A randomized trial of an Asthma Internet Self-management Intervention (RAISIN): study protocol for a randomized controlled trial

<b>Background</b><p></p> The financial costs associated with asthma care continue to increase while care remains suboptimal. Promoting optimal self-management, including the use of asthma action plans, along with regular health professional review has been shown to be an effective strategy and is recommended in asthma guidelines internationally. Despite evidence of benefit, guided self-management remains underused, however the potential for online resources to promote self-management behaviors is gaining increasing recognition. The aim of this paper is to describe the protocol for a pilot evaluation of a website 'Living well with asthma' which has been developed with the aim of promoting self-management behaviors shown to improve outcomes.<p></p> <b>Methods</b><p></p> The study is a parallel randomized controlled trial, where adults with asthma are randomly assigned to either access to the website for 12 weeks, or usual asthma care for 12 weeks (followed by access to the website if desired). Individuals are included if they are over 16-years-old, have a diagnosis of asthma with an Asthma Control Questionnaire (ACQ) score of greater than, or equal to 1, and have access to the internet. Primary outcomes for this evaluation include recruitment and retention rates, changes at 12 weeks from baseline for both ACQ and Asthma Quality of Life Questionnaire (AQLQ) scores, and quantitative data describing website usage (number of times logged on, length of time logged on, number of times individual pages looked at, and for how long). Secondary outcomes include clinical outcomes (medication use, health services use, lung function) and patient reported outcomes (including adherence, patient activation measures, and health status).<p></p> <b>Discussion</b><p></p> Piloting of complex interventions is considered best practice and will maximise the potential of any future large-scale randomized controlled trial to successfully recruit and be able to report on necessary outcomes. Here we will provide results across a range of outcomes which will provide estimates of efficacy to inform the design of a future full-scale randomized controlled trial of the 'Living well with asthma' website

Development of a Self‐Management Theory‐Guided Discharge Intervention for Parents of Hospitalized Children

Background Parents of hospitalized children, especially parents of children with complex and chronic health conditions, report not being adequately prepared for self‐management of their child\u27s care at home after discharge. Problem No theory‐based discharge intervention exists to guide pediatric nurses\u27 preparation of parents for discharge. Purpose To develop a theory‐based conversation guide to optimize nurses\u27 preparation of parents for discharge and self‐management of their child at home following hospitalization. Methods Two frameworks and one method influenced the development of the intervention: the Individual and Family Self‐Management Theory, Tanner\u27s Model of Clinical Judgment, and the Teach‐Back method. A team of nurse scientists, nursing leaders, nurse administrators, and clinical nurses developed and field tested the electronic version of a nine‐domain conversation guide for use in acute care pediatric hospitals. Conclusions The theory‐based intervention operationalized self‐management concepts, added components of nursing clinical judgment, and integrated the Teach‐Back method. Clinical Relevance Development of a theory‐based intervention, the translation of theoretical knowledge to clinical innovation, is an important step toward testing the effectiveness of the theory in guiding clinical practice. Clinical nurses will establish the practice relevance through future use and refinement of the intervention

Augev Method and an Innovative Use of Vocal Spectroscopy in Evaluating and Monitoring the Rehabilitation Path of Subjects Showing Severe Communication Pathologies

A strongly connotative element of developmental disorders (DS) is the total or partial impairment of verbal communication and, more generally, of social interaction. The method of Vocal-verb self-management (Augev) is a systemic organicistic method able to intervene in problems regarding verbal, spoken and written language development successfully. This study intends to demonstrate that it is possible to objectify these progresses through a spectrographic examination of vocal signals, which detects voice phonetic-acoustic parameters. This survey allows an objective evaluation of how effective an educational-rehabilitation intervention is. This study was performed on a population of 40 subjects (34 males and 6 females) diagnosed with developmental disorders (DS), specifically with a diagnosis of the autism spectrum disorders according to the DSM-5. The 40 subjects were treated in “la Comunicazione” centers, whose headquarters are near Bari, Brindisi and Rome. The results demonstrate a statistical significance in a correlation among the observed variables: supervisory status, attention, general dynamic coordination, understanding and execution of orders, performing simple unshielded rhythmic beats, word rhythm, oral praxies, phono-articulatory praxies, pronunciation of vowels, execution of graphemes, visual perception, acoustic perception, proprioceptive sensitivity, selective attention, short-term memory, segmental coordination, performance of simple rhythmic beatings, word rhythm, voice setting, intonation of sounds within a fifth, vowel pronunciation, consonant pronunciation, graphematic decoding, syllabic decoding, pronunciation of caudate syllables, coding of final syllable consonant, lexical decoding, phoneme-grapheme conversion, homographic grapheme decoding, homogeneous grapheme decoding, graphic stroke

Measuring well-being across Europe: Description of the ESS Well-being Module and preliminary findings

It has become customary to judge the success of a society through the use of objective indicators, predominantly economic and social ones. Yet in most developed nations, increases in income, education and health have arguably not produced comparable increases in happiness or life satisfaction. While much has been learned from the introduction of subjective measures of global happiness or life satisfaction into surveys, significant recent progress in the development of high-quality subjective measures of personal and social well-being has not been fully exploited. This paper describes the development of a set of well- being indicators which were included in Round 3 of the European Social Survey. This well-being Module seeks to evaluate the success of European countries in promoting the personal and social well-being of their citizens. In addition to providing a better understanding of domain-specific measures, such as those relating to family, work and income, the design of the Well-being Module recognises that advancement in the field requires us to look beyond measures which focus on how people feel (happiness, pleasure, satisfaction) to measures which are more concerned with how well they function. This also shifts the emphasis from relatively transient states of well-being to measures of more sustainable well-being. The ESS Well-being Module represents one of the first systematic attempts to create a set of policy-relevant national well-being accounts.well-being ; European social survey ; questionnaire design