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.

Can retired galaxies mimic active galaxies? Clues from the Sloan Digital Sky Survey

The classification of galaxies as star forming or active is generally done in the ([O III]/H beta, [N II]/H alpha) plane. The Sloan Digital Sky Survey (SDSS) has revealed that, in this plane, the distribution of galaxies looks like the two wings of a seagull. Galaxies in the right wing are referred to as Seyfert/LINERs, leading to the idea that non-stellar activity in galaxies is a very common phenomenon. Here, we argue that a large fraction of the systems in the right wing could actually be galaxies which stopped forming stars. The ionization in these `retired` galaxies would be produced by hot post-asymptotic giant branch stars and white dwarfs. Our argumentation is based on a stellar population analysis of the galaxies via our STARLIGHT code and on photoionization models using the Lyman continuum radiation predicted for this population. The proportion of LINER galaxies that can be explained in such a way is, however, uncertain. We further show how observational selection effects account for the shape of the right wing. Our study suggests that nuclear activity may not be as common as thought. If retired galaxies do explain a large part of the seagull`s right wing, some of the work concerning nuclear activity in galaxies, as inferred from SDSS data, will have to be revised.

Videography as production nexus : digital film cameras, media mangement and the distribution of creativity

This thesis is about new digital moving image recording technologies and how they augment the distribution of creativity and the flexibility in moving image production systems, but also impose constraints on how images flow through the production system. The central concept developed in this thesis is ‘creative space’ which links quality and efficiency in moving image production to time for creative work, capacity of digital tools, user skills and the constitution of digital moving image material. The empirical evidence of this thesis is primarily based on semi-structured interviews conducted with Swedish film and TV production representatives.This thesis highlights the importance of pre-production technical planning and proposes a design management support tool (MI-FLOW) as a way to leverage functional workflows that is a prerequisite for efficient and cost effective moving image production.

Bringing Japanese manufacturing systems to America: the feasibility of implementing just-in-time production in the United States

This paper addresses the feasibility of implementing Japanese manufacturing systems in the United States. The recent success of Japanese transplant companies suggests that Just-In-Time (JIT) production is possible within America's industrial environment. Once American workers receive proper training, they have little difficulty participating in rapid setup procedures and utilizing the kanban system. Japanese transplants are gradually developing Japanese-style relationships with their American supplier companies by initiating long-term, mutually beneficial agreements. They are also finding ways to cope with America's problem of distance, which is steadily decreasing as an obstacle to JIT delivery. American companies, however, encounter Significant problems in trying to convert traditionally organized, factories to the JIT system. This paper demonstrates that it is both feasible and beneficial for American manufacturers to implement JIT production techniques. Many of the difficulties manufacturers experience center around a general lack of information about JIT. Once a company realizes its potential for setup-time reduction, a prerequisite for the JIT system, workers and managers can work together to create a new process for handling equipment changeover. Significant results are possible with minimal investment. Also, supervisors often do not realize that the JIT method of ordering goods from suppliers is compatible with current systems. This "kanban system" not only enhances current systems but also reduces the amount of paperwork and scheduling involved. When arranging JlT delivery of supplier goods, American manufacturers tend to overlook important aspects of JIT supplier management. However, by making long-tenn commitments, initiating the open exchange of information, assisting suppliers in reaching new standards of performance, increasing the level of conununication, and relying more on suppliers' engineering capabilities, even American manufacturers can develop Japanese-style supplier relationships that enhance the effectiveness of the system.

Piraí digital e a teoria ator-rede: a trajetória de inclusão e desenvolvimento de Piraí

A cidade de Piraí, no estado do Rio de Janeiro, Brasil, é palco do programa Piraí Digital, um leque de iniciativas, em cinco áreas de atuação – governo, educação, saúde, negócios e cidadania –, com o objetivo de vencer a exclusão digital no município e contribuir para seu desenvolvimento. O programa foi estudado por meio da associação entre um modelo heurístico para análise da inclusão digital e a Teoria Ator-Rede (ANT). O trabalho apresenta a descrição da evolução do programa segundo os atores que o construíram. Entre 1997 e 2009, Piraí Digital contribuiu para uma série de mudanças positivas em Piraí, notadamente nas áreas de educação, a qual adotou a computação 1:1 em toda a rede municipal no ano de 2009; saúde, que utiliza a estrutura de rede de computadores e internet da cidade para disseminar seus sistemas; e governo, onde a administração pública teve ganhos de produtividade e arrecadação por meio da informatização da máquina administrativa. O estudo de Piraí Digital permite compreender a importância da associação de artefatos – rede de computadores, telecentros, Planos Diretores e outros – e das pessoas nos esforços para vencer a exclusão digital e contribuir para o desenvolvimento local. Explorando o contraste entre a grande notoriedade de Piraí Digital fora do município e o baixo conhecimento do programa pela população local, o autor faz a analogia com uma obra de saneamento, pouco conhecida e visível, mas essencial para a população. Em Piraí, o saneamento digital está pronto, com bits jorrando das torneiras nas escolas e a saúde se beneficiando da TI para escoar seu fluxo de informações para benefício dos cidadãos piraienses.

A Modular and digitally programmable interface based on band-pass sigma-delta modulator for mixed-signal systems-on-chip

The focus of this thesis is to discuss the development and modeling of an interface architecture to be employed for interfacing analog signals in mixed-signal SOC. We claim that the approach that is going to be presented is able to achieve wide frequency range, and covers a large range of applications with constant performance, allied to digital configuration compatibility. Our primary assumptions are to use a fixed analog block and to promote application configurability in the digital domain, which leads to a mixed-signal interface. The use of a fixed analog block avoids the performance loss common to configurable analog blocks. The usage of configurability on the digital domain makes possible the use of all existing tools for high level design, simulation and synthesis to implement the target application, with very good performance prediction. The proposed approach utilizes the concept of frequency translation (mixing) of the input signal followed by its conversion to the ΣΔ domain, which makes possible the use of a fairly constant analog block, and also, a uniform treatment of input signal from DC to high frequencies. The programmability is performed in the ΣΔ digital domain where performance can be closely achieved according to application specification. The interface performance theoretical and simulation model are developed for design space exploration and for physical design support. Two prototypes are built and characterized to validate the proposed model and to implement some application examples. The usage of this interface as a multi-band parametric ADC and as a two channels analog multiplier and adder are shown. The multi-channel analog interface architecture is also presented. The characterization measurements support the main advantages of the approach proposed.

A TV digital brasileira a serviço do processo judicial eletrônico: o ambiente da interatividade da TV digital brasileira como proposta para um modelo na gravação de audiência das varas federais criminais

Este trabalho descreve algumas das soluções atualmente adotadas pelos tribunais federais para a gravação de audiência, bem como indica a oportunidade que o ambiente de interatividade da TV Digital Brasileira oferece para uma proposta de modelo de documento eletrônico de escritório que sirva de suporte para o resultado da gravação de audiência (texto, som e imagem), bem como possa contribuir para a mudança de paradigma dos atuais sistemas processuais (softwares). O objetivo é estabelecer um padrão fundamentado em uma política pública (Governo Eletrônico Brasileiro e Sistema Brasileiro de TV Digital Terrestre), onde não existam restrições comerciais quanto ao uso das novas tecnologias de comunicação e informação no que se refere ao mínimo para se privilegiar a inclusão social sem perda de eficiência. O trabalho é formado por dois tipos de conteúdo: parte textual e parte digital. A parte textual contém o resultado de uma pesquisa realizada junto aos tribunais federais, bem como apresenta os principais pontos do Governo Eletrônico Brasileiro e do Sistema Brasileiro de TV Digital Terrestre. Ainda descreve a estrutura montada na elaboração e realização da parte digital. Por sua vez, a parte digital reúne o material utilizado para a apresentação de protótipos (vídeos e exemplos de aplicações), para demonstrar as possibilidades de interatividade da TV Digital Brasileira e dos benefícios que os jurisdicionados e os operadores do Direito alcançariam com a proposta. Palavras-

Mapping digital media: Brazil

The impact of digitization was felt before it could be described and explained. The Mapping Digital Media project is a way of catching up, an ambitious attempt at depicting and understanding the progress and effects of digitization on media and communications systems across the world. The publication of over 50 country reports provides the most comprehensive picture to date on the changes undergone by journalism, news production, and the media as a result of the transition of broadcasting from analog to digital and the advent of the internet. These extensive reports, all sharing the same structure, cover issues such as media consumption, public media, changes in journalism, digital activism, new regulation, and business models. Reports have been published from nine Latin American countries: Mexico, Argentina, Colombia, Peru, Chile, Brazil, Guatemala, Nicaragua, and Uruguay. Given the recent evolution of Brazil’s media landscape and regulation, and its position as a regional reference, few reports have generated as much expectation as the Brazilian one. This excellent text is key to understanding digitization in Brazil, in Latin America, and in the world at large.

Depleting the curriculum: teaching digital platforms and curricular impoverishment

The paper aims at showing how curricular complexity tends to be depleted by the use of digital platforms based on the SCORM (Sharable Content Object Reference Model) standard, which was created with the main purpose of recycling content as it is supposed to be independent both from the context of learning and the supporting technology also deemed to be neutral, all surrounded by a rhetoric of innovation and “pedagogical” innovation. The starting point of the discussion is García Perez’s model of Traditional Didactics as a simple tool to show almost graphically that any ancient didactic model is far richer in terms of complexity than the linearity, in disguise most of the times but still visible under a not so sophisticated critical lens, of the interaction human-(reusable) content that is the basis of the SCORM standard. The paper also addresses some of the more common deliberate mix-ups related to those digital platforms, such as learning and teaching, content and learning object, systems of automatic teaching and learning management systems.

Bibliotecas digitais em Arquitetura e urbanismo: um estudo sobre a arquitetura da informação digital

The goal of this paper was to search the state of the art from the Digital Libraries in Architecture and Urbanism in the Higher Education Institutions (IES) through conceptualizations and showing the importance of Digital Libraries in the disclosure and easing of information transferring. Questions about digital information architecture, usability, digital preservation and accessibility were approached. The research was made in the websites of Brazilian Universities, firstly to identify the institutions which offered the Architecture and Urbanism course, focusing on postgraduate education. After identifying the offering, the research was done by analyzing the contents, storage and dissemination and access to information, these libraries. It was found that the digital libraries are increasingly and taking part of organizations and educational institutions focusing on the knowledge dissemination releasing digitally information that may be needed for institution or the individual. A monitoring was done over of the physical and computational restructuring of the Board of Studies and Research in Architecture and Urbanism (Câmara de Estudos e Pesquisa em Arquitetura e Urbanismo, CEPAU), from the Architecture and Urbanism Course of the Federal University of Rio Grande do Norte (UFRN), showing the need of installing a Digital Library to integrate the databases of PPGAU s research groups, which today remain independent, with no interface among themselves. The research chosen area was Architecture and Urbanism, because there is a gap and little documentation about digital libraries in this area

Measurement systems of soil water matric potential and evaluation of soil moisture under different irrigation depths

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Uma fundamentação matemática para processamento digital de sinais intervalares

This work deals with a mathematical fundament for digital signal processing under point view of interval mathematics. Intend treat the open problem of precision and repesention of data in digital systems, with a intertval version of signals representation. Signals processing is a rich and complex area, therefore, this work makes a cutting with focus in systems linear invariant in the time. A vast literature in the area exists, but, some concepts in interval mathematics need to be redefined or to be elaborated for the construction of a solid theory of interval signal processing. We will construct a basic fundaments for signal processing in the interval version, such as basic properties linearity, stability, causality, a version to intervalar of linear systems e its properties. They will be presented interval versions of the convolution and the Z-transform. Will be made analysis of convergences of systems using interval Z-transform , a essentially interval distance, interval complex numbers , application in a interval filter.