What spaces? Designing authentic, sustainable online learning spaces for children with diabetes

This paper presents a work-in-progress of how social networking, Web 2.0 and emerging communication technologies might be successfully used to support authentic self-management education for children aged 11-13 years who are living with Type 1 diabetes. The study employs a mixed-method approach that has been adopted within a Design Based Research framework. This paper explains the research problem, the theoretical framework that will underpin the study and the overall research design

A social networking website that provides educational support to children living with Type 1 diabetes

Increasing access and use of social networking websites and tools by young people is enabling new opportunities for use in health care (Kamel Boulos & Wheeler, 2007). But, little is known about how these technologies can be used by hospital-based clinicians for the purposes of communicating, educating and supporting young people. Thus the research study reported in this case study investigated how to design, build and implement a hospital-based social networking website for children and adolescents to interact with clinicians and themselves. This case explains how the site was designed to support children living with Type 1 diabetes using an iterative research design process, the decisions made during this time, and the experiences of the clinicians as the website was implemented. Additionally the chapter describes the design principles and processes necessary for successful social networking websites that support young people living with diabetes

Identification of design principles for effective Internet-based education to support young people living with diabetes

Internet-based communication technologies and participatory software tools have created new opportunities for teaching and learning. Research determining the principles required for effective application of these innovations for children and adolescents is limited. This study focused on determining the principles required for effective and appropriate use Internet-based communication technologies for the education and support of young people living with diabetes. Type 1 diabetes is a life threatening disease, thus education aimed at developing competent self-management behaviours is vital in order to avoid serious complications (Court, Cameron, Berg-Kelly, & Swift, 2009; DCCT, 1993). Existing diabetes education models are often limited, yet there are calls for more accessible, ongoing, and adaptable education, which is integrated into routine clinical care (Swift, 2009). The Internet provides an opportunity to provide ongoing patient-centred education, but there has been little exploration of how Internet-based communication technologies can be used to provide effective, sustained, and accessible diabetes education. Thus the focus of this study was to identify the design principles that underpin an effective Internet-based learning environment about diabetes specifically aimed at children and adolescents. Two research questions guided this research: 1. What are the critical design principles and characteristics of Internet-based learning environments for young people who are living with type 1 diabetes? 2. What factors and processes do designers need to consider when building an online learning environment for young people living with Type 1 diabetes? Children aged 11-13 years were the focus of this study, and the setting was the Diabetes Unit at the Women\u27s and Children\u27s Hospital in Adelaide, South Australia. A pragmatic mixed-method approach was adopted and conducted in four Phases using a Design-Based Research framework. Phase 1 focused on determining design and implementation issues from the perspectives of the key stakeholders: children, parents, young diabetic adults, and clinicians. Formative evaluation methods were used in Phase 2 to develop a prototype Internet-based learning environment intervention. Phase 3 involved two cycles of testing and refinement of the prototype design solution. Cycle 1 consisted of a four-week implementation with six children, with a primary focus on the usability of the online learning environment. Refinements were made to the prototype design, and a revised prototype was tested in Cycle 2 with 10 children over nine weeks. The evaluation of Cycle 2 focused on the effectiveness of the online learning environment in terms of its potential as a learning tool. Key findings from the study included the importance of creating and supporting secure, private Internet-based social connections between children. New links between children, parents and clinicians were created and highly valued, and pedagogies that focus on authentic shared learning activities that are based on real-life problems resulted in diabetes self-management competency development. A reflection of the findings was conducted in Phase 4 culminating into four design principles being recommended: 1. Enable ways to provide secure online social interactions for young people and parents 2. Actively involve and support parents 3. Provide engaging real-life learning contexts that facilitate diabetes selfmanagement competencies 4. Implement expert coaching, guidance, and facilitate access to modelling. This study has demonstrated that new and emerging Internet-based communication technologies can address the considerable problems of providing ongoing and effective hospital-based diabetes education and psychosocial support for young people living with diabetes. Recommendations for future research include further refinements of the design, implementation for longer periods of time and in wider contexts, and support for clinicians in the use of Internet-based learning environments is essential

Bloody Good! The Impact of eLearning on Medical and Nursing Practice

Blood transfusion is a commonly-performed medical procedure that improves and saves the lives of patients. However, this procedure also has significant risks, is sometimes used inappropriately and has substantial costs associated with the collection, testing, processing and distribution of blood and blood products.BloodSafe eLearning Australia (BEA) (www.bloodsafelearning.org.au) is an education program for Australian doctors, nurses and midwives, designed to improve the safety and quality of clinical transfusion practice. Courses are interactive and include case studies, videos, and best-practice tips. Successful completion of a multiple-choice assessment provides learners with a certificate of completion. To date there are more than 400,000 registered learners, from more than 1500 organisations, who have completed more than 765,000 courses.Stakeholder feedback shows that the program: provides credible, consistent education across Australia; is cost effective; reduces duplication; is ‘best-practice’ elearning that is readily accessible; allows institutions to focus on practical aspects of transfusion education; results in change to clinical practice; and supports the broader implementation of a blood management strategy in Australia.User evaluation shows that the courses have a positive impact, with 89% of respondents stating they had gained additional knowledge of transfusion practice, processes and/or policy and more than 87% reporting they will make, or have made, changes to their work practices which will improve patient safety and outcomes.The BloodSafe eLearning Australia program provides education to a large number of health professionals across Australia. Evaluation demonstrates that these courses provide users with a consistent and reliable knowledge base that translates into changes to practice and improved patient outcomes

Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation

BACKGROUND: Sleep disturbance is associated with inflammatory disease risk and all-cause mortality. Here, we assess global evidence linking sleep disturbance, sleep duration, and inflammation in adult humans. METHODS: A systematic search of English language publications was performed, with inclusion of primary research articles that characterized sleep disturbance and/or sleep duration or performed experimental sleep deprivation, and assessed inflammation by levels of circulating markers. Effect sizes (ES) and 95% confidence intervals (CI) were extracted and pooled using a random effect model. RESULTS: A total of 72 studies (n>50000) were analyzed with assessment of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor α (TNF). Sleep disturbance was associated with higher levels of CRP (ES 0.12; 95% CI 0.05 – 0.19) and IL-6 (ES 0.20; 95% CI 0.08 – 0.31). Shorter sleep duration, but not the extreme of short sleep, was associated with higher levels of CRP (ES 0.09; 95% CI 0.01 – 0.17) but not IL-6 (ES 0.03; 95% CI −0.09 – 0.14). The extreme of long sleep duration was associated with higher levels of CRP (ES 0.17; 95% CI 0.01 – 0.34) and IL-6 (ES 0.11; 95% CI 0.02 – 0.20). Neither sleep disturbances nor sleep duration was associated with TNF. Neither experimental sleep deprivation nor sleep restriction was associated with CRP, IL-6, or TNF. Some heterogeneity among studies was found, but no evidence of publication bias. CONCLUSIONS: Sleep disturbance and long sleep duration, but not short sleep duration, are associated with increases in markers of systemic inflammation