It's LiFe! Mobile and Web-Based Monitoring and Feedback Tool Embedded in Primary Care Increases Physical Activity: A Cluster Randomized Controlled Trial

BackgroundPhysical inactivity is a major public health problem. The It’s LiFe! monitoring and feedback tool embedded in the Self-Management Support Program (SSP) is an attempt to stimulate physical activity in people with chronic obstructive pulmonary disease or type 2 diabetes treated in primary care.ObjectiveOur aim was to evaluate whether the SSP combined with the use of the monitoring and feedback tool leads to more physical activity compared to usual care and to evaluate the additional effect of using this tool on top of the SSP.MethodsThis was a three-armed cluster randomised controlled trial. Twenty four family practices were randomly assigned to one of three groups in which participants received the tool + SSP (group 1), the SSP (group 2), or care as usual (group 3). The primary outcome measure was minutes of physical activity per day. The secondary outcomes were general and exercise self-efficacy and quality of life. Outcomes were measured at baseline after the intervention (4-6 months), and 3 months thereafter.ResultsThe group that received the entire intervention (tool + SSP) showed more physical activity directly after the intervention than Group 3 (mean difference 11.73, 95% CI 6.21-17.25; P<.001), and Group 2 (mean difference 7.86, 95% CI 2.18-13.54; P=.003). Three months after the intervention, this effect was still present and significant (compared to Group 3: mean difference 10.59, 95% CI 4.94-16.25; P<.001; compared to Group 2: mean difference 9.41, 95% CI 3.70-15.11; P<.001). There was no significant difference in effect between Groups 2 and 3 on both time points. There was no interaction effect for disease type.ConclusionsThe combination of counseling with the tool proved an effective way to stimulate physical activity. Counseling without the tool was not effective. Future research about the cost-effectiveness and application under more tailored conditions and in other target groups is recommended.

Trial Registration

ClinicalTrials.gov: {"type":"clinical-trial","attrs":{"text":"NCT01867970","term_id":"NCT01867970"}}NCT01867970, https://clinicaltrials.gov/ct2/show/{"type":"clinical-trial","attrs":{"text":"NCT01867970","term_id":"NCT01867970"}}NCT01867970 (archived by WebCite at http://www.webcitation.org/6a2qR5BSr).     

Patient and Provider Attitudes Toward the Use of Patient Portals for the Management of Chronic Disease: A Systematic Review

Background

Patient portals provide patients with the tools to better manage and understand their health status. However, widespread adoption of patient portals faces resistance from patients and providers for a number of reasons, and there is limited evidence evaluating the characteristics of patient portals that received positive remarks from patients and providers.

Objective

The objectives of this systematic review are to identify the shared characteristics of portals that receive favorable responses from patients and providers and to identify the elements that patients and providers believe need improvement.

Methods

The authors conducted a systematic search of the CINAHL and PubMed databases to gather data about the use of patient portals in the management of chronic disease. Two reviewers analyzed the articles collected in the search process in order remove irrelevant articles. The authors selected 27 articles to use in the literature review.

Results

Results of this systematic review conclude that patient portals show significant improvements in patient self-management of chronic disease and improve the quality of care provided by providers. The most prevalent positive attribute was patient-provider communication, which appeared in 10 of 27 articles (37%). This was noted by both patients and providers. The most prevalent negative perceptions are security (concerns) and user-friendliness, both of which occurred in 11 of 27 articles (41%). The user-friendliness quality was a concern for patients and providers who are not familiar with advanced technology and therefore find it difficult to navigate the patient portal. The high cost of installation and maintenance of a portal system, not surprisingly, deters some providers from implementing such technology into their practice, but this was only mentioned in 3 of the 27 articles (11%). It is possible that the incentives for meaningful use assuage the barrier of cost.

Conclusions

This systematic review revealed mixed attitudes from patients and their providers regarding the use of patient portals to manage their chronic disease. The authors suggest that a standard patient portal design providing patients with the resources to understand and manage their chronic conditions will promote the adoption of patient portals in health care organizations.     

3D技术打印椎体在全脊椎整块切除术中应用的初步探索

目的初步探索3D技术打印椎体在全脊椎整块切除术(Total en bloc spondylectomy,TES)中应用的可行性。方法选取广东紫金蓝塘土猪3只,T12、L1椎体进行后路全椎体切除术,置入3D打印假体,于T11、L2进行双侧椎弓根螺钉固定。观察术后土猪活动度、脊柱影像、双后腿痛觉和肌力。术后4月时处死,观察实体标本情况。结果手术成功,术后猪双后腿活动、痛觉良好。正侧位X片及CT三维重建,实物脊柱3D打印椎体-脊柱复合体观察,提示假体位置、椎间高度、脊椎序列完好。结论 3D技术打印椎体在临床脊柱全椎体切除术中的应用具有可行性,但需充分做好术前准备,如抗感染、补充血容量、假体型号合适、手术器械齐全等,才能保证手术的顺利完成。     

基于课堂视频分析的信息技术与音乐深层整合的研究

信息技术以其突出的优势对中小学音乐教学产生了很大的影响,而在其与音乐课程整合的过程中,所暴露的不足也不容忽视。文章以基于设计的研究为研究范式,建构出深度交融的教学内容,以进行创新教学形式的探索。经过 ITIAS 课堂互动系统的综合分析表明：信息技术和音乐课程的整合教学,不仅营造了信息化的教学环境,更构建了主导—主体相结合的教学结构,也切实提高了学生学习两课程的兴趣。     

教育技术:一种制造“人-机”系统的技术

在教育技术的研究和发展中,系统科学理论及其方法论一直起到非常重要的作用,有着极其深远的意义。文章以系统科学为基础,从教育技术"94定义"与钱学森技术系统定义对比和一些学者的看法这两个方面,指出可把教育技术看作制造教育技术系统的系统方法,然后从教育技术"人-机"系统概念界定、多数教育技术系统是教育技术"人-机"系统、学习者与学习环境整合为一个系统较合理以及教育技术重新解读四方面展开论述,得出教育技术不仅是制造教育技术系统的技术,而且绝大多数的教育技术系统主要是教育技术"人-机"系统,并进而对教育技术的内涵给予了新的解读,以期对教育技术研究及学科发展有所促进。     

医疗美容技术专业教学模式改革调查问卷分析

针对2010~2012级医疗美容技术专业160名学生的问卷调查,了解不同级段学生对该专业教学模式改革的认识以及分析调查出现的问题,提出一些合理化的建议和意见.     

浅谈CAI在胸心外科教学应用中的利弊考量

目的：探讨并分析CAI应用于胸心外科教学的利弊。方法结合教学实践,总结CAI应用在心胸外科教学中的优势和弊端,探讨科学合理应用CAI和高教学质量的对策。结果 CAI存在一定的优势,也存在弊端,但优势大于弊端。结论应在胸心外科教学中充分发挥CAI的优势,并规避其弊端,做到科学合理使用CAI,进而提升教学效果。     

非平衡态热力学理论在证候热力学研究中的应用

引入非平衡态热力学理论,诠释中医阴阳理论.借助红外成像获得的人体体表脏腑三焦等对应区域热值数据和排序,以坐标图形式表达人体区域热值数据高低(人体热结构),确立中医证候热力学研究的思路和方法,提出健康人脏腑三焦等人体热结构符合耗散结构,不同证候出现不同人体热结构,辨证论治就是根据脏腑寒热偏离,用中医方法恢复人体正常热结构的调整.     

The effect of vitamin D supplementation on cardiorespiratory fitness and muscle strength in male adults undergoing basic military training

BackgroundVitamin D deficiency (VDD) is ubiquitous in the Indian subcontinent. VDD has been shown to impair muscle functions. However, the association of VDD with cardiorespiratory endurance is uncertain. Hence, we enrolled and supplemented vitamin D in military recruits with VDD with an aim to evaluate effect of supplementation on cardiorespiratory endurance and muscle strength.MethodWe enrolled 90 military recruits with VDD and randomly allotted them to two groups equally. The group I received cholecalciferol granules 60,000 IU every fortnight for twelve weeks (cases), and the group II was observed as control. Muscle strength and cardiorespiratory endurance was assessed with a battery of tests (standing broad jump, bent arm hang test, 20 m shuttle run) at baseline and repeated at the end of training (nineteen weeks). Blood samples were collected for measurement of serum 25(OH)D and parathyroid hormone.ResultsIn Group I and Group II, there was significant increase in 25(OH) D levels (25.8 ± 7.1 and 17.3 ± 3.5 ng/ml, respectively), and in VO2 max (9.8 ± 8.8 and 12.7 ± 8.6 ml/kg/min, respectively) compared with the baseline values. However, no significant change was observed in muscle strength after supplementation. There was no difference between the groups in VO2 max and muscle strength at baseline and at the end of training.ConclusionVitamin D supplementation did not improve muscle strength and cardiorespiratory endurance in military recruits with VDD. A significant rise in 25(OH) D was observed even in those not supplemented with vitamin D.