Background
Mobile phone applications (apps) have been shown to successfully facilitate the self-management of chronic disease. This study aims to evaluate firstly the experiences, barriers and facilitators to app usage among people with Type 2 Diabetes Mellitus (T2DM) and secondly determine recommendations to improve usage of diabetes apps.
Methods
Participants were aged ≥ 18 years with a diagnosis of T2DM for ≥ 6 months. Semi-structured phone-interviews were conducted with 16 app and 14 non-app users. Interviews were based on the Technology Acceptance Model, Health Information Technology Acceptance Model (HITAM) and the Mobile Application Rating Scale. Data were analysed using deductive content analysis.
Results
Most app-users found apps improved their T2DM self-management and health. The recommendation of apps by health professionals, as well as positive interactions with them, improved satisfaction; however, only a minority of patients had practitioners involved in their app use. All non-app users had never had the concept discussed with them by a health professional. Facilitators to app use included the visual representation of trends, intuitive navigation and convenience (for example, discretion and portability). Barriers to app use were participant’s lack of knowledge and awareness of apps as healthcare tools, perceptions of disease severity, technological and health literacy or practical limitations such as rural connectivity. Factors contributing to app use were classified into a framework based on the Health Belief Model and HITAM. Recommendations for future app design centred on educational features, which were currently lacking (e.g. diabetes complications, including organ damage and hypoglycaemic episodes), monitoring and tracking features (e.g. blood glucose level monitoring with trends and dynamic tips and comorbidities) and nutritional features (e.g. carbohydrate counters). Medication reminders were not used by participants. Lastly, participants felt that receiving weekly text-messaging relating to their self-management would be appropriate.
Conclusions
The incorporation of user-centred features, which engage T2DM consumers in self-management tasks, can improve health outcomes. The findings may guide app developers and entrepreneurs in improving app design and usability. Given self-management is a significant factor in glycaemic control, these findings are significant for GPs, nurse practitioners and allied health professionals who may integrate apps into a holistic management plan which considers strategies outside the clinical environment.
The Lihir open pit mine in Papua New Guinea is located inside an old volcano where geothermal activity is strongly present. Outbursts of hot water and steam into the mining areas were a major safety concern. Passive seismic monitoring was carried out at the mine to investigate whether the geothermal activities could be detected and located using microseismic techniques in a mining environment. In this trial, sixteen triaxial geophones which can withstand temperature up to 200°C were used and installed in four deep boreholes inside the pit. The microseismic events were discriminated using the STA/LTA triggering criterion. During 6 weeks of monitoring, more than 17,000 events were recorded. Approximately 12% of the events showed harmonic vibration characteristics similar to those observed in other geothermal and volcanic areas, suggesting that the geothermal activity inside the pit was captured by the microseismic monitoring system. More than 75% of the events present both P and S waves and they were interpreted to be associated with rock fracturing due to stress release near the bottom of the pit. Many geothermal-type events were located in areas where shear events occurred, implying that the detected geothermal events were not far from the mining area below the pit and they may also be associated with mining. The borehole installation of the geophones significantly reduced the interference of mining noise and achieved good observation of the seismic events. However, equipment installation requires great attention as the geophones may be destroyed due to unexpected rising temperature within the boreholes.
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