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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The Internet and computers increasingly determine our daily lives. This goes for almost everyone in the Netherlands. Still, it is mostly teenagers who are well informed on how to use all the possibilities of new technologies. They are building a digital world of their own that parents usually know very little about. This booklet intends to inform teachers, parents and other interested parties on what teenagers are actually doing online and how important it is to keep abreast of the new developments that the Internet and computers bring into their world. On the basis of research into these issues in the Netherlands and abroad we attempt to indicate what the digital world of teenagers looks like and how it differs from that of grown-ups. What do they do, exactly, and why? We also look into teenagers’ ICT behaviour and into dangers and abuse of the Internet. Moreover we provide tips for parents and teachers on how to handle certain phenomena. This book does not pretend to provide an exhaustive overview of the digital world of teenagers. It is focused on some important characteristics and parts of that world. It reports on research of the INHOLLAND Centre for eLearning into various aspects of ICT behaviour among teenagers. The research was undertaken in the spring of 2006, focusing mainly on texting, networking, gaming, dangers and abuse on the Internet and the digital relation between school and the home. Ultimately we are especially concerned with the question of what teenagers really learn in their digital world, and how education can profit. This book also addresses that issue.
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In media audience research we tend to assume that media are engaged with when they are used, however ‘light’ such engagement might be. Once ‘passive media use’ was banned as a reference to media use, being a media audience member became synonymous with being a meaning producer. In audience research however I find that media are not always the object of meaning making in daily life and that media texts can be hardly meaningful. Thinking about media and engagement, there is a threefold challenge in relation to audience research. The coming into being of platform media and hence of new forms of media production on a micro level that come out of and are woven into practices of media use, suggests that we need to redraft the repertoire of terms used in audience research (and maybe start calling it something else). Material and immaterial media production, the unpaid labour on the part of otherwise audience members should for instance be taken into account. Then, secondly, there is the continuing challenge to further develop heuristically strong ways of linking media use and meaning making, and most of all to do justice, thirdly, to those moments and ways in which audiences truly engage with media texts without identifying them with those texts.
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With the help of sensors that made data collection and processing possible, many products around us have become “smarter”. The situation that our car, refrigerator, or umbrella communicating with us and each other is no longer a future scenario; it is increasingly a shared reality. There are good examples of such connectedness such as lifestyle monitoring of elderly persons or waste management in a smart city. Yet, many other smart products are designed just for the sake of embedding a chip in something without thinking through what kind of value they add everyday life. In other words, the design of these systems have mainly been driven by technology until now and little studies have been carried out on how the design of such systems helps citizens to improve or maintain the quality of their individual and collective lives. The CREATE-IT research center creates new solutions and methodologies in “digital design” that contribute to the quality of life of citizens. Correspondingly, this proposal focuses on one type of digital design—smart products—and investigate the concept of empowerment in relation to the design of smart products. In particular, the proposal aims to develop a model with its supplementary tools and methods for designing such products better. By following a research-through-design methodology, the proposal intends to offer a critical understanding on designing smart products. Along with its theoretical contribution, the proposal will also aid the students of ICT and design, and professionals such as designers and engineers to create smart products that will empower people and the industry to develop products grounded in a clear user experience and business model.
In leaving the more traditional territories of the concert performance for broader societal contexts, professional musicians increasingly devise music in closer collaboration with their audience rather than present it on a stage. Although the interest for such forms of devising co-creative musicking within the (elderly) health care sector is growing, the work can be considered relatively new. In terms of research, multiple studies have sought to understand the impact of such work on musicians and participants, however little is known about what underpins the musicians’ actions in these settings. With this study, I sought to address this gap by investigating professional musicians’ emerging practices when devising co-creative musicking with elderly people. Three broad concepts were used as a theoretical background to the study: Theory of Practice, co-creative musicking, and Praxialism. Firstly, I used Theory of Practice to help understand the nature of emerging practices in a wider context of change in the field of music and habitus of musicians and participants. Theory of Practice enabled me to consider a practice as “a routinized type of behaviour which consists of several elements, interconnected to one another: forms of bodily activities, forms of mental activities, ‘things’ and their use, a background knowledge in the form of understanding, know-how, states of emotion, and motivational knowledge” (Reckwitz, 2002, p. 249). Secondly, I drew the knowledge from co-creative musicking, which is a concept I gathered from two existing concepts: co-creation and musicking. Musicking (Small, 1998), which considers music as something we do (including any mode of engagement with music), provided a holistic and inclusive way of looking at participation in music-making. The co-creation paradigm encompasses a view on enterprise that consists of bringing together parties to jointly create an outcome that is meaningful to all (Prahalad & Ramaswamy, 2004; Ramaswamy & Ozcan, 2014). The concept served as a lens to specify the jointness of the musicking and challenge issues of power in the engagement of participants in the creative-productive process. Thirdly, Praxialism considers musicking as an activity that encompasses “musical doers, musical doing, something done and contexts in which the former take place” (Elliott, 1995). Praxialism sets out a vision on music that goes beyond the musical work and includes the meanings and values of those involved (Silverman, Davis & Elliott, 2014). The concept allowed me to examine the work and emerging relationships as a result of devising co-creative musicking from an ethical perspective. Given the subject’s relative newness and rather unexplored status, I examined existing work empirically through an ethnographic approach (Hammersley & Atkinson, 2007). Four cases were selected where data was gathered through episodic interviewing (Flick, 2009) and participant observation. Elements of a constructivist Grounded Theory (Charmaz, 2014) were used for performing an abductive analysis. The analysis included initial coding, focused coding, the use of sensitizing concepts (Blumer 1969 in Hammersley, 2013) and memoing. I wrote a thick description (Geertz, 1973) for each case portraying the work from my personal experience. The descriptions are included in the dissertation as one separate chapter and foreshadow the exposition of the analysis in a next chapter. In-depth study of the creative-productive processes of the cases showed the involvement of multiple co-creative elements, such as a dialogical interaction between musicians and audience. However, participants’ contributions were often adopted implicitly, through the musicians interpreting behaviour and situations. This created a particular power dynamic and challenges as to what extent the negotiation can be considered co-creative. The implicitness of ‘making use’ of another person’s behaviour with the other not (always) being aware of this also triggered an ethical perspective, especially because some of the cases involved participants that were vulnerable. The imbalance in power made me examine the relationship that emerges between musicians and participants. As a result of a closer contact in the co-creative negotiation, I witnessed a contact of a highly personal, sometimes intimate, nature. I recognized elements of two types of connections. One type could be called ‘humanistic’, as a friendship in which there is reciprocal care and interest for the other. The other could be seen as ‘functional’, which means that the relationship is used as a resource for providing input for the creative musicking process. From this angle, I have compared the relationship with that of a relationship of an artist with a muse. After having examined the co-creative and relational sides of the interaction in the four cases, I tuned in to the musicians’ contribution to these processes and relationships. I discovered that their devising in practice consisted of a continuous double balancing act on two axes: one axis considers the other and oneself as its two ends. Another axis concerns the preparedness and unpredictability at its ends. Situated at the intersection of the two axes are the musicians’ intentionality, which is fed by their intentions, values and ethics. The implicitness of the co-creation, the two-sided relationship, the potential vulnerability of participants, and the musicians’ freedom in navigating and negotiation, together, make the devising of co-creative musicking with elderly people an activity that involves ethical challenges that are centred around a tension between prioritizing doing good for the other, associated with a eudaimonic intention, and prioritizing values of the musical art form, resembling a musicianist intention. The results therefore call for a musicianship that involves acting reflectively from an ethical perspective. Doctoral study by Karolien Dons
Zowel bij ondernemers als onder kunstenaars zien we steeds meer initiatieven gericht op de ontwikkeling van een ‘volhoudbare’ economie. Partijen uit deze domeinen zoeken manieren om een generatieve economie te bewerkstelligen die – anders dan een extractieve economie (‘de economie van het leegtrekken’) – sociaal rechtvaardig en ecologisch duurzaam wil zijn. Omdat kunstenaars en ondernemers in hun zoektocht naar innovaties-met-impact verschillende kwaliteiten inbrengen, wordt veel verwacht van samenwerking tussen de twee sectoren. In de praktijk echter is synergie eerder regel dan uitzondering. De grote verschillen tussen de twee ‘innovatiesferen’ leiden vooralsnog tot meer gedoe dan complementariteit. In het vraagarticulatietraject dat ten grondslag ligt aan SUSTAIN kwam naar voren dat hier een belangrijke rol is weggelegd voor zogeheten innovatiebrokers: derde partijen die werelden van ondernemerschap en kunst op duurzame wijze met elkaar weten te verbinden. In SUSTAIN willen we de body of knowledge en het handelingsinstrumentarium van deze innovatiebrokers verrijken. Door met praktijkgericht onderzoek juist in deze beroepsgroep te investeren, hopen we een hefboomeffect richting de volhoudbare economie te creëren: we dragen bij aan de effectiviteit van de samenwerking tussen de innovatiesferen kunst en ondernemerschap. Onze hoofdvraag luidt: Wat kunnen innovatiebrokers op het snijvlak van kunst en ondernemen in de verschillende fases van het innovatietraject leren en doen om de synergie van de samenwerking tussen ondernemers en kunstenaars te vergroten en zo een duurzame bijdrage te leveren aan de transitie richting een volhoudbare economie? Gedurende het onderzoek ontwikkelen we een gefundeerd Brokers Kenniscanvas dat beschrijft welke vraagstukken zich aandienen in samenwerkingsverbanden tussen kunstenaars en ondernemers en hoe de innovatiebrokers die vraagstukken hanteerbaar en productief kunnen maken. We richten ons welbewust op het ‘gedoe’ in de samenwerking en ontwikkelen vóór en mét de innovatiebrokers kennis over hoe vandaaruit synergie te realiseren.
