The antibody response of a single outbred rabbit was studied throughout three rounds of injections with Micrococcus lysodeikticus vaccine over a 31-mo period. The first-round response was characterized by a vigorous anti- micrococcus response and a strong anti-IgG rheumatoid factor response. The second-round response consisted of a triad of interacting molecules: anti- micrococcal antibodies, autoanti-idiotypic antibodies specific for distinct clonotypes of the first-round anti-micrococcal antibodies, and Fc-specific anti-IgG rheumatoid factor. The interacting triple complex was detected because of the formation of an immune complex that became insoluble upon dilution of the serum. Complex formation was inhibited in the presence of saccharide compounds known to be major immunodominant determinants of the micrococcal cell-wall carbohydrate polymer. The same saccharides did not affect the reaction of rheumatoid factor with IgG. Direct-binding radioimmunoassays ruled out mediation of the dilution-precipitation reaction by soluble micrococcal antigens. Specific absorption of rheumatoid factor inhibited the dilution-precipitation reaction. Auto-anti-idiotypic antibodies were specifically purified from second-round sera, directly confirming the presence of these antibodies. Suppressive effects of auto-anti-idiotypic antibodies on distinct antibody clonotypes were shown by gel isoelectric focusing of first-, second-, and third-round sera. Clonotypes expressed in the first round of immunizations were reduced in quantity or absent when auto-anti-idiotypic antibodies were detectable. Greatly enhanced levels or initial synthesis of new clonotypes of anti-micrococcal antibodies were detected during the period of auto-anti-idiotype synthesis. The third-round sera, devoid of detectable auto-anti-idiotype, contained clonotypes characteristic of both first- and second-round antisera. Thus, auto-anti- idiotypic-mediated suppression appeared to be reversible. The data are interpreted as lending strong support for concepts of autoregulation of immune processes in normal outbred animals via an idiotypic network.
Background Technology can benefit older adults in many ways, including by facilitating remote access to services, communication, and socialization for convenience or out of necessity when individuals are homebound. As people, especially older adults, self-quarantined and sheltered in place during the COVID-19 pandemic, the importance of usability-in-place became clear. To understand the remote use of technology in an ecologically valid manner, researchers and others must be able to test usability remotely. Objective Our objective was to review practical approaches for and findings about remote usability testing, particularly remote usability testing with older adults. Methods We performed a rapid review of the literature and reported on available methods, their advantages and disadvantages, and practical recommendations. This review also reported recommendations for usability testing with older adults from the literature. Results Critically, we identified a gap in the literature—a lack of remote usability testing methods, tools, and strategies for older adults, despite this population’s increased remote technology use and needs (eg, due to disability or technology experience). We summarized existing remote usability methods that were found in the literature as well as guidelines that are available for conducting in-person usability testing with older adults. Conclusions We call on the human factors research and practice community to address this gap to better support older adults and other homebound or mobility-restricted individuals.
Background Over 11 million care partners in the United States who provide care to people living with Alzheimer disease and related dementias (ADRD) cite persistent and pervasive unmet needs related to their caregiving role. The proliferation of mobile apps for care partners has the potential to meet care partners’ needs, but the quality of apps is unknown. Objective This study aims to evaluate the quality of publicly available apps for care partners of people living with ADRD and identify design features of low- and high-quality apps to guide future research and user-centered app development. Methods We searched the US Apple App and Google Play stores with the criteria that included apps needed to be available in the US Google Play or Apple App stores, accessible to users out of the box, and primarily intended for use by an informal (family or friend) care partner of a person living with ADRD. We classified and tabulated app functionalities. The included apps were then evaluated using the Mobile App Rating Scale (MARS) using 23 items across 5 dimensions: engagement, functionality, aesthetics, information, and subjective quality. We computed descriptive statistics for each rating. To identify recommendations for future research and app development, we categorized rater comments on score-driving factors for each MARS rating item and what the app could have done to improve the item score. Results We evaluated 17 apps. We found that, on average, apps are of minimally acceptable quality. Functionalities supported by apps included education (12/17, 71%), interactive training (3/17, 18%), documentation (3/17, 18%), tracking symptoms (2/17, 12%), care partner community (3/17, 18%), interaction with clinical experts (1/17, 6%), care coordination (2/17, 12%), and activities for the person living with ADRD (2/17, 12%). Of the 17 apps, 8 (47%) had only 1 feature, 6 (35%) had 2 features, and 3 (18%) had 3 features. The MARS quality mean score across apps was 3.08 (SD 0.83) on the 5-point rating scale (1=inadequate to 5=excellent), with apps scoring highest on average on functionality (mean 3.37, SD 0.99) and aesthetics (mean 3.24, SD 0.92) and lowest on average on information (mean 2.95, SD 0.95) and engagement (mean 2.76, SD 0.89). The MARS subjective quality mean score across apps was 2.26 (SD 1.02). Conclusions We identified apps whose mean scores were more than 1 point below minimally acceptable quality, whereas some were more than 1 point above. Many apps had broken features and were rated as below acceptable for engagement and information. Minimally acceptable quality is likely to be insufficient to meet care partner needs. Future research should establish minimum quality standards across dimensions for care partner mobile apps. Design features of high-quality apps identified in this study can provide the foundation for benchmarking these standards.
As the sixth leading cause of death within the United States, Alzheimer’s disease affects over 15 million caregivers administering home-based care for loved ones having this illness. The rise in advocacy for mobile health (mHealth) applications (apps) to facilitate chronic disease management presents a tremendous platform for Alzheimer’s caregivers to utilize mHealth apps while administering care. Although mHealth apps serve as potential healthcare interventions, little is known regarding their usability. This study will advance knowledge on the apps’ usability and provide user-centered design guidelines for future app development. Keyword searches in Apple and Google App Stores yielded 43 Alzheimer’s apps. Card sorting then generated three levels of categories for app classification. Stratified random sampling produced a sample size of six apps selected for review. Lastly, a heuristic evaluation of the six sampled apps was conducted according to Nielsen’s ten usability heuristics. User-centered design guidelines were constructed to remedy problematic usability issues for the intended users of these apps.
Marketing is a strategic, ongoing, interactive process; we listen to the "market"-our students-and then speak to them with messages and products suited to their needs and their dreams. This chapter describes marketing strategies for recruiting and retaining adult degree students, with frequent references to underlying principles of market research, marketing planning, outreach, and promotion.Three interrelated factors create the contemporary landscape we navigate as we develop marketing strategies: evolving technology, competition and collaboration, and shrinking state support. Evolving technology has provided new programming opportunities and new marketing tools. At the same time it has created expectations in the minds of students for sophisticated products and services. Technology has also changed the nature of interinstitutional relationships by blurring geographical boundaries. Institutions no longer have clear-cut service areas, and the competition is fierce. Old "gentlemen's agreements" about who serves which locality or population have given way to creative collaboration and partnerships-and to vigorous competition (Immerwahr, 2002). Finally, most public institutions have seen reductions in state funding (Hovey, 1999), putting more pressure on programs to be partially or wholly self-supporting (Pappas, 1996) and raising the expectation that marketing will generate additional revenue needed for the institution' s survival.
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