The organisation and delivery of health improvement in general practice and primary care: a scoping study

Background This project examines the organisation and delivery of health improvement activities by and within general practice and the primary health-care team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices, how individual practices and the primary health-care team organise such public health activities, and how these contribute to health improvement. Our focus was on health promotion and ill-health prevention activities. Aims The aim of this scoping exercise was to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary health-care team. The key objectives were to provide an overview of the range and type of health improvement activities, identify gaps in knowledge and areas for further empirical research. Our specific research objectives were to map the range and type of health improvement activity undertaken by general practice staff and the primary health-care team based within general practice; to scope the literature on health improvement in general practice or undertaken by health-care staff based in general practice and identify gaps in the evidence base; to synthesise the literature and identify effective approaches to the delivery and organisation of health improvement interventions in a general practice setting; and to identify the priority areas for research as defined by those working in general practice. Methods We undertook a comprehensive search of the literature. We followed a staged selection process involving reviews of titles and abstracts. This resulted in the identification of 1140 papers for data extraction, with 658 of these papers selected for inclusion in the review, of which 347 were included in the evidence synthesis. We also undertook 45 individual and two group interviews with primary health-care staff. Findings Many of the research studies reviewed had some details about the type, process or location, or who provided the intervention. Generally, however, little attention is paid in the literature to examining the impact of the organisational context on the way services are delivered or how this affects the effectiveness of health improvement interventions in general practice. We found that the focus of attention is mainly on individual prevention approaches, with practices engaging in both primary and secondary prevention. The range of activities suggests that general practitioners do not take a population approach but focus on individual patients. However, it is clear that many general practitioners see health promotion as an integral part of practice, whether as individual approaches to primary or secondary health improvement or as a practice-based approach to improving the health of their patients. Our key conclusion is that there is currently insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care more widely. Future Research Future research on health improvement in general practice and by the primary health-care team needs to move beyond clinical research to include delivery systems and be conducted in a primary care setting. More research needs to examine areas where there are chronic disease burdens – cancer, dementia and other disabilities of old age. Reviews should be commissioned that examine the whole prevention pathway for health problems that are managed within primary care drawing together research from general practice, pharmacy, community engagement, etc

Automatic Generation of Personalized Recommendations in eCoaching

Denne avhandlingen omhandler eCoaching for personlig livsstilsstøtte i sanntid ved bruk av informasjons- og kommunikasjonsteknologi. Utfordringen er å designe, utvikle og teknisk evaluere en prototyp av en intelligent eCoach som automatisk genererer personlige og evidensbaserte anbefalinger til en bedre livsstil. Den utviklede løsningen er fokusert på forbedring av fysisk aktivitet. Prototypen bruker bærbare medisinske aktivitetssensorer. De innsamlede data blir semantisk representert og kunstig intelligente algoritmer genererer automatisk meningsfulle, personlige og kontekstbaserte anbefalinger for mindre stillesittende tid. Oppgaven bruker den veletablerte designvitenskapelige forskningsmetodikken for å utvikle teoretiske grunnlag og praktiske implementeringer. Samlet sett fokuserer denne forskningen på teknologisk verifisering snarere enn klinisk evaluering.publishedVersio

Effect of aging on prose recall

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Impact Of A Multidisciplinary Education Class On Knowledge And Health-Promoting Behaviors In Persons With Type 2 Diabetes Mellitus In Rural Mississippi

Prevalence rates of known diabetes mellitus continue to increase in the United States. However, studies show that people can reduce their risks of long-term complications by maintaining adequate blood sugar control. Good metabolic control, however, can be very difficult for persons with diabetes because it requires knowledge, motivation, lifestyle adjustments, close monitoring, and ongoing support from a health care team. The purpose of this quasi-experimental pretest/posttest study was to determine the impact of a multidisciplinary education class on knowledge and health-promoting behaviors in persons with type 2 diabetes in rural Mississippi. Pender\u27s Health Promotion Model was used as the theoretical framework. Hypotheses for this study included the following: (a) There will be no difference in knowledge of diabetes in persons with type 2 diabetes before and after a multidisciplinary diabetes education program and (b) there will be no difference in health- promoting behaviors of persons with type 2 diabetes before 1 1 1 and after a multidisciplinary diabetes education program. The convenience sample (N = 26) consisted of a majority of individuals who had been diagnosed with diabetes for less than one year (35%) , were Caucasian (92%), and were married (73%). The mean age was 58 years. Diabetes education was provided by a multidisciplinary group of professionals, including a nurse, dietitian, and pharmacist. Data were collected using three instruments. A significant increase in knowledge scores after the educational intervention emerged (p = .038), thus the researcher rejected the first hypothesis. No significant difference was discovered in health-promoting behaviors before and after education (p = .445), thus the second null hypothesis failed to be rejected. Additional findings indicated a positive relationship (p = .02) between the length of time since the diagnosis of diabetes and the amount of knowledge change over time. The longer individuals had been diabetic, the more knowledge change they tended to show as a result of the educational intervention. Findings from this study imply that diabetes education programs should incorporate behavior modification techniques and task-focused interventions aimed at enhancing self-efficacy. Recommendations included conduction of more research utilizing behavior i v modification and task-focused education interventions to assess behavior change outcomes and implementation of qualitative research methods to investigate personal characteristics and health beliefs

Self management and symptom monitoring among older adults with chronic obstructive pulmonary disease

Aims. To describe self-management, symptom monitoring and the associated influences among older adults with chronic obstructive pulmonary disease. Background. Optimal self-management and monitoring of key symptoms in patients with chronic obstructive pulmonary disease reduces dyspnoea and preventable hospitalizations. Method. A prospective, descriptive survey design was used and data collected from patients with moderate severity chronic obstructive pulmonary disease during home interviews between April 2005 and June 2006. Predictors of self-management and symptom monitoring were determined by linear regression analyses

Understanding the Influencing Factors and Mechanism of Social Compensation for Chinese Older Adults Using Social Media in the Context of Smart Home: A Qualitative Analysis

As a new generation of necessary terminals for future homes, smart homes have become one of the essential mediums for smart aging at home. This paper aims to explore how older adults who age at home can overcome the digital divide of the new medium and achieve social participation in the home context to realize active aging. Based on the theory of social compensation, we select the smart-home smart screen, a representative new medium product in China, and carry out open coding, spindle coding, selective coding, and theoretical construction of the original interview data through the grounded theory research method. The results show that the main factors affecting the social compensation of older adults to smart home social media include user interface quality, interaction quality, content quality, and service quality, and these four factors are used as external variables to compensate older adults socially, thereby stimulating the emotional experience and perception changes at the cognitive level of older adults and then affecting the adoption and acceptance of smart home social media by older adults. This study refines the factors influencing the older adults' use of smart home social media from the perspective of social compensation. It explains the mechanism of acceptable behavior of older adults, bridging the gap in previous literature on the influencing factors and behavioral mechanisms of older adults of smart home social media. This paper provides a theoretical basis and guidance for the subsequent academic research and software development practice of social media under new technological devices to further help older adults in China achieve active and healthy aging

Feature Papers "Age-Friendly Cities & Communities: State of the Art and Future Perspectives"

The "Age-Friendly Cities & Communities: States of the Art and Future Perspectives" publication presents contemporary, innovative, and insightful narratives, debates, and frameworks based on an international collection of papers from scholars spanning the fields of gerontology, social sciences, architecture, computer science, and gerontechnology. This extensive collection of papers aims to move the narrative and debates forward in this interdisciplinary field of age-friendly cities and communities

Smart and Pervasive Healthcare

Smart and pervasive healthcare aims at facilitating better healthcare access, provision, and delivery by overcoming spatial and temporal barriers. It represents a shift toward understanding what patients and clinicians really need when placed within a specific context, where traditional face-to-face encounters may not be possible or sufficient. As such, technological innovation is a necessary facilitating conduit. This book is a collection of chapters written by prominent researchers and academics worldwide that provide insights into the design and adoption of new platforms in smart and pervasive healthcare. With the COVID-19 pandemic necessitating changes to the traditional model of healthcare access and its delivery around the world, this book is a timely contribution