End-user Groups Research Articles

Expert-consensus on lymphedema surgeries: candidacy, prehabilitation, and postoperative care.

For over 2 decades, the mainstay of lymphedema treatment has been complete decongestive therapy, however, surgical options are available when conservative treatment is not successful in reducing lymphedema. Standardized pre-surgical and post-surgical guidelines for candidates are not readily available. As part of the 2023 Lymphedema Summit that was sponsored by the American Cancer Society, and the Lymphology Association of North America, an expert consensus workgroup was formed and developed an expert consensus which affirms the importance of pre-surgical guidelines for candidates with lymphedema. The workgroup recommended that guidelines should be tailored to four major end-user groups: (1) patients, (2) referring physicians, (3) allied health professionals, and (4) surgeons.

Multicomponent Support Program for Secondary Prevention of Stroke Using Digital Health Technology: Co-Design Study With People Living With Stroke or Transient Ischemic Attack.

Few individuals (<2%) who experience a stroke or transient ischemic attack (TIA) participate in secondary prevention lifestyle programs. Novel approaches that leverage digital health technology may provide a viable alternative to traditional interventions that support secondary prevention in people living with stroke or TIA. To be successful, these strategies should focus on user needs and preferences and be acceptable to clinicians and people living with stroke or TIA. This study aims to co-design, with people with lived experience of stroke or TIA (referred to as consumers) and clinicians, a multicomponent digital technology support program for secondary prevention of stroke. A consumer user needs survey (108 items) was distributed through the Australian Stroke Clinical Registry and the Stroke Association of Victoria. An invitation to a user needs survey (135 items) for clinicians was circulated via web-based professional forums and national organizations (eg, the Stroke Telehealth Community of Practice Microsoft Teams Channel) and the authors' research networks using Twitter (subsequently rebranded X, X Corp) and LinkedIn (LinkedIn Corp). Following the surveys, 2 rounds of user experience workshops (design and usability testing workshops) were completed with representatives from each end user group (consumers and clinicians). Feedback gathered after each round informed the final design of the digital health program. Overall, 112 consumers (male individuals: n=63, 56.3%) and 54 clinicians (female individuals: n=43, 80%) responded to the survey; all items were completed by 75.8% (n=85) of consumers and 78% (n=42) of clinicians. Most clinicians (46/49, 94%) indicated the importance of monitoring health and lifestyle measures more frequently than current practice, particularly physical activity, weight, and sleep. Most consumers (87/96, 90%) and clinicians (41/49, 84%) agreed that providing alerts about potential deterioration in an individual's condition were important functions for a digital program. Intention to use a digital program for stroke prevention and discussing the data collected during face-to-face consultations was high (consumers: 79/99, 80%; clinicians 36/42, 86%). In addition, 7 consumers (male individuals: n=5, 71%) and 9 clinicians (female individuals: n=6, 67%) took part in the user experience workshops. Participants endorsed using a digital health program to help consumers manage stroke or TIA and discussed preferred functions and health measures in a digital solution for secondary prevention of stroke. They also noted the need for a mobile app that is easy to use. Clinician feedback highlighted the need for a customizable clinician portal that captures individual consumer goals. Following an iterative co-design process, supported by evidence from user needs surveys and user experience workshops, a consumer-facing app that integrates wearable activity trackers and a clinician web portal were designed and developed to support secondary prevention of stroke. Feasibility testing is currently in progress to assess acceptability and use.

Practical Application of a Relationship-Based Model to Engagement for Gene-Drive Vector Control Programs.

Engagement is an important component in the advancement of gene-drive vector control research programs as developers look to transition the technology from the laboratory to the field. As research advances and engagement surrounding this novel technology is put into practice, knowledge can be gained from practical experiences and applications in the field. A relationship-based model (RBM) provides a framework for end-user development of engagement programs and strategies. The model places end users at the center of the engagement decision-making processes rather than as recipients of predetermined strategies, methods, and definitions. Successful RBM application for healthcare delivery has previously been demonstrated, and the University of California Malaria Initiative (UCMI) has applied this model to its gene-drive program in the Democratic Republic of São Tomé and Príncipe. The model emphasizes the importance of local leadership in the planning, development, and implementation of all phases of project engagement. The primary aim of this paper is to translate the model from paper to practice and provide a transparent description, using practical examples, of the UCMI program implementation of RBM at its field site. End-user development of the UCMI engagement program provides a unique approach to the development of ethical, transparent, and effective engagement strategies for malaria control programs. This paper may also serve as a reference and example for projects looking to establish an engagement program model that integrates end-user groups in the decision-making processes surrounding engagement.

Individual and cluster demand response in retail electricity trading with end-users in differentiated oligopoly market: A game-theoretical approach

The characterization of the competitive interdependence among power consumers in power trading system contributes to pursuing efficient power supply and suppressing peak–valley load differences. Even though Stackelberg–Nash game approach has been applied to retail electricity trading with a single utility company and a group of end-users under competitive interdependence, the extension to multi-cluster retail electricity markets is not focused yet and the best strategies of end-users are still decoupled to each other. To bridge this gap this paper investigates the price-based demand response problem in multi-cluster retail electricity markets to coordinate the energy consumption behavior of the end-users and the retail price behavior of the utility companies. Adopting the structure of hierarchical game theory, the cluster retail price is controlled by the utility company to affect the energy consumption demand of end-users within the corresponding cluster and hence increase the income of both the utility companies and the end-users. In order to describe the coupled competition relationship among the bottom end-users in the system, the Cournot competition model of the differentiated oligopoly market is constructed by taking energy consumption as the individual strategy of end-users. The existence and uniqueness of Nash equilibrium and Stackelberg Nash equilibrium in such a hierarchical game system are proved, and a seeking algorithm is proposed to seek the Stackelberg Nash equilibrium, which is regarded as the extension from the existing algorithm for multi-cluster setup. This work gives an insight to theoretically check whether the utility companies need to redesign the contract with the power generator to ask for larger maximum supply.

Protocol for the development of a reporting guideline for umbrella reviews on epidemiological associations using cross-sectional, case-control and cohort studies: the Preferred Reporting Items for Umbrella Reviews of Cross-sectional, Case-control and Cohort studies (PRIUR-CCC)

IntroductionObservational studies are fraught with several biases including reverse causation and residual confounding. Overview of reviews of observational studies (ie, umbrella reviews) synthesise systematic reviews with or without meta-analyses of...

Informing existing technology acceptance models: a qualitative study with older persons and caregivers

New technologies can help older persons age in place and support their caregivers. However, they need to be accepted by the end-users to do so. Technology acceptance models, such as TAM and UTAUT and their extensions, use factors like performance expectancy and effort expectancy to explain acceptance. Furthermore, they are based on quantitative methods. Our qualitative study investigates factors fostering and hindering acceptance among older persons and their caregivers for a variety of assistive technologies, including wearables, ambient sensors at home with and without cameras and social companion robots. The goal of this paper is twofold: On the one hand, it investigates the factors of technology acceptance models in a qualitative setting. On the other hand, it informs these models with aspects currently overlooked by them. The results reveal that performance expectancy and effort expectancy are relevant for acceptance. We also find that reliability, anxiety around technology and different social aspects have an influence on acceptance of assistive technology in aged care for all end-user groups. Our findings can be used to update current technology acceptance models and provide in-depth knowledge about the currently used factors.

Multi-Factor Coral Disease Risk: A new product for early warning and management.

Ecological forecasts are becoming increasingly valuable tools for conservation and management. However, there are few examples of near-real-time forecasting systems that account for the wide range of ecological complexities. We developed a new coral disease ecological forecasting system that explores a suite of ecological relationships and their uncertainty and investigates how forecast skill changes with shorter lead times. The Multi-Factor Coral Disease Risk product introduced here uses a combination of ecological and marine environmental conditions to predict the risk of white syndromes and growth anomalies across reefs in the central and western Pacific and along the east coast of Australia and is available through the US National Oceanic and Atmospheric Administration Coral Reef Watch program. This product produces weekly forecasts for a moving window of 6 months at a resolution of ~5 km based on quantile regression forests. The forecasts show superior skill at predicting disease risk on withheld survey data from 2012 to 2020 compared with predecessor forecast systems, with the biggest improvements shown for predicting disease risk at mid- to high-disease levels. Most of the prediction uncertainty arises from model uncertainty, so prediction accuracy and precision do not improve substantially with shorter lead times. This result arises because many predictor variables cannot be accurately forecasted, which is a common challenge across ecosystems. Weekly forecasts and scenarios can be explored through an online decision support tool and data explorer, co-developed with end-user groups to improve use and understanding of ecological forecasts. The models provide near-real-time disease risk assessments and allow users to refine predictions and assess intervention scenarios. This work advances the field of ecological forecasting with real-world complexities and, in doing so, better supports near-term decision making for coral reef ecosystem managers and stakeholders. Secondarily, we identify clear needs and provide recommendations to further enhance our ability to forecast coral disease risk.

Culture-based lesson exemplar (CBLE) on least mastered learning competencies in science 4

This study presents the development of a Culture-Based Lesson Exemplar (CBLE) in Science 4, strategically tailored to address the least mastered learning competencies, with the aim of elevating learners' proficiency. Employing a Research and Development (R&amp;D) methodology, the research conducted an actual count of Public Grade 4 Science teachers from the Schools Division of Ilocos Norte (SDOIN), Schools Division of the City of Batac (SDCB), and Schools Division Office of Laoag City as its respondents. To address the research objectives, three research instruments were employed: a survey-questionnaire, content validation, and a level of acceptability assessment. The CBLE in Science 4 is meticulously crafted to facilitate teachers' guided comprehension of scientific concepts and enhance Grade 4 pupils' mastery of the subject matter. This instructional material seamlessly integrates local icons, narratives, resources, and scenarios that reflect the rich Ilocano culture while preserving the core scientific concepts. The CBLE underwent rigorous content validation, encompassing objectives, content alignment, values formation, technical attributes, and instructional quality. Furthermore, its level of acceptability was gauged through the input of a group of end-users. The research findings indicate that the proposed CBLE demonstrates very high validity and garners a high level of acceptability. Consequently, this meticulously developed material serves as an invaluable supplementary resource for educators aiming to enhance the mastery, performance, and comprehension of Grade 4 learners in science. The validation process yielded an overall mean rating of 4.75, affirming the practical utility and quality of the developed material for educational purposes.

The co-development and evaluation of an e-learning course on spinal cord injury physical activity counselling: a randomized controlled trial

BackgroundHealth, fitness and lifestyle professionals can play important roles in promoting physical activity in groups at risk of developing an inactive lifestyle, such as people with spinal cord injury (SCI). Tailored counselling is a promising tool to promote and improve physical activity levels. To support professionals to effectively have a conversation about physical activity with clients with SCI, evidence-based training and resources are needed. This project aimed to (1) co-develop an e-learning course on best practices for SCI physical activity counselling and, (2) examine the effectiveness and usability of this course.MethodsGuided by the technology-enhanced learning (TEL) evaluation framework, we used a systematic, multistep approach to co-develop and evaluate an e-learning course. The development process was informed by input and feedback from a diverse group of end-users and experts (n > 160) via online surveys and (think-aloud) interviews. A randomized controlled trial was used to compare learning outcomes (post-knowledge and self-efficacy) between participants who completed the course (intervention group) and the wait-listed control group. Usability, learning experiences, and satisfaction were assessed among all participants.ResultsForty-one participants (21 intervention-group; 20 control-group) with various backgrounds (e.g., lifestyle counsellors, physiotherapists, occupational therapists, recreation therapists, fitness trainers) enrolled in the randomized controlled trial. After completing the course, participants in the intervention group showed significantly improved knowledge on the best practices for SCI physical activity counselling and higher self-efficacy for using these best practices in conversations with clients with SCI compared to the control group (p <.001). Participants reported above average usability scores, positive learning experiences, and high levels of satisfaction when completing the course.ConclusionWe used a systematic, multi-step, theory-informed approach to co-develop and evaluate an evidence-based e-learning course on SCI physical activity counselling to support professionals to promote physical activity in their daily practices. The overall positive findings demonstrate that the e-learning course is feasible and ready for further implementation in various health and community settings. Implementation of the e-learning course can help professionals improve the physical activity support they provide to their clients, and subsequently increase physical activity participation in people with SCI.

Definition of sensory and instrumental thresholds of acceptability for selection of cassava genotypes with improved boiling properties.

Consumers of boiled cassava in Africa, Latin America and Asia use specific preference criteria to evaluate its cooking quality, in terms of texture, colour and taste. To improve adoption rates of improved cassava varieties intended for consumption after boiling, these preference criteria need to be determined, quantified and integrated as post-harvest quality traits in the target product profile of boiled cassava, so that breeding programs may screen candidate varieties based on both agronomic traits and consumer preference traits. Surveys of various end-user groups identified seven priority quality attributes of boiled cassava covering root preparation, visual aspect, taste and texture. Three populations of contrasted cassava genotypes, from good-cooking to bad-cooking, in three countries (Uganda, Benin, Colombia) were then characterized according to these quality attributes by sensory quantitative descriptive analysis (QDA) and by standard instrumental methods. Consumers' preferences of the texture attributes mealiness and hardness were also determined. By analysis of correlations, the consumers' preferences scores were translated into thresholds of acceptability in terms of QDA scores, then in terms of instrumental measurements (water absorption during boiling and texture analysis). The thresholds of acceptability were used to identify among the Colombian and Benin populations promising genotypes for boiled cassava quality. This work demonstrates the steps of determining priority quality attributes for boiled cassava and establishing their corresponding quantitative thresholds of acceptability. The information can then be included in boiled cassava target product profiles used by cassava breeders, for better selection and adoption rates of new varieties. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Agtech platforms: complementors and value propositions

ABSTRACT Traditionally regarded as one of the least digitised industries, agriculture is now transforming due to the emergence of digital platforms and ecosystems. Extant literature underscores Agtech platforms as business solutions capable of remedying operational inefficiencies, diminishing transaction costs, enhancing information exchange, mitigating spatiotemporal disparities, facilitating market integration, and generating novel forms of value. Nevertheless, persistent ambiguity surrounds the identification and assessment of the functional roles of peripheral actors, referred to as complementors, who play a pivotal role in engendering network effects. Grounded in network externality theory and platform value proposition framework, this study seeks to comprehensively discern complementors, lead firms, and end-users associated with Agtech platforms and their overarching value propositions. Employing the case research method, we synthesise existing literature and review archival sources while focusing on four illustrative cases: Dehaat, Agrielevate, IFFCO Bazar, and KRIBHCO-CSC-eGov. The analysis was further strengthened through consultation with domain experts, facilitating triangulation and validation. This study offers insights into complementor-core, lead firm, and end-user groups within Agtech platforms, thus deepening our epistemic comprehension.

Co-Producing the International Pediatric Oncology Exercise Guidelines (iPOEG) Toolkit with End-Users

The international Pediatric Oncology Exercise Guidelines (iPOEG) support physical activity among children and adolescents affected by cancer. Knowledge translation efforts are needed to ensure that those who will use and/or benefit from the iPOEG have access to it. This mixed-methods study followed co-production principles as guided by an integrated knowledge translation approach within the Knowledge to Action (KTA) Framework, to engage end-users (i.e., professionals and patients/caregivers) to: (1) identify the types of resources needed; (2) co-produce an iPOEG brand; (3) co-produce resources and content; and (4) co-produce dissemination plans to distribute the iPOEG Toolkit (i.e., resources and content). End-users indicated requiring resources such as posters, infographics, social media posts, and videos, and co-created resource content covering quick tips to get active and movement-related education and information. Generated strategies to disseminate the iPOEG Toolkit included: (1) academic presentations; (2) brief education sessions and facilitated discussions to different end-user groups; (3) engaging champions from different end-user groups; (4) emails and email reminders; (5) mainstream news outlets (e.g., newspaper, magazines, or segments on the television [i.e., local news]); and (6) social media. Co-production of the iPOEG Toolkit and dissemination plan were guided by two phases within the KTA framework to build tools that can promote the reach of the iPOEG, ultimately increasing physical activity in this population.

Tailoring community preventive care to personal health needs: a data-driven and participatory approach

A digital platform with tools for health promotion was developed as a proof of concept in co-creation with all relevant stakeholders involved: citizens, caregivers, and local policy makers, aiming to optimize community preventive care.&#x0D; The platform, referred to as BIBOPP, was developed as a proof of concept focusing on prevention and health promotion for citizens, local policy makers but also for primary care givers wanting to offer personalized follow up. To this end, we set up multiple co-creation sessions with different target groups of end users, including those with expected limited digital literacy skills, eg. older adults and people with no or low formal educational background. Based on this input, the functionalities of the tools were designed and developed and afterwards tested with a new group of end-users.&#x0D; The online prevention platform offered citizens from 5 Flemish municipalities a digital screening, allowing them to evaluate their health and lifestyle. This screening is the Domus Medica Health Guide (GGDM), an evidence-based tool predicting personal risk for chronic diseases. The outcome of the screening is linked to the electronic medical health record hosted by the general practitioner, notifying the latter in case of excessive risk and involving him in the process of disease prevention and health promotion.&#x0D; Based on the personalized lifestyle advice resulting from the survey responses, end users then received an overview of activities and primary care providers in their community, tailored to their personal risk profile and preferences.&#x0D; The data collected with consent from the end users, yielded insights on the self-reported lifestyle and health of these participants. On an aggregated level, this tool has the potential to provide data for population health management.&#x0D; First lessons learned indicate that the platform did require significant digital literacy skills from end-users, as indicated by the participants younger age and relatively healthy lifestyle (eg. less than 10% smokers, +50% daily physical activity, …). However, in a co-creation session group with older adults, they indicated that digital skills were not a threshold when peer support was available. Furthermore, they recognized that the tool helped them in the self-management of their health and that they trusted the data governance. People with low to no formal educational background on the other hand were more suspicious about the tool and data governance unless this was offered to them through their trusted care providers. Also, older adults indicated that support with the interpretation of the advices by a health professional could be of added value.&#x0D; Next steps for BIBOPP now are involving these health professionals, and more specifically primary care actors in onboarding and guiding people to and through the platform.&#x0D; To conclude, this data-driven proof of concept co-designed with end-users, has promise to deliver personalized services, strengthen community preventive care, and optimize the local health policy.&#x0D; &#x0D;

Capturing environmental DNA in snow tracks of polar bear, Eurasian lynx and snow leopard towards individual identification

Polar bears (Ursus maritimus), Eurasian lynx (Lynx lynx) and snow leopards (Panthera uncia) are elusive large carnivores inhabiting snow-covered and remote areas. Their effective conservation and management are challenged by inadequate population information, necessitating development of novel data collection methods. Environmental DNA (eDNA) from snow tracks (footprints in snow) has identified species based on mitochondrial DNA, yet its utility for individual-based analyses remains unsolved due to challenges accessing the nuclear genome. We present a protocol for capturing nuclear eDNA from polar bear, Eurasian lynx and snow leopard snow tracks and verify it through genotyping at a selection of microsatellite markers. We successfully retrieved nuclear eDNA from 87.5% (21/24) of wild polar bear snow tracks, 59.1% (26/44) of wild Eurasian lynx snow tracks, and the single snow leopard sampled. We genotyped over half of all wild polar bear samples (54.2%, 13/24) at five loci, and 11% (9/44) of wild lynx samples and the snow leopard at three loci. Genotyping success from Eurasian lynx snow tracks increased to 24% when tracks were collected by trained rather than untrained personnel. Thirteen wild polar bear samples comprised 11 unique genotypes and two identical genotypes; likely representing 12 individual bears, one of which was sampled twice. Snow tracks show promise for use alongside other non-invasive and conventional methods as a reliable source of nuclear DNA for genetic mark-recapture of elusive and threatened mammals. The detailed protocol we present has utility for broadening end user groups and engaging Indigenous and local communities in species monitoring.

Stakeholder assessment for mycotoxin analysis: exploring the demand along the European food supply chain

Abstract Mycotoxins are amongst the most prevalent food contaminants leading to serious health implications for humans and animals. Limiting exposure to them within the population remains a pressing food safety challenge. Prevention and timely detection are crucial for minimising mycotoxin contamination in food and feed. Therefore easy-to-use, rapid, eco-friendly and low-cost screening methods are increasingly implemented. Early-stage end-user engagement in the technological development process aids and guides the research towards increased societal impact. To investigate these end-user needs, the limitations of the currently used methods and the expectations towards a novel approach were mapped among stakeholders in a comprehensive survey. Stakeholders along the food supply chain (agricultural, food processing, retail, food safety and control, laboratories) were identified in five European countries and contacted. A total of 63 participants completed the survey, which was followed-up by an interview. The results of the survey revealed that different end-user groups have different priorities. Important limiting factors for agricultural, processing and retail stakeholders of the current methodologies include the complexity of sample preparation, high cost and time-to-results. Complementing the accredited laboratory tests with a pre-screening device would be especially interesting for agricultural producers (87.5% of the participants are interested) and food processors (80%), since there is an increasing demand for on-site detection of contamination. On the other hand, food control authorities and commercial laboratories indicated higher priority towards low quantification limits and multi-compound methods. The time to get the results was found to be more important than the testing cost (important aspect for 74.6 versus 66.7%). Overall, the findings of this study are critical input for end-user-targeted development of novel mycotoxin detection platforms.

Improved spatial-temporal sound perception using active MEMS

Current microphone technology is based on a transducer concept that is the same for all end user groups, namely, passive, linear. While most of the technology-related challenges have been overcome by sophisticated post-processing algorithms, some of the current limitations of sound detection technology, especially as recognized by groups dealing with hearing impairments and losses, should be addressed at the transducer stage. In this work we present the dynamic behaviour and performance of an active, nonlinear MEMS sensor subject to acoustic stimuli and noise. Our work includes the presentation of a reduced-order model of the composite MEMS structure, relevant dynamic analyses including bifurcation and stability diagrams, as well as experimental investigations. Simulations and experimental results demonstrate cochlear-like amplification properties, meaning that soft signals are amplified significantly different from louder signals. Signals which initially are imbedded in a noise floor can be amplified without also amplifying the noise and thus providing another way of detecting sound patterns.

An Integrated Support System for People with Intellectual Disability

People with Intellectual Disability (ID) encounter several problems in their daily living regarding their needs, activities, interrelationships, and communication. In this paper, an interactive platform is proposed, aiming to provide personalized recommendations for information and entertainment, including creative and educational activities, tailored to the special user needs of this population. Furthermore, the proposed platform integrates capabilities for the automatic recognition of health-related emergencies, such as fever, oxygen saturation decline, and tachycardia, as well as location tracking and detection of wandering behavior based on smartwatch/smartphone sensors, while providing appropriate notifications to caregivers and automated assistance to people with ID through voice instructions and interaction with a virtual assistant. A short-scale pilot study has been carried out, where a group of end-users participated in the testing of the integrated platform, verifying its effectiveness concerning the recommended services. The experimental results indicate the potential value of the proposed system in providing routine health measurements, identifying and managing emergency cases, and supporting a creative and qualitative daily life for people with disabilities.

Development and initial testing of EcoToxChip, a novel toxicogenomics tool for environmental management and chemical risk assessment.

New approach methods (NAMs) are increasingly important to help accelerate the pace of ecological risk assessment and offer more ethical, affordable, and efficient alternatives to traditional toxicity tests. In the present study, we describe the development, technical characterization and initial testing of a toxicogenomics tool, EcoToxChip (384-well qPCR array), to support chemical management and environmental monitoring for three laboratory model species - fathead minnow (Pimephales promelas), African clawed frog (Xenopus laevis), and Japanese quail (Coturnix japonica). Chip design, including gene selection, was informed by a diverse end-user group and quality control metrics (e.g. primer assay, reverse transcription and PCR efficiency) performed well based on a priori established criteria. Correlation with RNAseq data provided additional confidence in this novel toxicogenomics tool. While the present study represents an initial testing of only 24 EcoToxChips for each of the model species, the results provide increased confidence in the robustness/reproducibility of EcoToxChips for evaluating perturbations in gene expression associated with chemical exposure and thus, this NAM, combined with early-life stage toxicity testing, could augment current efforts for chemical prioritization and environmental management.

Female firefighters’ increased risk of occupational exposure due to ill-fitting personal protective clothing

Despite the growing female firefighter population, firefighting gear was originally designed with only the male human form in mind. As a result, women in the fire service experience issues of improper fit and injuries at rates exponentially higher than their male counterparts. Areas of ill-fit, specifically in interfaces, can increase the risk of occupational exposure for women in the fire service. The purpose of this research was to determine fit and sizing issues of personal protective clothing (PPC) to improve female firefighters’ comfort, mobility, and safety. A mixed methods approach was adopted including a nationwide questionnaire, end-user focus groups, and remote three-dimensional body scanning of 189 female structural and wildland firefighters. Between 15%–21% of female firefighters were found to intentionally leave off a part of their PPC at least “sometimes,” if not “nearly always,” with the coat and pants being the primary items not donned. 100% of participants had wrist and ankle circumferences smaller than the smallest size garment’s wrist and pant leg openings per the wildland sizing system, indicating interface areas and wildland PPC have the greatest opportunities for design and fit improvement. This study gathered and created the first and largest U.S. female firefighter anthropometric database. Overall results indicate female firefighters are wearing PPC with significant fit issues that not only reduce their comfort and restrict their mobility but pose increased safety risks related to occupational exposure.

Influence of Solid Oral Dosage Form Characteristics on Swallowability, Visual Perception, and Handling in Older Adults.

Swallowability, visual perception, and any handling to be conducted prior to use are all influence factors on the acceptability of an oral dosage form by the patient. Knowing the dosage form preferences of older adults, as the major group of medication end users, is needed for patient-centric drug development. This study aimed at evaluating the ability of older adults to handle tablets as well as to assess the anticipated swallowability of tablets, capsules, and mini tablets based on visual perception. The randomized intervention study included 52 older adults (65 to 94 years) and 52 younger adults (19 to 36 years). Within the tested tablets, ranging from 125 mg up to 1000 mg in weight and being of different shapes, handling was not seen as the limiting factor for the decision on appropriate tablet size. However, the smallest sized tablets were rated worst. According to visual perception, the limit of acceptable tablet size was reached at around 250 mg for older adults. For younger adults, this limit was shifted to higher weights and was dependent on the tablet shape. Differences in anticipated swallowability with respect to tablet shapes were most pronounced for tablets of 500 mg and 750 mg in weight, independent of the age category. Capsules performed worse compared to tablets, while mini tablets appeared as a possible alternative dosage form to tablets of higher weight. Within the deglutition part of this study, swallowability capabilities of the same populations were assessed and have been reported previously. Comparing the present results with the swallowing capabilities of the same populations with respect to tablets, it shows adults' clear self-underestimation of their ability to swallow tablets independent of their age.