Background A decreased capacity to self-manage medications results in nonadherence, medication errors, and drug-related problems in older adults. Previous research identified 80 electronic medication adherence products available to assist patients with self-management of medications. Unfortunately, the usability and workload of these products are unknown. Objective This study aimed to examine the usability and workload of a sample of electronic medication adherence products. Methods In a prospective, mixed methods study, a sample of older adults, health care professionals, and caregivers tested the usability and workload of 21 electronic medication adherence products. Each participant tested 5 products, one at a time, after which they completed the system usability scale (SUS) and NASA-task load index (NASA-TLX), instruments that measure the usability and workload involved in using a product. Higher SUS scores indicate more user-friendliness, whereas lower NASA-TLX raw scores indicate less workload when using a product. Results Electronic medication adherence products required a mean of 12.7 steps (range 5-20) for the appropriate use and took, on average, 15.19 min to complete the setup tasks (range 1-56). Participants were able to complete all steps without assistance 55.3% of the time (103 out of the 186 tests were completed by 39 participants; range 0%-100%). The mean SUS and NASA-TLX raw scores were 52.8 (SD 28.7; range 0-100) and 50.0 (SD 25.7; range 4.2-99.2), respectively, revealing significant variability among the electronic medication adherence products. The most user-friendly products were found to be TimerCap travel size (mean 78.67, SD 15.57; P=.03) and eNNOVEA Weekly Planner with Advanced Auto Reminder (mean 78.13, SD 14.13; P=.049) as compared with MedReady 1700 automated medication dispenser (mean 28.63, SD 21.24). Similarly, MedReady (72.92, SD 18.69) was found to be significantly more work intensive when compared with TimerCap (29.35, SD 20.35; P=.03), e-pill MedGlider home medication management system (28.43, SD 20.80; P=.02), and eNNOVEA (28.65, SD 14.97; P=.03). The e-pill MedTime Station automatic pill dispenser with tipper (71.77, SD 21.98) had significantly more workload than TimerCap (P=.04), MedGlider (P=.03), and eNNOVEA (P=.04). Conclusions This study demonstrated that variability exists in the usability and workload of different electronic medication adherence products among older adults, caregivers, and clinicians. With few studies having investigated the usability and workload of electronic medication adherence products, no benchmarks exist to compare the usability and workload of these products. However, our study highlights the need to assess the usability and workload of different products marketed to assist with medication taking and provides guidance to clinicians regarding electronic medication adherence product recommendations for their patients. Future development of electronic medication adherence products should ensure that the target populations of patients are able to use these products adequately to improve medication management.

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27 Young broilers have an underdeveloped ability for lipid digestion. The potential of lecithin and 28 lysolecithin to improve lipid digestion and growth performance was investigated in 3 29 experiments: an in vitro model that mimics the intestinal conditions of the chick, a digestibility 30 trial with chicks (5 to 7 days of age), and a performance trial until 21 days of age. In Experiment 31 1, palm oil (PO), palm oil with lecithin (PO+L), and palm oil with lysolecithin (PO+LY) were 32 subjected to in vitro hydrolysis and applied to Caco-2 monolayers to assess lipid absorption. 33 The in vitro hydrolysis rate of triglycerides was higher in PO+LY (k= 11.76 × 10-3 min-1) than 34 in either PO (k= 9.73 × 10 3 min 1) or PO+L (k= 8.41 × 10 3 min 1), and the absorption of 35 monoglycerides and free fatty acids was highest (P<0.01) for PO+LY. In Experiment 2, 90 36 broilers were assigned to three dietary treatments: a basal diet with 4% palm oil, and the basal 37 diet supplemented with either 250 ppm lecithin or lysolecithin. ATTD of crude fat was higher 38 in broilers supplemented with lysolecithin, but was lower in broilers supplemented with 39 lecithin. DM digestibility and AMEn in birds supplemented with lysolecithin were significantly 40 higher (3.03% and 0.47 MJ/kg, respectively). In Experiment 3, 480 broilers were randomly 41 allocated to four dietary treatments: basal diet with soybean oil (2%), basal diet with lecithin 42 (2%), soybean oil diet with 250 ppm lysolecithin, or lecithin oil diet with 250 ppm lysolecithin. 43 Lecithin diets significantly reduced weight at day 10 and 21 compared with soybean oil. 44 However, the addition of lysolecithin to lecithin-containing diets significantly improved bird 45 performance. The results of these studies show that, in contrast to lecithin, lysolecithin is able 46 to significantly improve the digestibility and energy values of feed in young broilers.

Perceived speed is modulated by a range of stimulus attributes such as contrast, luminance and adaptation duration. It has been suggested that such changes in perceived speed may influence driving behaviour. In order to evaluate the effect of luminance on driving speed we have measured subjects' driving speed in a driving simulator for a range of luminance and speed over time. The results indicate that reducing luminance results in a decrease in driving speed for all speeds measured. This reduction in driving speed at low luminance is consistent with previous findings that perceived speed increases at low luminance. However, the results also indicated that driving speed remained stable over a 30s period. The stability of driving speed over time is inconsistent with previous findings that perceived speed reduces exponentially as a function of adaptation duration. The results are suggestive of a scheme whereby driving speed is consistent with the known effects of luminance upon perceived speed but may also be modulated by higher order processes that serve to maintain a constant speed over time.

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