Open Access. Powered by Scholars. Published by Universities.®

Digital Commons Network™

Open Access. Powered by Scholars. Published by Universities.®

2022

Discipline
Institution
Keyword
Publication
Publication Type
File Type

Articles 55291 - 55320 of 56504

Full-Text Articles in Entire DC Network

Fake Malware Generation Using Hmm And Gan, Harshit Trehan, Fabio Di Troia Jan 2022

Fake Malware Generation Using Hmm And Gan, Harshit Trehan, Fabio Di Troia

Faculty Research, Scholarly, and Creative Activity

In the past decade, the number of malware attacks have grown considerably and, more importantly, evolved. Many researchers have successfully integrated state-of-the-art machine learning techniques to combat this ever present and rising threat to information security. However, the lack of enough data to appropriately train these machine learning models is one big challenge that is still present. Generative modelling has proven to be very efficient at generating image-like synthesized data that can match the actual data distribution. In this paper, we aim to generate malware samples as opcode sequences and attempt to differentiate them from the real ones with the …


In The Age Of Imperialism: A Study Of Hankow Based On The Maritime Customs Decennial Report (1892-1901), Sze Pui Yin Daisy Jan 2022

In The Age Of Imperialism: A Study Of Hankow Based On The Maritime Customs Decennial Report (1892-1901), Sze Pui Yin Daisy

Armstrong Undergraduate Journal of History

This research is based mainly on the Maritime Customs Decennial Report (1892-1901) to scrutinize the circumstances and development of Hankow, a typical Chinese port, in the Age of Imperialism. This essay argues that the western powers did not merely exploit the Chinese resources in the Age of Imperialism, but came hand in hand with capital, goods, and scientific knowledge, which facilitated trades and introduced technologies to China. This transformed Hankow into a global emporium with not only new constructions but also metropolitan characteristics. To this end, imperialism and modernization co-existed.


A Nation That Rebuilds Its Soils Rebuild Itself- An Engineer's Perspective, Karen L. Johnson, Neil D. Gray, Wendy Stone, Bryce F.J. Kelly, Mark F. Fitzsimons, Cathy Clarke, Lynsay Blake, Stephen Chivasa, Florence Mtambanengwe, Paul Mapfumo, Andy Baker, Sabrina Beckmann, Lena Dominelli, Andrew L. Neal, Tariro Gwandu Jan 2022

A Nation That Rebuilds Its Soils Rebuild Itself- An Engineer's Perspective, Karen L. Johnson, Neil D. Gray, Wendy Stone, Bryce F.J. Kelly, Mark F. Fitzsimons, Cathy Clarke, Lynsay Blake, Stephen Chivasa, Florence Mtambanengwe, Paul Mapfumo, Andy Baker, Sabrina Beckmann, Lena Dominelli, Andrew L. Neal, Tariro Gwandu

School of Geography, Earth and Environmental Sciences

Nations can build and rebuild degraded soils to help address climate change and potentially improve the nutritional content of food if we change policies that allow the addition of safe mineral and organic wastes to soil. We present a framework that facilitates the transition from intensive conventional to more regenerative farming practices by considering soil’s natural cycle. Our paper is presented in three parts. Firstly, we consider that ’soil is living’; just like humans, the soil biome needs a balanced diet of macro and micronutrients as well as a nurturing environment. We simplify the soil science and take a systems …


The Prevalence Of Patellar Tendinopathy In Athletic Populations And The Effectiveness Of Graston Technique As A Patellar Tendinopathy Treatment, Kiley Michelle Lovelace Jan 2022

The Prevalence Of Patellar Tendinopathy In Athletic Populations And The Effectiveness Of Graston Technique As A Patellar Tendinopathy Treatment, Kiley Michelle Lovelace

Health Nutrition and Exercise Science

The purpose of this paper is to examine both the prevalence of patellar tendinopathy (PT) in athletic populations and the effectiveness of Graston Technique® as a treatment for PT. Since PT is a common injury seen among athletes, it is important for clinicians to understand the condition and how common it is within athletics, especially those that involve an increased amount of jumping and landing such as volleyball or basketball. Graston Technique® is a popular treatment option among clinicians for various musculoskeletal injuries, including tendinopathies such as PT. Therefore, it is imperative for clinicians to understand the research surrounding Graston …


Navigating The Labyrinth Of House Of Leaves Through A Postmodern Archetypal Literary Theory, Samuel K. Hval Jan 2022

Navigating The Labyrinth Of House Of Leaves Through A Postmodern Archetypal Literary Theory, Samuel K. Hval

EWU Masters Thesis Collection

No abstract provided.


Population Assignment Of Entrained Migratory Westslope Cutthroat Trout In North Idaho, Craig D. Wells Jan 2022

Population Assignment Of Entrained Migratory Westslope Cutthroat Trout In North Idaho, Craig D. Wells

EWU Masters Thesis Collection

The Clark Fork-Pend Oreille River basin of northeastern Washington and the Idaho Panhandle historically supported a robust metapopulation of Westslope Cutthroat Trout (WCT) Oncorhynchus clarkii lewisi, a western native salmonid of high cultural and economic value. The construction of impassible hydroelectric dams and smaller in-stream barriers has prevented the return of migratory WCT to spawning tributaries, likely leading to the fragmentation of this metapopulation over the last 100 years. One such impassible barrier is Albeni Falls Dam near Newport, Washington. Completed without fish passage capabilities in 1955, Albeni Falls Dam has been of interest as a site for restoring fish …


Empirical Comparison Of Machine Learning Methods For Wind Power Predictions, Sidny M. Stewart Jan 2022

Empirical Comparison Of Machine Learning Methods For Wind Power Predictions, Sidny M. Stewart

EWU Masters Thesis Collection

No abstract provided.


Modernizing Fish Surveys: Evaluating How Reliable Environmental Dna Sampling Is In Monitoring Fish Populations, Alicia Cozza Jan 2022

Modernizing Fish Surveys: Evaluating How Reliable Environmental Dna Sampling Is In Monitoring Fish Populations, Alicia Cozza

EWU Masters Thesis Collection

No abstract provided.


Understanding The Mode Of Action Of Essential Oil Nanoemulsions To Inhibit Fusarium Growth And Mycotoxin Production In Cereal, Haiyang Jiang Jan 2022

Understanding The Mode Of Action Of Essential Oil Nanoemulsions To Inhibit Fusarium Growth And Mycotoxin Production In Cereal, Haiyang Jiang

Plant Sciences

Deoxynivalenol (DON) is a commonly occurred mycotoxin in cereal-based food, which is mainly produced by Fusarium spp. in the field. It is unfeasible to entirely avoid DON contamination in cereal grains with good agricultural practices. Therefore, it is of great importance to have a strategy for preventing DON contamination in our final food products. In recent years, utilization of plant extracts such as essential oils (EOs) as antifungal and mycotoxin inhibitory agents in foods have gained popularity. Depending on the EO type and chemical composition of EOs, the antifungal and mycotoxin inhibitory efficacies of different EOs might be varied. In …


Metasoftware: Building Blocks For Legal Technology, Houman Shadab Jan 2022

Metasoftware: Building Blocks For Legal Technology, Houman Shadab

Articles & Chapters

This Article develops a novel concept in information technology called metasoftware. It then applies the concept of metasoftware to developing legal technology.

Metasoftware enables users to create the software of their choosing and stands in sharp contrast to traditional, functional software that is intended for a particular purpose or a defined range of tasks. Functional software is the default type of software that is currently produced and includes word processing, email, social networking, enterprise resource management, online marketplaces, and video game software. Metasoftware, by contrast, is not functional. Metasoftware presents the user with a blank slate upon which to build …


Lawyers And The Lies They Tell, Bruce Green, Rebecca Roiphe Jan 2022

Lawyers And The Lies They Tell, Bruce Green, Rebecca Roiphe

Articles & Chapters

Noting that the First Amendment protects lies about the government made in the public square, this article explores whether lawyers’ free speech rights ought to be different from that of other speakers. The law holds lawyers to a more demanding standard of conduct than others when it comes to aspects of lawyers’ fiduciary relationships with courts and clients. But how much more demanding can the law be when it comes to lawyers’ speech — in this case, false political speech? Applying the current First Amendment framework, we question the bar’s assumption that lawyers’ speech outside of these contexts can be …


Trauma-Informed Forensic Mental Health Assessment: Practical Implications, Ethical Tensions, And Alignment With Therapeutic Jurisprudence Principles, Julie Goldenson, Stanley Brodsky, Michael L. Perlin Jan 2022

Trauma-Informed Forensic Mental Health Assessment: Practical Implications, Ethical Tensions, And Alignment With Therapeutic Jurisprudence Principles, Julie Goldenson, Stanley Brodsky, Michael L. Perlin

Articles & Chapters

The need for trauma-informed practice is well recognized across mental health and legal settings; however, relatively little has been written about its application in forensic mental health assessment. This paper focuses on trauma-informed assessment of criminal justice involved individuals, given the high rates of trauma exposure and related sequelae in this population. A trauma-informed lens allows forensic mental health examiners to assess examinees in the context of their developmental histories and lived experience. Such a lens also has implications for the entire assessment process in terms of interviewing, psychological testing, diagnostic conclusions, feedback, and the provision of testimony and educating …


Charts 2020: Family Law In The Fifty States, D.C., And Puerto Rico, Part 2: Family Law During Covid-19: Practical Responses And Systemic Innovations, Shelby Arenson, Lisa Grumet Jan 2022

Charts 2020: Family Law In The Fifty States, D.C., And Puerto Rico, Part 2: Family Law During Covid-19: Practical Responses And Systemic Innovations, Shelby Arenson, Lisa Grumet

Articles & Chapters

No abstract provided.


Culture And Fair Use, Michael Goodyear Jan 2022

Culture And Fair Use, Michael Goodyear

Articles & Chapters

The intersections of race and copyright have been underexamined in legal scholarship, despite repeated calls for further scrutiny. The scholarship has so far focused primarily on identifying where copyright has fallen short in protecting the creative works of artists of color. This Article, instead, hopes to offer one viable solution for creating more inclusivity of different cultures in copyright: the approval of cultural adaptations under fair use.
Cultural adaptations—the transforming of preexisting works to reflect the cultural and social mores and norms of a different group—would appear on first glance to be prohibited as derivative works, which, under the Copyright …


Returning To The Start? Federal Bipa Claims After Transunion V. Ramirez, Michael Goodyear Jan 2022

Returning To The Start? Federal Bipa Claims After Transunion V. Ramirez, Michael Goodyear

Articles & Chapters

The Illinois Biometric Information Privacy Act, more commonly known as “BIPA,” was the first statute to protect biometric privacy in the United States when it was passed in 2008. Although Texas and Washington have since passed their own biometric privacy laws, and other states have protected biometric information as part of more general data privacy legislation, BIPA remains the most powerful such law in the country due to being the only biometric privacy law to contain a private right of action. BIPA has also proven to be an important precedent for other states, such as New York, that are currently …


Keeping Current - Probate [Notes], Claire Hargrove, Paula Moore, William P. Lapiana, Jake W. Villanueva Jan 2022

Keeping Current - Probate [Notes], Claire Hargrove, Paula Moore, William P. Lapiana, Jake W. Villanueva

Articles & Chapters

36 Probate and Property, no. 1, 32-35 (January/February 2022)


Mesoscale Eddies And The Impact Of Coastal Iron Supply On Primary Production In The South Pacific Subtropical Front, Stephen M. Chiswell, Philip W. Boyd, Sylvia G. Sander, Michael J. Ellwood, Angela Milne Jan 2022

Mesoscale Eddies And The Impact Of Coastal Iron Supply On Primary Production In The South Pacific Subtropical Front, Stephen M. Chiswell, Philip W. Boyd, Sylvia G. Sander, Michael J. Ellwood, Angela Milne

School of Geography, Earth and Environmental Sciences

No abstract provided.


Cancer Related Cognitive Impairment In Breast Cancer Patients: Guidelines For Neuropsychological Evaluation And Management, Ali Al-Humadi Jan 2022

Cancer Related Cognitive Impairment In Breast Cancer Patients: Guidelines For Neuropsychological Evaluation And Management, Ali Al-Humadi

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Current literature indicates there is still some debate regarding the scope and severity of cancer treatment related cognitive impairment (CRCI), with a wide variety of complex factors contributing to cognitive decline and discrepancies between objective findings and patient self-report. This paper aims to provide guidelines for neuropsychological evaluation, management, and rehabilitation of CRCI in breast cancer patients based on current research. This paper also aims to discuss current research on proposed mechanisms of action for CRCI, the cognitive domains affected in CRCI, and significant bio-psycho-social risk factors impacting CRCI.


The Driving Forces Of Academic Integrity: A Survey Of Communication Disorder Students, Mary Ellen Huston Jan 2022

The Driving Forces Of Academic Integrity: A Survey Of Communication Disorder Students, Mary Ellen Huston

Theses and Dissertations

Academic dishonesty has been a pervasive problem in universities for decades, however, there has been limited research linking allied health students to specific cheating behaviors. For students studying to enter allied health fields, academic dishonesty is problematic as the health and safety of their clients is at risk. To date, there has been no research focused on the academic integrity of students enrolled in programs leading to a career in speech language pathology. This quantitative study explored the theories of reasoned action, neutralization, and motivation as they relate to academic dishonesty among SLP students. The study combined a slightly modified …


Rock Physics Based Velocity-Porosity Correlations Developed For Estimation Of The Elastic Properties Of The Bakken Formations Of The Williston Basin, North Dakota, Lynn D. Helms Jan 2022

Rock Physics Based Velocity-Porosity Correlations Developed For Estimation Of The Elastic Properties Of The Bakken Formations Of The Williston Basin, North Dakota, Lynn D. Helms

Theses and Dissertations

Oil production from the Bakken Shale in North Dakota has benefitted from significant technological advancements since its beginning approximately two decades ago. Most of the advancements resulted from better characterization of shales, which are very heterogeneous and their properties vary at different scales. The need for costly operations such as drilling long laterals and multi-stage hydraulic fracturing for production from these unconventional reservoirs, signifies the importance of understanding the physical and mechanical properties of these formations in order to reduce the risk margins and improve project economics at diffetent phases of the life of the field. Rock physics is a …


Internet Training Modules Targeting Home-Based Parent Involvement With Students In Early Childhood Special Education, Nicole Marie Reybok Jan 2022

Internet Training Modules Targeting Home-Based Parent Involvement With Students In Early Childhood Special Education, Nicole Marie Reybok

Theses and Dissertations

Parental engagement is an essential element in the social-emotional and academic achievement of students. However, barriers to this involvement continue to exist. Barriers may take many forms including time, school and staff perceptions and bias, power dynamic, communication with teachers, curriculum, and differences in language and culture. Barriers to parent engagement are typically increased for parents of children with special education needs. Therefore, it is the responsibility of school staff to identify barriers that may exist for families and help them to develop solutions to overcome those barriers. This quantitative study investigated possible barriers to home-based parent involvement in Early …


Preferences Of Newly Qualified Healthcare Professionals For Working With People With Dementia: A Qualitative Study, M Hebditch, S Banerjee, J Wright, S Daley Jan 2022

Preferences Of Newly Qualified Healthcare Professionals For Working With People With Dementia: A Qualitative Study, M Hebditch, S Banerjee, J Wright, S Daley

School of Health Professions

Background there is little research on preferences in students and newly qualified healthcare professionals for working with people with dementia. Understanding the development of these preferences can help inform strategies to increase workforce capacity in response to current suboptimal dementia care and the increasing numbers of people with dementia. Objective to explore the factors that influence career preferences in relation to working with people with dementia. Specifically, to understand how these factors relate to early career doctors’ and nurses’ preferences and how they influence decisions and perspectives on their careers. Methods qualitative in-depth interviews were conducted with 27 newly qualified …


The Impact Of Perceived Manipulation, Motives, And Ethicality In Cause-Related Marketing: A Crm+ Model, Nathan W. Twyman, Sarah M. Stanley, Cassandra C. Elrod, Tamara M. Masters Jan 2022

The Impact Of Perceived Manipulation, Motives, And Ethicality In Cause-Related Marketing: A Crm+ Model, Nathan W. Twyman, Sarah M. Stanley, Cassandra C. Elrod, Tamara M. Masters

Business and Information Technology Faculty Research & Creative Works

We Developed a CRM+ Model using Experimentation and Structural Equation Modeling Analysis. CRM+ Demonstrates Previously Unexplored Interrelationships among Consumer-Perceived Manipulation, Brand Motives, Perceived Ethicality of the Cause-Related Marketing, and Brand Attitude. CRM+ Reveals that Perceived Ethicality of the CRM Has a Significant Positive Effect on Brand Attitude, Though It is Not as Pronounced as the Effect of Perceived Altruistic Motives. Egoistic Motives Decrease Ethicality Perceptions But Has No Direct Effect on Brand Attitude. Altruistic Motive Perceptions Diminish Egoistic Motive Perceptions. CRM+ Suggests Marketing Managers Should Prioritize Emphasizing Altruistic Motives and Ethicality of the Partnership over Downplaying Egoistic Motives.


Information Systems Analysis And Design: Past Revolutions, Present Challenges, And Future Research Directions, Keng Siau, Carson Woo, Veda C. Storey, Roger H.L. Chiang, Cecil Eng Huang Chua, Jon W. Beard Jan 2022

Information Systems Analysis And Design: Past Revolutions, Present Challenges, And Future Research Directions, Keng Siau, Carson Woo, Veda C. Storey, Roger H.L. Chiang, Cecil Eng Huang Chua, Jon W. Beard

Business and Information Technology Faculty Research & Creative Works

Systems Analysis and Design (SAND) is Undoubtedly a Pillar in the Field of Information Systems (IS). Some Researchers Have Even Claimed that SAND is the Field that Defines the Information Systems Discipline and is the Core of Information Systems. the Past Decades Have Seen the Development of Structured SAND Methodologies and Object-Oriented Methodologies. in the Early 1990s, Key Players in the Field Collaborated to Develop the Unified Modeling Language and the Unified Process. Agile Approaches Followed, as Did Other Dynamic Methods. These Approaches Remain Heavily Employed in the Development of Contemporary Information Systems. at the Same Time, New Approaches Such …


Exploring The Effect Of Implementing Affordable Socially Assistive Pet Robots In Eight Care Homes Before And During The Covid-19 Pandemic: A Stratified Cluster Randomised Controlled Trial And Mixed-Method Study., Hannah Bradwell, Katie Edwards, Rhona Winnington, Serge Thill, Victoria Allgar, Ray Jones Jan 2022

Exploring The Effect Of Implementing Affordable Socially Assistive Pet Robots In Eight Care Homes Before And During The Covid-19 Pandemic: A Stratified Cluster Randomised Controlled Trial And Mixed-Method Study., Hannah Bradwell, Katie Edwards, Rhona Winnington, Serge Thill, Victoria Allgar, Ray Jones

School of Nursing and Midwifery

Abstract Background Robot pets may assist towards challenges of supporting an aging population with growing dementia prevalence. Prior work focused on impacts of robot seal Paro on older adult wellbeing, but recent studies suggest good acceptability and implementation feasibility of more affordable devices (Joy for All (JfA) cats and dogs), yet effectiveness research was limited. Methods We conducted an eight-month, stratified, cluster randomised controlled trial, in eight care homes in Cornwall, UK. Over four months, four care homes each received two JfA devices (one cat and dog), and four homes received care as usual (intervention and control group). Psychometrics were …


Insights Into Nervous System Repair From The Fruit Fly, David Coupe, Torsten Bossing Jan 2022

Insights Into Nervous System Repair From The Fruit Fly, David Coupe, Torsten Bossing

Peninsula Medical School

Abstract Millions of people experience injury to the central nervous system (CNS) each year, many of whom are left permanently disabled, providing a challenging hurdle for the field of regenerative medicine. Repair of damage in the CNS occurs through a concerted effort of phagocytosis of debris, cell proliferation and differentiation to produce new neurons and glia, distal axon/dendrite degeneration, proximal axon/dendrite regeneration and axon re-enwrapment. In humans, regeneration is observed within the peripheral nervous system, while in the CNS injured axons exhibit limited ability to regenerate. This has also been described for the fruit fly Drosophila. Powerful genetic tools available …


The Need, Opportunities, And Challenges For Creating A Standardized Framework For Marine Restoration Monitoring And Reporting, Aaron M. Eger, Hannah S. Earp, Kim Friedman, Yasmine Gatt, Valerie Hagger, Boze Hancock, Ratchanee Kaewsrikhaw, Elizabeth Mcleod, Abigail Mary Moore, Holly J. Niner, Frida Razafinaivo, Ana I. Sousa, Milica Stankovic, Thomas A. Worthington, Elisa Bayraktarov, Megan Saunders, Adriana Vergés, Simon Reeves Jan 2022

The Need, Opportunities, And Challenges For Creating A Standardized Framework For Marine Restoration Monitoring And Reporting, Aaron M. Eger, Hannah S. Earp, Kim Friedman, Yasmine Gatt, Valerie Hagger, Boze Hancock, Ratchanee Kaewsrikhaw, Elizabeth Mcleod, Abigail Mary Moore, Holly J. Niner, Frida Razafinaivo, Ana I. Sousa, Milica Stankovic, Thomas A. Worthington, Elisa Bayraktarov, Megan Saunders, Adriana Vergés, Simon Reeves

School of Biological and Marine Sciences

Marine ecosystems have been used, impacted by, and managed by human populations for millennia. As ecosystem degradation has been a common outcome of these activities, marine management increasingly considers ecosystem restoration. Currently, there is no coherent data recording format or framework for marine restoration projects. As a result, data are inconsistently recorded and it is difficult to universally track progress, assess restoration's global effectiveness, reduce reporting bias, collect a holistic suite of metrics, and share information. Barriers to developing a unified system for reporting marine restoration outcomes include: reaching agreement on a framework that meets the needs of all users, …


Creation Of A Neural Network For The American Sign Language To Russian Translation App, John T. Simmons Jan 2022

Creation Of A Neural Network For The American Sign Language To Russian Translation App, John T. Simmons

Capstone Projects

  1. A large population of people utilize American Sign Language for their primary method of communication.
  2. No commercially available product is available for these people for when they need to communicate with speakers of a foreign language.
  3. We must investigate methods to make communication between these two parties easier and more accessible.
  4. By using a neural network to classify images of American Sign Language letters, we can build a service to make translation of American Sign Language into foreign languages possible.


“What Works” Registries Of Interventions To Improve Child And Youth Psychosocial Outcomes: A Critical Appraisal, Nick Axford, Louise Morpeth, Gretchen Bjornstad, Tim Hobbs, Vashti Berry Jan 2022

“What Works” Registries Of Interventions To Improve Child And Youth Psychosocial Outcomes: A Critical Appraisal, Nick Axford, Louise Morpeth, Gretchen Bjornstad, Tim Hobbs, Vashti Berry

Peninsula Medical School

The last decade or more has seen a proliferation of online registries of evidence-based interventions designed to improve child and youth psychosocial outcomes. The purpose of these resources is typically to help decision-makers make sense of the evidence and thereby inform their decision-making about investment in interventions. Most registries are underpinned by standards of evidence, which are used to guide the rating of programs by a panel of experts. While supporters extol the influence of these initiatives in terms of making commissioners more discriminating about what they invest in, detractors contend that they stifle innovation and embody an unduly narrow …


Self-Management Intervention To Reduce Pulmonary Exacerbations By Supporting Treatment Adherence In Adults With Cystic Fibrosis: A Randomised Controlled Trial, Cfhealthhub Study Team, Martin J. Wildman, Alicia O’Cathain, Chin Maguire, Madelynne A. Arden, Marlene Hutchings, Judy Bradley, Stephen J. Walters, Pauline Whelan, John Ainsworth, Iain Buchan, Laura Mandefield, Laura Sutton, Paul Tappenden, Rachel A. Elliott, Zhe Hui Hoo, Sarah J. Drabble, Daniel Beever, H. Cantrill, J. Nicholl, S. Michie, S. Waterhouse, L. Robinson, A. Scott, S. Antrobus, E. Lumley, A. N. Biz, D. Hind, C. Orchard Jan 2022

Self-Management Intervention To Reduce Pulmonary Exacerbations By Supporting Treatment Adherence In Adults With Cystic Fibrosis: A Randomised Controlled Trial, Cfhealthhub Study Team, Martin J. Wildman, Alicia O’Cathain, Chin Maguire, Madelynne A. Arden, Marlene Hutchings, Judy Bradley, Stephen J. Walters, Pauline Whelan, John Ainsworth, Iain Buchan, Laura Mandefield, Laura Sutton, Paul Tappenden, Rachel A. Elliott, Zhe Hui Hoo, Sarah J. Drabble, Daniel Beever, H. Cantrill, J. Nicholl, S. Michie, S. Waterhouse, L. Robinson, A. Scott, S. Antrobus, E. Lumley, A. N. Biz, D. Hind, C. Orchard

Peninsula Medical School

Introduction Recurrent pulmonary exacerbations lead to progressive lung damage in cystic fibrosis (CF). Inhaled medications (mucoactive agents and antibiotics) help prevent exacerbations, but objectively measured adherence is low. We investigated whether a multi-component (complex) self-management intervention to support adherence would reduce exacerbation rates over 12 months. Methods Between October 2017 and May 2018, adults with CF (aged ≥16 years; 19 UK centres) were randomised to the intervention (data-logging nebulisers, a digital platform and behavioural change sessions with trained clinical interventionists) or usual care (data-logging nebulisers). Outcomes included pulmonary exacerbations (primary outcome), objectively measured adherence, body mass index (BMI), lung function …