3,214 research outputs found
Findings from a pilot randomised trial of an asthma internet self-management intervention (RAISIN)
<b>Objective </b>To evaluate the feasibility of a phase 3
randomised controlled trial (RCT) of a website (Living
Well with Asthma) to support self-management.<p></p>
<b>Design and setting</b> Phase 2, parallel group, RCT,
participants recruited from 20 general practices across
Glasgow, UK. Randomisation through automated voice
response, after baseline data collection, to website
access for minimum 12 weeks or usual care.<p></p>
<b>Participants </b>Adults (age≥16 years) with physician
diagnosed, symptomatic asthma (Asthma Control
Questionnaire (ACQ) score ≥1). People with unstable
asthma or other lung disease were excluded.<p></p>
<b>Intervention</b> Living Well with Asthma’ is a desktop/
laptop compatible interactive website designed with
input from asthma/ behaviour change specialists, and
adults with asthma. It aims to support optimal
medication management, promote use of action plans,
encourage attendance at asthma reviews and increase
physical activity.<p></p>
<b>Outcome measures</b> Primary outcomes were
recruitment/retention, website use, ACQ and mini-
Asthma Quality of Life Questionnaire (AQLQ).
Secondary outcomes included patient activation,
prescribing, adherence, spirometry, lung inflammation
and health service contacts after 12 weeks. Blinding
postrandomisation was not possible.<p></p>
<b>Results </b>Recruitment target met. 51 participants
randomised (25 intervention group). Age range
16–78 years; 75% female; 28% from most deprived
quintile. 45/51 (88%; 20 intervention group) followed
up. 19 (76% of the intervention group) used the
website, for a mean of 18 min (range 0–49). 17 went
beyond the 2 ‘core’ modules. Median number of logins
was 1 (IQR 1–2, range 0–7). No significant difference
in the prespecified primary efficacy measures of ACQ
scores (−0.36; 95% CI −0.96 to 0.23; p=0.225), and
mini-AQLQ scores (0.38; −0.13 to 0.89; p=0.136). No
adverse events.<p></p>
<b>Conclusions</b> Recruitment and retention confirmed
feasibility; trends to improved outcomes suggest use of
Living Well with Asthma may improve self-management
in adults with asthma and merits further development
followed by investigation in a phase 3 trial
Empirical Studies of Evolving Systems
This paper describes the results of the working group investigating the issues of empirical studies for
evolving systems. The groups found that there were many issues that were central to successful evolution and this
concluded that this is a very important area within software engineering. Finally nine main areas were selected for consideration. For each of these areas the central issues were identified as well as success factors. In some cases success stories were also described and the critical factors accounting for the success analysed. In some cases it was later found that a number of areas were so tightly coupled that it was important to discuss them together
MOTOR CONTROL PATTERNS IN ELITE SWIMMERS’ FREESTYLE STROKE DURING DRYLAND SWIMMING
The purpose of this study was to compare motor control patterns of elite freestyle swimmers when asked to swim at 100m freestyle pace using a dryland swimbench. Collegiate and masters level swimmers (n=15) whose 100m freestyle time were faster than 75% of the FINA cutoff time, performed four 10 second trials of freestyle swimming on a dryland swimbench. 3-D kinematic analysis was used to calculate displacement in the hand in the cranial-caudal, vertical, and medial-lateral directions. A 2-way repeated measures ANOVA was used to compare hand path between swimmers and within trials (n=58). Data was not statically significant, but three distinct combinations of hand paths were used to perform the 100m freestyle task on the swimbench. These hand paths differed from historical in-water data. Findings imply individual swimmers adjusted kinematics on the swimbench to accommodate for environmental constraints
From theory to 'measurement' in complex interventions: methodological lessons from the development of an e-health normalisation instrument
<b>Background</b> Although empirical and theoretical understanding of processes of implementation in health care is advancing, translation of theory into structured measures that capture the complex interplay between interventions, individuals and context remain limited. This paper aimed to (1) describe the process and outcome of a project to develop a theory-based instrument for measuring implementation processes relating to e-health interventions; and (2) identify key issues and methodological challenges for advancing work in this field.<p></p>
<b>Methods</b> A 30-item instrument (Technology Adoption Readiness Scale (TARS)) for measuring normalisation processes in the context of e-health service interventions was developed on the basis on Normalization Process Theory (NPT). NPT focuses on how new practices become routinely embedded within social contexts. The instrument was pre-tested in two health care settings in which e-health (electronic facilitation of healthcare decision-making and practice) was used by health care professionals.<p></p>
<b>Results</b> The developed instrument was pre-tested in two professional samples (N = 46; N = 231). Ratings of items representing normalisation 'processes' were significantly related to staff members' perceptions of whether or not e-health had become 'routine'. Key methodological challenges are discussed in relation to: translating multi-component theoretical constructs into simple questions; developing and choosing appropriate outcome measures; conducting multiple-stakeholder assessments; instrument and question framing; and more general issues for instrument development in practice contexts.<p></p>
<b>Conclusions</b> To develop theory-derived measures of implementation process for progressing research in this field, four key recommendations are made relating to (1) greater attention to underlying theoretical assumptions and extent of translation work required; (2) the need for appropriate but flexible approaches to outcomes measurement; (3) representation of multiple perspectives and collaborative nature of work; and (4) emphasis on generic measurement approaches that can be flexibly tailored to particular contexts of study
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