An offer to help: Impacts of covid-19 lockdown on local sharing economies

The preventive measures applied in response to the covid-19 pandemic have transformed social and economic activities. Based on a case study of the Norwegian digital sharing platform Nabohjelp (English: Neighbour help), this article describes how sudden introductions of social distancing policies, such as lockdowns, affect the usage of peer-to-peer (p2p) sharing economy platforms. The analysis includes all messages posted by users on the Nabohjelp platform over a period covering one month before and two and a half months after the announcement of the first covid-19 lockdown in Norway (N=14997). Statistical analysis is applied to understand the impact of the lockdown on different types of platform activities, and text analysis is performed on a stratified random sample of messages (n=400). We find evidence of a rapid response to the lockdown and highly increased app usage, as well as increased technology adoption rates, in the first five weeks of lockdown. Before the lockdown, the messages were mainly related to specific needs with a short deadline, while messages during the lockdown were more open-ended and general in nature. We find an initial spike in the number of messages from people offering to help others, driven by both pre-existing and new users. When society gradually opened up again after about two months, the daily number of posted messages remained about three times higher than before the lockdown. We conclude that p2p sharing platforms can play an important role in the robustness of local societies in times of a pandemic.publishedVersio

User Needs in the Development of a Health App Ecosystem for Self-Management of Cystic Fibrosis: User-Centered Development Approach

Background: Digital self-management in cystic fibrosis (CF) is foreseen as a means toward better understanding of the disease and its treatment and better adherence to the treatment. Mobile apps hold the potential to provide access to information, motivate, and strengthen compliance. However, to deliver high-quality apps, the development should be based on thorough knowledge about user needs. Empirical research on the user-centered development of mobile apps for health care is, however, still limited. Objective: The aim of this research is to develop and evaluate an app ecosystem for self-management in CF. It targets not only those directly affected by CF but also parents and health care professionals involved in the treatment. This paper covers the first step of the design process that aims to analyze the context and the user requirements. The primary research question is as follows: what digital support has the potential to usefully support persons with CF and their caregivers in the CF care? To answer this question, we address two preliminary questions: what important factors in everyday life affect the care of persons with CF? and how is the CF care delivered today and what are the limitations of CF care services? Methods: The overall research adopts a user-centered design approach in which future users are involved in the development process from the very beginning to ensure that the apps developed best suit the potential users. The research presented in the paper follows an interpretative case study research strategy seeking to understand the concerns and needs of persons with CF and their caregivers. Data were collected through semistructured qualitative interviews involving 74 participants in seven European countries and from internet forums. Results: The results of the analysis phase show a strong need for individuality of the digital support, as well as for its adaptability to different contexts. The paper presents the concerns and needs of the participants in the study and extracts a set of relevant features for a self-management app ecosystem. Education, enzyme dosage calculation, nutrition management, treatment organization, health diary, treatment follow-up, practical guidelines for treatment, communication with doctors, and communication with peers are foreseen as useful features. Conclusions: The results indicate the readiness for self-management in the CF care even in countries that provide well-functioning health care services for CF care. The large diversity of user requirements identified reflects the crucial role user integration plays in developing apps for a chronic condition such as CF. The need for personalization stemming from the individuality of the patients and the need for communication with health care professionals support the idea of an app ecosystem for the self-management of CF.User Needs in the Development of a Health App Ecosystem for Self-Management of Cystic Fibrosis: User-Centered Development ApproachpublishedVersio

The Potential of Self-Management mHealth for Pediatric Cystic Fibrosis: Mixed-Methods Study for Health Care and App Assessment

Background: Remote care services and patient empowerment have boosted mobile health (mHealth). A study of user needs related to mHealth for pediatric cystic fibrosis (PCF) identified the set of preferred features mobile apps should support; however, the potential use of PCF apps and their suitability to fit into PCF clinical management remains unexplored. Objective: We examine whether PCF holds potential for the implementation of mHealth care. Methods: The study is based on a literature review and qualitative analysis of content and was conducted in two parts: (1) we reviewed scientific and gray literature to explore how European countries manage PCF and conducted a qualitative study of 6 PCF units and (2) we performed a systematic review of apps available in the myhealthapps.net repository searching for cystic fibrosis (CF) management and nutrition apps, which we analyzed for characteristics, business models, number of downloads, and usability. Results: European CF routine care guidelines are acknowledged in most European countries, and treatments are fully covered in almost all countries. The majority of teams in CF units are interdisciplinary. With respect to the systematic review of apps, we reviewed 12 apps for CF management and 9 for general nutrition management in the myhealthapps.net directory. All analyzed apps provided functionalities for recording aspects related to the disease and nutrition such as medication, meals, measurements, reminders, and educational material. None of the apps reviewed in this study supported pancreatic enzyme replacement therapy. CF apps proved to be less appealing and usable than nutrition apps (2.66 [SD 1.15] vs 4.01 [SD 0.90]; P<.001, z-value: –2.6). User needs detected in previous research are partially matched by current apps for CF management. Conclusions: The health care context for PCF is a unique opportunity for the adoption of mHealth. Well-established clinical guidelines, heterogeneous clinical teams, and coverage by national health care systems provide a suitable scenario for the use of mHealth solutions. However, available apps for CF self-management do not cover essential aspects such as nutrition and education. To increase the adoption of mHealth for CF self-management, new apps should include these features.European Commission / MyCyFAPP H2020–64380

Users' Experiences of a Mobile Health Self-Management Approach for the Treatment of Cystic Fibrosis: Mixed Methods Study

[EN] Background: Despite a large number of clinical trials aiming at evaluating the digital self-management of chronic diseases, there is little discussion about users¿ experiences with digital approaches. However, a good user experience is a critical factor for technology adoption. Understanding users¿ experiences can inform the design of approaches toward increased motivation for digital self-management. Objective: This study aimed to evaluate the self-management of cystic fibrosis (CF) with a focus on gastrointestinal concerns and the care of young patients. Following a user-centered design approach, we developed a self-management app for patients and parents and a web tool for health care professionals (HCPs). To evaluate the proposed solutions, a 6-month clinical trial was conducted in 6 European CF competence centers. This paper analyzes the user acceptance of the technology and the benefits and disadvantages perceived by the trial participants. Methods: A mixed methods approach was applied. Data were collected through 41 semistructured qualitative interviews of patients, parents, and HCPs involved in the clinical trial. In addition, data were collected through questionnaires embedded in the self-management app. Results: Support for enzyme dose calculation and nutrition management was found to be particularly useful. Patients and parents rapidly strengthened their knowledge about the treatment and increased their self-efficacy. Reported benefits include reduced occurrence of symptoms and enhanced quality of life. Patients and parents had different skills, requiring follow-up by HCPs in an introductory phase. HCPs valued obtaining precise information about the patients, allowing for more personalized advice. However, the tight follow-up of several patients led to an increased workload. Over time, as patient self-efficacy increased, patient motivation for using the app decreased and the quality of the reported data was reduced. Conclusions: Self-management enfolds a collaboration between patients and HCPs. To be successful, a self-management approach should be accepted by both parties. Through understanding behaviors and experiences, this study defines recommendations for a complex case¿the demanding treatment of CF. We identify target patient groups and situations for which the app is most beneficial and suggest focusing on these rather than motivating for regular app usage over a long time. We also advise the personalized supervision of patients during the introduction of the approach. Finally, we propose to develop guidance for HCPs to facilitate changes in practice. As personalization and technology literacy are factors found to influence the acceptance of digital self-management of other chronic diseases, it is relevant to consider the proposed recommendations beyond the case of CF.The authors of this paper, on behalf of the MyCyFAPP consortium, acknowledge the European Union and the Horizon 2020 Research and Innovation Framework Programme for funding the project (ref. 643806). The authors would like to thank all project partners for their collaboration during participant recruitment and project management. Without the dedication of participants in terms of time, effort, and valuable input, this publication would not have been possible. The authors would like to thank all the participants who contributed to this work.Floch, J.; Vilarinho, T.; Zettl, A.; Ibáñez Sánchez, G.; Calvo-Lerma, J.; Stav, E.; Halland Haro, P.... (2020). 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The Relative Contribution of Food Groups to Macronutrient Intake in Children with Cystic Fibrosis: A European Multicenter Assessment. Journal of the Academy of Nutrition and Dietetics, 119(8), 1305-1319. doi:10.1016/j.jand.2019.01.003Turck, D., Braegger, C. P., Colombo, C., Declercq, D., Morton, A., Pancheva, R., … Wilschanski, M. (2016). ESPEN-ESPGHAN-ECFS guidelines on nutrition care for infants, children, and adults with cystic fibrosis. Clinical Nutrition, 35(3), 557-577. doi:10.1016/j.clnu.2016.03.004Vo, V., Auroy, L., & Sarradon-Eck, A. (2019). Patients’ Perceptions of mHealth Apps: Meta-Ethnographic Review of Qualitative Studies. JMIR mHealth and uHealth, 7(7), e13817. doi:10.2196/13817Anderson, K., Burford, O., & Emmerton, L. (2016). Mobile Health Apps to Facilitate Self-Care: A Qualitative Study of User Experiences. PLOS ONE, 11(5), e0156164. doi:10.1371/journal.pone.0156164Boon, M., Calvo-Lerma, J., Claes, I., Havermans, T., Asseiceira, I., Bulfamante, A., … Ribes-Koninckx, C. (2020). Use of a mobile application for self-management of pancreatic enzyme replacement therapy is associated with improved gastro-intestinal related quality of life in children with Cystic Fibrosis. Journal of Cystic Fibrosis, 19(4), 562-568. doi:10.1016/j.jcf.2020.04.001Hevner, March, Park, & Ram. (2004). Design Science in Information Systems Research. MIS Quarterly, 28(1), 75. doi:10.2307/25148625-ISO 9241-210:2010 Ergonomics of Human-System Interaction — Part 210: Human-Centred Design for Interactive SystemsInternational Organization for Standardization20102020-06-05https://www.iso.org/standard/52075.htmlVilarinho, T., Floch, J., & Stav, E. (2017). Co-designing a mHealth Application for Self-management of Cystic Fibrosis. Lecture Notes in Computer Science, 3-22. doi:10.1007/978-3-319-67687-6_1Kristensen, G. K., & Ravn, M. N. (2015). The voices heard and the voices silenced: recruitment processes in qualitative interview studies. Qualitative Research, 15(6), 722-737. doi:10.1177/1468794114567496Etikan, I. (2016). Comparison of Convenience Sampling and Purposive Sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1. doi:10.11648/j.ajtas.20160501.11Bryman, A. (2006). Integrating quantitative and qualitative research: how is it done? Qualitative Research, 6(1), 97-113. doi:10.1177/1468794106058877Klein, H. K., & Myers, M. D. (1999). A Set of Principles for Conducting and Evaluating Interpretive Field Studies in Information Systems. MIS Quarterly, 23(1), 67. doi:10.2307/249410Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. doi:10.1191/1478088706qp063oaLee, Y., Kozar, K. A., & Larsen, K. R. T. (2003). The Technology Acceptance Model: Past, Present, and Future. Communications of the Association for Information Systems, 12. doi:10.17705/1cais.01250Calvo-Lerma, J., Hulst, J. M., Asseiceira, I., Claes, I., Garriga, M., Colombo, C., … Ribes-Koninckx, C. (2017). Nutritional status, nutrient intake and use of enzyme supplements in paediatric patients with Cystic Fibrosis; a European multicentre study with reference to current guidelines. Journal of Cystic Fibrosis, 16(4), 510-518. doi:10.1016/j.jcf.2017.03.005Johnson, K. B., Patterson, B. L., Ho, Y.-X., Chen, Q., Nian, H., Davison, C. L., … Mulvaney, S. A. (2015). The feasibility of text reminders to improve medication adherence in adolescents with asthma. Journal of the American Medical Informatics Association, 23(3), 449-455. doi:10.1093/jamia/ocv158Granger, D., Vandelanotte, C., Duncan, M. J., Alley, S., Schoeppe, S., Short, C., & Rebar, A. (2016). Is preference for mHealth intervention delivery platform associated with delivery platform familiarity? BMC Public Health, 16(1). doi:10.1186/s12889-016-3316-2Cook, K. A., Modena, B. D., & Simon, R. A. (2016). Improvement in Asthma Control Using a Minimally Burdensome and Proactive Smartphone Application. The Journal of Allergy and Clinical Immunology: In Practice, 4(4), 730-737.e1. doi:10.1016/j.jaip.2016.03.005Cafazzo, J. A., Casselman, M., Hamming, N., Katzman, D. K., & Palmert, M. R. (2012). Design of an mHealth App for the Self-management of Adolescent Type 1 Diabetes: A Pilot Study. Journal of Medical Internet Research, 14(3), e70. doi:10.2196/jmir.2058Riis, A., Hjelmager, D. M., Vinther, L. D., Rathleff, M. S., Hartvigsen, J., & Jensen, M. B. (2018). Preferences for Web-Based Information Material for Low Back Pain: Qualitative Interview Study on People Consulting a General Practitioner. JMIR Rehabilitation and Assistive Technologies, 5(1), e7. doi:10.2196/rehab.8841Goetz, M., Müller, M., Matthies, L. M., Hansen, J., Doster, A., Szabo, A., … Wallwiener, S. (2017). Perceptions of Patient Engagement Applications During Pregnancy: A Qualitative Assessment of the Patient’s Perspective. JMIR mHealth and uHealth, 5(5), e73. doi:10.2196/mhealth.7040Giunti, G., Kool, J., Rivera Romero, O., & Dorronzoro Zubiete, E. (2018). Exploring the Specific Needs of Persons with Multiple Sclerosis for mHealth Solutions for Physical Activity: Mixed-Methods Study. JMIR mHealth and uHealth, 6(2), e37. doi:10.2196/mhealth.8996Aujoulat, I., d’ Hoore, W., & Deccache, A. (2007). Patient empowerment in theory and practice: Polysemy or cacophony? Patient Education and Counseling, 66(1), 13-20. doi:10.1016/j.pec.2006.09.008Waite-Jones, J. M., Majeed-Ariss, R., Smith, J., Stones, S. R., Van Rooyen, V., & Swallow, V. (2018). Young People’s, Parents’, and Professionals’ Views on Required Components of Mobile Apps to Support Self-Management of Juvenile Arthritis: Qualitative Study. JMIR mHealth and uHealth, 6(1), e25. doi:10.2196/mhealth.9179Lubberding, S., van Uden-Kraan, C. 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A Basis for Performance Property Prediction of Ubiquitous Self-Adapting Systems Gunnar Brataas,

Utility-based adaptation approaches permit to determine the “best ” suited variant of an application at run-time. Utility policies are usually specified in terms of resources and QoS dimensions. Although utility policies provide a precise formulation for adaptation decision, they are difficult to specify. The developer especially needs assistance in the specification of performance properties. In this paper, we investigate using a performance engineering framework, for the specification of such properties and identify several open research issues

Integrating SDL and a configuration language

Most methodologies deal with the design and the implementation of an individual system. Traditionally SDL is used to describe the functional properties of one system; from the SDL description a concrete system is derived which implements the defined functionality. In the ESPRIT project PROTEUS, we wanted to support evolving systems i.e. a family of systems from which various instances can be adapted. The PROTEUS Configuration Language, PCL, is a notation for describing and controlling variability. Using PCL, it is also possible to describe files and tools which are used to build executable systems. PCL tools and a flexible SDL code generator support automate system building. This paper presents how we use PCL together with SDL to model variability and automated system building. 1. INTRODUCTION Most methodologies deal with the development of individual systems. However, software products seldom live unchanged after their initial creation. They are typically adapted according to the ne..

Towards Plug-and-Play Services : Design and Validation Using Roles

Today telecommunication service users expect to access a similar set of services independently of what network they happen to use, they expect services to adapt to new surroundings and contexts as they move around, and they expect to get access to new and useful services as soon as they become available. Building services operating satisfactorily under such requirements poses new challenges and requires new solutions and new engineering methods for rapid service development and deployment. The PaP project at NTNU was initiated in order to define a framework for service development and execution that supports the dynamic composition of services using Plug-and- Play techniques. By dynamic composition, we mean that services and service components can be designed separately, and then composed at run-time. In the frame of the PaP project, this doctoral work has addressed two issues: the design and the validation of Plugand- Play services. Service design is complex. In a PaP context, this complexity increases further as services are designed to be dynamically adapted to changing contexts. A design approach based on service roles is proposed, and role composition is proposed as a means to achieve adaptability. We model service role behaviours and their composition using state machines that interact asynchronously. Describing system behaviours in terms of state machines has proven to be of great value, and is widely adopted in most teleservice engineering approaches. We favour the use of the modelling language SDL because of its formal semantics that enables an unambiguous interpretation of the system specification. However, our design and validation results are not bound to SDL. They may be applied on systems specified using other modelling languages that support state machines, as for example UML. In our work, we investigate how SDL-2000 can be used to model composition. Differently from process algebra, SDL and other approaches using state machines do not explicitly define composition operators. By defining design patterns and rules for expressing composition in SDL, this thesis contributes to promote using SDL as a behaviour composition language. SDL is not only a language for the modelling of state machines. SDL-2000 has newly been released, and to the best of our knowledge little experimentation using the new concepts of SDL-2000 has been done. We propose original and innovative employment of some of the newly introduced SDL concepts, that should be of interest for the SDL community. Dynamic composition of services requires incremental and compositional validation methods. It should be possible to validate components introduced in a system at run-time, and to restrict the analysis to the parts of the system affected by the dynamic modifications. This thesis proposes a validation approach suited for dynamic service composition. Validation analysis is complex and requires simplification. Two simplification schemes, projection and incrementation, are proposed. Projection and incrementation are two main contributions of this thesis: • A projection is a simplified system description or viewpoint that emphasises some system properties while hiding some others. Rather than analysing the whole system, projections are analysed. In our work, the projection only retains the aspects significant for the purpose of validation of associations between service roles. • Incrementation means that validation can be applied incrementally. The proposed validation approach is tightly integrated with the composition of service roles. Elementary roles are first validated, and then the roles composed of elementary roles, and then the composite of composites. In that way, the proposed validation techniques enable us to validate parts of systems and the composition of system parts. Another contribution of this thesis are design rules that enable the designer to avoid making certain dynamic errors and to develop well-formed state machines. Error search is not postponed until after the specification phase: ambiguous and conflicting behaviours can be identified already at design time. The projection of service roles lead to interface descriptions that are described using state machines. In that way, our interface descriptions overcome the limitations of static object interfaces. In our work, the interface descriptions represent the dynamic behaviour of interactions between service roles. It is also possible to determine required interfaces from provided interfaces. The results of this thesis should then be of interest for the research related to the definition of semantic interfaces. A major concern in our work has been to provide validation techniques that are easy to understand and apply. Current verification and validation techniques often require high competence and knowledge in formal modelling and reasoning on the part of the system developer, and their use in the software industry is rather moderate. We believe that our approach, although thoroughly justified, remains easy to understand and use. In that way, the applicability of the proposed approach is wider than the context of dynamic validation. It should also be of interest for the validation of static systems

Co-designing a mHealth Application for Self-management of Cystic Fibrosis

Self-management has the potential to improve patient care and decrease healthcare costs. It is especially beneficial for patients suffering from chronic diseases that require continuous therapy and follow-up such as cystic fibrosis (CF). Mobile phones have become pervasive and, therefore, are perfectly suited for self-management. However, due to the large amount of time CF patients spend in their treatment, usability and usefulness are critical factors for the adoption of an assistive mobile application (App). In our work, we applied co-design in the development of high fidelity mockups for a CF Self-management App. The co-design was conducted as a series of workshops involving CF patients, theirs parents, as well as health professionals, from multiple countries in Europe. The results include design concepts and User Interface elements that conciliate the different perspectives between the stakeholders. This paper describes the co-design process, the resulting design and further considerations which emerged along the process.acceptedVersio