Adaptive intervention design in mobile health: Intervention design and development in the Cell Phone Intervention for You trial.

BACKGROUND/AIMS: The obesity epidemic has spread to young adults, and obesity is a significant risk factor for cardiovascular disease. The prominence and increasing functionality of mobile phones may provide an opportunity to deliver longitudinal and scalable weight management interventions in young adults. The aim of this article is to describe the design and development of the intervention tested in the Cell Phone Intervention for You study and to highlight the importance of adaptive intervention design that made it possible. The Cell Phone Intervention for You study was a National Heart, Lung, and Blood Institute-sponsored, controlled, 24-month randomized clinical trial comparing two active interventions to a usual-care control group. Participants were 365 overweight or obese (body mass index≥25 kg/m2) young adults. METHODS: Both active interventions were designed based on social cognitive theory and incorporated techniques for behavioral self-management and motivational enhancement. Initial intervention development occurred during a 1-year formative phase utilizing focus groups and iterative, participatory design. During the intervention testing, adaptive intervention design, where an intervention is updated or extended throughout a trial while assuring the delivery of exactly the same intervention to each cohort, was employed. The adaptive intervention design strategy distributed technical work and allowed introduction of novel components in phases intended to help promote and sustain participant engagement. Adaptive intervention design was made possible by exploiting the mobile phone's remote data capabilities so that adoption of particular application components could be continuously monitored and components subsequently added or updated remotely. RESULTS: The cell phone intervention was delivered almost entirely via cell phone and was always-present, proactive, and interactive-providing passive and active reminders, frequent opportunities for knowledge dissemination, and multiple tools for self-tracking and receiving tailored feedback. The intervention changed over 2 years to promote and sustain engagement. The personal coaching intervention, alternatively, was primarily personal coaching with trained coaches based on a proven intervention, enhanced with a mobile application, but where all interactions with the technology were participant-initiated. CONCLUSION: The complexity and length of the technology-based randomized clinical trial created challenges in engagement and technology adaptation, which were generally discovered using novel remote monitoring technology and addressed using the adaptive intervention design. Investigators should plan to develop tools and procedures that explicitly support continuous remote monitoring of interventions to support adaptive intervention design in long-term, technology-based studies, as well as developing the interventions themselves.

The numerical simulation of aircraft evacuation and its application to aircraft design and certification

Computer based mathematical models describing the aircraft evacuation process have a vital role to play in the design and development of safer aircraft, in the implementation of safer and more rigorous certification criteria and in cabin crew training and post mortuum accident investigation. As the risk of personal injury and costs involved in performing large-scale evacuation experiments for the next generation `Ultra High Capacity Aircraft' (UHCA) are expected to be high, the development and use of these evacuation modelling tools may become essential if these aircraft are to prove a viable reality. This paper describes the capabilities and limitations of the airEXODUS evacuation model and some attempts at validation, including its successful application to the prediction of a recent certification trial, prior to the actual trial taking place, is described. Also described is a newly defined parameter known as OPS which can be used as a measure of evacuation trial optimality. In addition, sample evacuation simulations in the presence of fire atmospheres are described.

The numerical simulation of aircraft evacuation and its application to aircraft design and certification

Computer based mathematical models describing the aircraft evacuation process have a vital role to play in the design and development of safer aircraft, the implementation of safer and more rigorous certification criteria, in cabin crew training and post-mortem accident investigation. As the risk of personal injury and the costs involved in performing large-scale evacuation experiments for the next generation ultra high capacity aircraft (UHCA) are expected to be high, the development and use of these evacuation modelling tools may become essential if these aircraft are to prove a viable reality. This paper describes the capabilities and limitations of the airEXODUS evacuation model and some attempts at validation, including its successful application to the prediction of a recent certification trial, prior to the actual trial taking place. Also described is a newly defined performance parameter known as OPS that can be used as a measure of evacuation trial optimality. In addition, sample evacuation simulations in the presence of fire atmospheres are described.

An intelligent assistant for design and material engineers in the submarine cable industry

This paper describes an industrial application of case-based reasoning in engineering. The application involves an integration of case-based reasoning (CBR) retrieval techniques with a relational database. The database is specially designed as a repository of experiential knowledge and with the CBR application in mind such as to include qualitative search indices. The application is for an intelligent assistant for design and material engineers in the submarine cable industry. The system consists of three components; a material classifier and a database of experiential knowledge and a CBR system is used to retrieve similar past cases based on component descriptions. Work has shown that an uncommon retrieval technique, hierarchical searching, well represents several search indices and that this techniques aids the implementation of advanced techniques such as context sensitive weights. The system is currently undergoing user testing at the Alcatel Submarine Cables site in Greenwich. Plans are for wider testing and deployment over several sites internationally.

Book Review Sharon L. Lohr Sampling: Design and Analysis

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Design and modeling challenges for high density packaging

Today most of the IC and board designs are undertaken using two-dimensional graphics tools and rule checks. System-in-package is driving three-dimensional design concepts and this is posing a number of challenges for electronic design automation (EDA) software vendors. System-in-package requires three-dimensional EDA tools and design collaboration systems with appropriate manufacturing and assembly rules for these expanding technologies. Simulation and Analysis tools today focus on one aspect of the design requirement, for example, thermal, electrical or mechanical. System-in-Package requires analysis and simulation tools that can easily capture the complex three dimensional structures and provided integrated fast solutions to issues such as thermal management, reliability, electromagnetic interference, etc. This paper discusses some of the challenges faced by the design and analysis community in providing appropriate tools to engineers for System-in-Package design

Sustainable Olympic design and urban development

With appropriate planning and design, Olympic urban development has the potential to leave positive environmental legacies to the host city and contribute to environmental sustainability. This book explains how a modern Olympic games can successfully develop a more sustainable design approach by learning from the lessons of the past and by taking account of the latest developments. It offers an assessment tool that can be tailored to individual circumstances – a tool which emerges from the analysis of previous summer games host cities and from techniques in environmental analysis and assessment.