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.

Improving the TanDEM-X Digital Elevation Model for flood modelling using flood extents from Synthetic Aperture Radar images

The topography of many floodplains in the developed world has now been surveyed with high resolution sensors such as airborne LiDAR (Light Detection and Ranging), giving accurate Digital Elevation Models (DEMs) that facilitate accurate flood inundation modelling. This is not always the case for remote rivers in developing countries. However, the accuracy of DEMs produced for modelling studies on such rivers should be enhanced in the near future by the high resolution TanDEM-X WorldDEM. In a parallel development, increasing use is now being made of flood extents derived from high resolution Synthetic Aperture Radar (SAR) images for calibrating, validating and assimilating observations into flood inundation models in order to improve these. This paper discusses an additional use of SAR flood extents, namely to improve the accuracy of the TanDEM-X DEM in the floodplain covered by the flood extents, thereby permanently improving this DEM for future flood modelling and other studies. The method is based on the fact that for larger rivers the water elevation generally changes only slowly along a reach, so that the boundary of the flood extent (the waterline) can be regarded locally as a quasi-contour. As a result, heights of adjacent pixels along a small section of waterline can be regarded as samples with a common population mean. The height of the central pixel in the section can be replaced with the average of these heights, leading to a more accurate estimate. While this will result in a reduction in the height errors along a waterline, the waterline is a linear feature in a two-dimensional space. However, improvements to the DEM heights between adjacent pairs of waterlines can also be made, because DEM heights enclosed by the higher waterline of a pair must be at least no higher than the corrected heights along the higher waterline, whereas DEM heights not enclosed by the lower waterline must in general be no lower than the corrected heights along the lower waterline. In addition, DEM heights between the higher and lower waterlines can also be assigned smaller errors because of the reduced errors on the corrected waterline heights. The method was tested on a section of the TanDEM-X Intermediate DEM (IDEM) covering an 11km reach of the Warwickshire Avon, England. Flood extents from four COSMO-SKyMed images were available at various stages of a flood in November 2012, and a LiDAR DEM was available for validation. In the area covered by the flood extents, the original IDEM heights had a mean difference from the corresponding LiDAR heights of 0.5 m with a standard deviation of 2.0 m, while the corrected heights had a mean difference of 0.3 m with standard deviation 1.2 m. These figures show that significant reductions in IDEM height bias and error can be made using the method, with the corrected error being only 60% of the original. Even if only a single SAR image obtained near the peak of the flood was used, the corrected error was only 66% of the original. The method should also be capable of improving the final TanDEM-X DEM and other DEMs, and may also be of use with data from the SWOT (Surface Water and Ocean Topography) satellite.

Research methods in TESOL and digital literacies

One of the biggest challenges of integrating research in TESOL with research in digital literacies is that the research methodologies of these two traditions have developed out of different ontological and episte- mological assumptions about what is being researched (the object of study), where the research is located (the research site), and who is being researched (the research participants).

e-Leadership through strategic alignment: an empirical study of small and medium sized enterprises in the digital age

Small and medium sized enterprises (SMEs) play an important role in the European economy. A critical challenge faced by SME leaders, as a consequence of the continuing digital technology revolution, is how to optimally align business strategy with digital technology to fully leverage the potential offered by these technologies in pursuit of longevity and growth. There is a paucity of empirical research examining how e-leadership in SMEs drives successful alignment between business strategy and digital technology fostering longevity and growth. To address this gap, in this paper we develop an empirically derived e-leadership model. Initially we develop a theoretical model of e-leadership drawing on strategic alignment theory. This provides a theoretical foundation on how SMEs can harness digital technology in support of their business strategy enabling sustainable growth. An in-depth empirical study was undertaken interviewing 42 successful European SME leaders to validate, advance and substantiate our theoretically driven model. The outcome of the two stage process – inductive development of a theoretically driven e-leadership model and deductive advancement to develop a complete model through in-depth interviews with successful European SME leaders – is an e-leadership model with specific constructs fostering effective strategic alignment. The resulting diagnostic model enables SME decision makers to exercise effective e-leadership by creating productive alignment between business strategy and digital technology improving longevity and growth prospects.

Geography, skills and careers patterns at the boundary of creativity & innovation: digital technology and creative arts graduates in the UK

In the last decades, research on knowledge economies has taken central stage. Within this broader research field, research on the role of digital technologies and the creative industries has become increasingly important for researchers, academics and policy makers with particular focus on their development, supply-chains and models of production. Furthermore, many have recognised that, despite the important role played by digital technologies and innovation in the development of the creative industries, these dynamics are hard to capture and quantify. Digital technologies are embedded in the production and market structures of the creative industries and are also partially distinct and discernible from it. They also seem to play a key role in innovation of access and delivery of creative content. This chapter tries to assess the role played by digital technologies focusing on a key element of their implementation and application: human capital. Using student micro-data collected by the Higher Education Statistical Agency (HESA) in the United Kingdom, we explore the characteristics and location patterns of graduates who entered the creative industries, specifically comparing graduates in the creative arts and graduates from digital technology subjects. We highlight patterns of geographical specialisation but also how different context are able to better integrate creativity and innovation in their workforce. The chapter deals specifically with understanding whether these skills are uniformly embedded across the creative sector or are concentrated in specific sub-sectors of the creative industries. Furthermore, it explores the role that these graduates play in different sub-sector of the creative economy, their economic rewards and their geographical determinants.

Digital visualisation in Classics teaching and beyond

For the last few years, I have been working on an extensive digital model of ancient Rome as it appeared in the early 4th Century AD. This sort of visualisation lends itself to many applications in diverse fields: I am currently using it for research work into illumination and sightlines in the ancient city, have licensed it for broadcast in TV documentaries and publication in magazines, and am working with a computer games studio to turn it into an online game where players will be able to walk round the streets and buildings of the entire city (when not engaged in trading with or assassinating one another). Later this year I will be making a free online course, or MOOC, about the architecture of ancient Rome, which will largely be illustrated by this model.

Evaluation of directional microphone drift in digital hearing aids

The occurrence of directional microphone drift following hearing aid use has been infrequently examined. This study uses the front-to-side ratio to evaluate changes in directional microphone output from new behind-the-ear hearing aids and following approximately three months of hearing aid use. Results indicate no overall significant differences in the front-to-side ratio between initial and follow-up measurements.

A complex network approach to text summarization

Automatic summarization of texts is now crucial for several information retrieval tasks owing to the huge amount of information available in digital media, which has increased the demand for simple, language-independent extractive summarization strategies. In this paper, we employ concepts and metrics of complex networks to select sentences for an extractive summary. The graph or network representing one piece of text consists of nodes corresponding to sentences, while edges connect sentences that share common meaningful nouns. Because various metrics could be used, we developed a set of 14 summarizers, generically referred to as CN-Summ, employing network concepts such as node degree, length of shortest paths, d-rings and k-cores. An additional summarizer was created which selects the highest ranked sentences in the 14 systems, as in a voting system. When applied to a corpus of Brazilian Portuguese texts, some CN-Summ versions performed better than summarizers that do not employ deep linguistic knowledge, with results comparable to state-of-the-art summarizers based on expensive linguistic resources. The use of complex networks to represent texts appears therefore as suitable for automatic summarization, consistent with the belief that the metrics of such networks may capture important text features. (c) 2008 Elsevier Inc. All rights reserved.

Comparison of learning between Digital gallery and Hands-on Laboratory

This thesis has been done in ROM (Royal Ontario Museum) located in Toronto Canada. It focuses on learning in two parts of the museum. It tries to find out how much each part is effective in terms of learning. Studies have been done in the Digital gallery, which has been equipped with digital video projector and workstation that allows visitors to interact with the collections in 2 or 3 dimensional spaces while they are watching the presenting film. The rest of the study was in Hands-on laboratory, which allows students to examine artifacts and discuss their findings .The method was used in this research is Concept mapping .In Digital gallery, 24 schools surveys in the form of pre-post- test by help of the concept mapping method has been done. In Hands-on laboratory, 12 schools have been studied by using the combination of interviewing and written pre post-test of concept mapping.

Analog eller digital summering vid mixning av ljud : Blir det någon skillnad i slutresultatet?

I denna uppsats undersöks huruvida en lyssnare kan skilja på två ljudmixar som är mixade på samma sätt men summerade på olika sätt. Den ena summeras analogt och den andra digitalt. Om så är fallet, hur tycker lyssnaren att dessa skillnader yttrar sig? Som metod fick en testpanel i ett blindtest lyssna på två olika mixar, en rocklåt och en jazzlåt, som båda fanns i både analogt och digitalt summerade versioner. Dessa fick testsubjekten sedan besvara några frågor kring och tycka till om dessa olika versioner i en kvalitativ enkätundersökning Det visade sig att skillnader uppfattades av merparten av lyssnarna. Den vanligast förekommande beskrivningen var att det var skillnad på stereobredd, djup och dynamik i mixarna beroende på hur de summerats. Även ord som klarhet, värme och tydlighet förekom. Testpanelen var överlag även väldigt bra på att gissa vilken version som var summerad på vilket sätt. Dessa gissningar verkar i på många fall vara baserad på den förutfattade meningen att analogt borde vara bättre. Det är ganska tydligt att detta forskningsarbete i mångt och mycket är en fallstudie för just de variabler som förekom (märke på den analoga summeraren, ljudkvalité på de inspelade ljudet, programmaterial med mera). Fler tester och undersökningar behövs för att kunna dra generella slutsatser.

Lärare i en digital tidsålder : en kvalitativ studie av lärares förhållande till sociala medier

Detta arbete är en kvalitativ fallstudie med syfte att undersöka hur några intervjuade lärare från en gymnasieskola i södra Norrland förhåller sig till sociala medier, hur dessa lärare uppfattar att sociala medier påverkar deras integritet, yrkesetik, fostransuppdrag och pedagogiska arbete. Frågeställningarna arbetet har utgått ifrån har berört gränsdragningar mellan privatliv och offentlighet, hur lärare kan uppträda i sociala medier, hur lärare ser på vänskapsrelationer till elever, vilka eventuella pedagogiska vinningar respektive hot sociala medier kan tänkas medföra.För att besvara uppsatsens frågeställningar har intervjuer med sju anställda lärare på en given gymnasieskola gjorts. De resultat som framkommit i denna studie, är bland annat att samtliga lärare är överens om att lärares privatliv påverkar deras yrkesroll i viss mån. Ifråga om vad lärare kan göra i sociala medier, med åtanke på deras yrkesroll, var de flesta lärare överens om att brott mot skolans värdegrund samt yrkesetiska principer var förbjudna, men också att lärare utöver detta har ett visst ansvar över hur man framställer sig själv i sociala medier. Gällande pedagogiska hot och vinningar, finns det ett potentiellt hot att lärares arbetsbörda ökar, samtidigt är vinningen att lärares förståelse för elever kan tillta.

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.

Talar de om samma sak? : Lärares respektive skollednings syn på implementeringen av digital teknik i en F-6-skola

Syftet med denna studie är att få en insikt i lärares respektive skollednings syn på implementering av digital teknik i undervisningen på en mindre F–6-skola. Genom enkäter till samtliga lärare på skolan samt intervjuer med fyra lärare och rektor på skolan undersöktes hur de ser på syftet med implementeringen och hur de använder den utrustning de har tillgång till. De tillfrågades även om hur de ser på resultatet och vad de kan ange som framgångsfaktorer respektive hinder i implementeringen. Genom att använda ett verksamhetsteoretiskt perspektiv gavs möjlighet att undersöka hur individer som innehar olika positioner i en organisation samverkar i implementeringsprocessen. Verksamhetsteorin hjälper oss att se på hur lärare respektive skolledning kommunicerar på olika nivåer i organisationen. Resultatet av studien visar att lärare och skolledning till stora delar har samma mål med implementeringen, men att deras uppfattning om vad som styr användandet av den digitala tekniken i undervisningen skiljer sig åt. Lärarna fokuserar på kommunikationen med eleverna och de ser den digitala tekniken som lärresurser medan skolledningen fokuserar mera på den fysiska tillgången till utrustningen och lärarnas behov av fortbildning för att öka möjligheterna att hantera denna.    En nedskriven plan för implementeringen av digital teknik i undervisningen saknas på den aktuella skolan. Därför har de inte tillgång till det verktyg planen skulle kunna utgöra för att tillsammans kunna driva implementeringen med gemensamma krafter. De diskuterar därigenom inte tillsammans hur de ska arbeta med denna process, utan de diskussioner som förekommer sker i mindre grupper.