Research Study Research Articles

Reinforced concrete block masonry walls under eccentric compression: Assessment using experimental and numerical data

This paper presents the outcome of a research study carried out to assess the eccentric compression behaviour of reinforced concrete block masonry (RM) walls. The design provisions pertaining to axial compression capacity of RM walls are overly conservative, especially where slender walls are to be designed. To verify the relevancy of the design provisions outlined in the Australian masonry standards (AS 3700), an experimental database of RM walls tested under eccentric compression was created by gathering data from the past studies. In total, 76 partially grouted (PG) and 18 fully grouted (FG) RM wall test data were gathered. The established database revealed that the performance of fully grouted (FG-RM) walls are generally overlooked. To fill this gap, a finite element (FE) based numerical modelling procedure was established to understand the performance of FG-RM walls under eccentric compression. The established FE modelling procedure was validated with a set of experimental results and the validated modelling procedure was then used to parametrically analyse the eccentric compression behaviour of FG-RM walls. In total, 72 FG-RM wall cases were numerically simulated under eccentric compression, varying slenderness ratios (15, 21, 26, 32, 37, and 42), grout strengths (20 MPa, 30 MPa and 40 MPa) and boundary conditions (pinned-pinned and fixed-fixed). The analysed numerical data along with the experimental database were then used to verify the design provisions outlined in previous version of AS 3700 (2011) and current version of AS 3700 (2018). It was found that the provisions specified in AS 3700 (2011) were overly conservative than the AS 3700 (2018), justifying the need of deliberate revisions in terms of the treatment of slenderness, eccentricity and grout strength for designing the RM walls under compression.

Analysis of Student and Teachers Perspective using Hybrid e-Learning Method

The technological development also enhances the usage in the educational world. The subpar performance of traditional classroom learning has raised significant concerns within the realm of teaching and learning. This conventional approach, characterized by the age-old "chalk and talk" method, has been replaced by the adoption of pure online learning, often referred to as e-learning. This educational method, which has its roots in distance education, has garnered substantial attention from public universities. However, for e-learning to be truly effective, it must be integrated with other forms of learning, including face-to-face instruction. This amalgamation of different learning modalities gives rise to a novel approach known as blended learning, which has proven to be the most efficient and effective educational system. Many enduring insights from this technology have been influenced by the rhetorical works of the past. As society propels itself deeper into the information age, the importance of blended learning in higher education is becoming increasingly prominent. Higher education institutions stand on the brink of a significant paradigm shift in the way knowledge and truth are disseminated. To comprehend this transition to new computer-mediated methods of knowledge delivery through blended learning experiences, it is crucial to grasp the perceptions held by both instructors and students. In this quantitative research study, a survey questionnaire was employed to gather feedback from faculty and students at a private institute. The survey aimed to capture their perceptions regarding the use, frequency, readiness, and satisfaction with web-based technology in a blended learning environment. To gain deeper insights into these perceptions, both quantitative and qualitative data were collected through an online survey distributed to faculty and students during the spring semester.

Assessing methodological quality in dental education research using MERSQI: Analysis of publications from two journals.

The Medical Education Research Study Quality Instrument (MERSQI) has been used frequently to assess the methodological quality of medical education but not for dental education. The present study aimed to assess the methodological quality using MERSQI scores of articles published in the Journal of Dental Education (JDE) and the European Journal of Dental Education (EJDE). A cross-sectional assessment of the quality of manuscripts published in 2012, 2017, and 2022 JDE and EJDE was conducted. MERSQI data, numbers of authors, first and corresponding author degrees, geographic origins, and funding information were also extracted for each included study. Descriptive and analytical statistics were conducted, and significance level was set at α<0.05. Four hundred ninety-five articles met the inclusion criteria. The most common study design was a single-group cross-sectional or single-group posttest and conducted in one institution for all studied years. In all journals and years, studies were assessed mainly by participants. The study outcome was mostly satisfaction, attitudes, perceptions, opinions, and general facts. The total mean MERSQI score for each journal and year varied. Year and geographic origin significantly affected the total MERSQI score. Papers originating from Asia had the highest score, followed by South America, Europe, North America, Oceania, and Africa. MERSQI score is applicable to the assessment of the methodological quality of dental educational research. The MERSQI score for most of the domains was similar for both journals. The MERSQI score was affected by publication years and geographic origins.

Transitioning solidification mode via electroplated Ni coatings in martensitic stainless steel resistance spot welds: new insights into fabricating tough microstructure

The present study addresses the enhancement of fracture toughness of martensitic stainless steel (MSS) spot welds by utilizing through electroplating of Ni on MSS sheets. The equilibrium and non-equilibrium solidification modelling showed that by Ni coating with 50 μm thick on 1.5 mm thick MSSs, the solidification mode changes from δ-ferrite to γ-austenite, leading to a weld nugget (WN) dominated by austenite grains. Moreover, electron backscatter diffraction (EBSD) and electron probe microanalysis (EPMA) showed that the other phases (martensite, δ-ferrite) appeared in band areas of WN owing to incomplete mixing of MSS and the Ni-coating. The tough microstructure in the Ni-coated MSS spot welds provided superior mechanical properties compared to non-coated welds, both in cross-tension (CT) and tensile-shear (TS) tests. Notably, the TS and CT strengths of the Ni-coated MSS spot welds showed a remarkable increase of 57% and 127%, respectively, in comparison to the conventional bare MSS spot welds. Furthermore, in terms of failure energy, the Ni-coated MSS spot welds demonstrated a substantial enhancement of 296% in TS and 520% in CT, when compared to their non-coated counterparts. This research study showcased the effectiveness of Ni electroplating as an industrial method for improving the spot weldability of MSSs.

Barriers to risk management in small construction projects in Sri Lanka

PurposeThis study explores the current status of risk management (RM) in Sri Lanka and the obstacles in implementing RM in Sri Lankan small construction projects.Design/methodology/approachThe current research study adopted a quantitative research method. Using a purposeful sampling strategy, 100 construction companies engaged in small construction projects in Sri Lanka were selected and a questionnaire was distributed among top managerial employees of these companies. Employees belonging to 47 companies responded to the survey which provided information relating to 812 construction projects. The collected data were analyzed using the RM implementation index (RMII) and other quantitative measures such as mean, median and percentages.FindingsThe research findings indicated that RM incorporation was at a lower degree in small construction projects in Sri Lanka. The findings further indicated that RM incorporation was relatively high in the public construction projects compared to the private construction projects. The main obstacles identified through the survey for RM implementation were: “lack of funding”, “lack of time”, “low profit margin”, “not economical” and “lack of knowledge”.Research limitations/implicationsThe study was limited to exploring RM implementation in small construction projects in Sri Lanka. The study was limited to the building construction companies under the 150-million-rupee (approx. below 450,000 USD) financial limit registered with the construction industry development authority in Sri Lanka.Originality/valueRM in small construction projects in developing countries is a relatively less explored domain. Sri Lankan construction industry is another relatively less explored domain in terms of new management technique implementation such as RM and value management. The quantitative approach used for the study revealed that RM implementation is at a lower degree in the small construction projects. Moreover, several obstacles pertaining to RM implementation were recognized through this study. These findings will be useful for the construction stakeholders to overcome the recognized barriers and effectively use RM in their respective construction projects.

Implementation and Impact of Perinatal Food Is Medicine Programs: A Qualitative Research Study

BackgroundImproving social determinants of health, such as access to nutritious food, is crucial for achieving health equity. Nutrition insecurity, especially during pregnancy and postpartum, can lead to poor maternal and birth outcomes. Food is Medicine (FIM) programs, which integrate food into the health care system to prevent or manage disease, have the potential to improve nutrition insecurity, but research about perinatal FIM programs is limited. ObjectiveThe purpose of this study was to explore perceptions of public health impacts of perinatal FIM programs from the perspectives of both program implementers and program supporters and implementation strategies used to enhance program adoption, implementation, and maintenance. DesignQualitative data were collected through semi-structured interviews. The interview guide was based on the Reach, Effectiveness, Adoption, Implementation, Maintenance framework. Participants/settingProgram implementers (n = 16) and program supporters (n = 20) were recruited across the United States through purposive sampling in 2022 and 2023. AnalysisData were analyzed using deductive thematic analysis and an iterative feedback loop with the project partner. ResultsInterviews were completed with program implementers and program supporters and generated meaning units (n = 1,942), which were coded into themes aligned with each Reach, Effectiveness, Adoption, Implementation, Maintenance dimension. Perinatal FIM programs reached multiple priority populations who were mainly recruited through health care systems. Effectiveness measures typically included nutrition patterns and practices, as well as return on investment. Motivations for adopting programs primarily included partnerships and connections, financing, and policies and laws. Program components varied and were adapted to meet participants and setting needs. Policy, evidence, funding, and partnerships could lead to program maintenance. Implementation strategies applied by the program supporters included financial strategies and infrastructure changes. ConclusionsThere is a need to identify the core functions and adaptable forms of perinatal FIM programs, which could lead to identification of standard evaluation metrics. This could result in greater uptake by potential delivery agents, increased funding and policy support, and enhanced benefits for perinatal population experiencing health disparities.

Enhancement of Undergraduate Students' Consciousness about Multicultural Identity

The perspective of multicultural identity enables an individual to acknowledge and respect the prevailing diverse identities individually and socially. This particular approach provides liberty and acceptance towards unique individuals around us. As a practicing community, respect for one's originality and openness towards diverse practices need to be promoted for peace and harmony in any society. This research study aims to enhance the consciousness about multicultural identity through mixed method research, qualitative followed by quantitative research with an experimental intervention. Semantic content analysis of the curriculum of Pakistan Studies designed by HEC enlightened the researcher about existing gaps between the outline and recommended topics and sub-topics in the outline. Triangulation has been performed through focused group discussion to ensure the results and actual influence of the introduced phenomena on the Undergraduate students of B.Ed. (Hons) II (N=46). The findings clearly illustrate the significance of the pretest and posttest results of gender identity and psycho-social identity with effect sizes of r= 0.59 and 0.44, respectively. The research study suggested inculcating the phenomena of multicultural identity at the national level through policymakers and curriculum developers and practiced at the institutional level in educational settings to promote healthy and well-rounded individuals and progressive society.

Yarışmacı Eğitim Yaklaşımının Öğrencilere Etkisine İlişkin Öğretmen Görüşleri

The purpose of this study is to determine teachers' opinions regarding the impact of competitive education approach - practices - on students' social and emotional development. Qualitative method was preferred in the research study and interview technique was used. Criterion sampling, one of the purposeful sampling methods, was used when determining the participants. The participants consist of 20 teachers who work in Sincan district of Ankara province in the 2022-2023 academic year, vary in terms of demographic characteristics, teach 12th grade students, and have worked for at least 5 years. In this study, a semi-structured interview form was created as a data collection tool to examine the social and emotional development of students in competitive education in terms of teachers' opinions, and was applied remotely via Google form. The answers given to the interview form in the study were analyzed with the content analysis method used in qualitative studies. The findings were coded and interpreted by creating themes. The classroom guidance program of the Ministry of National Education includes competencies in three development areas of students: academic, career and social and emotional. Social and emotional development area; It consists of ensuring personal safety, self-awareness, interpersonal skills, understanding and managing emotions, and decision-making competencies. As a result of our study, in which we discussed the effect of the competitive education approach, which is the purpose of our research, on the social and emotional development of students in the context of the social and emotional development competencies of the 12th grade guidance program, it can be said that the competitive education approach is insufficient to realize the social and emotional development of students at the desired level. While protecting personal security, self-awareness, interpersonal relations and decision-making skills show development in the social field, understanding and managing emotions show emotional development. At the end of the research, comparative practices that support emotional development can be determined by universities, and it can be recommended to provide consultancy services to the Ministry of Education and schools, to support the social development of students by school-family cooperation for each student, and to be supported by school administrators. Keywords: Competition, competitive education, social and emotional development, meritocracy

Examining Teacher Attrition through the Experiences of Former Teachers before and during the COVID-19 Pandemic

Schools across the nation are impacted by the influx of teachers leaving the profession. Record-high teacher shortages devastate public schools as classrooms remain unstaffed, and students miss quality instruction. The current study examined the experiences of former teachers before and during the COVID-19 pandemic that led to their exit from the profession. The overall research question was, “What experiences led teachers to exit the profession before and during the COVID-19 pandemic?” Using Maslach’s Burnout Theory as a guiding framework, qualitative data were collected during 10 in-depth interviews with former educators. Ten participants were selected using purposive sampling for interviews. The following criteria were utilized to select participants for interviews: taught in a South Carolina public school for at least eight years, taught during the pandemic, and quit or retired early. Potential limitations that were identified for the study included a limited number of participants, the emotional distress of reliving leaving the teaching profession, and the utilization of a virtual platform to conduct interviews. Data analyses resulted in the following themes contributing to teacher attrition: Lack of support from the administration, lack of professional autonomy, and increased stress. These were the most consistent themes noted before and during the pandemic. This research study provides educational leaders and policy makers with the voices of teachers who have left the profession, thus providing valuable data to make informed decisions in an effort to reverse the current teacher attrition trend. The determinants of teacher shortage identified in the data analysis of this phenomenological study can be addressed immediately within individual schools to help resolve the teacher shortage. Recommendations for future practice include administrators developing trusting relationships with teachers as well as educational leaders providing educators with a voice in decisions that affect their classrooms.

IMPACT OF DIFFERENT NPK LEVELS AND SOWING METHODS ON MAIZE GROWTH, YIELD, AND QUALITY CHARACTERISTICS

Crop management practices are crucially important to increased yield and quality. This research study was planned to investigate the effects of different levels of NPK and sowing methods on maize. Results showed that different NPK levels and sowing methods significantly affected the growth and yield traits of maize (p&lt;0.05). The better results for plant height (cm), leaf area index, cob length (cm), grains per cob, 1000-grain weight, grain yield (kg ha-1), protein content (%) total sugars (%) and starch (%) were recorded when crop-fertilized NPK with 150-120-120 kg ha-1. However, all these parameters were marginally different compared to NPK rate of 120-90-90 kg ha-1, except for plant height (cm). This treatment produced significantly higher grain yield and quality traits of maize compared to lower and control treatment. Minimum values for plant height (cm), leaf area index, cob length (cm), grains per cob, 1000-grain weight, grain yield kg ha-1, protein content (%), total sugars (%) and starch (%) were noted in the control treatment. In case of sowing methods, ridge sowing produced maximum plant height (cm) , leaf area index, 50% days to tasselling and yield contributing characters like cob length (cm), grains cob-1, 1000-grain weight (g) and grain yield (kg ha-1) of maize as compared to broadcasting and drilling sowing methods. But sowing methods did not significantly affected the quality characteristics of maize, particularly protein content (%), total sugars (%) and starch (%). Among different sowing methods, ridge sowing method produced the maximum grain yield kg ha-1 of maize as compared to drilling and broadcasting. Considering the results comprehensively, the NPK rate of 120-90-90 kg ha-1 under ridge method would be the best management practice for maize cultivation:

Differences in nasalance scores obtained with different Nasometer headsets

ABSTRACT The goal of the present research study was to investigate possible differences in nasalance scores between different Nasometer headgears. Frequency response characteristics of microphone pairs in a Nasometer model 6200, a model 6450 and two model 6500 headsets were compared using long-term average spectra of white noise and multi-speaker babble signals. Prerecorded sound files from a male and a female speaker were used to record nasalance scores with the four Nasometer headsets and to calculate cumulative absolute differences within and between the headsets. The main outcome measures were the cumulative absolute differences between the decibel (dB) values in the frequency bins from 300 to 750 Hz for the nasal and oral channels of each microphone pair. Cumulative absolute differences between nasalance scores of repeated stimuli within and across Nasometer headsets were tabulated. Results showed that cumulative absolute differences for the frequency range 300–750 Hz were between 6.58 and 7.68 dB. Within headsets, 95.6% to 100% of measurements of all four Nasometer headsets were within 3 nasalance points, although test–retest differences of up to 6 nasalance points were found. Between headsets, 56.1% to 98.9% of measurements were within 3 nasalance points, with the single largest difference of 8 nasalance points. In conclusion, differences between repeated nasalance scores obtained with the same and different headsets were noted. Clinicians should allow a margin of error of ±6 to 8 nasalance points when interpreting scores from different Nasometer headsets.

Penggunaan Media Sosial Instagram Sebagai Media Dakwah Mahasiswa Komunikasi Penyiaran Islam Uinsu

Social media is one of the information media that exists today, social media users come from various circles, from 9 year old children to adults, using social media requires vigilance, especially as parents, you must provide education to children, because through media Children can get positive sides from social media, such as interesting learning, but through social media there are also many negative sides, therefore there is a need for a high level of supervision over the use of social media. To make social media a medium that provides a positive side, there must be more content about da'wah, so in this research study Islamic broadcasting students create da'wah content through social media, how to spread their da'wah will be studied further in the discussion. The method used is literature and the type of research is qualitative. Based on the research results, the use of social media Instagram as a medium for Islamic broadcasting communication for students of Islamic broadcasting. Instagram social media is very influential for students of Islamic broadcasting communication, because Instagram social media can make preaching more interesting. And students can develop their existing talents and potential.

Lethality assessment protocol: Challenges and barriers of implementation for domestic violence victim advocates

This exploratory qualitative research study examined the attitudes and barriers domestic violence victim advocates identified in successful implementation of the lethality assessment protocol, a collaborative intervention between police departments and domestic violence advocacy agencies in the state of Connecticut. Focus groups were conducted at four domestic violence agencies to ascertain advocates’ perceptions of the lethality assessment protocol. Advocates (N = 24) were recruited through an individual contact at each agency. Responses to focus group questions indicated both system-wide and individual agency and police department collaboration barriers. Results showed advocates generally support the protocol and believe it has beneficial intent and purpose. Challenges identified included lack of victim cooperation, variations in law enforcement officer attitude, and deficiencies in training. Implementation barriers and advocates’ attitudes are also discussed. Lethality assessment protocol is a useful tool, yet all stakeholders must actively engage in cooperative training, tackle personal biases toward domestic violence victims, and gain a better understanding of victim psychology.

The Potential for Sustainable Local Development through Digital Communication and Digitization of Intangible Cultural Heritage Resources in Făgăraș Land, Romania

Intangible cultural heritage (ICH) strengthens community identity and represents a resource for sustainable community development. The current extensive access to the Internet has facilitated the digitization of communication, including ICH. The aim of this article is to highlight the importance of both digitizing ICH and digital communication about ICH for local development. The results of a longitudinal research study on local ICH resources available on the official websites of Făgăraș Land administrative territorial units (ATUs) before and after the COVID-19 pandemic, together with the results of a content analysis on ICH on the social media accounts of the same ATUs, indicate the digitization of ICH as a sustainable local development resource whose potential can be better exploited. In Făgăraș Land there are also successful initiatives in the fields of both ICH digitization and digital communication about ICH local resources. The Museum of Canvases and Stories in Mândra ATU and the use of social media for communication about ICH in the case of Drăguș ATU are related to such initiatives and are presented as case studies in this article, highlighting the potential of ICH as a resource for sustainable community development in Făgăraș Land.

AN ASSESSMENT OF PARADIGM SHIFT IN PEOPLE’S PRIORITIES TOWARD INTERIOR DESIGNING OF SPACE DURING THE PANDEMIC OUTBREAK

This investigation surfaces a thought of change in peoples’ priorities toward Interior design of space during the Pandemic outbreak. It re-examines the issues that influenced the change in the overall arrangement of a physical space. Five constructs were identified to validate the paradigm shift in peoples’ approach to dealing with spatial areas specifically in housing during the pandemic outbreak. The research study has shown a strong paradigm shift in the resident’s approach to the interior design of housing. The research study also discusses about the issues faced while stay at home during COVID-19, spatial layout during the pandemic, the utility of space during the pandemic, and targeting to achieve the required resilience through design implications. There were 404 participants considered in the structured questionnaire survey where the snowball sample technique to distribute among the policymakers, planners, architects, interior designers, and general citizens, from various residential areas in the Chandigarh Capital Region (CCR) i.e., Chandigarh, Mohali, and Panchkula who responded on varied issues faced during COVID-19.The outlook of people’s approach and interior design community to post-COVID has offered a new opportunity to re-look at the spatial arrangement of interior space. The residential dwelling units that were earlier considered for relaxation, safety, and storage are now considered for online classes, office work, play areas, recreation, and exercise areas. The post-COVID-19 era has changed the outlook of habitable space by providing a new thought process to visualize a spatial layout uniquely, which may further full-fill multiple interests at the same time.The research study not only focuses on residential dwelling units but also on the way people used their spaces and issues faced. Lack of proper spaces for classes, meetings, office works and other interested have changed the outlook people have perceive their spaces. And spaces during Covid-19 era have offered a fresh opportunity to rethink the design of any habitable space. Spaces with better adaptability, natural light, ventilation, and open spaces may have more potential of resilience than the space having poor ventilation, dingy and no open spaces. Clearly, in the research people of underprivileged were more susceptible to Covid infection and their recovery period may be longer as compared to the people living in planned and spaces residential dwelling units.

Who Funds Published Disability Research in Australia?

In this article, we describe the sources of funding cited, and topics of research associated with that funding, in Australian disability research. We conducted a systematic search for publicly available peer-reviewed papers reporting the findings of Australian disability research studies focused on Australia in the 2018–2020 period. Papers identified were analyzed according to research topic, participant group, study methodology, and funding sources acknowledged. In total, 1,241 relevant papers were identified. Of these, 582 papers (47%) reported at least one funding source. Government sources accounted for most funding identified ( n = 487), followed by university sector ( n = 112), nongovernment organizations ( n = 99) and for-profit organization funding ( n = 17). The most funding went to intellectual disability (22%), autism (15%), and psychosocial disability (12%). Only 16 (1.3%) papers citing funding sources reported their research was conducted in partnership with people with disability. Research funding influences the priorities of disability research, how it is conducted, and its outputs. Funding therefore shapes the information available to build evidence-based systems of service and support for and with people with disability. It is essential that research funding policies are considered in relation to broader disability policy goals and the research priorities of the disability community.

Experimental Characterization of Screw-Extruded Carbon Fibre-Reinforced Polyamide: Design for Aeronautical Mould Preforms with Multiphysics Computational Guidance

In this research work, the suitability of short carbon fibre-reinforced polyamide 6 in pellet form for printing an aeronautical mould preform with specific thermomechanical requirements is investigated. This research study is based on an extensive experimental characterization campaign, in which the principal mechanical properties of the printed material are determined. Furthermore, the temperature dependency of the material properties is characterized by testing samples at different temperatures for bead printing and stacking directions. Additionally, the thermal properties of the material are characterized, including the coefficient of thermal expansion. Moreover, the influence of printing machine parameters is evaluated by comparing the obtained tensile moduli and strengths of several manufactured samples at room temperature. The results show that the moduli and strengths can vary from 78% to 112% and from 55% to 87%, respectively. Based on a real case study of its aeronautical use and on the experimental data from the characterization stage, a new mould design is iteratively developed with multiphysics computational guidance, considering 3D printing features and limitations. Specific design drivers are identified from the observed material’s thermomechanical performance. The designed mould, whose mass is reduced around 90% in comparison to that of the original invar design, is numerically proven to fulfil thermal and mechanical requirements with a high performance.

How activist investors value target firms: Evidence from hedge fund presentations

AbstractThis research study provides insights on how activist hedge funds perform valuation analyses of target firms. Relevant data was hand‐collected from a sample of activist hedge fund presentations. Based on the hedge funds’ valuation analyses, the undervaluation of the target firms amounts to approximately 30%, compared to the targets’ current share price. Besides, activist investors derive a value enhancement potential from their proposed strategies of approximately 70% to the targets’ current share price. These valuation results rely predominately on trading multiples. The dominant multiples are Enterprise value/EBITDA (EV/EBITDA) and Price/Earnings (P/E). Further, applied multiples are mainly forward‐looking, and the predicted performance measures are primarily consensus estimates. Besides, hedge funds sometimes adjust multiples arbitrarily to increase the comparability. Our results confirm that short‐term investors rely predominately on pricing analyses in their valuations.

Relationship between cognitive function and weight-adjusted waist index in people ≥ 60 years old in NHANES 2011–2014

BackgroundWidespread attention has been given to the detrimental effects of obesity on cognitive function. However, there is no evidence on the connection between low cognitive performance and the WWI (weight-adjusted waist index). This study looked into the connection between poor cognitive performance and the WWI in senior Americans.MethodsA cross-sectional research study was carried out with information from the NHANES 2011–2014. With multivariate linear regression models, the pertinence between the WWI and low cognitive function in persons older than 60 years was examined. The nonlinear link was described using threshold effect analyses and fitted smoothed curves. Interaction tests and subgroup analysis were also conducted.ResultsThe study had 2762 individuals in all, and subjects with higher WWI values were at greater risk for low cognitive function. In the completely adjusted model, the WWI was positively connected with low cognitive performance assessed by CERAD W-L (OR = 1.22, 95% CI 1.03–1.45, p = 0.0239), AFT (OR = 1.30, 95% CI 1.09–1.54, p = 0.0029), and DSST (OR = 1.59, 95% CI 1.30–1.94, p < 0.0001). The effect of each subgroup on the positive correlation between the WWI and low cognitive performance was not significant. The WWI and low cognitive performance as determined by CERAD W-L and AFT had a nonlinear connection (log-likelihood ratio < 0.05).ConclusionAmong older adults in the United States, the risk of low cognitive performance may be positively related to the WWI.

Investigation of the Impact of Wellinks on the Quality of Life and Clinical Outcomes in Patients With Chronic Obstructive Pulmonary Disease: Interventional Research Study.

Wellinks is a remote disease management solution that provides novel chronic obstructive pulmonary disease (COPD) care delivery. This study evaluated the satisfaction, engagement, and clinical outcomes of Wellinks participants. This study also investigated the cadence of health coaching for patients with COPD. A 24-week interventional study was conducted by Wellinks and the COPD Foundation in 2022. Adults with COPD were recruited by the COPD Foundation in the United States and determined to be eligible if they had phone and internet access, owned a smartphone, and were not currently participating in pulmonary rehabilitation. All study participants provided written informed consent. The Wellinks solution included remote health coaching, pulmonary rehabilitation, and group education; participants were provided the Wellinks app and smart spirometry and pulse oximetry devices. Participants were offered 6 coaching sessions in the first 12 weeks. For the second 12-week period, participants either reduced frequency or discontinued coaching; all other components of the Wellinks solution remained unchanged. The COPD Self-Efficacy Scale, Modified Medical Research Council dyspnea scale, pulmonary function, pulse oximetry, and patient-reported healthcare resource utilization were the clinical outcome measures. Nonclinical outcomes included engagement and satisfaction with Wellinks and net promoter score. In total, 141 adults consented and completed Wellinks onboarding; 84.4% (n=119) of whom remained engaged throughout the 24-week study. Participants had a mean age of 70 (SD 7.8; range 48-88) years, and 55.7% (n=78) were female. Most participants (n=119, 84.4%) completed all 6 coaching sessions during the first 12-week period. Compliance with spirometer and pulse oximeter use was 82.3% and 89.4%, respectively, at week 1 but waned over the study period to 8.5% and 9.2%, respectively, at the end of the study. Participants indicated a high degree of satisfaction with Wellinks, with 95.5% (n=85) and 91% (n=81) of participants indicating that they agreed or strongly agreed that the educational content and health coaching, respectively, were valuable. At the end of the study, the net promoter score was +64 and +55 in the coaching continuation and discontinuation arms, respectively. A significant improvement from baseline to end of the study was observed in the COPD Self-Efficacy Scale total score (P<.001) and domain scores (P<.001 for each domain). In total, 35.1% (n=27) of participants improved by at least 1 category of change on the 5-point Modified Medical Research Council dyspnea scale from baseline to week 24. This study confirmed the feasibility of using a remote model of care delivery to support people living with COPD. The insights gained in this study have allowed for further refinement and personalization of the Wellinks care model. Findings related to the combined use of technology and personal care delivery should be considered by others developing remote disease management tools. ClinicalTrials.gov NCT05259280; https://clinicaltrials.gov/ct2/show/NCT05259280.