Mixed methods feasibility study for a trial of blood pressure telemonitoring for people who have had stroke/transient ischaemic attack (TIA).

Background Good blood pressure (BP) control reduces the risk of recurrence of stroke/transient ischaemic attack (TIA). Although there is strong evidence that BP telemonitoring helps achieve good control, none of the major trials have considered the effectiveness in stroke/TIA survivors. We therefore conducted a feasibility study for a trial of BP telemonitoring for stroke/ TIA survivors with uncontrolled BP in primary care. Method Phase 1 was a pilot trial involving 55 patients stratified by stroke/TIA randomised 3:1 to BP telemonitoring for 6 months or usual care. Phase 2 was a qualitative evaluation and comprised semi-structured interviews with 16 trial participants who received telemonitoring and 3 focus groups with 23 members of stroke support groups and 7 carers. Results Overall, 125 patients (60 stroke patients, 65 TIA patients) were approached and 55 (44%) patients were randomised including 27 stroke patients and 28 TIA patients. Fifty-two participants (95%) attended the 6-month follow-up appointment, but one declined the second daytime ambulatory blood pressure monitoring (ABPM) measurement resulting in a 93% completion rate for ABPM − the proposed primary outcome measure for a full trial. Adherence to telemonitoring was good; of the 40 participants who were telemonitoring, 38 continued to provide readings throughout the 6 months. There was a mean reduction of 10.1 mmHg in systolic ABPM in the telemonitoring group compared with 3.8 mmHg in the control group, which suggested the potential for a substantial effect from telemonitoring. Our qualitative analysis found that many stroke patients were concerned about their BP and telemonitoring increased their engagement, was easy, convenient and reassuring Conclusions A full-scale trial is feasible, likely to recruit well and have good rates of compliance and follow-up.

Going global in small steps: e-internships in SMEs.

Technological developments over the last thirty years increasingly shaped the means by which we recruit, select and appraise employees. Today, technology supports more flexible and geographically dispersed working modes: From teleworkers, to virtual workers, to e-interns (also known as virtual interns). The current article describes how developments in e-HRM and changes in employment forms contribute to the development and increasing popularity of e-internships (better known as virtual internships) amongst small and medium-sized enterprises. In this paper, we reflect on the rise of e-internships across different countries and relate this to e-HRM and technological advances. We explore the opportunities and challenges. These include developing effective global talent and knowledge management practices, managing diversity as well as intellectual and social capital. We furthermore link the employment of e-internship practices to strategic organizational goals and learning. In the final section, we also critically reflect on the high investment required for e-internships to succeed. The discussion on e-internships is set in the literature on e-HRM, virtual teams and knowledge management, which is furthermore supported by interviews conducted with e-interns or internship managers. Keywords: e-internships, virtual internships, computer-mediated communication