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Digital health applications (apps) have the potential to improve health behaviors and outcomes. We aimed to examine the effectiveness of a consumer web-based app linked to primary care electronic health records (EHRs). CONNECT was a multicenter randomized controlled trial involving patients with or at risk of cardiovascular disease (CVD) recruited from primary care (Clinical Trial registration ACTRN12613000715774). Intervention participants received an interactive app which was pre-populated and refreshed with EHR risk factor data, diagnoses and, medications. Interactive risk calculators, motivational messages and lifestyle goal tracking were also included. Control group received usual health care. Primary outcome was adherence to guideline-recommended medications (≥80% of days covered for blood pressure (BP) and statin medications). Secondary outcomes included attainment of risk factor targets and eHealth literacy. In total, 934 patients were recruited; mean age 67.6 (±8.1) years. At 12 months, the proportion with >80% days covered with recommended medicines was low overall and there was no difference between the groups (32.8% vs. 29.9%; relative risk [RR] 1.07 [95% CI, 0.88–1.20] p = 0.49). There was borderline improvement in the proportion meeting BP and LDL targets in intervention vs. control (17.1% vs. 12.1% RR 1.40 [95% CI, 0.97–2.03] p = 0.07). The intervention was associated with increased attainment of physical activity targets (87.0% intervention vs. 79.7% control, p = 0.02) and e-health literacy scores (72.6% intervention vs. 64.0% control, p = 0.02). In conclusion, a consumer app integrated with primary health care EHRs was not effective in increasing medication adherence. Borderline improvements in risk factors and modest behavior changes were observed.

Introduction Community-based weight management programmes are important in addressing childhood obesity. However, the mechanisms that lead to behaviour change within the programmes are rarely studied within the context of the programmes themselves once they have been implemented. This means that further potential gains in the effectiveness of the programme are often not made and any potential losses of efficacy are often not noticed. Qualitative research alongside randomised controlled trials (RCTs) can tell us the context in which these programmes are implemented and elucidate potential mediators or modifiers of the programmes' effectiveness. The aim of this evaluation is to determine the barriers and enablers to the delivery and impact of an incentive-based behaviour change strategy targeting child obesity to inform future translation. Methods and analysis Qualitative analysis, including stakeholder and family interviews, focus groups and a survey, will be used. The research will be conducted in collaboration with policymakers, researchers and community health professionals. Participants will be selected from programme providers, and parents/carers and children participating in an Australian community weight management programme during an RCT examining the effectiveness of incentives for improving behaviour change. A maximum variation sampling method based on participant demographics and group characteristics will be used. Thematic analysis will be carried out inductively based on emergent themes, using NVivo V.9. Ethics and dissemination This research is approved by the South West Sydney Human Ethics Committee review body (HREC/14/LPOOL/480). The evaluation will provide information about the contextual and influencing factors related to the outcomes of the RCT. The results will assist researchers, community health practitioners and policymakers regarding the development, implementation and translation of behaviour change strategies in community initiatives for ob

Recent advances in ultra-short pulse visible and uv laser technology make it practical for the first time to consider the production of multiply ionized laboratory plasmas in which ionization is moderated by an external optical field rather than by electron collisions. Such plasmas will be remarkable for the high degree of disequilibrium that can be achieved between the distribution of ionization and the electron energy distribution. In particular it should be possible to produce plasmas in which the electron energy distribution is much cooler (either locally or over a distance comparable to an electron mean free path) than the ionization temperature. This leads naturally to consideration of the use of these plasmas for short wavelength recombination lasers.

Thomson scattering diagnostics were used to measure electron and ion temperatures in plasmas similar to those used for x-ray lasers. These measurements were compared with predictions of a hydrodynamic simulation. Experimental measurements which can test the accuracy of the codes' predictions can be used to 'calibrate' the codes, and hence lead to either code improvements or an increased confidence in the codes' accuracy. Experiments were performed with plasmas produced from a laser spot focused on solid targets of carbon, germanium and tantalum. The electron temperature could be measured as a function of time at different locations in the plasma, for various laser intensities.

Population inversion is expected on 2p-2s transitions in neon-like germanium in the 60-80 A region. The feasibility of observing gain on these transitions is explored. Soft x-ray amplification is collisionally excited. Ne-like Ge plasmas has been extensively studied in a number of laboratories. Gains in excess of 4/cm-1 have been reported for the 3p-3s transitions and significant gains have been inferred over a wide range of irradiance conditions. In our laboratory we have made use of a novel focusing arrangement that employs a segmented wedge array to overlap several line foci to produce a more uniform linear plasma.