Design trade-offs in self-management technology: the HeartMan case

ABSTRACT

Health self-management technology has the potential to significantly improve the Quality of Life of patients suffering from chronic diseases. However, designing the technology involves numerous highly context-dependent design decisions. In this paper, we analyse a case study of self-monitoring technology in the field of congestive heart failure. We analyse the design process of the technology from the perspective of design trade-offs. Three important trade-offs related to health self-monitoring technology are described in detail, related to patient autonomy, technology appropriation, and patient well-being. For each of the trade-offs, various mediating factors that influence design decisions are described in detail. On a practical level, this analysis can inform future developments in self-management technology. In addition, this design trade-off analysis provides intermediary knowledge that can contribute to a better theoretical understanding of health self-management technology.     

大学生信守社会主义核心价值观“三自”理性演进论——基于主体能动价值的实现

依据马克思主义哲学观对人的主体能动价值实现的条件，联系高校对大学生社会主义核心价值观培育的实践，尊重、培育、强化大学生信守社会主义核心价值观的主体性就应当基于其主体能动价值的实现，应当尊重、培育、强化自为、自觉、自由的“三自”理性的能动性，使之信守社会主义核心价值观的“三自”理性能动性向着由高校引领的方向演进。     

Glycemic control among Latinos with type 2 diabetes: The role of social-environmental support resources.

Objective: Although active diabetes self-management is required to achieve glycemic control, adherence is poor among ethnic minorities, especially Latinos. Research shows that individuals who report greater social-environmental support resources for disease management manage their diabetes more effectively than those with fewer support resources. Methods: Path analysis was conducted to investigate the value of a multiple-mediator model in explaining how support resources for disease management influence hemoglobin A1c (HbA1c) levels in a sample of 208 Latinos with Type 2 diabetes recruited from low-income serving community clinics in San Diego County. We hypothesized that the relationship between support resources for disease-management and HbA1c would be mediated by diabetes self-management and/or depression. Results: Participants who perceived greater support resources for disease-management reported better diabetes self-management (β = .40, p     

Review and analysis of literature on self-management interventions to promote appropriate classroom behaviors (1988–2008).

In the late 1980s, J. W. Fantuzzo and colleagues conducted a review of the self-management literature in order to better define the characteristics of this class of interventions. Results indicated that many interventions were minimally student-directed despite the title “self-managed” and that student-managed interventions demonstrated incremental effects above teacher-managed interventions. In the current study, updated information was compiled with regard to how self-management interventions have been described, including the degree to which self-management interventions continue to rely on external (i.e., teacher) contingencies. Review of the literature identified 16 different characterizations of self-management interventions, each of which varied widely in terms of the number of intervention components included as well as the degree to which students were involved in implementation. Although self-observation and recording of a predefined behavior appear to be the cornerstones of self-management interventions, meaningful differences were noted, including whether reinforcement was involved and whether changes in performance were tracked over time. Furthermore, although self-management interventions appear to have undergone a small shift toward increased reliance on internal (i.e., student-managed) contingencies, adults continue to play a large role in the implementation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

基于系统级芯片和射频集成电路的无线网络卫星平台设计与验证

为解决传统卫星设计中有线连接带来的各种问题,提出了一种基于无线网络技术的卫星平台系统方案。该方案以嵌入式系统级芯片处理器及射频集成电路作为基本通信单元,进行了以星载计算机为核心的无线网络卫星平台结构的设计,集星务管理、任务管理和设备管理于一体的无线网络卫星通信协议的设计,星载计算机与其他分系统、部件和单元之间均采用无线方式进行数据交互,实现了无线网络卫星自主管理和即插即用,支持卫星的快速测试、快速集成和装配。通过无线网络：卫星平台原型系统软硬件设计、实现及测试,验证了无线卫星平台的可行性和设计的正确性、有效性。     

Medication Adherence and Diabetes Control in Urban African Americans With Type 2 Diabetes.

In 181 urban African Americans with Type 2 diabetes, medication adherence was assessed using a measure designed specifically for an urban, impoverished sociodemographic population. Hemoglobin A1c, blood pressure and cholesterol levels, medication-related beliefs, and depression were assessed. Seventy-four percent of the sample reported adherence to diabetes medication. Adherence, adjusted for age, was associated with lower hemoglobin A1c. The specific behaviors associated with poorer diabetes control were forgetting to take medications and running out of medications. Knowledge of blood glucose goals differed for adherers and nonadherers. Blood pressure and cholesterol medication adherence rates were not associated with actual levels of blood pressure or lipids, respectively. These data suggest that specific medication-taking behaviors are important to diabetes control and constitute logical targets for interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

基于mobile agent的分布式网络自管理模型

为了解决大规模、异构网络环境下基于“管理员密集”的传统网络管理模式带来的低效率和高出错率问题，提出了一种网络自管理模型，从网络管理的自动初始化和动态自管理两个方面实现对网络自动、自主、自适应的管理；提出了管理定位服务这一关键技术，在多个管理站协同工作的分布式网络环境中为设备自动定位出合适的管理站及初始的管理任务；采用可伸缩的分布式体系结构，适应了大规模网络的规模可变性等特点；基于mobile agent的管理框架进一步提高了管理的自适应性和灵活性。     

Stage of change in self-management of chronic diseases: Psychometric properties of the Chinese version of the University of Rhode Island Change Assessment (C-URICA) Scale.

Objective: The University of Rhode Island Change Assessment (URICA) Scale has been widely used to assess the readiness to change with regard to various health-related behaviors. The present study aimed to develop a Chinese version of the URICA (C-URICA) for measuring the readiness to change of Chinese participants with chronic diseases. Participants: A group of participants (N=101; 87 women and 14 men) in a chronic disease self-management program were asked to complete the C-URICA. Method: The C-URICA was conducted at the baseline, middle, and end of the 6-week program. Changes in self-management behaviors were also measured. Results: Factor analyses revealed a moderate item-to-subscale fit, indicating that structural validity was retained. Item analyses suggested a moderate item quality. The C-URICA subscales can differentially and effectively predict participants' gains in self-management behaviors at the completion of the intervention program. Conclusion: The C-URICA is suitable for use among Chinese patients with chronic diseases. Further studies should explore the generalizability of the results to different diagnostic groups and subgroups among Chinese populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Resources for health: A primary-care-based diet and physical activity intervention targeting urban Latinos with multiple chronic conditions.

Objective: The Resources for Health trial evaluates a social-ecologically based lifestyle (physical activity and diet) intervention targeting low-income, largely Spanish-speaking patients with multiple chronic conditions. Design: A randomized controlled trial was conducted with 200 patients recruited from an urban community health center and assigned to intervention and usual care conditions. Intervention involved 2 face-to-face, self-management support and community linkage sessions with a health educator, 3 follow-up phone calls, and 3 tailored newsletters. Main Outcome Measures: Primary outcomes measured at 6-months were changes in dietary behavior and physical activity. Changes in multilevel support for healthy living were evaluated as a secondary outcome. Results: After adjustment for age, sex, language, and number of chronic conditions, significant intervention effects were observed for dietary behavior and multilevel support for healthy lifestyles but not for physical activity. Conclusion: The Resources for Health intervention provides an effective and practical model for improving health behavior among low-income, Spanish-speaking patients with multiple chronic conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing a Self-Determination Theory Process Model for Promoting Glycemic Control Through Diabetes Self-Management.

A longitudinal study tested the self-determination theory (SDT) process model of health behavior change for glycemic control within a randomized trial of patient activation versus passive education. Glycosylated hemoglobin for patients with Type 2 diabetes (n=159) was assessed at baseline, 6 months, and 12 months. Autonomous motivation and perceived competence were assessed at baseline and 6 months, and the autonomy supportiveness of clinical practitioners was assessed at 3 months. Perceptions of autonomy and competence were promoted by perceived autonomy support, and changes in perceptions of autonomy and competence, in turn, predicted change in glycemic control. Self-management behaviors mediated the relation between change in perceived competence and change in glycemic control. The self-determination process model fit the data well. (PsycINFO Database Record (c) 2010 APA, all rights reserved)