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BackgroundInflammatory bowel disease (IBD) poses significant challenges for patients, requiring continuous monitoring and self-management to improve quality of life. ObjectiveThis study aims to investigate the viewpoints of individuals living with IBD on the use of information and communication technology (ICT) for the self-management of their condition, with a particular focus on the concept of a “smart” toilet seat as an example of ICT for IBD self-management. MethodsWe conducted an analysis of questionnaire responses obtained from 724 participants. They were encouraged to share their use cases and identify any perceived barriers associated with ICT adoption for managing their condition. To assess their responses, we used descriptive quantitative analysis, summative content analysis, and thematic qualitative analysis. We combined these results in an epistemic network analysis to look for meaningful patterns in the responses. ResultsOf the 724 participants, more than half (n=405, 55.9%) were already using various forms of ICT for IBD self-management. The primary factor influencing their use of ICT was their affinity for interacting with technology. Distinct differences emerged between individuals who were using ICT and those who were not, particularly regarding their perceived use cases and concerns. ConclusionsThis study provides valuable insights into the perspectives of individuals with IBD on the use of ICT for self-management. To facilitate wider adoption, addressing privacy concerns, ensuring data security, and establishing reliable ICT integration will be critical.

Abstract The Southern African Development Community (SADC) region, a regional economic body comprised of 16 member states, is one of our planet’s most vulnerable regions to natural hazards, and has a complex disaster risk profile. The region has sustained several disasters over the past decades. These events include annual floods in 2004–2019 and extreme droughts (1990–1993); other climate-induced disasters, such as cyclones, also have had devastating impacts, particularly on the Indian Ocean island states and east coast countries. To reduce the risk and impacts of disasters, governments must invest in disaster risk reduction (DRR). However, interventions aimed at reducing social and economic vulnerability and investing in long-term mitigation activities are often few, poorly funded, and insignificant in comparison with money spent on humanitarian assistance, disaster relief, and post-disaster reconstruction. This study investigated whether DRR is adequately funded within SADC member states in light of the high stakes in human life, infrastructure, and economic losses and the potential savings involved. The study applied a qualitative research design with data collected through semistructured interviews and focus group discussions. Respondents were selected purposefully and through snowball sampling with a total of 67 respondents from Botswana, Eswatini, Namibia, South Africa, and Zimbabwe participating in the study. The study findings reveal that DRR is inadequately funded in all the member states consulted in comparison to funding allocated to disaster response. In light of the underfunding experienced by DRR activities, this study provides a platform for lobbying and advocacy for adequate funding for DRR.

The research concerns the relationship between Western classical music and Arabian cultures in the United Arab Emirates (UAE) as experienced by independent classical chamber musicians. The main research question was: what stories do independent Western classical chamber musicians tell about their lived experiences of practicing and performing Western classical music in the UAE? The real-life problem guiding this research has two parts: i. the problem that Western classical music is not a sustainable profession for performers in the UAE and ii. the gap in the literature on Western classical music in the UAE. The real-life problem the first author experienced in the UAE as a Western musician had the following challenges: practical obstacles related to sourcing fellow musicians who uphold the same standards and music ideals, finding rehearsal venues and creating performance opportunities. These challenges lead to the formation of the research problem.

The purpose of this interpretative phenomenological analysis (IPA) is to explore how five professional South African violinists make sense of their lived experiences of performance-related pain. The research problem this study investigates is multifaceted. It includes examining the career implications for violinists who play despite experiencing pain and are afraid to speak up because of the stigma associated with being injured. There is a lack of support and understanding from fellow musicians, doctors and other specialists when faced with diagnosing injuries and recommending treatment options. In South Africa, there is limited research on these aspects. In this IPA study, the data were collected through semi-structured interviews with five professional South African violinists with performance-related pain. The six subordinate themes that emerged from the data analysis were: (i) Playing through the pain; (ii) Lack of identity; (iii) Depression when unable to play because of pain; (iv) Growth through faith and spirituality; (v) Support and lack of support from family, friends, management, doctors and other experts; and (vi) Lack of awareness and understanding of performance-related injuries. Heightened awareness of musicians’ lived experience of performance-related pain could bring about much-needed change and support advocacy for pain-prevention initiatives and assistance for violinists.

No abstract available.

Abstract Background Point-of-care diagnosis of malaria is currently based on microscopy and rapid diagnostic tests. However, both techniques have their constraints, including poor sensitivity for low parasitaemias. Hence, more accurate diagnostic tests for field use and routine clinical settings are warranted. The miniature direct-on-blood PCR nucleic acid lateral flow immunoassay (mini-dbPCR-NALFIA) is an innovative, easy-to-use molecular assay for diagnosis of malaria in resource-limited settings. Unlike traditional molecular methods, mini-dbPCR-NALFIA does not require DNA extraction and makes use of a handheld, portable thermal cycler that can run on a solar-charged power pack. Result read-out is done using a rapid lateral flow strip enabling differentiation of Plasmodium falciparum and non-falciparum malaria infections. A laboratory evaluation was performed to assess the performance of the mini-dbPCR-NALFIA for diagnosis of pan-Plasmodium and P. falciparum infections in whole blood. Methods Diagnostic accuracy of the mini-dbPCR-NALFIA was determined by testing a set of Plasmodium-positive blood samples from returned travellers (n = 29), and Plasmodium-negative blood samples from travellers with suspected malaria (n = 23), the Dutch Blood Bank (n = 19) and intensive care patients at the Amsterdam University Medical Centers (n = 16). Alethia Malaria (LAMP) with microscopy for species differentiation were used as reference. Limit of detection for P. falciparum was determined by 23 measurements of a dilution series of a P. falciparum culture. A fixed sample set was tested three times by the same operator to evaluate the repeatability, and once by five different operators to assess the reproducibility. Results Overall sensitivity and specificity of the mini-dbPCR-NALFIA were 96.6% (95% CI, 82.2%–99.9%) and 98.3% (95% CI, 90.8%–100%). Limit of detection for P. falciparum was 10 parasites per microlitre of blood. The repeatability of the assay was 93.7% (95% CI, 89.5%–97.8%) and reproducibility was 84.6% (95% CI, 79.5%–89.6%). Conclusions Mini-dbPCR-NALFIA is a sensitive, specific and robust method for molecular diagnosis of Plasmodium infections in whole blood and differentiation of P. falciparum. Incorporation of a miniature thermal cycler makes the assay well-adapted to resource-limited settings. A phase-3 field trial is currently being conducted to evaluate the potential implementation of this tool in different malaria transmission areas.

BackgroundSmart bathroom technology offers unrivaled opportunities for the automated measurement of a range of biomarkers and other data. Unfortunately, efforts in this area are mostly driven by a technology push rather than market pull approach, which decreases the chances of successful adoption. As yet, little is known about the use cases, barriers, and desires that potential users of smart bathrooms perceive. ObjectiveThis study aimed to investigate how participants from the general population experience using a smart sensor-equipped toilet seat installed in their home. The study contributes to answering the following questions: What use cases do citizens see for this innovation? and What are the limitations and barriers to its everyday use that they see, including concerns regarding privacy, the lack of fit with everyday practices, and unmet expectations for user experience? MethodsOverall, 31 participants from 30 households participated in a study consisting of 3 (partially overlapping) stages: sensitizing, in which participants filled out questionnaires to trigger their thoughts about smart bathroom use and personal health; provotyping, in which participants received a gentle provocation in the form of a smart toilet seat, which they used for 2 weeks; and discussion, in which participants took part in a web-based focus group session to discuss their experiences. ResultsParticipants mostly found the everyday use of the toilet, including installation and dismantling when necessary, to be relatively easy and free of complications. Where complications occurred, participants mentioned issues related to the design of the prototype, technology, or mismatches with normal practices in using toilets and hygiene. A broad range of use cases were mentioned, ranging from signaling potentially detrimental health conditions or exacerbations of existing conditions to documenting physical data to measuring biomarkers to inform a diagnosis and behavioral change. Participants differed greatly in whether they let others use, or even know about, the seat. Ownership and control over their own data were essential for most participants. ConclusionsThis study showed that participants felt that a smart toilet seat could be acceptable and effective, as long as it fits everyday practices concerning toilet use and hygiene. The range of potential uses for a smart toilet seat is broad, as long as privacy and control over disclosure and data are warranted.

Detailed knowledge of human B‐cell development is crucial for the proper interpretation of inborn errors of immunity and malignant diseases. It is of interest to understand the kinetics of protein expression changes during development, but also to properly interpret the major and possibly alternative developmental trajectories. We have investigated human samples from healthy individuals with the aim of describing all B‐cell developmental trajectories. We validated a 30‐parameter mass cytometry panel and demonstrated the utility of "vaevictis" visualization of B‐cell developmental stages. We used the trajectory inference tool "tviblindi" to exhaustively describe all trajectories leading to all developmental ends discovered in the data. Focusing on Natural Effector B cells, we demonstrated the dynamics of expression of nuclear factors (PAX‐5, TdT, Ki‐67, Bcl‐2), cytokine and chemokine receptors (CD127, CXCR4, CXCR5) in relation to the canonical B‐cell developmental stage markers. We observed branching of the memory development, where follicular memory formation was marked by CD73 expression. Lastly, we performed an analysis of two example cases of abnormal B‐cell development caused by mutations in RAG‐1 and Wiskott–Aldrich syndrome gene in patients with primary immunodeficiency. In conclusion, we developed, validated, and presented a comprehensive set of tools for the investigation of B‐cell development in the bone marrow compartment. [ABSTRACT FROM AUTHOR]

Discontinuing antidepressant medication (ADM) can be challenging for patients and clinicians. In the current study we investigated if Mindfulness-Based Cognitive Therapy (MBCT) added to supported protocolized discontinuation (SPD) is more effective than SPD alone to help patients discontinue ADM. This study describes a prospective, cluster-randomized controlled trial (completed). From 151 invited primary care practices in the Netherlands, 36 (24%) were willing to participate and randomly allocated to SPD+MBCT (k = 20) or SPD (k = 16). Adults using ADM > 9 months were invited by GPs to discuss tapering, followed by either MBCT+SPD, or SPD alone. Exclusion criteria included current psychiatric treatment; substance use disorder; non-psychiatric indication for ADM; attended MBCT within past 5 years; cognitive barriers. From the approximately 3000 invited patients, 276 responded, 119 participated in the interventions and 92 completed all assessments. All patients were offered a decision aid and a personalized tapering schedule (with GP). MBCT consisted of eight group sessions of 2.5 hours and one full day of practice. SPD was optional and consisted of consultations with a mental health assistant. Patients were assessed at baseline and 6, 9 and 12 months follow-up, non-blinded. In line with our protocol, primary outcome was full discontinuation of ADM within 6 months. Secondary outcomes were depression, anxiety, withdrawal symptoms, rumination, well-being, mindfulness skills, and self-compassion. Patients allocated to SPD + MBCT (n = 73) were not significantly more successful in discontinuing (44%) than those allocated to SPD (n = 46; 33%), OR 1.60, 95% CI 0.73 to 3.49, p = .24, number needed to treat = 9. Only 20/73 allocated to MBCT (27%) completed MBCT. No serious adverse events were reported. In conclusion, we were unable to demonstrate a significant benefit of adding MBCT to SPD to support discontinuation in general practice. Actual participation in patient-tailored interventions was low, both for practices and for patients. (Trial registration: ClinicalTrials.gov PRS ID: NCT03361514 registered December 2017).

Disaster risk reduction (DRR) has become a policy priority worldwide and in line with this trend, the South African Disaster Management Act and National Disaster Management Framework prioritise DRR in efforts to build resilient communities with local municipalities being required to develop their own Disaster Management Frameworks. The problem is that public participation is treated as of secondary importance yet international agreements such as the Sendai Framework for Disaster Risk Reduction (SFDRR) actively promote public participation in DRR. A bottom-up approach is the most effective in ensuring successful DRR initiatives at the local level because communities take ownership of these initiatives and gain a better understanding of their risks. Community-based disaster risk reduction originated in the paradigm shift away from the traditional disaster management approach, moving away from reactive responses in the top-down approach in disaster risk management to more proactive responses. This research study explored approaches used for public participation to ensure successful DRR initiatives in Katlehong township. The study is exploratory and descriptive, having used qualitative and quantitative research approaches, which included questionnaires and interviews. The results gleaned from the data suggested that the role of public participation in DRR initiatives is ineffective in Katlehong township because of the reluctance of stakeholders to participate in DRR. Accordingly, it was recommended that the municipality host stakeholder sessions where stakeholders are informed about the role of the centre and about their own role in DRR. Such stakeholder sessions should assist in resolving issues such as confusion about the stakeholders’ roles in DRR and help to obtain buy-in from all the stakeholders.

Background:. Flap monitoring after a deep inferior epigastric perforator flap breast reconstruction is crucial to detect complications in time. A novel and innovative wireless device has been developed and tested in a feasibility study. This study describes our experience with remote patient monitoring via this device in postoperative monitoring of deep inferior epigastric perforator flaps. Methods:. Following a deep inferior epigastric perforator breast reconstruction, the “Free Flap Patch” was adhered to the flap, continuously measuring temperature and tissue saturation. Data were stored locally on the patch and analyzed in a retrospective manner. Raw analog-digital-conversion values from the red- and infrared sensors, delta muscle saturation (dSmO2), and estimated tissue oxygenation (StO2) were assessed and compared with clinical records. Results:. No adverse events related to the device were recorded. One patient suffered flap loss; a decrease in estimated tissue oxygenation was measured with the device in situ. No deviations in clinical variables were recorded in the uncompromised flaps. Conclusions:. A wearable patient monitoring device was successfully utilized in clinical practice. In one patient, a flap failure was recorded where the PPG-derived StO2 parameter was indicatory for this event. The Free Flap Patch has the potential of automatically predicting blood supply issues in an early stage. More data are needed for clinical validation.