ObjectiveConsumers are living longer, creating more pressure on the health system and increasing their requirement for self-care of chronic conditions. Despite rapidly-increasing numbers of mobile health applications (‘apps’) for consumers’ self-care, there is a paucity of research into consumer engagement with electronic self-monitoring. This paper presents a qualitative exploration of how health consumers use apps for health monitoring, their perceived benefits from use of health apps, and suggestions for improvement of health apps.Materials and Methods‘Health app’ was defined as any commercially-available health or fitness app with capacity for self-monitoring. English-speaking consumers aged 18 years and older using any health app for self-monitoring were recruited for interview from the metropolitan area of Perth, Australia. The semi-structured interview guide comprised questions based on the Technology Acceptance Model, Health Information Technology Acceptance Model, and the Mobile Application Rating Scale, and is the only study to do so. These models also facilitated deductive thematic analysis of interview transcripts. Implicit and explicit responses not aligned to these models were analyzed inductively.ResultsTwenty-two consumers (15 female, seven male) participated, 13 of whom were aged 26–35 years. Eighteen participants reported on apps used on iPhones. Apps were used to monitor diabetes, asthma, depression, celiac disease, blood pressure, chronic migraine, pain management, menstrual cycle irregularity, and fitness. Most were used approximately weekly for several minutes per session, and prior to meeting initial milestones, with significantly decreased usage thereafter. Deductive and inductive thematic analysis reduced the data to four dominant themes: engagement in use of the app; technical functionality of the app; ease of use and design features; and management of consumers’ data.ConclusionsThe semi-structured interviews provided insight into usage, benefits and challenges of health monitoring using apps. Understanding the range of consumer experiences and expectations can inform design of health apps to encourage persistence in self-monitoring.

Parties to the United Nations Framework Convention on Climate Change have agreed to hold the “increase in global average temperature to well below 2°C above preindustrial levels and to pursue efforts to limit the temperature increase to 1.5°C.” Comparison of the costs and benefits for different warming limits requires an understanding of how risks vary between warming limits. As changes in risk are often associated with changes in exposure due to projected changes in local or regional climate extremes, we analyze differences in the risks of extreme daily temperatures and extreme daily precipitation amounts under different warming limits. We show that global warming of 2°C would result in substantially larger changes in the probabilities of the extreme events than global warming of 1.5°C. For example, over the global land area, the probability of a warm extreme that occurs once every 20 years on average in the current climate is projected to increase 130% and 340% at the 1.5°C and 2.0°C warming levels, respectively (median values). Moreover, the relative changes in probability are larger for rarer, more extreme events, implying that risk assessments need to carefully consider the extreme event thresholds at which vulnerabilities occur.

The question of how an individual firm's environmental performance impacts its firm risk has not been examined in any empirical UK research. Does a company that strives to attain good environmental performance decreases its market risk or is environmental performance just a disadvantageous cost that increases such risk levels for these firms? Answers to this question have important implications for the management of companies and the investment decisions of individuals and institutions. The purpose of this paper is to examine the relationship between corporate environmental performance and firm risk in the British context. Using the largest dataset so far assembled, with Community and Environmental Responsibility (CER) rankings for all rated UK companies between 1994 and 2006, we show that a company's environmental performance is inversely related to its systematic financial risk. However, an increase of 1.0 in the CER score is associated with only a 0.02 reduction in firm's risk and cost of capital.

To better equip engineers to enter a dynamic technological and economic environment, educators must improve their understanding of the wide-ranging work of engineers and the flexible skills it demands. To that end, we studied engineering practice in six firms of varying size and industry. We analyzed the similarities and differences of engineering practice across these sites, and gathered narrative examples of what it means to be an engineer at these locations. Our data indicates more similarities across sites than differences. Although workplace cultures differed, most engineers saw their work similarly. They saw their work as problem solving, almost always done in explicitly organized teams or in informal collaboration with others. Engineers cited clear communication as the most important skill, with budgets and time limitations generally noted as the most significant constraints. Engineers generally valued solving a problem, learning, and working in a team more than other aspects of their jobs. This understanding of engineering work can be used to better equip engineers for the workforce and improve organizational practices.

Hailed by supporters as the answer to many challenges facing medical schools and the wider health care system, longitudinal integrated clerkships (LICs) offer a practical and sustainable alternative to more traditional block rotational models. Given this, their popularity as a curricular measure is increasing, although such clerkships remain relatively novel within the United Kingdom. This narrative literature review of international work provides a comprehensive introduction to developing and implementing LICs within medical education. This review generates a practical guide for medical educators with a focus on the development and implementation of LICs within the United Kingdom, on which there is little work. Using illustrated examples and with reference to contemporary literature, it outlines the rationale for considering an LIC within a curriculum, the different types of LIC, barriers and enabling factors to LIC implementation and considers the contemporary application of LIC models within the United Kingdom. The practical guide details key questions educators must consider when developing and implementing an LIC, particularly within the landscape of UK medical education.

To identify the efficacy of short message service (SMS) reminders in health care appointment attendance. A systematic review was undertaken to identify studies published between 2005 and 2015 that compared the attendance rates of patients receiving SMS reminders compared to patients not receiving a reminder. Each article was examined for information regarding the study design, sample size, population demographics and intervention methods. A meta-analysis was used to calculate a pooled estimate odds ratio. Twenty-eight (28) studies were included in the review, including 13 (46 %) randomized controlled trials. The pooled odds ratio of the randomized control trials was 1.62 (1.35-1.94). Half of the studies reviewed sent the reminder within 48 h prior to the appointment time, yet no significant subgroups differences with respect to participant age, SMS timing, rate or type, setting or specialty was detectable. All studies, except one with a small sample size, demonstrated a positive OR, indicating SMS reminders were an effective means of improving appointment attendance. There was no significant difference in OR when controlling for when the SMS was sent, the frequency of the reminders or the content of the reminder. SMS appointment reminders are an effective and operative method in improving appointment attendance in a health care setting and this effectiveness has improved over the past 5 years. Further research is required to identify the optimal SMS reminder timing and frequency, specifically in relation to the length of time since the appointment.

No abstract

Assuming that quality science education plays a role in economic growth within a country, it becomes important to understand how education policy might influence science education teaching and learning. This integrative research review draws on Cooper's methodology (Cooper, 1982;Cooper & Hedges, 2009) to synthesize empirical findings on the relationship between science education and test-based accountability policies. Current accountability policy, particularly at the federal level, is intended to influence educators to more fully consider the needs of all students; however, research suggests that, under these policies, many research-based reform efforts in science become sidetracked, teacher practice becomes more fact based, science is taught less, teachers become less satisfied, and many students' needs are not met. Therefore, a clear understanding of educators' perceptions of the impacts of current test-based accountability policies should guide the development and implementation of the next generation of national science standards and subsequent large-scale assessments. By also delineating the limitations of the research into the perceived connections between test-based accountability and science education, this synthesis reveals further research to be done. Finally, this paper details what the reviewed research suggests for improvements to K-12 science education accountability policies.