Kawasaki Disease

Kawasaki disease is an acute febrile, systemic vasculitic syndrome of an unknown etiology that primarily occurs in children younger than five years of age. The principal presentations of Kawasaki disease include fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develops in 15% to 25% of untreated children with the disease, which may later lead to myocardial infarction, sudden death, or ischemic heart disease. Treatment with intravenous gamma globulin (IVIG) is effective, but the mode of action is still unclear. The development of a diagnostic test, a more specific therapy, and ultimately the prevention of this potentially fatal illness in children are all dependent upon the continued advances in determining the etiopathogenesis of this fascinating disorder

Studying usage and experiences of mHealth technology for its improved usability - Mixed methods research for understanding users’ long-term engagement with the Few Touch application for self-management of Type 2 diabetes mellitus -

In spite of a number of mHealth (use of mobile computing for health care) studies targeting people with diabetes, there has not yet been any clear evidence of its effect. Due to obscurity regarding subjects’ engagement with each component of the provided technology, it is not clear which factors are important and why. Considering that behavior change is a path of improvement in self-management of Type 2 diabetes mellitus (T2DM), it is crucial to investigate users’ usage and experiences of mHealth technology over time. Furthermore, ensuring usability of a technology is essential for the initial uptake and continuous usage of it. This research was conducted in three phases using mixed methods research. In Phases 1 and 2, long-term trials of a mobile phone-based self-help application “the Few Touch application” were carried out by involving two different user groups: one had been involved in the design process from an early stage and the other had not. In Phase 3, design of a food-information database module as a part of improvement of the Few Touch application was carried out by involving users and non-users. The study empirically showed the following: the users basically used and experienced the Few Touch application as a flexible learning tool in terms of self-management of T2DM. Patterns and degrees of usage varied a lot among users and they changed over time depending on each user’s needs and background both directly and indirectly relevant to T2DM. This was because motivation for continuation of usage was a result of balancing between expected benefit and effort required to use it. Usability of the technology could be improved by designing it so that it simplifies tedious self-management activities without posing extra effort to use the technology while it enhances the learning process and maximizes its learning effect

Survey of eHealth Use Among First-generation Pakistani Immigrants in Oslo Area With Focus on Diabetes, 2016

The purpose of the project is to investigate how first-generation immigrants from Pakistan in the Oslo area perceive and/or use ICT for diabetes-related purposes. The survey was conducted in 2015-2016 with a selection of 176 participants. The report contains descriptive results for the study that was not published in scientific articles. Pakistani immigrants living in the Oslo area have a much higher risk of Type 2 diabetes than their Norwegian counterparts. This group also reports relatively low ICT skills. The project examines the use and attitudes towards eHealth services, specifically: information searches, communication using ICT and the use of ICT for self-management or decision-making, all concerning Type 2 diabetes. For eHealth to become an influential social innovation, equal access to eHealth services regardless of the users' language, culture and ICT skills is a prerequisite. Results from this study are important for understanding how perople who may not maximally benefit from eHealth services today can be targeted in the future. Data are freely available for downloading

Cultivating a Universal Design Mindset in Young Students

Universal Design (UD) is an approach to promoting an inclusive society with equity as a central focus. With trends in globalization and population aging , it is critical to cultivate a UD-oriented mindset among younger people who will be responsible for promoting a more democratic and sustainable society. However, the challenge remains to convince students in higher education of the importance of UD . One potential reason is the common misunderstanding that UD is only dedicated to persons with disabilities, and thus, possibly due to the social stigma associated with disability, students deem UD irrelevant in many cases. Another potential reason is an unfamiliarity with the principles associated with UD as well as situations where they experience any inability or discomfort using a non-universally designed product, service or environment. On the other hand, human/user-centered design (UCD) is supported by the ISO standard 9241-210:2010 and has been more widely recognized as a fundamental approach to successful design and development of a product, especially in the field of human-computer interaction. The lack of a UD-oriented mindset may unconsciously limit the image of “users” within their knowledge, and hence the potential diversity in user traits or use situations could be neglected. In other words, if the students experience UD as beneficial for themselves, it could provide a useful basis for recognizing the importance and impact of UD. By taking two international student projects as cases, this study retrospectively discusses how such tactics may effectively cultivate a UD mindset among graduate-level students

Long-Term Engagement With a Mobile Self-Management System for People With Type 2 Diabetes

BACKGROUND: In a growing number of intervention studies, mobile phones are used to support self-management of people with Type 2 diabetes mellitus (T2DM). However, it is difficult to establish knowledge about factors associated with intervention effects, due to considerable differences in research designs and outcome measures as well as a lack of detailed information about participants’ engagement with the intervention tool. OBJECTIVE: To contribute toward accumulating knowledge about factors associated with usage and usability of a mobile self-management application over time through a thorough analysis of multiple types of investigation on each participant’s engagement. METHODS: The Few Touch application is a mobile-phone–based self-management tool for patients with T2DM. Twelve patients with T2DM who have been actively involved in the system design used the Few Touch application in a real-life setting from September 2008 until October 2009. During this period, questionnaires and semistructured interviews were conducted. Recorded data were analyzed to investigate usage trends and patterns. Transcripts from interviews were thematically analyzed, and the results were further analyzed in relation to the questionnaire answers and the usage trends and patterns. RESULTS: The Few Touch application served as a flexible learning tool for the participants, responsive to their spontaneous needs, as well as supporting regular self-monitoring. A significantly decreasing (P<.05) usage trend was observed among 10 out of the 12 participants, though the magnitude of the decrease varied widely. Having achieved a sense of mastery over diabetes and experiences of problems were identified as reasons for declining motivation to continue using the application. Some of the problems stemmed from difficulties in integrating the use of the application into each participant’s everyday life and needs, although the design concepts were developed in the process where the participants were involved. The following factors were identified as associated with usability and/or usage over time: Integration with everyday life; automation; balance between accuracy and meaningfulness of data with manual entry; intuitive and informative feedback; and rich learning materials, especially about foods. CONCLUSION: Many grounded design implications were identified through a thorough analysis of results from multiple types of investigations obtained through a year-long field trial of the Few Touch application. The study showed the importance and value of involving patient-users in a long-term trial of a tool to identify factors influencing usage and usability over time. In addition, the study confirmed the importance of detailed analyses of each participant’s usage of the provided tool for better understanding of participants’ engagement over time

eHealth Use Among First-Generation Immigrants From Pakistan in the Oslo Area, Norway, With Focus on Diabetes: Survey Protocol

Background: A variety of eHealth services are available and commonly used by the general public. eHealth has the potential to engage and empower people with managing their health. The prerequisite is, however, that eHealth services are adapted to the sociocultural heterogeneity of the user base and are available in a language and with contents that fit the users’ preference, skills, and abilities. Pakistani immigrants in the Oslo area, Norway, have a much higher risk of Type-2 diabetes (T2D) than their Norwegian counterparts do. In spite of having access to information and communication technology (ICT) and the Internet, ICT skills in this population are reported to be relatively low. Further, there is insufficient information about their use of and attitudes toward eHealth services, necessitating investigation of this group in particular. Objective: This study targets first-generation immigrants from Pakistan living in the Oslo area and examines their use of and attitudes toward eHealth services, specifically: information searches, communication using ICT, and use of ICT for self-management or decision making, all concerning T2D. Methods: Due to a high prevalence of low literacy among the target population, we employed questionnaire-based individual interviews. The questionnaire was developed by implementing potentially relevant theoretical constructs (technology acceptance model (TAM) and health belief model (HBM)) as measures. To explore issues around language, culture, and general ICT skills, we also implemented questions that we assume were particularly relevant in the context studied but do not appear in any theoretical frameworks. The questionnaire was revised to reflect results of a pilot study involving 10 participants. We employed culturally sensitive sampling methods to reach informants who could otherwise fail to be included in the survey. Results: This paper presents a survey protocol. The data collection is ongoing. The aim is to collect 200 responses in total by March 2016. Conclusions: For eHealth to become an influential social innovation, equal access to eHealth services regardless of users’ language, culture, and ICT skills is a prerequisite. Results from this study will be of importance for understanding how people who may not maximally benefit from eHealth services today could be targeted in the future