188,938 research outputs found

    Digital support interventions for the self-management of low back pain: a systematic review

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    Background: Low back pain (LBP) is a common cause of disability and is ranked as the most burdensome health condition globally. Self-management, including components on increased knowledge, monitoring of symptoms, and physical activity, are consistently recommended in clinical guidelines as cost-effective strategies for LBP management and there is increasing interest in the potential role of digital health. Objective: The study aimed to synthesize and critically appraise published evidence concerning the use of interactive digital interventions to support self-management of LBP. The following specific questions were examined: (1) What are the key components of digital self-management interventions for LBP, including theoretical underpinnings? (2) What outcome measures have been used in randomized trials of digital self-management interventions in LBP and what effect, if any, did the intervention have on these? and (3) What specific characteristics or components, if any, of interventions appear to be associated with beneficial outcomes? Methods: Bibliographic databases searched from 2000 to March 2016 included Medline, Embase, CINAHL, PsycINFO, Cochrane Library, DoPHER and TRoPHI, Social Science Citation Index, and Science Citation Index. Reference and citation searching was also undertaken. Search strategy combined the following concepts: (1) back pain, (2) digital intervention, and (3) self-management. Only randomized controlled trial (RCT) protocols or completed RCTs involving adults with LBP published in peer-reviewed journals were included. Two reviewers independently screened titles and abstracts, full-text articles, extracted data, and assessed risk of bias using Cochrane risk of bias tool. An independent third reviewer adjudicated on disagreements. Data were synthesized narratively. Results: Of the total 7014 references identified, 11 were included, describing 9 studies: 6 completed RCTs and 3 protocols for future RCTs. The completed RCTs included a total of 2706 participants (range of 114-1343 participants per study) and varied considerably in the nature and delivery of the interventions, the duration/definition of LBP, the outcomes measured, and the effectiveness of the interventions. Participants were generally white, middle aged, and in 5 of 6 RCT reports, the majority were female and most reported educational level as time at college or higher. Only one study reported between-group differences in favor of the digital intervention. There was considerable variation in the extent of reporting the characteristics, components, and theories underpinning each intervention. None of the studies showed evidence of harm. Conclusions: The literature is extremely heterogeneous, making it difficult to understand what might work best, for whom, and in what circumstances. Participants were predominantly female, white, well educated, and middle aged, and thus the wider applicability of digital self-management interventions remains uncertain. No information on cost-effectiveness was reported. The evidence base for interactive digital interventions to support patient self-management of LBP remains weak

    Progress in information technology and tourism management: 20 years on and 10 years after the Internet—The state of eTourism research

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    This paper reviews the published articles on eTourism in the past 20 years. Using a wide variety of sources, mainly in the tourism literature, this paper comprehensively reviews and analyzes prior studies in the context of Internet applications to Tourism. The paper also projects future developments in eTourism and demonstrates critical changes that will influence the tourism industry structure. A major contribution of this paper is its overview of the research and development efforts that have been endeavoured in the field, and the challenges that tourism researchers are, and will be, facing

    Informal learning evidence in online communities of mobile device enthusiasts

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    This chapter describes a study that investigated the informal learning practices of enthusiastic mobile device owners. Informal learning is far more widespread than is often realized. Livingston (2000) pointed out that Canadian adults spend an average of fifteen hours per week on informal learning activities, more than they spend on formal learning activities. The motivation for these learning efforts generally comes from the individual, not from some outside force such as a school, university, or workplace. Therefore, in the absence of an externally imposed learning framework, informal learners will use whatever techniques,resources, and tools best suit their learning needs and personal preferences. As ownership of mobile technologies becomes increasingly widespread in the western world, it is likely that learners who have access to this technology will use it to support their informal learning efforts. This chapter presents the findings of a study into the various and innovative ways in which PDA and Smartphone users exploit mobile device functionality in their informal learning activities. The findings suggested that mobile device users deploy the mobile, connective, and collaborative capabilities of their devices in a variety of informal learning contexts, and in quite innovative ways. Trends emerged, such as the increasing importance of podcasting and audio and the use of built-in GPS, which may have implications for future studies. Informal learners identified learning activities that could be enhanced by the involvement of mobile technology, and developed methods and techniques that helped them achieve their learning goals

    User-driven design of decision support systems for polycentric environmental resources management

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    Open and decentralized technologies such as the Internet provide increasing opportunities to create knowledge and deliver computer-based decision support for multiple types of users across scales. However, environmental decision support systems/tools (henceforth EDSS) are often strongly science-driven and assuming single types of decision makers, and hence poorly suited for more decentralized and polycentric decision making contexts. In such contexts, EDSS need to be tailored to meet diverse user requirements to ensure that it provides useful (relevant), usable (intuitive), and exchangeable (institutionally unobstructed) information for decision support for different types of actors. To address these issues, we present a participatory framework for designing EDSS that emphasizes a more complete understanding of the decision making structures and iterative design of the user interface. We illustrate the application of the framework through a case study within the context of water-stressed upstream/downstream communities in Lima, Peru

    Supporting Special-Purpose Health Care Models via Web Interfaces

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    The potential of the Web, via both the Internet and intranets, to facilitate development of clinical information systems has been evident for some time. Most Web-based clinical workstations interfaces, however, provide merely a loose collection of access channels. There are numerous examples of systems for access to either patient data or clinical guidelines, but only isolated cases where clinical decision support is presented integrally with the process of patient care, in particular, in the form of active alerts and reminders based on patient data. Moreover, pressures in the health industry are increasing the need for doctors to practice in accordance with ¿best practice¿ guidelines and often to operate under novel health-care arrangements. We present the Care Plan On-Line (CPOL) system, which provides intranet-based support for the SA HealthPlus Coordinated Care model for chronic disease management. We describe the interface design rationale of CPOL and its implementation framework, which is flexible and broadly applicable to support new health care models over intranets or the Internet
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