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• The use of the ProFibro app for six weeks was not more effective than the use of a traditional paper book with similar content for health-related quality of life, symptoms, or self-care agency in individuals with fibromyalgia. • Improvements on severity of symptoms in both groups suggest that the self-care program using a mobile app or a paper book may be beneficial in individuals with fibromyalgia. • The Sleep Strategies was the most used function of the ProFibro app, followed by the Exercise Program, and the diary for the practice of gratitude. The ProFibro application (app) was developed as a Mobile Health resource to promote self-care in fibromyalgia management. This study aimed to assess the effects of the use of the ProFibro app for six weeks compared to the use of a traditional paper book of similar content to improve health-related quality of life, symptoms, and self-care agency in individuals with fibromyalgia. Forty individuals with fibromyalgia were included in this randomized, single-blind, parallel trial. One group received intervention content using the ProFibro app on a smartphone while the other received similar information using a paper book. Participants were assessed at baseline and after six weeks. The primary outcome was the Revised Fibromyalgia Impact Questionnaire. Secondary outcomes were Widespread Pain Index, Pain Visual Analog Scale, Symptom Severity Scale, and Appraisal of Self-Care Agency Scale – Revised. No differences in changes were found between groups at the end of the treatment for any outcome. Both groups showed improvements in symptom severity. The use of the ProFibro app for six weeks was not more effective than the use of a traditional paper book with similar content for health-related quality of life, symptoms, or self-care agency in individuals with fibromyalgia. Both groups showed improvements from baseline on severity of symptoms, suggesting that the self-care program using a mobile app or a paper book may be beneficial for individuals with fibromyalgia. [ABSTRACT FROM AUTHOR]

The article discusses a sit-to-stand training program for children with cerebral palsy improves mobility and self-care function.

The article discusses a sit-to-stand training program for children with cerebral palsy improves mobility and self-care function.

The monitoring of blood glucose is a key aspect of diabetes care in limiting the negative effects of hyperglycaemia to both the microvasculature and macrovasculature. Self-monitoring of blood glucose (SMBG) gives an indication of blood glucose at a specific point in time and is recommended to be carried out four times daily. However, due to the inconvenience and associated pain of blood withdrawal, SMBG is often carried out less frequently than recommended or not at all. Extraction and subsequent determination of glucose in interstitial fluid (ISF) using microneedles (MNs) is an emerging area of research due to their minimally invasive nature and lack of associated pain. In this manuscript, a novel method for the fabrication of a hollow microneedle device is reported. The microneedle produced had a sharp bevelled edge and was 400 µm in length. Additionally, a paper backplate embedded with a colorimetric system for the rapid visual determination of glucose in simulated ISF was developed and paired with the hollow MN. This device rapidly extracted simulated ISF within five seconds and its ability to produce a glucose concentration dependent colour change within 30 s was demonstrated. Using this approach, it was possible to discriminate between glucose concentrations in normal glycaemia (4–7 mM) and hyperglycaemia (>7 mM) ranges using the naked eye. While further development is required, the results herein highlight the potential of this device to be used as a blood-free minimally invasive approach to glucose monitoring. [ABSTRACT FROM AUTHOR]

The article focuses on self-directed and web-based exercise and physical activity program supported with text messages improves knee pain and function for people with knee osteoarthritis.

The article reflects on standard management for children with symptomatic joint hypermobility for improving pain. Topics include The non-pharmacological trials often consist of multi-component interventions; active ingredients are sometimes difficult to isolate and the final intervention may substantially differ from the planned intervention; and recommend explicitly describing the components, including whether it was standardized and the adherence rates to the protocol and to the intervention.

Background: In 2019, a randomized controlled trial (RCT) authored by Dr. Ismail was retracted due to concerns about data integrity. Since there are no policies in place to investigate other publications of authors of retracted studies, we investigated Dr. Ismail's other trials.Methods: We searched for RCTs authored by Dr. Ismail. We made pairwise comparisons of values in baseline and outcome tables between trials. We assessed whether the distributions of baseline characteristics were compatible with properly conducted randomization, using Monte Carlo simulations and the Kolmogorov-Smirnov test. We read the publications carefully for unusual features.Results: Dr. Ismail was author in eight published and one unpublished trial. In three of his first author studies we found multiple identical values in the baseline and/or outcome tables from different trials. At least some of the trials were unlikely to have followed a proper randomization process. There were a number of other unusual features in the papers we reviewed.Conclusions: It is probable that other trials published by Dr. Ismail contain questionable data. We call for a thorough investigation of the original trial data and related official documents. Our exercise suggests that the practice to assess research integrity should include all publications of authors with retracted fabricated articles. [ABSTRACT FROM AUTHOR]

The article presents a commentary on the breathing retraining programs that can improve health-related quality of life in people with asthma. Topics discussed include pharmacological treatment is effective in Asthma; produce such substantial improvement in asthma-related quality of life in people; and breathing retraining did not improve pathophysiological outcomes such as clinical control.

The article presents abstracts of papers presented at the 2005 Combined Forces Pharmacy Seminar. They include "Adult Pain Management: Gastrointestinal Risk, Nonprescription Drug Use, and Satisfaction With Therapy," "Refilling Medications for Deployed Soldiers Should Be an Error-Free Task," "Self-Care: Implementation at a Soldier Readiness Center," "Use of a Screening Tool to Help Identify Patients With Probable Overactive Bladder," "Watching the Patient and the Anticoagulation Clinic."

Functional foods can be considered to be those whole, fortified, enriched or enhanced foods that provide health benefits beyond the provision of essential nutrients (e.g., vitamins and minerals), when they are consumed at efficacious levels as part of a varied diet on a regular basis. Linking the consumption of functional foods or food ingredients with health claims should be based on sound scientific evidence, with the "gold standard" being replicated, randomized, placebo-controlled, intervention trials in human subjects. However, not all foods on the market today that are claimed to be functional foods are supported by enough solid data to merit such claims. This review categorizes a variety of functional foods according to the type of evidence supporting their functionality, the strength of that evidence and the recommended intakes. Functional foods represent one of the most intensively investigated and widely promoted areas in the food and nutrition sciences today. However, it must be emphasized that these foods and ingredients are not magic bullets or panaceas for poor health habits. Diet is only one aspect of a comprehensive approach to good health. [ABSTRACT FROM AUTHOR]

This was a cross-sectional study. Home exercise programs (HEPs) are frequently prescribed to maximize a patient's recovery and ensure maintenance of therapeutic gains produced during supervised treatment. Improved understanding of patient preferences and incorporation of simple mobile health technologies may be beneficial strategies for improving patient HEP adherence. The purpose of this study was to determine client's preferred mode of home exercise program delivery when offered a choice between a cellular video and paper handout. A convenience sample was recruited from clients receiving services at an upper extremity rehabilitation facility. Participants were provided a paper handout with written instructions and an audiovisual recording of themselves performing the exercises. A questionnaire was developed to compare clients' preferences and perceptions. Quantitative data regarding patient preference were gathered and analyzed with descriptive statistics. Collected qualitative data were themed to determine the characteristics of home exercise programs (HEPs) perceived by patients. A total of 30 patients participated in the study. Of the 29 responses regarding patient preference of HEP mode, 20 (69%) patients preferred a video, 4 (14%) patients preferred a paper handout, and 5 (17%) patients preferred both paper and video HEP. Patients with preference to a paper HEP reported the handout was helpful to be accessed in a simple manner and could be displayed as a visual reminder to perform the exercises. Those who preferred the cellular video reported increased understanding and confidence with accurate performance of exercises using audiovisual instructions. HEP adherence enhancement techniques include improved understanding of patient preferences in order to facilitate customized client-centered treatment. The majority of participants in this study preferred a mobile-based video HEP. Participants perceived the video as visually appealing and a more effective mode of instruction than paper handouts. • This survey asked patients their preferred mode of delivery for home exercise programs. • Most patients prefer video home program delivery. • Patients reports video home exercise programs have more visual appeal and provide effective directions. [ABSTRACT FROM AUTHOR]

• Functional and work disability in people with rheumatic diseases remain high despite advances in medical and pharmacological management • Hand therapists can play a vital role in chronic rheumatic disease management to improve self-management and increase participation in meaningful activities. • Patients, primary care, and rheumatology providers need to be educated about the scope of services occupational and physical therapy provide beyond the hand impairments. Invited Clinical Commentary Arthritis is one of the most frequently reported causes of disability in the United States and the prevalence is expected to increase in the coming decades. While many rheumatic diseases involve hand impairments, most are systemic and involve more than the musculoskeletal system. Functional and work disability are high and people would benefit from the services of occupational and physical therapists. This paper reviews concepts of self-management, and symptoms that contribute to limitations and restrictions to participation in daily life in people with rheumatic diseases and suggests roles for hand therapists beyond the immediate hand impairments. The impact of selected rheumatic diseases on functional and work disability are reviewed along with strategies for symptom management and self-management. Upper extremity impairments of selected rheumatic diseases are also discussed. The role for hand therapists in evaluating and addressing the complex needs of persons with rheumatic diseases, including less common diseases, is discussed. Outcome measures for fatigue, muscle involvement, ergonomics and computer use, and work disability are introduced. Finally, strategies for self-management and prevention of work and functional disability, along with symptom management for fatigue and pain are presented. Hand therapists can play a vital role in chronic rheumatic disease management to improve self-management and increase participation in meaningful activities. Patients, primary care and rheumatology providers need to be educated about the scope of services occupational and physical therapists provide beyond the hand impairments. [ABSTRACT FROM AUTHOR]

Abstract Sciatica is a common form of low back pain (LBP) that has been identified as distinct both in terms of the persistence and severity of symptoms. Little research has explored individual experiences of sciatica, and none focuses on individuals with the most severe, long-lasting symptoms who may experience the most profound impact. This paper addresses this gap through proposing a theoretical framework for understanding such experiences, that of biographical suspension as a form of liminality of Self. Twenty semi-structured interviews were conducted with individuals with severe sciatic symptoms between January 2016‒March 2017, as part of the UK-based SCOPiC (SCiatica Outcomes in Primary Care) randomised controlled trial. Data were analysed thematically using the constant comparison method. The concept of 'biographical suspension', originally developed in LBP, emerged as one whereby individuals put life on-hold in the expectation of an eventual return to their former, pain-free selves. Deeper analysis extended this concept to a form of liminality, whereby individuals are caught between pre- and post-sickness selves, unable to fully identify with either. This liminality is underpinned by ongoing beliefs about sciatica as a temporary and fixable 'injury' rather than long-term 'illness', even among those with long-lasting symptoms. This led to a disjuncture between individuals' ongoing pain beliefs and experiences, resulting in longer-term psychological impacts. Biographical suspension is further conceptualised as an experiential stage giving rise to four distinct short-term trajectories: i) symptom resolution leading individuals to occupy a clearly post-liminal state; ii) remaining in suspended liminality; iii) ongoing symptoms leading to a post-liminal state of resignation; ix) a state of being both between sickness and wellness, and straddling hope and fear; thus exemplifying differing states of liminality experienced over time. Findings have implications for the support provided in clinical settings to individuals who may struggle to self-manage due to sustained liminality of Self. Highlights • First paper to explore lived experiences of individuals with most severe sciatica. • Individuals experience biographical suspension, conceptualised as liminality. • Liminality is underpinned by conceptualisation of sciatica as a fixable 'injury'. • Biographical suspension can give rise to four distinct experiential trajectories. • Differing forms of liminality identified throughout course of pain trajectory. [ABSTRACT FROM AUTHOR]

Abstract Recent health policy renders patients increasingly responsible for managing their health via digital technology such as health apps and online patient platforms. This paper discusses underlying tensions between empowerment and self-discipline embodied in discourses of technological self-care. It presents findings from documentary analysis and interviews with key players in the English digital health context including policy makers, health designers and patient organisations. We show how discourses ascribe to patients an enterprising identity, which is inculcated with economic interests and engenders self-discipline. However, this reading does not capture all implications of technological self-care. A governmentality lens also shows that technological self-care opens up the potential for a de-centring of medical knowledge and its subsequent communalization. The paper contributes to Foucauldian healthcare scholarship by showing how technology could engender agential actions that operate at the margins of an enterprising discourse. Highlights • Digital health policy in UK assumes an enterprising & empowered patient identity. • Tensions between empowerment & discipline occur as patients self-care digitally. • Digital health creates space for agential actions that improve communal health. • A health-making agency operates in the margins of governmental self-care discourse. [ABSTRACT FROM AUTHOR]

Despite assumptions that wearable self-care technologies such as smart wristbands and smart watches help users to monitor and self-manage health in daily life, adherence rates are often quite low. In an effort to better understand what determines adherence to wearable self-care technologies, researchers have started to consider the extent to which a technology is perceived as being part of the user (i.e., technology embodiment) and the extent to which users feel they can influence reaching their health goals (i.e., empowerment). Although both concepts are assumed to determine adherence, few studies have empirically validated their influence. Furthermore, the relationships between technology embodiment, empowerment, and adherence to wearable self-care technology have also not been addressed. Drawing upon embodied theory and embodiment cognition theory, this research paper introduces and empirically validates 'embodied empowerment' as a predictor of adherence to wearable self-care technology. Using partial least squares structural equation modeling and multigroup analysis on a dataset of 317 wearable self-care technology users, we find empirical evidence of the validity of embodied empowerment as a determinant of adherence. We also discuss the implications for research and practice. • We introduce embodied empowerment to explain adherence to self-care wearables. • Embodiment and empowerment reinforce each other and function in conjunction. • Embodied and empowerment predict adherence to wearable self-care technology. • The results are consistent for male versus female and younger versus older users. [ABSTRACT FROM AUTHOR]

Background Having support from an informal carer is important for heart failure patients. Carers have the potential to improve patient self-care. At the same time, it should be acknowledged that caregiving could affect the carer negatively and cause emotional reactions of burden and stress. Dyadic (patient and informal carer) heart failure self-care interventions seek to improve patient self-care such as adherence to medical treatment, exercise training, symptom monitoring and symptom management when needed. Currently, no systematic assessment of dyadic interventions has been conducted with a focus on describing components, examining physical and delivery contexts, or determining the effect on patient and/or carer outcomes. Objective To examine the components, context, and outcomes of dyadic self-care interventions. Design A systematic review registered in PROSPERO, following PRISMA guidelines with a narrative analysis and realist synthesis. Data Sources: PubMed, EMBASE, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials were searched using MeSH, EMTREE terms, keywords, and keyword phrases for the following concepts: dyadic, carers, heart failure and intervention. Eligible studies were original research, written in English, on dyadic self-care interventions in adult samples. Review methods We used a two-tiered analytic approach including both completed studies with power to determine outcomes and ongoing studies including abstracts, small pilot studies and protocols to forecast future directions. Results Eighteen papers – 12 unique, completed intervention studies (two quasi- and ten experimental trials) from 2000 to 2016 were reviewed. Intervention components fell into three groups – education, support, and guidance. Interventions were implemented in 5 countries, across multiple settings of care, and involved 3 delivery modes – face to face, telephone or technology based. Dyadic intervention effects on cognitive, behavioral, affective and health services utilization outcomes were found within studies. However, findings across studies were inconclusive as some studies reported positive and some non-sustaining outcomes on the same variables. All the included papers had methodological limitations including insufficient sample size, mixed intervention effects and counter-intuitive outcomes. Conclusions We found that the evidence from dyadic interventions to promote heart failure self-care, while growing, is still very limited. Future research needs to involve advanced sample size justification, innovative solutions to increase and sustain behavior change, and use of mixed methods for capturing a more holistic picture of effects in clinical practice. [ABSTRACT FROM AUTHOR]

Le « développement personnel » renvoie à un ensemble hétéroclite de savoirs syncrétiques, délivrés sous forme de livres, de vidéos ou de formations. Ces contenus sont recherchés par de nombreuses personnes dont l'objectif manifeste est la quête d'un soi authentique, dans une société où vacillent les étayages identitaires. Au-delà d'une considération critique, notre étude vise à mieux comprendre les motivations de ceux qui investissent ces savoirs et dispositifs non conventionnels. Au sein d'une revue de littérature sous forme d'anthropologie clinique, trois vignettes cliniques sont présentées à partir d'entretiens de recherche. L'un des participants est dans une pratique articulée autour de deux mentors ; un autre poursuit uniquement une réflexion nourrie par ses lectures ; et le dernier combine ses lectures à la consultation d'une psychologue. Tous poursuivent un désir de transformation intérieure en lien avec un questionnement identitaire. La lecture de tels ouvrages peut favoriser des formes de symbolisation médiatisée par la lecture. L'identification à des mentors constitue un étayage comparable aux préceptes religieux. Selon la perspective des participants à l'étude, le développement personnel stimule un travail auto-thérapeutique dont les limites sont dépassées par une ouverture progressive vers un autre, selon un processus de pré-engagement thérapeutique. S'il est possible de localiser les coordonnées de l'engouement actuel pour le développement personnel dans certaines mutations du lien social, il paraît nécessaire de développer une approche attentive et rigoureuse de cette forme de pluralisme thérapeutique sollicitée par une portion de la population générale. "Self-help" refers to a heterogeneous collection of syncretic knowledge, delivered in the form of books, videos or training courses. This content is sought after by many people whose obvious objective is the quest for an authentic self, in a society where identity supports are wavering. In addition to being a critical consideration, our study aims to better understand the motivations of those who invest in this knowledge and who feed their preferences for these non-conventional approaches. Within the framework of a literature review in the form of clinical anthropology, three clinical vignettes are presented, based on clinical research interviews conducted with volunteers engaged in a personal development process. One of the participants is involved in a practice that includes two mentors; another pursues only a reflective approach nourished by his readings; and the last one supplements his readings with psychological consultations. All of them pursue a desire for inner transformation in connection with a questioning of identity. Reading such works can promote forms of symbolization mediated by reading. The first vignette provides a clinical illustration of the concept of "apérité" developed by Nicolas Marquis. It demonstrates that the possibility for the subject to identify himself with the contents of the self-help book, which allows him to develop new representations, linked to his personal life history, thereby helping him to move towards a clearer representation of his internal world and the functioning of his identity. The second subject is more motivated by the hope of the existence of an ideal of life that he could implement with the help of the concrete application of certain key factors. He is trying to rebound from a complex family situation that has pushed him to break with his family. By adopting a self-help approach, he is attempting to find the support and backing that he did not have in his family environment. The identification with mentors constitutes a support comparable to a religious precept. The practice of mentoring embodies a real system of reference and support in the life of the third subject interviewed. Over time, this practice enabled him to establish a new relationship with his parents and to gradually emancipate himself. The mentor is often assigned to accompany the individual in the development of a mindset that favors his or her empowerment. This practice also underpins a path towards self-awareness, by inviting the subject to consciously reconnect with his internal world and the different sensations that run through it at various moments of daily life. From the perspective of the participants in the study, personal development stimulates a self-therapeutic work whose limits are exceeded by a gradual openness towards another, in a process of therapeutic pre-commitment. If it is possible to locate the coordinates of the current tendency to strive for personal development in certain mutations of the social bond, it seems necessary to develop a careful and rigorous approach to this form of therapeutic pluralism sought out by a portion of the general population. [ABSTRACT FROM AUTHOR]

Abstract: Cognitive Behavioral Therapy (CBT) is effective in reducing insomnia complaints, but the effects of self-help CBT have been inconsistent. The aim of this study was to determine the effectiveness of self-help for insomnia delivered in either electronic or paper-and-pencil format compared to a waiting-list. Participants kept a diary and filled out questionnaires before they were randomized into electronic (n = 216), paper-and-pencil (n = 205), or waiting-list (n = 202) groups. The intervention consisted of 6 weeks of unsupported self-help CBT, and post-tests were 4, 18, and 48 weeks after intervention. At 4-week follow-up, electronic and paper-and-pencil conditions were superior (p < .01) compared to the waiting-list condition on most daily sleep measures (Δd = 0.29–0.64), global insomnia symptoms (Δd = 0.90–1.00), depression (Δd = 0.36–0.41), and anxiety symptoms (Δd = 0.33–0.40). The electronic and paper-and-pencil groups demonstrated equal effectiveness 4 weeks after treatment (Δd = 0.00–0.22; p > .05). Effects were sustained at 48-week follow-up. This large-scale unsupported self-help study shows moderate to large effects on sleep measures that were still present after 48 weeks. Unsupported self-help CBT for insomnia therefore appears to be a promising first option in a stepped care approach. [Copyright &y& Elsevier]

The use of ‘brain training’ games is often regarded as relating to wider ideals of self-improvement and youthfulness. Hence, use is intertwined with discourses of ‘active’ ageing. This paper analyzes how the use and users of brain training games were configured in the UK media, from 2005 to 2015, and examines how notions of active ageing relate to these representations. Game users were rarely constructed solely as gamers, and were more often presented as prudent individuals focused on a serious goal. This configuration related to assumed and enjoined motivations for brain training; specifically, users were commonly framed as seeking to enhance cognition and limit/delay cognitive decline. Scientific evidence about brain training was often deployed to explain how games might work; sometimes, however, it was used to undermine the utility of games and assert the significance and cognitive health-benefits of other activities. A minority of texts explicitly critiqued ideals of self-improvement, arguing that game playing was important for its own sake. Yet, even the pleasure associated with gaming was occasionally instrumentalized as a mechanism for ensuring prudent life choices. The analysis casts fresh light on how debates around health, ageing, and science correspond to configurations of technology uses and users. It presents evidence of the widespread cultural circulation of enjoiners regarding self-care and healthy ageing within British society. However, the paper also provides indications of the limits to such imperatives: discourses of pleasure co-exist with and perhaps supplant logics of prudence in (accounts of) practices ostensibly aimed at ageing ‘well’. [ABSTRACT FROM AUTHOR]

Objective: To understand how parents view and experience their role as their child with a long-term physical health condition transitions to adulthood and adult healthcare services.Methods: Five databases were systematically searched for qualitative articles examining parents' views and experiences of their child's healthcare transition. Papers were quality assessed and thematically synthesised.Results: Thirty-two papers from six countries, spanning a 17-year period were included. Long-term conditions were diverse. Findings indicated that parents view their child's progression toward self-care as an incremental process which they seek to facilitate through up-skilling them in self-management practices. Parental perceptions of their child's readiness, wellness, competence and long-term condition impacted on the child' progression to healthcare autonomy. A lack of transitional healthcare and differences between paediatric and adult services served as barriers to effective transition. Parents were required to adjust their role, responsibilities and behaviour to support their child's growing independence.Conclusion: Parents can be key facilitators of their child's healthcare transition, supporting them to become experts in their own condition and care. To do so, they require clarification on their role and support from service providers.Practice Implications: Interventions are needed which address the transitional care needs of parents as well as young people. [ABSTRACT FROM AUTHOR]

• Self-management support is person-centred care reinforcing patient autonomy. • Avoid strong clinician control and help patients developing self-efficacy. • Let patients' value-based goals and shared decisions guide management. • Help patients make sense of symptoms and reframe unhelpful perspectives. Use supervised exercises as a tool to practice problem-solving skills A paradigm shift away from clinician-led management of people with chronic disorders to people playing a key role in their own care has been advocated. At the same time, good health is recognised as the ability to adapt to changing life circumstances and to self-manage. Under this paradigm, successful management of persistent back pain is not mainly about clinicians diagnosing and curing patients, but rather about a partnership where clinicians help individuals live good lives despite back pain. In this paper, we discuss why there is a need for clinicians to engage in supporting self-management for people with persistent back pain and which actions clinicians can take to integrate self-management support in their care for people with back pain. People with low back pain (LBP) self-manage their pain most of the time. Therefore, clinicians and health systems should empower them to do it well and provide knowledge and skills to make good decisions related to LBP and general health. Self-management does not mean that people are alone and without health care, rather it empowers people to know when to consult for diagnostic assessment, symptom relief, or advice. A shift in health care paradigm and clinicians' roles is not only challenging for individual clinicians, it requires organisational support in clinical settings and health systems. Currently, there is no clear evidence showing how exactly LBP self-management is most effectively supported in clinical practice, but core elements have been identified that involve working with cognitions related to pain, behaviour change, and patient autonomy. [ABSTRACT FROM AUTHOR]

Background: Juvenile Idiopathic Arthritis (JIA) is a chronic inflammatory arthritis that impacts biomechanical features of gait. This systematic review describes the effects of JIA on gait motion parameters and walking performance.Methods: Six databases were searched (PubMed/Medline, Cochrane, the EBSCOHost database SPORTDiscus, Web of Science, and Embase). Studies were restricted to children with any subtype of JIA who were assessed for gait motion features (kinematic, kinetic, temporalspatial) or walking performance (velocity or distance covered); could include intervention or treatment exposure with measures of gait and gait speed; could involve comparison of gait in JIA to healthy controls. Quality of evidence was assessed using the GRADE system. This systematic review was registered at PROSPERO (CRD42018109582) RESULTS: The search yielded 625 papers, 23 of which described biomechanical features of gait and/or assessed walking performance. Twenty studies measured walking velocity and walking ability using simple field tests or laboratory methods. Eleven studies measured temporalspatial parameters such as cadence, step length, stride length, step width, single and double support time. Nine studies evaluated kinetic measurements including joint power, flexion and extension and joint moments. Nine studies evaluated kinematic parameters including range of motion, pelvic tilt, center of motion and trunk sway.Conclusions: Key features of gait in children with JIA include slower gait velocity, shortened step length, decreased range of motion at the hip, knee and ankle with trend towards flexion, decreased joint power, anteriorly tilted pelvis and trunk with shifted center of motion. There is a potential to ameliorate JIA-related gait changes with exercise and/or pharmaceutical interventions. [ABSTRACT FROM AUTHOR]

• Adaptation and validation the scale of Positive Parental Practices for children 0- to 3 years. • Exploratory and Confirmatory Factor Analysis were performed with 950 participants. • This study provides the standardization of the Spanish scale scores in parental competences. • The final version for the Spanish population is composed of 27 items and 7 subscales. • This scale is considered useful for assessing parental competences in parents of young children. This study aims to adapt and validate the scale of Positive Parental Practices of the Caregiver (SP + C), in the version for children from 0 to 3 years. First, the process of cross-cultural adaptation was performed. Subsequently, for the validation of the scale, we analyzed a sample of 950 participants, with children aged between 0 and 3 years. The participants' native language was Spanish or it was the language spoken at home. Exploratory Factor Analysis (EFA) was performed with Sample 1 (n = 483 participants), yielding 7 factors: Daily Involvement, Mentalization, Sensitivity, Promoting Learning, Attention and Organization of Daily Life, Monitoring of Parental Activity, and Parental Self-Care. Confirmatory Factory Analysis (CFA) was performed with Sample 2 (n = 467), which confirmed the factor structure of the scale. Reliability analysis showed that the scale had an adequate internal consistency. To determine criterion validity, bivariate correlations were calculated with other variables that evaluate parental competence, expecting to find significant positive relationships between them. This paper provides the standardization of the Spanish scale scores. In conclusion, the final validated scale is composed of 27 items and 7 subscales, with adequate psychometric properties. It is considered useful for the evaluation of parental competences in parents of young children. [ABSTRACT FROM AUTHOR]

Objectives: Research has shown that mobile applications provide a powerful alternative to traditional paper diaries; however, little data exists in comparing apps to the traditional mode of paper as a patient education and engagement tool in the clinical setting. This study was designed to compare the effectiveness of a mobile app versus a spiral-notebook guide throughout prenatal care.Methods: This randomized (n=173) controlled pilot was conducted at an East Coast community hospital. Chi-square and repeated-measures analysis of variance was used to test intervention effects in the sample of 127 pregnant mothers who completed their prenatal care in the healthcare system.Results: Patients who were distributed the mobile application used the tool to record information about pregnancy more frequently (p=.04) and developed greater patient activation (p=.02) than patients who were distributed notebooks. No difference was detected on interpersonal clinical communication.Conclusion: A mobile application successfully activated a patient population in which self-management is a critical factor.Practice Implications: This study shows that mobile apps can prompt greater use and result in more activated patients. Findings may be translated to other patient populations who receive recurring care for chronic disease. [ABSTRACT FROM AUTHOR]

This paper discusses how a research team negotiated the challenges of language differences in a qualitative study that involved two languages. The lead researcher shared the participants’ language and culture, and the interviews were conducted using the Arabic language as a source language, which was then translated and disseminated in the English language (target language). The challenges in relation to translation in cross-cultural research were highlighted from a perspective of establishing meaning as a vital issue in qualitative research. The paper draws on insights gained from a study undertaken among Arabic-speaking participants involving the use of in-depth semi-structured interviews. The study was undertaken using a purposive sample of 15 participants with Type 2 Diabetes Mellitus and co-existing depression and explored their perception of self-care management behaviours. Data analysis was performed in two phases. The first phase entailed translation and transcription of the data, and the second phase entailed thematic analysis of the data to develop categories and themes. In this paper there is discussion on the translation process and its inherent challenges. As translation is an interpretive process and not merely a direct message transfer from a source language to a target language, translators need to systematically and accurately capture the full meaning of the spoken language. This discussion paper highlights difficulties in the translation process, specifically in managing data in relation to metaphors, medical terminology and connotation of the text, and importantly, preserving the meaning between the original and translated data. Recommendations for future qualitative studies involving interviews with non-English speaking participants are outlined, which may assist researchers maintain the integrity of the data throughout the translation process. [ABSTRACT FROM AUTHOR]

Diabetes represents a tremendous burden at a global scale. Changing and sustaining desirable health behaviours, such as engaging in a healthy diet, physical activity and taking prescribed medication, is key to achieve better health outcomes in people with type 2 diabetes (T2D). This paper describes the first stage of a plan to translate an innovative a mobile application to facilitate self-care of older adults with T2D from bench to daily life. The project plan emerged in the context of the StartUp Research program for scientists, held by ITQB NOVA and NOVA SBE. PMBOK was selected as the project management framework; we briefly explain its knowledge areas - scope, time, quality, human resources, stakeholders' management, communications, costs, procurement and risks– in relation to VASelfCare T2D. [ABSTRACT FROM AUTHOR]

Objective: The study aims to evaluate the ability of self-management programmes to change the healthcare-seeking behaviours of people with Chronic Obstructive Pulmonary Disease (COPD), and any associations between programme design and outcomes.Methods: A systematic search of the literature returned randomised controlled trials of SMPs for COPD. Change in healthcare utilisation was the primary outcome measure. Programme design was analysed using the Theoretical Domains Framework (TDF).Results: A total of 26 papers described 19 SMPs. The most common utilisation outcome was hospitalisation (n = 22). Of these, 5 showed a significant decrease. Two theoretical domains were evidenced in all programmes: skills and behavioural regulation. All programmes evidenced at least 5 domains. However, there was no clear association between TDF domains and utilisation. Overall, study quality was moderate to poor.Conclusion: This review highlights the need for more alignment in the goals, design, and evaluation of SMPs. Specifically, the TDF could be used to guide programme design and evaluation in future.Practice Implications: Practices have a reasonable expectation that interventions they adopt will provide patient benefit and value for money. Better design and reporting of SMP trials would address their ability to do so. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is revolutionizing the medical industry. This paper first investigates the mechanism of patients' medical AI acceptance after experiencing AI service failure from the perspective of responsibility attribution. Using data from 249 patients in China, findings reveal that patients' self-responsibility attribution is positively related to human–computer trust (HCT) and sequentially enhances the acceptance of medical AI for independent diagnosis and treatment. This paper also investigates the moderating role of personality traits. Specifically, conscientiousness and openness strengthen the association between HCT and acceptance of AI for independent diagnosis and treatment; agreeableness and conscientiousness weaken the association between HCT and acceptance of AI for assistive diagnosis and treatment. • Medical AI diagnosis consisted of independent and assistive diagnosis. • This paper discusses the medical AI acceptance after experiencing AI service failure. • Attribution theory was considered as a theoretical framework. • Personality affects the association between human–computer trust and AI acceptance. [ABSTRACT FROM AUTHOR]

This paper aims to increase understanding of how mothers diagnosed with breast cancer while in the paid workforce experience and manage their multiple demands of taking care of themselves, their children and their paid work. In-depth, semi-structured interviews were conducted with 32 women who were mothers of dependent children and in the paid workforce at the time of their breast cancer diagnosis. The sample includes women living in urban and rural Australia. The study found that after a breast cancer diagnosis, participants tended to prioritise their health and wellbeing over paid work. Yet dominance of gendered identity meant that they tended to place the needs of family, especially children, above their own health and wellbeing. The key factors that influenced mothers' decisions to continue in, return to, or leave paid work after a breast cancer diagnosis included: a change in perspective regarding what was important in their lives; level of support from the workplace and home; the extent to which participating in paid work was a financial necessity; the extent to which their identity was connected to paid work, and; ongoing level of pain or fatigue. The paper concludes that using the sociological concepts of the fateful moment, boundary maintenance and a feminist ethic of care produces a more nuanced understanding of women's participation in paid work after breast cancer than examining paid workforce participation, or unpaid responsibilities and mothering, separately. The nature of the permeability or malleability of boundaries between work, family and taking care of the self affects women's participation in paid work during and/or after breast cancer treatment. Increased boundary permeability or malleability brought about more by cooperation than conflict facilitated positive experiences of re-negotiating boundaries, whereas increased permeability or malleability brought about more by conflict than cooperation created difficulties for women in finding an acceptable balance between their family, paid work and taking care of their own health after breast cancer. [ABSTRACT FROM AUTHOR]

Anxiety and panic symptoms are widespread in the general population. The physical manifestations of anxiety and panic commonly account for people presenting to Emergency Departments (EDs). It is therefore important for ED clinicians to be informed of the numerous causes of anxiety and panic and equipped to respond effectively. This paper describes the underlying pathophysiology of the physical symptoms of anxiety and panic and differential diagnoses to consider. Organic conditions that are associated with symptoms of anxiety and panic are highlighted. Brief interventions are tabled for ED clinicians to use when explaining symptoms, and to promote individual self-management. [ABSTRACT FROM AUTHOR]

Disruptive connected health technologies, or digitalization, are suggested to tackle the healthcare challenges and transform traditional care models. In Finland, the transformation is manifested by the development of various digital hospitals and citizen-centric care models that foster self-care by utilizing connected health technologies. In this paper we introduce qualitative research that uses social practice theory in order to understand how connected health technologies shape a pediatric day surgery practice in future digital hospitals. Major improvement needs were identified to center on discursive actions (i.e., communication that occurs between health professionals and patients), since hospital IT systems, data exchange, and internal and external communication were found to not support pediatric surgery practice as expected. To improve the current situation, we found out that there is a need to change the patient role to be more active, creating data that health professionals could use through their own patient record systems. Connected health solutions allow this type of interaction between things (i.e., communication through mobile apps, medical devices, etc.) and agents (i.e., health professionals). There is an urgent need to improve communication channels such as Chat, WhatsApp, and mobile applications that gather all necessary information and instructions from patients before and after the surgery. However, these solutions cannot be co-created separately from the clinical decision systems that allow discursive actions among healthcare professionals. These solutions, e.g. mobile applications designed to support patients going through the surgery practice, will also significantly impact and change pediatric surgery practice at hospitals. • Connected health solutions allow the interaction between the mobile apps, medical devices and health professionals. • Change of pediatric surgery practice resulted from the needs for better communication. • There is a need to improve communication channels that gather and give necessary information before and after the surgery. • More active patient role makes it possible to create data that health professionals could use through their own systems. • Health professionals and the patients agreed that a mobile application would enhance and facilitate the surgery practice. [ABSTRACT FROM AUTHOR]

Abstract: This paper problematizes anti-ageing discourse and interpretations that cosmetic surgery is an ageist practice and older people who undergo cosmetic surgery are denying ageing. It argues that conceptions of cosmetic surgery as anti-ageing are premised on an essentialist conception of the ‘naturally ageing body’. Interview data and media texts are used to demonstrate how, through the notion of “re” suggested by terms such as rejuvenation, reversal and renewal, anti-ageing discourses inscribe ‘ageing’ in the practice of cosmetic surgery by older people. The oppressive interpretation that older people who undergo cosmetic surgery are ‘denying ageing,’ and associated subjection to moral critique, are effects of this discourse. To counter interpretations of cosmetic surgery as ‘anti-ageing’, the paper takes up the idea that cosmetic surgery is undertaken to look better not younger. To advance this argument, the paper suggests that the forms of rationality associated with cosmetic surgery constitute a contemporary regimen of ‘care of the self’ which enable ethical agency and creative self-stylisation. Through this framework cosmetic surgery can be re-imagined as a practice for designing ‘older’ rather than denying ageing. [Copyright &y& Elsevier]

Abstract: In the recently published lectures from the College de France series, The Birth of Bio-Politics, offers his most explicit analysis of neo-liberal governmentality and its impact upon states and societies in the late twentieth century. Framed in terms of the bio-political as a mode of governance of populations and its relationship to neo-liberalism, these lectures offer a rich seam of theoretical resources with which to interrogate contemporary forms of governmentality. This paper seeks to apply these and some recent critical analysis by Foucauldian scholars, to the study of health governance, with particular reference to the use of social marketing as a strategy to improve the health of populations ‘at a distance’. Reflecting a broader decollectivisation of welfare, such strategies are identified as exemplars of neo-liberal methods of governance through inculcating self management and individualisation of responsibility for health and wellbeing. Drawing on original empirical data collected with a sample of fifty long term unemployed men in 2009, this paper critically examines social marketing as a newer feature of health governance and reflects upon participants'' responses to it as a strategy in the context of their wider understandings of health, choice and responsibility. [Copyright &y& Elsevier]

Abstract: Background: Chronic obstructive pulmonary disease is a common, chronic and burdensome condition requiring the individual to engage in a range of self-management strategies. The capacity to engage in self-management is dependent on a range of internal (e.g. personal) and external (e.g. health service) factors. Objectives: This paper seeks to define self-management, identify the determinants which influence the individual''s ability to cope and adjust to living with chronic obstructive pulmonary disease in the community, and identify implications for clinical practice and research. Design: Integrative review. Data sources: Medline, Embase, PubMed, CINAHL, Google Scholar. Review methods: Integrative review using prospective research questions. Papers were included in the review if they were published in peer reviewed journals and written in English between 2000 and 2010. Articles were accepted for inclusion if they discussed the determinants that influenced self-management of chronic obstructive pulmonary disease in the community. Confirmation of results and discussion themes was validated by specialists in chronic obstructive pulmonary disease and complex care. Findings: Self-management is less well characterised in chronic obstructive pulmonary disease compared with other chronic conditions. Functional limitation and the need to balance disease management with everyday life are the two key elements that patients face in managing their condition. Provider characteristics, socioeconomic status and health literacy are sparsely discussed yet are known to influence chronic obstructive pulmonary disease self-management. Conclusions: Chronic obstructive pulmonary disease self-management must be a key focus internationally as the disease incidence increases. Collaborative care is required between patients and health providers in order facilitate patients in confident management of their condition. [Copyright &y& Elsevier]

Highlights • The evidence of core stabilization exercises is controversial. • Exercises need to be understood in the bio-psycho-social context. • Individually tailor the exercises to the patient's needs and capability. • Adherence might increase when the patients understand the aim of the exercises. • Exercises need to guided and supervised to secure performance and quality. Abstract Background Pregnancy-related low back pain (LBP) and pelvic girdle pain (PGP) have been associated with an alteration in the strategy for lumbopelvic stabilization. Different core stabilization approaches exist, the evidence is however controversial. Methods This paper discusses how to improve the evidence of exercises for women suffering from LBP and PGP during and after pregnancy. Exercises should be understood in a context, where the bio-psycho-social perspective directs the prescription of exercises, targeting both psychological and physical factors. The type of exercise probably should be individually tailored to the needs and capability of the individual and it is not only about the most appropriate exercise, it is about dosage and delivery of the exercises, and it is about performance. To promote adherence the use of patient preferences, with self-defined movement goals, may be a motivational basis for behavior change. Communication skills may facilitate positive beliefs and provide a motivational foundation for empowerment, self-efficacy and for self-management. To learn by discovery where the patient learns through their own experiences, might motivate the patients to active engagement and to behavioral change. Adherence probably will increase when the patients understand the aim and the rationale behind the exercises they are prescribed. However, with high adherence to exercises that maintains an inappropriate motor pattern, LBP and PGP possibly could proceed into chronicity. Conclusion Exercises need to be meaningful to the patient, relevant for daily activities, individualized according to patient preferences, guided and supervised to secure performance and quality. [ABSTRACT FROM AUTHOR]

Abstract The purpose of the current study was to revise and test the preliminary trauma-informed self-care (TISC) measure to clarify items, test additional items related to the trauma-informed and self-care literature, confirm the preliminary factors, and to further test the reliability and validity of the revised measure. The sample consisted to 177 child welfare workers who completed paper and pencil surveys. Measures included a revised TISC measure, burnout, secondary traumatic stress, compassion satisfaction, psychological well-being, and organizational supports and resources. Results indicated a three factor 10-item TISC-R measure with the following subscales: Utilizing Organizational Resources, Organizational Practices, and Professional Self-Care. Overall reliability was good (0.84) with reliability coefficients for subscales ranging from 0.68 to 0.88. As expected, the TISC-R measure was negatively associated with burnout and secondary traumatic stress, and positively associated with compassion satisfaction, psychological well-being, and organizational resources provided. The brief TISC-R measure may be a practical tool that child welfare case managers and supervisors could use to assess, monitor and improve trauma-informed self-care practices to help workers who often face high stress environments. Future research on the utility of the measure with child welfare workers and other helping professions who work with traumatized individuals is needed. Highlights • Trauma-Informed Self-Care-Revised demonstrated strong psychometric properties. • TISC-R is a brief 10-item measure. • TISC-R was negatively associated with burnout and secondary traumatic stress. • TISC-R was positively associated with compassion satisfaction, and well-being. • TISC-R was positively correlated with organizational resources and supports. [ABSTRACT FROM AUTHOR]

This paper explores compulsive use of YouTube by university students and investigates how the uses and gratifications perspective and the personality perspective work together to explain compulsive use of the social medium. It compares the effects of motivation to use YouTube for information with motivation to use the platform for entertainment, and examines how the different motivational effects compare with those of personality. It also explores the influence of compulsive use of YouTube on academic motivation. Data from 807 students at a Malaysian university were analysed using hierarchical multiple regression. Stronger motivation to use YouTube for information and learning is associated with lower compulsive use, while stronger motivation to use YouTube for entertainment is associated with higher compulsive use. Entertainment motivation has a stronger effect than information motivation. Although tendency to compulsive use differs with personality traits, the motivation effects are independent of personality. Compulsive YouTube use negatively influences academic motivation. While educators can take risks of compulsive use into account when they propose YouTube resources to their students, information literacy education and training can play an additional role in risk reduction by alerting social media users to the risks of compulsive use and helping them to develop self-management strategies. [ABSTRACT FROM AUTHOR]

Abstract: Information and communication technologies have introduced new and impressive tools for information sharing and building computer-mediated knowledge repositories in a global context. Clinicians and researchers pay particular attention to technology as a promising tool to empower patients through self-health care management skills and to improve health care communication with providers. This represents a significant step in modern medicine of computer-integrated patient self-health care. This paper aims to examine perceived informational and decisional benefits of computer-mediated health and medical information, more specifically of cancer web-sites, and presents the results of two separate statistical models of perceived benefits. Multivariate hierarchical regression analyses showed that the frequency and time spent visiting medical web-sites are significant predictors of perceived benefits of computer-mediated knowledge. The results also indicated that computer-mediated medical information empowers health consumers to make informed decisions for their health care. The discussion section of the paper contextualizes the findings within the current sociomedical trends of self-health care and partnership with health providers. It is important to understand the perceived benefits of using computer-mediated medical knowledge, so that information and communication technologies can be targeted to educate patients to make informed decisions and to develop patient self-health-care management competencies. [ABSTRACT FROM AUTHOR]

Abstract: Background: The burden of chronic disease on healthcare services worldwide is growing and the increased development of educational interventions which help patients to better manage their own conditions is evident internationally. Objectives: This paper reports on findings of a review of Cochrane systematic reviews of interventions designed to improve patients’ knowledge and skills to manage chronic disease, with particular reference to nursing contribution and practice. Methods: Thirty Cochrane systematic reviews were identified as meeting the inclusion criteria. Data were extracted and summarised. Findings: The majority of reviews included in this paper were judged by Cochrane reviewers to provide inadequate evidence (n =18, 60%) of the effectiveness of the interventions reviewed. Information on the professional delivering the interventions was often not available, although 77% (23) of reviews mentioned that nurses were involved in a proportion of studies. Conclusion: Educational programmes have definite benefits for patients suffering from asthma and are promising for interventions in areas such as diabetes mellitus, epilepsy and mental health. However, it still is not clear what the active ingredients of many successful interventions are. [Copyright &y& Elsevier]

Pressure ulcers are a common complication with a high impact on well-being and quality of life in people with impaired mobility and/or dysfunctional pain sensations. Prevention is therefore crucial. However, persons at risk seem to experience difficulties in adhering to self-management regimens that can help to prevent or diminish the development of pressure ulcers. Self-management support interventions might help to improve their self-management skills. To review the content, components and effectiveness of self-management support interventions on clinical and behavioral outcomes for people at risk of pressure ulcers. A systematic literature search for the period of January 2000 to February 2020 was conducted in five databases (CINAHL, Cochrane, PsycINFO, PubMed, and Web of Science). Inclusion criteria were: (1) studies including persons at a high risk of pressure ulcers; (2) studies investigating interventions focused on self-management support; (3) studies describing clinical and behavioral outcomes related to prevention and care of pressure ulcers. All studies were independently screened on title, abstracts and full text by two researchers. The PRISMS taxonomy of 14 components was used to code intervention content. The search yielded 5297 papers, which resulted in the inclusion of 16 papers on self-management support interventions for persons at risk of pressure ulcers. Interventions focused mostly on 'Information about condition and/or management' (13 interventions), 'Training in practical self-management activities' (7 interventions), and 'Training in psychological strategies' (6 interventions). 'Provision of equipment' was not investigated. The intensity of the interventions varied in delivery mode, frequency and duration. Improvements were found in clinical outcomes in four studies and in behavioral outcomes in ten studies. Four studies showed improvements in clinical outcomes and ten studies in behavioral outcomes. Knowledge was positively influenced in eight studies. Self-management support interventions show potential. The extensiveness and intensity of the interventions seem to be predictive for the effectiveness, but specific content components cannot be recommended. This review revealed recommendations for future research and international consensus should be reached about patient-relevant outcomes. [ABSTRACT FROM AUTHOR]

Recent empirical work suggests that acute exercise engagement may help to subserve episodic memory function. In this paper, we discuss these effects as well as introduce a hypothesized model suggesting a potential bi-directional relationship between exercise and memory. We provide empirical support for each of the pathways delineated within this model. Future research is needed to empirically evaluate the totality of this model. If such work demonstrates utility and predictive validity, then this model will have important implications not only for clinicians, but for the exercise neurobiology field as well. [ABSTRACT FROM AUTHOR]

Objective: The PAL project develops a conversational agent with a physical (robot) and virtual (avatar) embodiment to support diabetes self-management of children ubiquitously. This paper assesses 1) the effect of perceived similarity between robot and avatar on children's' friendship towards the avatar, and 2) the effect of this friendship on usability of a self-management application containing the avatar (a) and children's motivation to play with it (b).Methods: During a four-day diabetes camp in the Netherlands, 21 children participated in interactions with both agent embodiments. Questionnaires measured perceived similarity, friendship, motivation to play with the app and its usability.Results: Children felt stronger friendship towards the physical robot than towards the avatar. The more children perceived the robot and its avatar as the same agency, the stronger their friendship with the avatar was. The stronger their friendship with the avatar, the more they were motivated to play with the app and the higher the app scored on usability.Conclusion: The combination of physical and virtual embodiments seems to provide a unique opportunity for building ubiquitous long-term child-agent friendships.Practice Implications: an avatar complementing a physical robot in health care could increase children's motivation and adherence to use self-management support systems. [ABSTRACT FROM AUTHOR]

Objective: Patient participation is facilitated by patients' ability to take responsibility for and engage in health issues. Yet, there is limited research as to the promotion of these aspects of patient participation in long-term healthcare interactions. This paper describes patient participation as experienced by patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF); the aim was to describe if and how a self-management programme in primary healthcare influenced patient participation.Methods: Patients who had participated in a self-management programme were interviewed in nine focus groups (36 patients). Data was analysed using qualitative content analysis.Results: Patients described equality in personal interactions, opportunities to share and discuss, and a willingness to share and learn to facilitate patient participation in a self-management programme. Consequently, patient participation was promoted by a match between the individuals' personal traits and the context.Conclusion: Features facilitating patient participation by means of sharing and assimilating knowledge and insights should be included in self-management programmes and in the care for patients with COPD and CHF.Practice Implications: A self-management programme can complement regular primary care regarding enhanced understanding of one's disease and support patient participation and the patient's own resources in self-management. [ABSTRACT FROM AUTHOR]

Smart aging is an emerging research topic that has a profound impact on society and well-being of aging population. To the best of our knowledge, there has been no systematic analysis of grasping what research has been conducted on smart aging. Thus, there is no discussion of major issues and future directions of smart aging. In this paper, we provide an overview of smart aging in three ways: 1) to synthesize the components of smart aging based on the comprehensive literature review, 2) to examine the range of topics extracted from 3760 web pages and 3) to analyze the research activities on smart aging by conducting a content analysis of 4500 web pages of the NIH funded organizations' websites related to smart aging. The results of the comprehensive literature review indicate that the discussions on smart aging in the scientific publications are by and large classified into the following three directions: Technologies, Aging Medical Care, and Behavior and Social. In addition, the major topics from search engine datasets, which echoes more general discussions from various different parties, are related to entertainment program and social media, along with medical science and innovation technologies, whereas the research activities of NIH funded organizations focused on cross-disciplinary research in Behavioral and Social science, and Medical Care. [ABSTRACT FROM AUTHOR]

Background: New evidence with regard to a previously undocumented practice - self phlebotomy, known as 'bloodletting' - incontemporary injecting performance and image enhancing drug (PIED) culture is the subject of this paper. While self phlebotomy has been evidenced in psychiatric patients previously, it was performed here in people who inject AAS as a self directed health care procedure.Methods: Data was collected from five publicly accessible internet discussion forums and coded using NVivo software. For the purposes of this study, posts in relation to bloodletting were extracted from the final set of records for analysis RESULTS: Motivation to perform bloodletting or to 'self - bleed' was largely grounded in experiencing symptoms of high blood pressure or a high red blood cell count (RBC).Instructions on how to perform bloodletting were found within discussion threads.Conclusion: This study is intended to provide the first snapshot of online communal activity around practice of self-phlebotomy or bloodletting amongst people who inject AAS. Further research in this area is warranted, and will be of benefit to healthcare workers, treatment providers and policy makers particularly as this relates to evidence informed and targeted harm reduction policies and effective public health interventions. [ABSTRACT FROM AUTHOR]

The Flexible Lifestyle Empowering Change (FLEX) Intervention Study is a multi-site randomized controlled trial to test the efficacy of an adaptive behavioral intervention to promote self-management for youth with type 1 diabetes mellitus (T1D). This paper details FLEX design, demographic characteristics of the sample, and outcome variables at baseline. Participants were randomized to either an intervention or control arm after their baseline standardized measurement visit. Baseline data for the primary (glycemic levels) and secondary outcome variables (e.g., motivation and problem-solving, health-related quality of life, risk factors associated with T1D complications) as well as the potential mediator variables (e.g., self-management behavior, family conflict and responsibility) suggest that the study sample was representative of the general population of adolescents with T1D and their parents. The FLEX adaptive intervention is an innovative application of a tailored treatment intervention designed to be readily adopted in real-world practice to meet each adolescent's individualized T1D self-management goals. [ABSTRACT FROM AUTHOR]

Background The increasing prevalence of diabetes is well-documented along with the findings that some ethnic minorities have a higher prevalence than non-minority individuals. Along with possible biological differences between ethnicities, access to economic, social, cultural and symbolic capital may impact on the success of managing type-2 diabetes. Objectives To examine how people from ethnic minorities in Western countries describe their experiences of managing type-2 diabetes mellitus. Data sources PubMed and Ovid Medline databases. Eligibility criteria Studies between 1946 and July 2016 were included if they were qualitative in design and presented findings in relation to adults from ethnic minorities and their descriptions of self-managing type-2 diabetes mellitus. Study appraisal and synthesis The CASP evaluation for qualitative studies was used for quality appraisal and synthesis involved thematic analysis and evaluation of evidence using GRADE-CERQual approach. Findings Twenty-seven papers were included in the review. The primary studies were all conducted in middle-high income western countries with people from diverse ethnicities, although the majority were Black American. There was high confidence in the evidence that a sense of powerlessness, issues of treatment accessibility and acceptability, and the culturally defined roles within families impacted on how some participants managed their diabetes. There was moderate confidence in the evidence in relation to the cultural significance of food and for the cultural effect of stigma. Conclusion The potential for a sense of powerlessness to manage diabetes, the acceptability and accessibility of treatment, the significance of food, the impact of cultural roles and stigma needs to be pivotal to diabetes education for people from ethnic minorities in Western countries. [ABSTRACT FROM AUTHOR]

Neoliberalism, austerity and health responsibilisation are increasingly informing policies and practices designed to encourage older patients to take responsibility for the management of their own healthcare. Combined with an ageing population, novel ways to address the increasing healthcare needs of older people have become a priority, with the emergence in recent years of new models of integrated care enhanced by combinatorial health technologies (CHTs). This paper presents qualitative findings from the evaluation of one programme, the Lancashire and Cumbria Innovation Alliance (LCIA) Test Bed, a programme funded by NHS England and conducted in England between 2016 and 2018. Drawing on data from patients, family carers, and staff members involved in the programme, this paper explores the extent to which CHTs, as part of the LCIA Test Bed programme, contributed to health responsibilisation amongst older people with complex health conditions. Through this programme, we find that relationships between patients, family carers and healthcare professionals combined to create a sense of reassurance and shared responsibility for all parties. Our findings suggest the need for a more nuanced approach to responsibilisation and self-management for older people living with complex health conditions. By focusing on co-management – and recognising the potential of CHTs to facilitate this approach – there is potential to increase patient confidence in managing their health condition, reduce carer burden, and enhance clinician satisfaction in their work roles. While neoliberal agendas are focused on self-management and self-responsibility of one's own health care, with technology as a facilitator of this, our findings suggest that the successful use of CHTs for older people with complex health conditions may instead be rooted in co-management. This paper argues that co-management may be a more successful model of care for patients, carers and clinicians. • The use of CHTs in the programme encouraged health responsibilisation. • However, this was not through individual healthcare responsibilisation. • Rather, CHTs facilitated health co-management between patient, carer and staff. • Benefits included increased patient confidence and enhanced staff satisfaction. • Co-management may be a more successful model of care for these patients. [ABSTRACT FROM AUTHOR]

In this paper, we offer insights into practices of tracking as part of healthy living through talk about home blood pressure and weight from adults living in the UK. Drawing on theoretical resources from feminist ethics of care and Science and Technology Studies on care as socio-material practice, we build on interest in the relational dimensions of tracking and the potential for intimate surveillance and care using monitoring technologies. Our cases offer not only new perspectives in a field that has often focused on fitness tracking but also help go beyond a narrow focus on surveillance, showing how surveillance and care may be intertwined in the everyday negotiation of health-related tracking and other 'health practices' in family life. Using the diversity in our relatively large sample, and reflecting on the different types of interview completed, we highlight the varied ways in which adults engage with tracking blood pressure and weight (or body mass index) in the context of established relationships. The combination of attentiveness and appeals to responsibility for maintaining health as something owed to a partner can make tracking a very ethically sensitive area. In this paper we emphasise that reciprocity is one important way in which couples make tracking feel more like care. Tracking together or discussing it can take couples in this direction even if the actual practice remains somewhat difficult. On the other hand, responsiveness to someone else's feelings, including a desire to avoid the topic altogether, or avoid weight as a specific parameter, might all help move towards more caring tracking. We therefore develop a more sustained account of care in relation to tracking than in previous work, and a novel account of tracking as a (potential) care practice between adult partners. • Explores tracking of blood pressure and BMI in the context of 'healthy living'. • Combines insights from feminist ethics of care and STS 'care-in-practice'. • Analyses 'tracking-as-care' negotiated in intimate adult relationships. • Negotiations understood as practical ethics - disentangling care and surveillance. • Shows how method of joint interviews surface such negotiations. [ABSTRACT FROM AUTHOR]

Objective: Patients are seeking greater choice and flexibility in how they engage with self-management programmes. While digital innovations offer opportunities to deliver supportive interventions to patients undergoing cardiac rehabilitation little is known about how accessible, useful and acceptable they are for this group. This project developed a digital version of a leading evidenced cardiac rehabilitation programme, the Heart Manual (HM). The prototype was developed and evaluated iteratively in collaboration with end users.Methods: Using a mixed methods design 28 participants provided feedback using semi-structured questionnaires and telephone interviews.Results: Rich data revealed the perceived user-friendliness of the HM digital format and its effectiveness at communicating the programme's key messages. It flagged areas requiring development, such as more flexible and intuitive navigation pathways. These suggestions informed the refinement of the resource.Conclusion: This evaluation offers support for the new Digital Heart Manual and confirms the value of employing a user-centred approach when developing and improving online interventions. The system is now in use and recommendations from the evaluation are being translated into quality improvements.Practice Implications: The Digital Heart Manual is user friendly and accessible to patients and health professionals, regardless of age, presenting a suitable alternative to the paper version. [ABSTRACT FROM AUTHOR]