A novel Interactive Health Communication Application (IHCA) for parents of children with long-term conditions: Development, implementation and feasibility assessment.

BACKGROUND: Few evidence-based, on-line resources exist to support home-based care of childhood long-term conditions. METHODS: In a feasibility study, children with stages 3, 4, or 5 chronic kidney disease, parents and professionals collaboratively developed a novel Online Parent Information and Support (OPIS) application. Parents were randomized to an intervention arm with access to OPIS or a control arm without access. OPIS usage was assessed using Google Analytics. Parents in the intervention arm completed the Suitability Assessment of Materials (SAM) and User Interface Satisfaction (USE) questionnaires and participated in qualitative interviews. RESULTS: Twenty parents accessed OPIS with a mean of 23.3 (SD 20.8, range 2-64) visits per user. Responses from the SAM and USE questionnaires were positive, most respondents rating OPIS highly and finding it easy to use. Qualitative suggestions include refinement of OPIS components, enabling personalization of OPIS functionalities and proactive endorsements of OPIS by professionals. CONCLUSIONS: Implementation of OPIS into standard practice is feasible in the centre where it was developed. Suggested developments will augment reported strengths to inform ongoing testing in the wider UK network of units. Our design and methods are transferrable to developing and evaluating web-applications to support home-based clinical care-giving for other long-term conditions.

Designing a web-application to support home-based care of childhood CKD stages 3-5: qualitative study of family and professional preferences.

BACKGROUND: There is a lack of online, evidence-based information and resources to support home-based care of childhood CKD stages 3-5. METHODS: Qualitative interviews were undertaken with parents, patients and professionals to explore their views on content of the proposed online parent information and support (OPIS) web-application. Data were analysed using Framework Analysis, guided by the concept of Self-efficacy. RESULTS: 32 parents, 26 patients and 12 professionals were interviewed. All groups wanted an application that explains, demonstrates, and enables parental clinical care-giving, with condition-specific, continously available, reliable, accessible material and a closed communication system to enable contact between families living with CKD. Professionals advocated a regularly updated application to empower parents to make informed health-care decisions. To address these requirements, key web-application components were defined as: (i) Clinical care-giving support (information on treatment regimens, video-learning tools, condition-specific cartoons/puzzles, and a question and answer area) and (ii) Psychosocial support for care-giving (social-networking, case studies, managing stress, and enhancing families' health-care experiences). CONCLUSIONS: Developing a web-application that meets parents' information and support needs will maximise its utility, thereby augmenting parents' self-efficacy for CKD caregiving, and optimising outcomes. Self-efficacy theory provides a schema for how parents' self-efficacy beliefs about management of their child's CKD could potentially be promoted by OPIS.

Silicalite crystal growth investigated by atomic force microscopy.

Atomic force microscopy has been used to image the various facets of two morphologically distinct samples of silicalite. The smaller (20 microm) sample A crystals show 1 nm high radial growth terraces. The larger (240 microm) sample B crystals show growth terraces 1 to 2 orders of magnitude higher than the terraces on sample A with growth edges parallel to the crystallographic axes. Moreover, the terraces on the (010) face are significantly higher than the terraces on the (100) face - inconsistent with the previously proposed 90 degrees intergrowth structure. Sample A highlights that under certain synthetic conditions, silicalite grows in a manner akin to zeolites Y and A, via the deposition of layers comprising, in the case of silicalite, pentasil chains. It is probable that the rate of terrace advance is identical on the (010) and (100) faces, and it is the rate of terrace nucleation that dictates the overall growth rate of each facet and hence the relative size expressed in the final crystal morphology. Analysis of the growth terraces of sample B and detailed consideration of the structures of both MFI, and a closely related material MEL, lead to the proposal of a generalized growth mechanism for silicalite including the incorporation of defects within the structure. These defects are thought to be responsible for both the relative and the absolute terrace heights observed and may also explain the hourglass phenomenon observed by optical microscopy. The implications of this growth mechanism, supported by results of infrared microscopy, generate a new dimension to the continuing debate on the existence of intergrowths within one of the most important structures relevant to zeolite catalysis.

Fundamental Zeolite Crystal Growth Rates from Simulation of Atomic Force Micrographs.

An accurate model of the surface growth of one of the most important industrial zeolites, zeolite A, has been created. Comparison of the simulation with experimental data in the form of atomic force micrographs highlights the non-diffusion-limited nature of zeolite growth and provides the first ever quantification of fundamental crystal growth processes in zeolites.