BackgroundNonadherence and medication errors are common among patients with complex drug regimens. Apps for smartphones and tablets are effective for improving adherence, but they have not been tested in elderly patients with complex chronic conditions and who typically have less experience with this type of technology.ObjectiveThe objective of this study was to design, implement, and evaluate a medication self-management app (called ALICE) for elderly patients taking multiple medications with the intention of improving adherence and safe medication use.MethodsA single-blind randomized controlled trial was conducted with a control and an experimental group (N=99) in Spain in 2013. The characteristics of ALICE were specified based on the suggestions of 3 nominal groups with a total of 23 patients and a focus group with 7 professionals. ALICE was designed for Android and iOS to allow for the personalization of prescriptions and medical advice, showing images of each of the medications (the packaging and the medication itself) together with alerts and multiple reminders for each alert. The randomly assigned patients in the control group received oral and written information on the safe use of their medications and the patients in the experimental group used ALICE for 3 months. Pre and post measures included rate of missed doses and medication errors reported by patients, scores from the 4-item Morisky Medication Adherence Scale (MMAS-4), level of independence, self-perceived health status, and biochemical test results. In the experimental group, data were collected on their previous experience with information and communication technologies, their rating of ALICE, and their perception of the level of independence they had achieved. The intergroup intervention effects were calculated by univariate linear models and ANOVA, with the pre to post intervention differences as the dependent variables.ResultsData were obtained from 99 patients (48 and 51 in the control and experimental groups, respectively). Patients in the experimental group obtained better MMAS-4 scores (P<.001) and reported fewer missed doses of medication (P=.02). ALICE only helped to significantly reduce medication errors in patients with an initially higher rate of errors (P<.001). Patients with no experience with information and communication technologies reported better adherence (P<.001), fewer missed doses (P<.001), and fewer medication errors (P=.02). The mean satisfaction score for ALICE was 8.5 out of 10. In all, 45 of 51 patients (88%) felt that ALICE improved their independence in managing their medications.ConclusionsThe ALICE app improves adherence, helps reduce rates of forgetting and of medication errors, and increases perceived independence in managing medication. Elderly patients with no previous experience with information and communication technologies are capable of effectively using an app designed to help them take their medicine more safely.Trial RegistrationClinicaltrials.gov NCT02071498; http://clinicaltrials.gov/ct2/show/NCT0207...

In this paper a new method towards automatic personalized recommendation based on the behavior of a single user in accordance with all other users in web-based information systems is introduced. The proposal applies a modified version of the well-known Apriori data mining algorithm to the log files of a web site (primarily, an e-commerce or an e-learning site) to help the users to the selection of the best user-tailored links. The paper mainly analyzes the process of discovering association rules in this kind of big repositories and of transforming them into user-adapted recommendations by the two-step modified Apriori technique, which may be described as follows. A first pass of the modified Apriori algorithm verifies the existence of association rules in order to obtain a new repository of transactions that reflect the observed rules. A second pass of the proposed Apriori mechanism aims in discovering the rules that are really inter-associated. This way the behavior of a user is not determined by ''what he does'' but by ''how he does''. Furthermore, an efficient implementation has been performed to obtain results in real-time. As soon as a user closes his session in the web system, all data are recalculated to take the recent interaction into account for the next recommendations. Early results have shown that it is possible to run this model in web sites of medium size.

The wavelet packet transform gives information in both the time and frequency domains, and it is very useful for describing nonstationary signals like seismograms. Moreover, this structure is dependent on the signal under study; hence we can choose the time-frequency decomposition more appropriate for every signal. In this article, we propose a new method for filtering based on the wavelet packet transform. This approach uses different parameters for filtering, depending on the band of frequencies that we are analyzing. This filtering is employed in order to achieve a high signal-to-noise ratio (SNR) and low distortion. We first apply the method to synthetic signals that we have contaminated with noise. In this way, the shape of the whole output signal and the onset time of the first pulse can be compared to the ideal signal. Finally, we apply it to short-period seismograms recorded at the local seismic network of the University of Alicante in southeastern Spain. The method proposed is compared with conventional passband filters and other methods based on wavelets. The comparison demonstrates that our method achieves a higher SNR without introducing noticeable distortion.

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