Effectiveness of balance training on pain and functional outcomes in knee osteoarthritis: A systematic review and meta-analysis [version 2; peer review: 2 approved, 1 approved with reservations]

Background: Knee osteoarthritis (OA) is a musculoskeletal disorder that causes pain and increasing loss of function, resulting in reduced proprioceptive accuracy and balance. Therefore, the goal of this systematic review and meta-analysis is to evaluate the effectiveness of balance training on pain and functional outcomes in knee OA. Methods: “PubMed”, “Scopus”, “Web of Science”, “Cochrane”, and “Physiotherapy Evidence Database” were searched for studies conducted between January 2000 and December 2021. Randomized controlled trials (RCTs) that investigated the effectiveness of balance training in knee OA, as well as its effects on pain and functional outcome measures, were included. Conference abstracts, case reports, observational studies, and clinical commentaries were not included. Meta-analysis was conducted for the common outcomes, i.e., Visual Analog Scale (VAS), The Timed Up and Go (TUG), Western Ontario and McMaster Universities Arthritis Index (WOMAC). The PEDro scale was used to determine the quality of the included studies. Results: This review includes 22 RCTs of which 17 articles were included for meta-analysis. The included articles had 1456 participants. The meta-analysis showed improvement in the VAS scores in the experimental group compared to the control group [I 2= 92%; mean difference= -0.79; 95% CI= -1.59 to 0.01; p<0.05] and for the WOMAC scores the heterogeneity (I 2) was 81% with a mean difference of -0.02 [95% CI= -0.44 to 0.40; p<0.0001]. The TUG score was analyzed, the I 2 was 95% with a mean difference of -1.71 [95% CI= -3.09 to -0.33; p<0.0001] for the intervention against the control group. Conclusions: Balance training significantly reduced knee pain and improved functional outcomes measured with TUG. However, there was no difference observed in WOMAC. Although due to the heterogeneity of the included articles the treatment impact may be overestimated. Registration: The current systematic review was registered in PROSPERO on 7th October 2021 (registration number CRD42021276674)

Building Theoretical Foundations for Electronic Governance Benchmarking

Part 1: FoundationsInternational audienceThe success of the electronic governance (EGOV) benchmarking has been limited so far. Lacking a theory to integrate existing conceptualizations has made the acquisition and sharing of knowledge produced by different benchmarking exercises difficult. In order to address this problem, this paper: 1) explains the nature of the EGOV benchmarking activity though a wellestablished theoretical framework - Activity Theory, 2) applies the framework to carry out a mapping between a number of existing EGOV benchmarking conceptualizations, 3) develops an unified conceptualization based on these mappings and 4) validates the resulting model though a real-life national EGOV strategy development project. The use of the Activity Theory in the paper has enabled defining and relating initial dimensions of the EGOV benchmarking activity, and mapping the dimensions present in existing conceptualizations. This not only created a unifying theoretical basis for conceptualizing the EGOV benchmarking activity but allowed learning from and integrating existing conceptualizations. The work impacts on the EGOV benchmarking practice by enabling a logical design of the activity, and contextually correct understanding of existing EGOV benchmarking results with respect to their intended usage

Building Theoretical Foundations for Electronic Governance Benchmarking

The success of the electronic governance (EGOV) benchmarking has been limited so far. Lacking a theory to integrate existing conceptualizations has made the acquisition and sharing of knowledge produced by different benchmarking exercises difficult. In order to address this problem, this paper: 1) explains the nature of the EGOV benchmarking activity though a well-established theoretical framework - Activity Theory, 2) applies the framework to carry out a mapping between a number of existing EGOV benchmarking conceptualizations, 3) develops an unified conceptualization based on these mappings and 4) validates the resulting model though a real-life national EGOV strategy development project. The use of the Activity Theory in the paper has enabled defining and relating initial dimensions of the EGOV benchmarking activity, and mapping the dimensions present in existing conceptualizations. This not only created a unifying theoretical basis for conceptualizing the EGOV benchmarking activity but allowed learning from and integrating existing conceptualizations. The work impacts on the EGOV benchmarking practice by enabling a logical design of the activity, and contextually correct understanding of existing EGOV benchmarking results with respect to their intended usage

eHealth Technology Competencies for Health Professionals Working in Home Care to Support Older Adults to Age in Place: Outcomes of a Two-Day Collaborative Workshop

Background: The demand for care is increasing, whereas in the near future the number of people working in professional care will not match with the demand for care. eHealth technology can help to meet the growing demand for care. Despite the apparent positive effects of eHealth technology, there are still barriers to technology adoption related to the absence of a composite set of knowledge and skills among health care professionals regarding the use of eHealth technology. Objective: The objective of this paper is to discuss the competencies required by health care professionals working in home care, with eHealth technologies such as remote telecare and ambient assisted living (AAL), mobile health, and fall detection systems. Methods: A two-day collaborative workshop was undertaken with academics across multiple disciplines with experience in working on funded research regarding the application and development of technologies to support older people. Results: The findings revealed that health care professionals working in home care require a subset of composite skills as well as technology-specific competencies to develop the necessary aptitude in eHealth care. This paper argues that eHealth care technology skills must be instilled in health care professionals to ensure that technologies become integral components of future care delivery, especially to support older adults to age in place. Educating health care professionals with the necessary skill training in eHealth care will improve service delivery and optimise the eHealth care potential to reduce costs by improving efficiency. Moreover, embedding eHealth care competencies within training and education for health care professionals ensures that the benefits of new technologies are realized by casting them in the context of the larger system of care. These care improvements will potentially support the independent living of older persons at home. Conclusions: This paper describes the health care professionals’ competencies and requirements needed for the use of eHealth technologies to support elderly adults to age in place. In addition, this paper underscores the need for further discussion of the changing role of health care professionals working in home care within the context of emerging eHealth care technologies. The findings are of value to local and central government, health care professionals, service delivery organizations, and commissioners of care to use this paper as a framework to conduct and develop competencies for health care professionals working with eHealth technologies

Grundlagen des Benchmarkings

Der Begriff Benchmarking, nach dem heutigen Verständnis wurde vor allem durch die US-Firma Xerox maßgebend geprägt. Robert C. Camp, Manager bei Xerox, bezeichnete Benchmarking als „die Suche nach den besten Industriepraktiken, die zu Spitzenleistungen führen“. Darauf folgten viele verschiedene Definitionen dieses Begriffes als auch abgeleitete Ziele, die im Wesentlichen auf die Arbeit von Camp zurückzuführen sind. Über die Zeit erfolgte eine Erweiterung des Konzeptes vom reinen Vergleichsinstrument hin zur Managementmethode, die zum organisationalen Lernen sowie zur positiven Entwicklung der Organisation beiträgt. Dabei wurde Benchmarking aus verschiedenen Perspektiven betrachtet und in neue Anwendungsfelder eingeführt. Hierzu wird in der Literatur und der unternehmerischen Praxis zwischen unterschiedlichen Arten von Benchmarking-Objekten und -Partnern unterschieden. Die Basis für die Durchführung eines Benchmarking bildet in der Regel ein strukturierter, mehrstufiger Prozess, der sogenannte Benchmarking -Prozess. Als Orientierungshilfe für die Entwicklung eines Benchmarkings dient dabei häufig der PDCA-Zyklus nach Deming, entnommen aus dem Total Quality Management (TQM). Der PDCA-Zyklus beschreibt einen kontinuierlichen Prozess ohne Endzustand. Es ist Aufgabe der Unternehmen sich durchgehend weiterzuentwickeln und ständige Verbesserung anzustreben