has been done in this area. Objective: To identify the types of social support provided by an online peer support group to survivors of pediatric stroke and their families. Methods: Qualitative thematic analysis of posts from a pediatric stroke population on a UK online stroke community active between 2004-2011. The population was split into two groups, based upon whether stroke survivors were 18 and under ( 18y) or over 18 (>18y) at the time of posting. The posts were read by two authors who used the adapted Social Support Behaviour Code to analyze the types of social support exchanged. Results: 52 participants who experienced a pediatric stroke were identified, who posted a total of 425 messages to the community. 41 survivors were 18y at the time of posting and written about by others (31/35 mothers), while 11 were >18y and writing about themselves. Survivors and their familes joined together in discussion threads . Support was offered and received by all participants, regardless of age. Of all 425 posts, 193 (45.4%) contained at least one instance of social support. All five types of social support were identified: informational, emotional, network, esteem support and tangible aid. Informational and emotional support were most commonly exchanged. Emotional support was offered more often than informational support among participants 18y at the time of posting, this finding was reversed in the >18y group. Network support and esteem support were less commonly exchanged. Notably, no access support (a sub-category of network support) was exchanged on the community. Tangible aid was the least commonly type of support offered. Conclusions: We found evidence of engagement of childhood stroke survivors and their families in an online stroke community, with peer support being exchanged between both long and short-term survivors of pediatric stroke. Engagement of long-term survivors of pediatric stroke through the online community was key as they were able to offer informational support from lived experience. Further interventional research is needed to assess health and rehabilitation outcomes from engagement with online support groups. Research is also needed to ensure safe, nurturing online communities. Clinical Trial: n/

Factors Influencing Recovery From Pediatric Stroke Based on Discussions From a UK-Based Online Stroke Community: Qualitative Thematic Study.

BACKGROUND: The incidence of stroke in children is low, and pediatric stroke rehabilitation services are less developed than adult ones. Survivors of pediatric stroke have a long poststroke life expectancy and therefore have the potential to experience impairments from their stroke for many years. However, there are relatively few studies characterizing these impairments and what factors facilitate or counteract recovery. OBJECTIVE: This study aims to characterize the main barriers to and facilitators of recovery from pediatric stroke. A secondary aim was to explore whether these factors last into adulthood, whether they change, or if new factors impacting recovery emerge in adulthood. METHODS: We performed a qualitative thematic analysis based on posts from a population of participants from a UK-based online stroke community, active between 2004 and 2011. The analysis focused on users who talked about their experiences with pediatric stroke, as identified by a previous study. The posts were read by 3 authors, and factors influencing recovery from pediatric stroke were mapped into 4 areas: medical, physical, emotional, and social. Factors influencing recovery were divided into short-term and long-term factors. RESULTS: There were 425 posts relating to 52 survivors of pediatric stroke. Some survivors of stroke posted for themselves, while others were talked about by a third party (mostly parents; 31/35, 89% mothers). In total, 79% (41/52) of survivors of stroke were aged ≤18 years and 21% (11/52) were aged >18 years at the time of posting. Medical factors included comorbidities as a barrier to recovery. Medical interventions, such as speech and language therapy and physiotherapy, were also deemed useful. Exercise, particularly swimming, was deemed a facilitator. Among physical factors, fatigue and chronic pain could persist decades after a stroke, with both reported as a barrier to feeling fully recovered. Tiredness could worsen existing stroke-related impairments. Other long-standing impairments were memory loss, confusion, and dizziness. Among emotional factors, fear and uncertainty were short-term barriers, while positivity was a major facilitator in both short- and long-term recovery. Anxiety, grief, and behavioral problems hindered recovery. The social barriers were loneliness, exclusion, and hidden disabilities not being acknowledged by third parties. A good support network and third-party support facilitated recovery. Educational services were important in reintegrating survivors into society. Participants reported that worrying about losing financial support, such as disability allowances, and difficulties in obtaining travel insurance and driving licenses impacted recovery. CONCLUSIONS: The lived experience of survivors of pediatric stroke includes long-term hidden disabilities and barriers to rehabilitation. These are present in different settings, such as health care, schools, workplaces, and driving centers. Greater awareness of these issues by relevant professional groups may help ameliorate them

Acoustic charge transport in n-i-n three terminal device

We present an unconventional approach to realize acoustic charge transport devices that takes advantage from an original input region geometry in place of standard Ohmic input contacts. Our scheme is based on a n-i-n lateral junction as electron injector, an etched intrinsic channel, a standard Ohmic output contact and a pair of in-plane gates. We show that surface acoustic waves are able to pick up electrons from a current flowing through the n-i-n junction and steer them toward the output contact. Acoustic charge transport was studied as a function of the injector current and bias, the SAW power and at various temperatures. The possibility to modulate the acoustoelectric current by means of lateral in-plane gates is also discussed. The main advantage of our approach relies on the possibility to drive the n-i-n injector by means of both voltage or current sources, thus allowing to sample and process voltage and current signals as well.Comment: 9 pages, 3 figures. Submitted to Applied Physics Letter

What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum

ADS is funded by an NIHR Academic Clinical Lectureship. AB is an NIHR Senior Investigator and additionally was supported by the NIHR Respiratory Disease. RH was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research (CLAHRC) North Thames at Barts NHS Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, NIHR or Department of Health

Delocalized-localized transition in a semiconductor two-dimensional honeycomb lattice

We report the magneto-transport properties of a two-dimensional electron gas in a modulation-doped AlGaAs/GaAs heterostructure subjected to a lateral potential with honeycomb geometry. Periodic oscillations of the magneto-resistance and a delocalized-localized transition are shown by applying a gate voltage. We argue that electrons in such artificial-graphene lattices offer a promising approach for the simulation of quantum phases dictated by Coulomb interactions