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The paper explores the integration of emotional design elements in the development of medical devices to enhance user acceptance and adherence. It emphasizes the importance of a user-centered approach, acknowledging both functional and emotional needs. The study compares two cases within healthcare design, highlighting the impact of emotional design on users' perception of medical devices. Despite the different stages of development in the two cases, both employed a higher level of refflective design, aiming to create a lasting impact on users' identity using the products.
NASA’s all-sky survey mission, the Transiting Exoplanet Survey Satellite (TESS), is specifically engineered to detect exoplanets that transit bright stars. Thus far, TESS has successfully identified approximately 400 transiting exoplanets, in addition to roughly 6 000 candidate exoplanets pending confirmation. In this study, we present the results of our ongoing project, the Validation of Transiting Exoplanets using Statistical Tools (VaTEST). Our dedicated effort is focused on the confirmation and characterisation of new exoplanets through the application of statistical validation tools. Through a combination of ground-based telescope data, high-resolution imaging, and the utilisation of the statistical validation tool known as TRICERATOPS, we have successfully discovered eight potential super-Earths. These planets bear the designations: TOI-238b (1.61$^{+0.09} _{-0.10}$ R$_\oplus$), TOI-771b (1.42$^{+0.11} _{-0.09}$ R$_\oplus$), TOI-871b (1.66$^{+0.11} _{-0.11}$ R$_\oplus$), TOI-1467b (1.83$^{+0.16} _{-0.15}$ R$_\oplus$), TOI-1739b (1.69$^{+0.10} _{-0.08}$ R$_\oplus$), TOI-2068b (1.82$^{+0.16} _{-0.15}$ R$_\oplus$), TOI-4559b (1.42$^{+0.13} _{-0.11}$ R$_\oplus$), and TOI-5799b (1.62$^{+0.19} _{-0.13}$ R$_\oplus$). Among all these planets, six of them fall within the region known as ‘keystone planets’, which makes them particularly interesting for study. Based on the location of TOI-771b and TOI-4559b below the radius valley we characterised them as likely super-Earths, though radial velocity mass measurements for these planets will provide more details about their characterisation. It is noteworthy that planets within the size range investigated herein are absent from our own solar system, making their study crucial for gaining insights into the evolutionary stages between Earth and Neptune.
Insomnia in depression is common and difficult to resolve. Music is commonly used as a sleep aid, and clinical trials pointing to positive effects of music as a sleep aid are increasing adding to the evidence base. There is little knowledge on the effectiveness of music for depression related insomnia.
Objectives
A recent RCT study conducted in psychiatry at Aalborg University Hospital examined effects of a music intervention for insomnia in depression. The intervention group listened to music at bedtime for four weeks, controls were offered music intervention post-test. Primary outcome measure was Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes included Actigraphy, The Hamilton depression Rating Scale (HAMD-17) and World Health Organisation well-being questionnaires (WHO-5, WHOQOL-BREF).
Methods
A two-armed randomized controlled trial (n=112) and a qualitative interview study (n=4)
Results
The RCT study showed signficant improvements for the music intervention group in sleep quality and quality of life at four weeks according to global PSQI scores (effect size= -2.1, 95%CI -3.3; -0.9) and WHO-5 scores (effect size 8.4, 95%CI 2.7; 14.0). Actigraphy measures showed no changes and changes in depression symptoms (HAMD-17) were not detected.
The interview study unfolded examples of the influences of music on sleep and relaxation. Music distracted, affected mood and arousal positively and supported formation of sleep habits.
Results from the trial are discussed and merged with findings from the interview study. The results from the trial suggested moderate effects of music listening for the population while findings from the interview study showed examples of individual and highly varying outcomes.
Conclusions
Music is suggested as a low-cost, side-effect free and safe intervention in supplement to existing treatments improving sleep in depression.
The way in which domestic cats are kept and bred has changed dramatically over the last two centuries. Notably, a significant number of cats are kept indoors, most of them are neutered and many are selectively bred. This likely has consequences for their welfare. A few studies link housing, neuter status and breeding in cats to risks of welfare problems. However, the study presented here is the first to quantify the risks and document the prevalence of risk factors. It builds on results from a questionnaire sent to a representative sample of the Danish population. Using the responses from cat owners who keep cats in the home (n = 378), the paper aims to investigate how indoor confinement, neutering and selective breeding affect health, behaviour and other factors relating to cat welfare. The paper reports that confined cats had significantly more behavioural problems than free-roaming cats; that a smaller proportion of the free-roaming cats suffered from the behavioural problems investigated; and that entire cats had significantly more behavioural problems than neutered cats. Finally, significantly more purebred cats than domestic shorthair cats were found to have diseases. Being confined, being intact and being purebred are therefore significant risk factors for behavioural or health problems associated with reduced welfare in privately owned cats.
Mental disorders are common in people living with HIV (PLWH) but often remain untreated. This study aimed to explore the treatment gap for mental disorders in adults followed-up in antiretroviral therapy (ART) programmes in South Africa and disparities between ART programmes regarding the provision of mental health services.
Methods
We conducted a cohort study using ART programme data and linked pharmacy and hospitalisation data to examine the 12-month prevalence of treatment for mental disorders and factors associated with the rate of treatment for mental disorders among adults, aged 15–49 years, followed-up from 1 January 2012 to 31 December 2017 at one private care, one public tertiary care and two pubic primary care ART programmes in South Africa. We calculated the treatment gap for mental disorders as the discrepancy between the 12-month prevalence of mental disorders in PLWH (aged 15–49 years) in South Africa (estimated based on data from the Global Burden of Disease study) and the 12-month prevalence of treatment for mental disorders in ART programmes. We calculated adjusted rate ratios (aRRs) for factors associated with the treatment rate of mental disorders using Poisson regression.
Results
In total, 182 285 ART patients were followed-up over 405 153 person-years. In 2017, the estimated treatment gap for mental disorders was 40.5% (95% confidence interval [CI] 19.5–52.9) for patients followed-up in private care, 96.5% (95% CI 95.0–97.5) for patients followed-up in public primary care and 65.0% (95% CI 36.5–85.1) for patients followed-up in public tertiary care ART programmes. Rates of treatment with antidepressants, anxiolytics and antipsychotics were 17 (aRR 0.06, 95% CI 0.06–0.07), 50 (aRR 0.02, 95% CI 0.01–0.03) and 2.6 (aRR 0.39, 95% CI 0.35–0.43) times lower in public primary care programmes than in the private sector programmes.
Conclusions
There is a large treatment gap for mental disorders in PLWH in South Africa and substantial disparities in access to mental health services between patients receiving ART in the public vs the private sector. In the public sector and especially in public primary care, PLWH with common mental disorders remain mostly untreated.
We evaluated the relationship between local MRSA prevalence rates and antibiotic use across 122 VHA hospitals in 2016. Higher hospital-level MRSA prevalence was associated with significantly higher rates of antibiotic use, even after adjusting for case mix and stewardship strategies. Benchmarking anti-MRSA antibiotic use may need to adjust for MRSA prevalence.
The properties of the acoustic modes are sensitive to magnetic activity. The unprecedented long-term Kepler photometry, thus, allows stellar magnetic cycles to be studied through asteroseismology. We search for signatures of magnetic cycles in the seismic data of Kepler solar-type stars. We find evidence for periodic variations in the acoustic properties of about half of the 87 analysed stars. In these proceedings, we highlight the results obtained for two such stars, namely KIC 8006161 and KIC 5184732.
The treatment gap between the number of people with mental disorders and the number treated represents a major public health challenge. We examine this gap by socio-economic status (SES; indicated by family income and respondent education) and service sector in a cross-national analysis of community epidemiological survey data.
Methods
Data come from 16 753 respondents with 12-month DSM-IV disorders from community surveys in 25 countries in the WHO World Mental Health Survey Initiative. DSM-IV anxiety, mood, or substance disorders and treatment of these disorders were assessed with the WHO Composite International Diagnostic Interview (CIDI).
Results
Only 13.7% of 12-month DSM-IV/CIDI cases in lower-middle-income countries, 22.0% in upper-middle-income countries, and 36.8% in high-income countries received treatment. Highest-SES respondents were somewhat more likely to receive treatment, but this was true mostly for specialty mental health treatment, where the association was positive with education (highest treatment among respondents with the highest education and a weak association of education with treatment among other respondents) but non-monotonic with income (somewhat lower treatment rates among middle-income respondents and equivalent among those with high and low incomes).
Conclusions
The modest, but nonetheless stronger, an association of education than income with treatment raises questions about a financial barriers interpretation of the inverse association of SES with treatment, although future within-country analyses that consider contextual factors might document other important specifications. While beyond the scope of this report, such an expanded analysis could have important implications for designing interventions aimed at increasing mental disorder treatment among socio-economically disadvantaged people.
There is convincing evidence that lower socioeconomic position is associated with increased risk of mental disorders. However, the mechanisms involved are not well understood. This study aims to elucidate the causal pathways between socioeconomic position and depression symptoms in South African adults. Two possible causal theories are examined: social causation, which suggests that poor socioeconomic conditions cause mental ill health; and social drift, which suggests that those with poor mental health are more likely to drift into poor socioeconomic circumstances.
Methods.
The study used longitudinal and cross-sectional observational data on 3904 adults, from a randomised trial carried out in 38 primary health care clinics between 2011 and 2012. Structural equation models and counterfactual mediation analyses were used to examine causal pathways in two directions. First, we examined social causation pathways, with language (a proxy for racial or ethnic category) being treated as an exposure, while education, unemployment, income and depression were treated as sequential mediators and outcomes. Second, social drift was explored with depression treated as a potential influence on health-related quality of life, job loss and, finally, income.
Results.
The results suggest that the effects of language on depression at baseline, and on changes in depression during follow-up, were mediated through education and income but not through unemployment. Adverse effects of unemployment and job loss on depression appeared to be mostly mediated through income. The effect of depression on decreasing income appeared to be mediated by job loss.
Conclusions.
These results suggest that both social causation and social selection processes operate concurrently. This raises the possibility that people could get trapped in a vicious cycle in which poor socioeconomic conditions lead to depression, which, in turn, can cause further damage to their economic prospects. This study also suggests that modifiable factors such as income, employment and treatable depression are suitable targets for intervention in the short to medium term, while in the longer term reducing inequalities in education will be necessary to address the deeply entrenched inequalities in South Africa.
Suicidal behaviour is an under-reported and hidden cause of death in most low- and middle-income countries (LMIC) due to lack of national systematic reporting for cause-specific mortality, high levels of stigma and religious or cultural sanctions. The lack of information on non-fatal suicidal behaviour (ideation, plans and attempts) in LMIC is a major barrier to design and implementation of prevention strategies. This study aims to determine the prevalence of non-fatal suicidal behaviour within community- and health facility-based populations in LMIC.
Methods
Twelve-month prevalence of suicidal ideation, plans and attempts were established through community samples (n = 6689) and primary care attendees (n = 6470) from districts in Ethiopia, Uganda, South Africa, India and Nepal using the Composite International Diagnostic Interview suicidality module. Participants were also screened for depression and alcohol use disorder.
Results
We found that one out of ten persons (10.3%) presenting at primary care facilities reported suicidal ideation within the past year, and 1 out of 45 (2.2%) reported attempting suicide in the same period. The range of suicidal ideation was 3.5–11.1% in community samples and 5.0–14.8% in health facility samples. A higher proportion of facility attendees reported suicidal ideation than community residents (10.3 and 8.1%, respectively). Adults in the South African facilities were most likely to endorse suicidal ideation (14.8%), planning (9.5%) and attempts (7.4%). Risk profiles associated with suicidal behaviour (i.e. being female, younger age, current mental disorders and lower educational and economic status) were highly consistent across countries.
Conclusion
The high prevalence of suicidal ideation in primary care points towards important opportunities to implement suicide risk reduction initiatives. Evidence-supported strategies including screening and treatment of depression in primary care can be implemented through the World Health Organization's mental health Global Action Programme suicide prevention and depression treatment guidelines. Suicidal ideation and behaviours in the community sample will require detection strategies to identify at risks persons not presenting to health facilities.
Although financing represents a critical component of health system strengthening and also a defining concern of efforts to move towards universal health coverage, many countries lack the tools and capacity to plan effectively for service scale-up. As part of a multi-country collaborative study (the Emerald project), we set out to develop, test and apply a fully integrated health systems resource planning and health impact tool for mental, neurological and substance use (MNS) disorders.
Methods.
A new module of the existing UN strategic planning OneHealth Tool was developed, which identifies health system resources required to scale-up a range of specified interventions for MNS disorders and also projects expected health gains at the population level. We conducted local capacity-building in its use, as well as stakeholder consultations, then tested and calibrated all model parameters, and applied the tool to three priority mental and neurological disorders (psychosis, depression and epilepsy) in six low- and middle-income countries.
Results.
Resource needs for scaling-up mental health services to reach desired coverage goals are substantial compared with the current allocation of resources in the six represented countries but are not large in absolute terms. In four of the Emerald study countries (Ethiopia, India, Nepal and Uganda), the cost of delivering key interventions for psychosis, depression and epilepsy at existing treatment coverage is estimated at US$ 0.06–0.33 per capita of total population per year (in Nigeria and South Africa it is US$ 1.36–1.92). By comparison, the projected cost per capita at target levels of coverage approaches US$ 5 per capita in Nigeria and South Africa, and ranges from US$ 0.14–1.27 in the other four countries. Implementation of such a package of care at target levels of coverage is expected to yield between 291 and 947 healthy life years per one million populations, which represents a substantial health gain for the currently neglected and underserved sub-populations suffering from psychosis, depression and epilepsy.
Conclusions.
This newly developed and validated module of OneHealth tool can be used, especially within the context of integrated health planning at the national level, to generate contextualised estimates of the resource needs, costs and health impacts of scaled-up mental health service delivery.
Evidence is needed for the integration of mental health into primary care advocated by the national health sector strategic investment plan in Uganda.
Aims
To describe the processes of developing a district mental healthcare plan (MHCP) in rural Uganda that facilitates integration of mental health into primary care.
Method
Mixed methods using a situational analysis, qualitative studies, theory of change workshops and partial piloting of the plan at two levels informed the MHCP.
Results
A MHCP was developed with packages of care to facilitate integration at the organisational, facility and community levels of the district health system, including a specified human resource mix. The partial embedding period supports its practical application. Key barriers to scaling up the plan were identified.
Conclusions
A real-world plan for the district was developed with involvement of stakeholders. Pilot testing demonstrated its feasibility and implications for future scaling up.
Direct numerical simulation (DNS) of a time-developing turbulent wake evolving in a stably stratified background is presented. A large initial Froude number is chosen to allow the wake to become fully turbulent and axisymmetric before stratification affects the spreading rate of the mean defect. Turbulence statistics are formed by averaging over the homogeneous streamwise direction of a domain that is larger than earlier stratified-wake simulations in order to reduce the statistical uncertainty. The DNS results are used to cast light on the mechanisms that lead to the various states of this flow – namely the three-dimensional (essentially unstratified), non-equilibrium (or ‘wake-collapse’) and quasi-two-dimensional (or ‘two-component’) regimes, previously observed for wakes embedded in both weakly and strongly stratified backgrounds. For this relatively high-initial-Reynolds- and Froude-number simulation, we find that the signature reduction in the rate of decay of the maximum mean defect velocity during the wake-collapse regime is due to buoyancy-induced alterations of the turbulence structure, which weaken and redistribute the Reynolds shear stresses whose gradients appear in the streamwise mean momentum equation. The change in the rate of decay of the turbulence kinetic energy (TKE) observed during the wake-collapse regime (which occurs well after the mean velocity decay reduction begins) is not caused by transfer of turbulent gravitational potential energy to TKE, as has been previously suggested. The results instead reveal that the reduction in TKE decay – which for this flow, with its relatively weak internal waves, eventually leads to TKE growth, heralding the arrival of the two-component regime – is caused by an increase in the rate of TKE production associated with the wake structure becoming increasingly two-dimensional, such that the lateral Reynolds shear stress, $-\overline{u^{\prime }v^{\prime }}$, becomes dominant. The present results are also compared with those of previous simulations at different Froude and Reynolds numbers, and whose initial conditions contain different turbulence structures. This comparison confirms a strong degree of commonality in the late-wake behaviour, which lends support to the hypothesis that all wakes in stably stratified environments achieve a universal state in the final stages of decay.
The Ultra-Fast Flash Observatory (UFFO), which will be launched onboard theLomonosov spacecraft, contains two crucial instruments: UFFO BurstAlert & Trigger Telescope (UBAT) for detection and localization of Gamma-Ray Bursts(GRBs) and the fast-response Slewing Mirror Telescope (SMT) designed for the observationof the prompt optical/UV counterparts. Here we discuss the in-space calibrations of theUBAT detector and SMT telescope. After the launch, the observations of the standard X-raysources such as pulsar in Crab nebula will provide data for necessary calibrations ofUBAT. Several standard stars will be used for the photometric calibration of SMT. Thecelestial X-ray sources, e.g. X-ray binaries with bright optical sourcesin their close angular vicinity will serve for the cross-calibration of UBAT and SMT.
The Ultra-Fast Flash Observatory (UFFO) Pathfinder for Gamma-Ray Bursts (GRBs) consistsof two telescopes. The UFFO Burst Alert & Trigger Telescope (UBAT) handles thedetection and localization of GRBs, and the Slewing Mirror Telescope (SMT) conducts themeasurement of the UV/optical afterglow. UBAT is equipped with an X-ray detector, analogand digital signal readout electronics that detects X-rays from GRBs and determines thelocation. SMT is equipped with a stepping motor and the associated electronics to rotatethe slewing mirror targeting the GRBs identified by UBAT. First the slewing mirror pointsto a GRB, then SMT obtains the optical image of the GRB using the intensified CCD and itsreadout electronics. The UFFO Data Acquisition system (UDAQ) is responsible for theoverall function and operation of the observatory and the communication with the satellitemain processor. In this paper we present the design and implementation of the electronicsof UBAT and SMT as well as the architecture and implementation of UDAQ.
LOFT (Large Observatory For X-ray Timing) is one of the four candidate missions currentlyunder assessment study for the M3 mission in ESAs Cosmic Vision program to be launched in2024. LOFT will carry two instruments with prime sensitivity in the 2–30 keV range: a 10m2 class large area detector (LAD) with a <1° collimated field of viewand a wide field monitor (WFM) instrument. The WFM is based on the coded mask principle,and 5 camera units will provide coverage of more than 1/3 of the sky. The prime goal ofthe WFM is to detect transient sources to be observed by the LAD. With its wide field ofview and good energy resolution of <500 eV, the WFM will be an excellent instrumentfor detecting and studying GRBs and X-ray flashes. The WFM will be able to detect~150 gamma ray bursts per year, and a burst alert system will enable thedistribution of ~100 GRB positions per year with a ~1 arcmin locationaccuracy within 30 s of the burst.
By 1975 the hunt for GRB counterparts had been on for almost ten years without success.Gamma burst instruments of that day provided little or no directional data in themselves.Positions could be extracted only using the time delay technique – potentially accuratebut very slow. Triggered by a japanese report of a balloon instrument for GRB studiesbased on a Rotation Modulation Collimator we at the Danish Space Research Institutestarted the development of an RMC detector for GRBs, the WATCH wide field monitor.
Four WATCH units were flown on the Soviet Granat satellites, and one on ESA’s EURECAsatellite. The design and results will be summarized. Now, 35 years later, recent detectordevelopments may allow the construction of WATCH-type instruments able to fit weight,power and data-wise into 1 kg cubesats. This could provide the basis for a true all-skymonitor with 100 percent duty cycle for rare, bright events.
The UFFO (Ultra-Fast Flash Observatory) is a GRB detector on board the Lomonosovsatellite, to be launched in 2013. The GRB trigger is provided by an X-ray detector,called UBAT (UFFO Burst Alarm & Trigger Telescope), which detects X-rays from the GRBand then triggers to determine the direction of the GRB and then alerts the Slewing MirrorTelescope (SMT) to turn in the direction of the GRB and record the optical photon fluxes.This report details the calibration of the two components: the MAPMTs and the YSO crystalsand simulations of the UBAT. The results shows that this design can observe a GRB within afield of view of ±35° and can trigger in a time scale as short as 0.2 – 1.0 safter the appearance of a GRB X-ray spike.
The Ultra-Fast Flash Observatory (UFFO) is a space observatory for optical follow-ups ofgamma ray bursts (GRBs), aiming to explore the first 60 seconds of GRBs optical emission.UFFO is utilized to catch early optical emissions from GRBs within few sec after triggerusing a Gimbal mirror which redirects the optical path rather than slewing entirespacecraft. We have developed a 15 cm two-axis Gimbal mirror stage for the UFFO-Pathfinderwhich is going to be on board the Lomonosov satellite which is to be launched in 2013. Thestage is designed for fast and accurate motion with given budgets of 3 kg of mass and 3Watt of power. By employing stepping motors, the slewing mirror can rotate faster than 15deg/sec so that objects in the UFFO coverage (60 deg × 60 deg) can be targeted in~1 sec. The obtained targeting resolution is better 2 arcmin using a close-loopcontrol with high precision rotary encoder. In this presentation, we will discuss detailsof design, manufacturing, space qualification tests, as well as performance tests.
The Ultra-Fast Flash Observatory (UFFO) aims to detect the earliest moment of Gamma-RayBursts (GRBs) which is not well known, resulting into the enhancement of GRB mechanismunderstanding. The pathfinder mission was proposed to be a scaled-down version of UFFO,and only contains the UFFO Burst Alert & Trigger Telescope (UBAT) measuring theX-ray/gamma-ray with the wide-field of view and the Slewing Mirror Telescope (SMT) with arapid-response for the UV/optical photons. Once the UBAT detects a GRB candidate with theposition accuracy of 10 arcmin, the SMT steers the UV/optical photons from the candidateto the telescope by the fast rotatable mirror and provides the early UV/optical photonsmeasurements with 4 arcsec accuracy. The SMT has a modified Ritchey-Chrètien telescopewith the aperture size of 10 cm diameter including the rotatable mirror and the imagereadout by the intensified charge-coupled device. There is a key board called the UFFOData Acquisition system (UDAQ) that manages the communication of each telescope and alsoof the satellite and the UFFO overall operation. This pathfinder is designed and builtwithin the limited size and weight of ~20 kg and the low power consumption up to ~30 W. We will discuss the design and performance of the UFFO-pathfinder, and itsintegration to the Lomonosov satellite.