Background: Peritoneal dialysis (PD) affords patients increased independence and improved quality of life. However, the lack of more frequent monitoring may compromise outcomes and decrease wider uptake of this modality. This study uses a novel tablet computer-based interface to allow real-time monitoring and two-way communication to better link PD patients with a dialysis center and care providers. Methods: A tablet computer with an application that allows enhanced monitoring of all aspects of PD was given to patients to assess their usage in a pilot trial. The interface allows patients to review sterility techniques, enter vital signs and exchange data, upload media such as photos and video clips, synchronize data to be viewed by medical staff, and allow real-time adjustments to the PD prescription. Satisfaction with the interface and comments for enhancement were analyzed using a simple self-administered questionnaire. Results: Six continuous ambulatory PD patients were enrolled in this pilot study. A total number of 1,172 exchanges were recorded over a period of 251 days. Compliance with the applications ranged from 51 to 92%. No major adverse events were recorded. The overall impression of the interface was 5.2 out of 10. The major criticism was that the application needs to be adjusted depending upon the experience level of the patient and that data entry needs to be simplified and automated. Conclusion: A tablet computer platform is a feasible concept for continuous ambulatory PD. The major components include flexibility, advanced infrastructure, two-way communication, and real-time interaction. This may encourage more patients to take up PD as their preferred modality of therapy for end-stage renal disease. Modifications to enhance use will be incorporated in subsequent versions.
Background: For a blind or visually impaired person, a vital prerequisite to accessing any feature of the built environment is being able to find this feature. Braille signs, even where available, d o not replace the functions of print signage because they cannot be read from a distance. Remotely readable infrared signs utilise spoken infrared message transmissions to label key environmental features, so that a blind person with a suitable receiver can locate and identify them from a distance. Methods: Three problems that are among the most challenging and dangerous faced by blind travellers are negotiating complex transit stations, locating bus stops and safely and efficiently crossing light-controlled intersections. We report the results of human factors studies using a remote infrared audible sign system (RIAS), Talking Signs@, in these critical tasks, examining issues such as the amount of training needed to use the system, its impact on performance and safety, benefits for different population subgroups and user opinions of its value. Results: Results are presented in the form of both objective performance measures and in subjects' ratings of the usefulness of the system in performing these tasks. Findings are that blind people can quickly and easily learn to use remote infrared audible signage effectively and that its use improves travel safety, efficiency and independence. Conclusions:The technology provides equal access to a wide variety of public facilities. (Clin Exp Optom 2001; 84: 3: 120-131)
SummaryDuring advanced AIDS tuberculosis (TB) often presents atypically with smear-negative and non-cavitary disease, yet immune features associated with this change are poorly characterized. We examined the local immune response in a cohort of Tanzanian AIDS-associated TB patients who underwent bronchoalveolar lavage. TB infection was confirmed in bronchoalveolar lavage (BAL) fluid by culture, probe and polymerase chain reaction (PCR). Among TB patients CD4 count correlated positively with the extent of cavitary disease as well as BAL TB load (qPCR CT). TB patients had significantly higher granulocyte-macrophage colony-stimulating factor (GM-CSF) than non-TB patients, and those with non-cavitary TB had significantly higher BAL interferon gamma-inducible protein (IP-10) and interleukin (IL)-7 than those with cavities. BAL neutrophils were as prevalent as monocytes/macrophages or epithelial cells, and immunohistochemistry revealed that neutrophils, monocytes/macrophages, and epithelial cells were major sources of the IP-10 and IL-7. These data suggest a dysregulated cytokine profile may contribute to the TB of advanced AIDS.
People who are print-disabled, who are blind, or who have other visual impairments are restricted in their ability to participate in public life because of lack of labels and signs in the environment. Currently, persons with severe visual impairments often require extensive assistance from strangers to travel in unfamiliar areas. Many other types of disabilities can prevent people from reading print. In addition to people who are blind or who have low vision, there are many head-injured, autistic, and dyslexic (or even just educationally impaired) people, along with persons who have had a stroke, who are not able to assimilate printed language even though they can see the page. Many people can accept the information through speech—that is, having print read aloud to them. Some human factors evaluations of a signage system specifically developed to aid people who have visual impairments or a print-reading disability gain information that is available to sighted people through print are described in this paper. This remote, infrared audible signage system—Talking Signs—is composed of a small infrared transmitter that emits a repeating voice message over a directional light beam to a handheld receiver carried by the blind pedestrian. The infrared system greatly reduces the need for travelers to remember distances, directions, and turns, thereby enhancing independence and efficiency in travel. Results show that remote infrared audible signage provides effective wayfinding information for using transit stations, surface transit, and intersections, thereby enhancing independent use of public transit by people who have visual impairments or cognitive disabilities.
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