Chronic diseases represent a significant burden for the society and health systems; addressing this burden is a key goal of the European Union policy. Health and other professionals are expected to deliver behaviour change support to persons with chronic disease. A skill gap in behaviour change support has been identified, and there is room for improvement. Train4Health is a strategic partnership involving seven European Institutions in five countries, which seeks to improve behaviour change support competencies for the self-management of chronic disease. The project envisages a continuum in behaviour change support education, in which an interprofessional competency framework, relevant for those currently practising, guides the development of a learning outcomes-based curriculum and an educational package for future professionals (today’s undergraduate students).
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In many western countries informal care is conceived as the answer to the increasing care demand. Little is known how formal and informal caregivers collaborate in the context of an diverse ageing population. The aim of this study was to gain insight in how professionals’ perspectives regarding the collaboration with informal carers with a migration background are framed and shaped by intersecting aspects of diversity. We used an intersectionality informed qualitative design with informal conversations (N = 12) and semi-structured interviews (N = 17) with healthcare professionals working with clients with Acquired Brain Injury. Two critical friends were involved in the analysis which was substantiated by a participatory analysis with a community of practice. We identified four interrelated themes: (a) ‘The difficult Other’ in which professionals reflected on carers with a migration background causing ‘difficulties’; (b) ‘The dependent Other’ refers to professionals’ realization that ‘difficulties’ are intensified by the context in which care takes place; (c) in ‘The uncomfortable self’ professionals describe how feelings of insecurities evoked by the Other are associated with an inability to act ‘professionally’, and; (d) ‘The reflexive self’ shows how some professionals reflect on their own identities and identify their blind spots in collaboration within a care network. These themes demonstrate the tensions, biases and power imbalances between carers and professionals, which may explain some of the existing health disparities perpetuated through care networks.
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Today, consumers expect companies to be socially responsible. However, the literature is undecided about the effects of communicating one's corporate social responsibility activities to consumers. This raises the question of how sustainability-driven companies can best advertise their products to stimulate ethical consumption: using self-benefit frames, where the main beneficiary is the consumer, or using other-benefit frames, where the main beneficiary is a third party. Using three experiments, this study examines the effect of other-benefit (vs. self-benefit) advertising frames on consumers' impulse purchases from sustainability-driven companies. Increasing impulse purchases can help such companies to strengthen their competitive positions. Additionally, it is studied to what extent two types of justification (moral versus deservingness) explain the proposed effect of advertising frames. The results show that only other-benefit frames affect impulse buying behavior, both directly, as mediated by moral justification. This study's insights may help sustainability-driven companies to decide on their advertising strategies by providing evidence that other-benefit-framed advertisements are more effective in enhancing impulse purchases than self-benefit-framed advertisements.
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In this critical review article, Isaac and Platenkamp present the case that tourism is not isolated from the world's dramatic situations in which humanity is at stake. Their argument principally centers on the devastating historical and contemporary conflict in Palestine and its relations with tourism. In this article, Isaac and Platenkamp maintain that (in relation to current happenings in Palestine) ethical and moral argumentation would be beside the point, and might even be a "cynical" exercise. They suggest that the conflict there is imbued with many kinds of normative argumentation. It is their view that positions need to be taken with regard to "Palestine," as in all extreme circumstances, where at the same time respect for the other positions becomes crucial. In this critical review article, therefore, Arendt's idea of "agora" will be introduced, in order to create a space where these "respectful positions" can be taken in a public arena and in order to contribute to a possible peaceful development. To Isaac and Platenkamp, tourism could enable this sort of "peaceful development" and could promote or help empower conditions where violence would be excluded, and where different sorts of "argumentation" could be generated and heard about these so-called "controversial spaces." In these respects, they maintain that tourism is a challenging field, because it has (itself) many faces-and they argue that such scenarios for "tourism" indeed could apply/should be applied for many controversial other spaces like Nepal and Burma (for instance) where (as in Palestine) the original population has no say in any economic development, such as that of tourism. But Isaac and Platenkamp recognize that (even in Burma) resistance against injustice can never be destroyed. Their own principal focus remains targeted upon Palestine, though. There, tourism is known to have "an incredibly high potential," despite the fact that (in their view) a strong and powerful "Israeli self" indeed controls the "humiliated Palestinian other." Thus, to our two reviewers in the Netherlands, therefore, tourism seems to be a communicative activity that might enable the implementation of Arendt's idea of and about "the agora." Isaac and Platenkamp suggest that there is no violence in the agora, itself, because only the force of argumentation rules. there.
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BackgroundIt can be very challenging for practitioners to talk with autistic children, especially when the conversation calls for self-regulation. Self-regulation is inextricably linked to awareness of oneself and others in social contexts. Encouraging the need for autonomy could help increase self-awareness and awareness of others in social events, which in turn could strengthen self-regulation. However, little is known about how autonomy influences competence in reasoning about self and others when regarding social events in which autistic children participate. This study explores the reasoning of self-other awareness on a microlevel timescale using ipsative, dynamic approaches to autism. The central question in this study is: to what extent can autonomy-provided scaffolding (APS) elicit high levels of reasoning about self-others in social events (RSS) over time?MethodWe used video-taped interaction data from three sessions between one autistic child and a practitioner, contextualized by a set of animated DSM-5-based items of social events on which the child was asked to reflect. Interaction variables were the child's level of RSS and the practitioner's level of APS. We coded the real-time interaction.ResultsFirst, when exploring the dynamics of the microdata, we found contingency over time within sessions. Second, over the sessions, the practitioner showed a stable high level of APS, whereas the child's level of RSS increased. Third, a coupling effect between the level of APS and RSS was found within and over sessions. Salient is that the child and practitioner increasingly adapted to each other over the three sessions, and over time, high-level APS of the practitioner elicited higher levels of RSS of the child.DiscussionBecause the child showed a significant improvement in RSS over time, our research question provides a promising perspective. Contrary to what one might expect in autism, APS supported the performance of the child in reasoning about self-others in social situations. These outcomes underline the importance of giving voice to autistic children. The results may encourage researchers to develop strategies and tools that can help give a voice to children, to gain more insight into the child's reasoning. This may further develop self-other awareness and self-regulation in the social events of autistic children.
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Understanding the actions of others is important for predicting whether their intentions are honest or deceitful. Common-coding theory [Prinz, W. (1997). Perception and action planning. European Journal of Cognitive Psychology, 9(2), 129-154. https://doi.org/10.1080/713752551] suggests that the capability to produce a deceptive action could influence the ability to perceive the same action (and vice versa), but can an actor easily fool themselves? The aim of this study was to investigate whether individuals are better able to anticipate the outcome of their own deceptive actions than when others anticipate those same actions. Eighteen skilled rugby players were filmed performing deceptive (side-step) and non-deceptive actions. Eight equally skilled rugby players anticipated the outcomes of the filmed actions (i.e., viewing deceptive actions generated by others) and, six-months after filming, the original group of eighteen rugby players anticipated the action outcome of their own deceptive actions (i.e., viewing self-generated deceptive actions). Results revealed that players were no better at anticipating the outcomes of their own actions than others were. Instead, the response behaviour of the individuals viewing their own actions was indistinguishable from that of others viewing the same actions. In contrast with what might be expected based on common-coding theory, these findings suggest that the typical advantage of self-observation might be negated when the observer has acquired considerable amounts of visual experience in that observation task.
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Abstract: Background: Chronic obstructive pulmonary disease (COPD) and asthma have a high prevalence and disease burden. Blended self-management interventions, which combine eHealth with face-to-face interventions, can help reduce the disease burden. Objective: This systematic review and meta-analysis aims to examine the effectiveness of blended self-management interventions on health-related effectiveness and process outcomes for people with COPD or asthma. Methods: PubMed, Web of Science, COCHRANE Library, Emcare, and Embase were searched in December 2018 and updated in November 2020. Study quality was assessed using the Cochrane risk of bias (ROB) 2 tool and the Grading of Recommendations, Assessment, Development, and Evaluation. Results: A total of 15 COPD and 7 asthma randomized controlled trials were included in this study. The meta-analysis of COPD studies found that the blended intervention showed a small improvement in exercise capacity (standardized mean difference [SMD] 0.48; 95% CI 0.10-0.85) and a significant improvement in the quality of life (QoL; SMD 0.81; 95% CI 0.11-1.51). Blended intervention also reduced the admission rate (relative ratio [RR] 0.61; 95% CI 0.38-0.97). In the COPD systematic review, regarding the exacerbation frequency, both studies found that the intervention reduced exacerbation frequency (RR 0.38; 95% CI 0.26-0.56). A large effect was found on BMI (d=0.81; 95% CI 0.25-1.34); however, the effect was inconclusive because only 1 study was included. Regarding medication adherence, 2 of 3 studies found a moderate effect (d=0.73; 95% CI 0.50-0.96), and 1 study reported a mixed effect. Regarding self-management ability, 1 study reported a large effect (d=1.15; 95% CI 0.66-1.62), and no effect was reported in that study. No effect was found on other process outcomes. The meta-analysis of asthma studies found that blended intervention had a small improvement in lung function (SMD 0.40; 95% CI 0.18-0.62) and QoL (SMD 0.36; 95% CI 0.21-0.50) and a moderate improvement in asthma control (SMD 0.67; 95% CI 0.40-0.93). A large effect was found on BMI (d=1.42; 95% CI 0.28-2.42) and exercise capacity (d=1.50; 95% CI 0.35-2.50); however, 1 study was included per outcome. There was no effect on other outcomes. Furthermore, the majority of the 22 studies showed some concerns about the ROB, and the quality of evidence varied. Conclusions: In patients with COPD, the blended self-management interventions had mixed effects on health-related outcomes, with the strongest evidence found for exercise capacity, QoL, and admission rate. Furthermore, the review suggested that the interventions resulted in small effects on lung function and QoL and a moderate effect on asthma control in patients with asthma. There is some evidence for the effectiveness of blended self-management interventions for patients with COPD and asthma; however, more research is needed. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42019119894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=119894
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