Targeting medication non-adherence behavior in selected autoimmune diseases: a systematic approach to digital health program development

Background 29 autoimmune diseases, including Rheumatoid Arthritis, gout, Crohn’s Disease, and Systematic Lupus Erythematosus affect 7.6-9.4% of the population. While effective therapy is available, many patients do not follow treatment or use medications as directed. Digital health and Web 2.0 interventions have demonstrated much promise in increasing medication and treatment adherence, but to date many Internet tools have proven disappointing. In fact, most digital interventions continue to suffer from high attrition in patient populations, are burdensome for healthcare professionals, and have relatively short life spans. Objective Digital health tools have traditionally centered on the transformation of existing interventions (such as diaries, trackers, stage-based or cognitive behavioral therapy programs, coupons, or symptom checklists) to electronic format. Advanced digital interventions have also incorporated attributes of Web 2.0 such as social networking, text messaging, and the use of video. Despite these efforts, there has not been little measurable impact in non-adherence for illnesses that require medical interventions, and research must look to other strategies or development methodologies. As a first step in investigating the feasibility of developing such a tool, the objective of the current study is to systematically rate factors of non-adherence that have been reported in past research studies. Methods Grounded Theory, recognized as a rigorous method that facilitates the emergence of new themes through systematic analysis, data collection and coding, was used to analyze quantitative, qualitative and mixed method studies addressing the following autoimmune diseases: Rheumatoid Arthritis, gout, Crohn’s Disease, Systematic Lupus Erythematosus, and inflammatory bowel disease. Studies were only included if they contained primary data addressing the relationship with non-adherence. Results Out of the 27 studies, four non-modifiable and 11 modifiable risk factors were discovered. Over one third of articles identified the following risk factors as common contributors to medication non-adherence (percent of studies reporting): patients not understanding treatment (44%), side effects (41%), age (37%), dose regimen (33%), and perceived medication ineffectiveness (33%). An unanticipated finding that emerged was the need for risk stratification tools (81%) with patient-centric approaches (67%). Conclusions This study systematically identifies and categorizes medication non-adherence risk factors in select autoimmune diseases. Findings indicate that patients understanding of their disease and the role of medication are paramount. An unexpected finding was that the majority of research articles called for the creation of tailored, patient-centric interventions that dispel personal misconceptions about disease, pharmacotherapy, and how the body responds to treatment. To our knowledge, these interventions do not yet exist in digital format. Rather than adopting a systems level approach, digital health programs should focus on cohorts with heterogeneous needs, and develop tailored interventions based on individual non-adherence patterns.

Putting theory to work: the use of theory in construction research

Attention to epistemology, theory use and citation practices are all issues which distinguish academic disciplines from other ways of knowing. Examples from construction research are used to outline and reflect on these issues. In doing so, the discussion provides an introduction to some key issues in social research as well as a reflection on the current state of construction research as a field. More specifically, differences between positivist and interpretivist epistemologies, the role of theory in each and their use by construction researchers are discussed. Philosophical differences are illustrated by appeal to two published construction research articles by Reichstein et al. and Harty on innovation (Reichstein, Salter and Gann, 2005; Harty, 2008). An analysis of citations for each highlights different cumulativity strategies. The potential contribution of mixed research programmes, combining positivist and interpretivist research, is evaluated. The paper should be of interest to early researchers and to scholars concerned with the ongoing development of construction research as an academic field.

Creativity, entrepreneurship and economic development: city-level evidence on creativity spillover of entrepreneurship

We examine the black box of creativity, entrepreneurship and economic development by asking about the mechanisms through which creativity can influence economic development in cities. We propose that, like the knowledge spillover theory of entrepreneurship, creativity spillovers occur and can be slowed by a creativity filter. We examine how creativity and entrepreneurship, and creativity and a melting pot environment, interact to influence urban economic development. Using data on 187 cities in 15 European countries for the period 1999–2009, we advance the extant literature by providing evidence on the existence and dynamics of a creativity filter.

Axial ligand influence on geometries, charge distributions and electronic structures of iron tetraazamacrocycle [Fe((II))TIM(X)(Y)](2+) complexes assessed by Density Functional Theory

We employed the Density Functional Theory along with small basis sets, B3LYP/LANL2DZ, for the study of FeTIM complexes with different pairs of axial ligands (CO, H(2)O, NH(3), imidazole and CH(3)CN). These calculations did not result in relevant changes of molecular quantities as bond lengths, vibrational frequencies and electronic populations supporting any significant back-donation to the carbonyl or acetonitrile axial ligands. Moreover, a back-donation mechanism to the macrocycle cannot be used to explain the observed changes in molecular properties along these complexes with CO or CH(3)CN. This work also indicates that complexes with CO show smaller binding energies and are less stable than complexes with CH(3)CN. Further, the electronic band with the largest intensity in the visible region (or close to this region) is associated to the transition from an occupied 3d orbital on iron to an empty pi* orbital located at the macrocycle. The energy of this Metal-to-Ligand Charge Transfer (MLCT) transition shows a linear relation to the total charge of the macrocycle in these complexes as given by Mulliken or Natural Population Analysis (NPA) formalisms. Finally, the macrocycle total charge seems to be influenced by the field induced by the axial ligands. (C) 2011 Elsevier Ltd. All rights reserved.

The Development of Swedish Tourism Public Policy 1930-2010

In this article, the development and changes in Swedish public policy relating to tourism from the 1930s to 2010 is described and interpreted from a political economy perspective. A case study, compiled from mainly secondary sources, is analyzed from a theoretical framework based on regulation theory. The purpose with this study is to increase the understanding of how the macro political economy context has influenced the policy-making in tourism in Sweden, but also to make a contribution to an area which seems to be quite neglected when it comes to research. The changes are analyzed according to the three periods denoted as pre-Fordism (mid-19th century-1930s), Fordism (1930s-1970s) and post-Fordism (1970s to present). It is observed how the general changes between these periods regarding aspects such as regulation and deregulation, and the degree of state involvement, have affected tourism policy making. The tourism policy making has changed from being insignificant, to a high degree of state involvement including planning, control and supervision, to a situation where the market rather than government regulation is considered as state of the art. 

The implications of embodiment and Putty-Clay to economic development

In this paper we construct and analyze a growth model with the following three ingredients. (i) Technological progress is embodied. (ii) The production function of a firm is such that the firm makes both technology upgrade as well as capital and labor decisions. (iii) The firm’s production technology is putty-clay. We assume that there are disincentives to the accumulation of capital, resulting in a divergence between the social and the private cost of investment. We solve a single firm’s problem in this environment. Then we determine general equilibrium prices of capital goods of different vintages. Using these prices we aggregate firms’ decisions and construct the theoretical analogues of National Income statistics. This generates a relationship between disincentives and per capita incomes. We analyze this relationship and show the quantitative and qualitative roles of embodiment and putty-clay. We also show how the model is taken to data, quantified and used to determine to what extent income gaps across countries can be attributed to disincentives.

Achieving quality in management of development ngos: analysis of four ngos in Rio de Janeiro.

Rio de Janeiro is among the cities with the highest amount of NGOs in the world. However, not all of the projects carried out by the NGOs are equally successful. In this research, I would like to analyze a selection of some of the most well-known social development enterprises operating in Rio, in order to better understand how they operate, what difficulties they face, which factors play the crucial role in achieving peak performance. Moreover, I would like to compare the field research findings with the academic theory on management of social development NGOs, and possibly come up with ideas for further improvements.

The importance of clusters for the development of small & medium enterprises

This thesis aims to open a theoretical discussion on the importance of cluster for the development of Small and Medium Enterprises. The methodology applied was based on bibliographical and qualitative research. The basic questions raised by this study can be summarized as follows: How the creation of a cluster will help in the development of the SME?. Consequently, the final objective of the work is to identify which are the characteristics that help into the success of a Small & Medium Enterprises inserted in a cluster. The answer to this question led the research to a better understanding of (i) the characterization of the Small & Medium Enterprises; (ii) the clusters theory; (iii) evidence for a developed (Italy) and a developing (Chile) country that support our proposition to verify. The main results confirm the relevance of the cluster for the development of the Small and Medium Enterprises because of the collective efficiency that generates, improving the funding conditions, the exporter capacity and diminishing the activities costs of the small companies that are part of the conglomerate.

The influence of the supply chain agents on the new product development's performance: an analysis based on the multi-group moderation

Este estudo buscou verificar a influencia dos agentes da cadeia de suprimentos no desempenho do desenvolvimento de novos produtos quando os agentes são analisados em conjunto. A motivação desta pesquisa veio de estudos que alertaram para a consideração da integração da cadeia de suprimentos como um constructo multidimensional, englobando o envolvimento da manufatura, fornecedores e clientes no desenvolvimento de novos produtos; e devido à falta de informação sobre as influencias individuais destes agentes no desenvolvimento de novos produtos. Sob essas considerações, buscou-se construir um modelo analítico baseado na Teoria do Capital Social e Capacidade Absortiva, construir hipóteses a partir da revisão da literatura e conectar constructos como cooperação, envolvimento do fornecedor no desenvolvimento de novos produtos (DNP), envolvimento do cliente no DNP, envolvimento da manufatura no DNP, antecipação de novas tecnologias, melhoria contínua, desempenho operacional do DNP, desempenho de mercado do NPD e desempenho de negócio do DNP. Para testar as hipóteses foram consideradas três variáveis moderadoras, tais como turbulência ambiental (baixa, média e alta), indústria (eletrônicos, maquinários e equipamentos de transporte) e localização (América, Europa e Ásia). Para testar o modelo foram usados dados do projeto High Performance Manufacturing que contém 339 empresas das indústrias de eletrônicos, maquinários e equipamentos de transporte, localizadas em onze países. As hipóteses foram testadas por meio da Análise Fatorial Confirmatória (AFC) incluindo a moderação muti-grupo para as três variáveis moderadoras mencionadas anteriormente. Os principais resultados apontaram que as hipóteses relacionadas com cooperação foram confirmadas em ambientes de média turbulência, enquanto as hipóteses relacionadas ao desempenho no DNP foram confirmadas em ambientes de baixa turbulência ambiental e em países asiáticos. Adicionalmente, sob as mesmas condições, fornecedores, clientes e manufatura influenciam diferentemente no desempenho de novos produtos. Assim, o envolvimento de fornecedores influencia diretamente no desempenho operacional e indiretamente no desempenho de mercado e de negócio em baixos níveis de turbulência ambiental, na indústria de equipamentos de transporte em países da Americanos e Europeus. De igual forma, o envolvimento do cliente influenciou diretamente no desempenho operacional e indiretamente no desempenho de mercado e do negócio em médio nível de turbulência ambiental, na indústria de maquinários e em países Asiáticos. Fornecedores e clientes não influenciam diretamente no desempenho de mercado e do negócio e não influenciam indiretamente no desempenho operacional. O envolvimento da manufatura não influenciou nenhum tipo de desempenho do desenvolvimento de novos produtos em todos os cenários testados.

Sustainable silvopastoral systems: theory and a practical case

Muitas transformações são esperadas por causa das mudanças do clima, especialmente das atividades agrícolas realizadas nos trópicos. Esta tese centra-se em dois aspectos. O primeiro deles é o de reunir o conhecimento de sistemas silvipastoris; este ponto de vista estabelece a importância de solos tropicais e sua gestão adequada de acordo com as normas ambientais e sustentáveis. A segunda parte da tese é a aplicação desses princípios em um caso específico: a fazenda "El Paraíso". O objetivo central ou problema a resolver da segunda parte é propor um projeto para melhorar as atividades de produção de carne e, ao mesmo tempo, ajudar a preservar e melhorar o meio ambiente e especialmente os ecossistemas tropicais. A metodologia utilizada na tese foi buscar e analisar informações sobre o assunto. Depois disso, a investigação experimental e de campo foi realizada para levantar o projeto que combinaria as duas partes da obra. No final, com a informação recolhida uma proposta de projeto foi feita. O objetivo era propor a transformação dos processos de produção na fazenda selecionada. Logo de desenvolver e apresentar o projeto, foram analisadas as possibilidades de implementação do projeto. A conclusão do estudo foi o de apresentar e discutir três cenários possíveis após a implementação. Finalmente, a conclusão geral apresenta as realizações, as oportunidades e possíveis expansões futuras do projeto.

An essay on economic growth: classical determinants, convergence and financial development

This dissertation surveys the literature on economic growth. I review a substantial number of articles published by some of the most renowned researchers engaged in the study of economic growth. The literature is so vast that before undertaking new studies it is very important to know what has been done in the field. The dissertation has six chapters. In Chapter 1, I introduce the reader to the topic of economic growth. In Chapter 2, I present the Solow model and other contributions to the exogenous growth theory proposed in the literature. I also briefly discuss the endogenous approach to growth. In Chapter 3, I summarize the variety of econometric problems that affect the cross-country regressions. The factors that contribute to economic growth are highlighted and the validity of the empirical results is discussed. In Chapter 4, the existence of convergence, whether conditional or not, is analyzed. The literature using both cross-sectional and panel data is reviewed. An analysis on the topic of convergence using a quantile-regression framework is also provided. In Chapter 5, the controversial relationship between financial development and economic growth is analyzed. Particularly, I discuss the arguments in favour and against the Schumpeterian view that considers financial development as an important determinant of innovation and economic growth. Chapter 6 concludes the dissertation. Summing up, the literature appears to be not fully conclusive about the main determinants of economic growth, the existence of convergence and the impact of finance on growth.

Markets-as-networks theory: a review

This paper exposes the development of markets-as-networks theory from formal inception in the mid-1970s until 2010 state-of-the-art, en route presenting its historical roots. This largely European-based theory challenges the conventional, dichotomous view of the business world as including firms and markets, arguing for the existence of relational governance structures (the so-called ‘‘interfirm cooperation’’) in addition to hierarchical and transactional ones.

Alternative Model of Three-Phase Transmission Line Theory-Based Modal Decomposition

In this paper is shown the development of a transmission line, based on discrete circuit elements that provide responses directly in the time domain and phase. This model is valid for ideally transposed rows represent the phases of each of the small line segments are separated in their modes of propagation and the voltage and current are calculated at the modal field. However, the conversion phase-mode-phase is inserted in the state equations which describe the currents and voltages along the line of which there is no need to know the user of the model representation of the theory in the field lines modal.

GT4CCI: uma abordagem baseada em grounded theory para a identificação de interesses transversais em documentos de requisitos

When crosscutting concerns identification is performed from the beginning of development, on the activities involved in requirements engineering, there are many gains in terms of quality, cost and efficiency throughout the lifecycle of software development. This early identification supports the evolution of requirements, detects possible flaws in the requirements specification, improves traceability among requirements, provides better software modularity and prevents possible rework. However, despite these several advantages, the crosscutting concerns identification over requirements engineering faces several difficulties such as the lack of systematization and tools that support it. Furthermore, it is difficult to justify why some concerns are identified as crosscutting or not, since this identification is, most often, made without any methodology that systematizes and bases it. In this context, this paper proposes an approach based on Grounded Theory, called GT4CCI, for systematizing and basing the process of identifying crosscutting concerns in the initial stages of the software development process in the requirements document. Grounded Theory is a renowned methodology for qualitative analysis of data. Through the use of GT4CCI it is possible to better understand, track and document concerns, adding gains in terms of quality, reliability and modularity of the entire lifecycle of software