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
This open access book is a valuable resource for students in health and other professions and practicing professionals interested in supporting effective change in self-management behaviors in chronic disease, such as medication taking, physical activity and healthy eating. Developed under the auspices of the Train4Health project, funded by the Erasmus+ program of the European Union, the book contains six chapters written by international contributors from different disciplines. This chapter sets the stage for the remaining book, by introducing the Train4Health project and by explaining how the learning outcomes presented in subsequent chapters have been derived and linked with content of the book. Firstly, the Train4Health interprofessional competency framework to support behaviour change in persons self-managing chronic disease is briefly presented. This European competency framework was the starting point for developing the learning outcomes-based curriculum, which is succinctly addressed in the subsequent section. Finally, practical considerations about the Train4Health curriculum are discussed, including opportunities and challenges for interprofessional education.
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Quantifying measures of physical loading has been an essential part of performance monitoring within elite able-bodied sport, facilitated through advancing innovative technology. In wheelchair court sports (WCS) the inter-individual variability of physical impairments in the athletes increases the necessity for accurate load and performance measurements, while at the same time standard load monitoring methods (e.g. heart-rate) often fail in this group and dedicated WCS performance measurement methods are scarce. The objective of this review was to provide practitioners and researchers with an overview and recommendations to underpin the selection of suitable technologies for a variety of load and performance monitoring purposes specific to WCS. This review explored the different technologies that have been used for load and performance monitoring in WCS. During structured field testing, magnetic switch based devices, optical encoders and laser systems have all been used to monitor linear aspects of performance. However, movement in WCS is multidirectional, hence accelerations, decelerations and rotational performance and their impact on physiological responses and determination of skill level, is also of interest. Subsequently both for structured field testing as well as match-play and training, inertial measurement units mounted on wheels and frame have emerged as an accurate and practical option for quantifying linear and non-linear movements. In conclusion, each method has its place in load and performance measurement, yet inertial sensors seem most versatile and accurate. However, to add context to load and performance metrics, position-based acquisition devices such as automated image-based processing or local positioning systems are required.
The focus of the research is 'Automated Analysis of Human Performance Data'. The three interconnected main components are (i)Human Performance (ii) Monitoring Human Performance and (iii) Automated Data Analysis . Human Performance is both the process and result of the person interacting with context to engage in tasks, whereas the performance range is determined by the interaction between the person and the context. Cheap and reliable wearable sensors allow for gathering large amounts of data, which is very useful for understanding, and possibly predicting, the performance of the user. Given the amount of data generated by such sensors, manual analysis becomes infeasible; tools should be devised for performing automated analysis looking for patterns, features, and anomalies. Such tools can help transform wearable sensors into reliable high resolution devices and help experts analyse wearable sensor data in the context of human performance, and use it for diagnosis and intervention purposes. Shyr and Spisic describe Automated Data Analysis as follows: Automated data analysis provides a systematic process of inspecting, cleaning, transforming, and modelling data with the goal of discovering useful information, suggesting conclusions and supporting decision making for further analysis. Their philosophy is to do the tedious part of the work automatically, and allow experts to focus on performing their research and applying their domain knowledge. However, automated data analysis means that the system has to teach itself to interpret interim results and do iterations. Knuth stated: Science is knowledge which we understand so well that we can teach it to a computer; and if we don't fully understand something, it is an art to deal with it.[Knuth, 1974]. The knowledge on Human Performance and its Monitoring is to be 'taught' to the system. To be able to construct automated analysis systems, an overview of the essential processes and components of these systems is needed.Knuth Since the notion of an algorithm or a computer program provides us with an extremely useful test for the depth of our knowledge about any given subject, the process of going from an art to a science means that we learn how to automate something.
Due to their diverse funding sources, theatres are under increasing pressure to demonstrate impact on society. The Raad voor Cultuur (2023) for example advised the secretary of state to include societal impact as an additional evaluation measure next to artistic value. Many theaters, such as the Chassé Theater and Parkstad Limburg Theaters, have reformulated their missions to focus on impact of performances on visitors. This is a profound transformation from merely selling tickets and filling seats, and requires new measurement instruments to monitor, manage, and improve impact. Currently available instruments are insufficient, and effective monitoring is crucial to larger future projects that theaters are currently planning to systematically broaden impacts of performances on their communities. The specific goal of this project is to empower theaters to monitor and improve impact by developing a brief experience impact questionnaire, taking existing data from student projects conducted at the Chassé Theater about performing arts experiences on one hand, and experience impact theory innovations on the other, as starting points. We will develop potential items to measure and benchmark against established measures of valued societal outcomes, such as subjective well-being and quality of life. These will be measured in questionnaires developed with project partners Chassé Theater and Parkstad Limburg Theaters and administered before and after performances across a wide range of genres. The resulting data will enable comparison of new questionnaire items with benchmarked measures of valued societal outcomes. The final product of the project will be a brief impact questionnaire, which within several brief self-report instruments and just a few minutes can effectively be used to quantify the impact of a performing arts experience. A workshop and practice-oriented article will make this questionnaire implementable, thereby mobilizing the key enabling methodology of monitoring and impact measurement in the performing arts sector.
Due to their diverse funding sources, theatres are under increasing pressure to demonstrate impact on society. The Raad voor Cultuur (2023) for example advised the secretary of state to include societal impact as an additional evaluation measure next to artistic value. Many theaters, such as the Chassé Theater and Parkstad Limburg Theaters, have reformulated their missions to focus on impact of performances on visitors. This is a profound transformation from merely selling tickets and filling seats, and requires new measurement instruments to monitor, manage, and improve impact. Currently available instruments are insufficient, and effective monitoring is crucial to larger future projects that theaters are currently planning to systematically broaden impacts of performances on their communities.The specific goal of this project is to empower theaters to monitor and improve impact by developing a brief experience impact questionnaire, taking existing data from student projects conducted at the Chassé Theater about performing arts experiences on one hand, and experience impact theory innovations on the other, as starting points. We will develop potential items to measure and benchmark against established measures of valued societal outcomes, such as subjective well-being and quality of life. These will be measured in questionnaires developed with project partners Chassé Theater and Parkstad Limburg Theaters and administered before and after performances across a wide range of genres. The resulting data will enable comparison of new questionnaire items with benchmarked measures of valued societal outcomes. The final product of the project will be a brief impact questionnaire, which within several brief self-report instruments and just a few minutes can effectively be used to quantify the impact of a performing arts experience. A workshop and practice-oriented article will make this questionnaire implementable, thereby mobilizing the key enabling methodology of monitoring and impact measurement in the performing arts sector.Societal issueThe specific goal of this project is to empower theaters to monitor and improve impact by developing a brief experience impact questionnaire, taking existing data about performing arts experiences on one hand, and experience impact theory innovations on the other, as starting points. Benefit to societyWe will develop potential items to measure and benchmark against established measures of valued societal outcomes, such as subjective well-being and quality of life. Collaborative partnersChassé Theater N.V., Parkstad Limburg Theaters N.V.
