Development and evaluation of a computer-based, self-management tool for people recently diagnosed with type 2 diabetes

Aim. The purpose of this study was to develop and evaluate a computer-based, dietary, and physical activity self-management program for people recently diagnosed with type 2 diabetes. Methods. The computer-based program was developed in conjunction with the target group and evaluated in a 12-week randomised controlled trial (RCT). Participants were randomised to the intervention (computer-program) or control group (usual care). Primary outcomes were diabetes knowledge and goal setting (ADKnowl questionnaire, Diabetes Obstacles Questionnaire (DOQ)) measured at baseline and week 12. User feedback on the program was obtained via a questionnaire and focus groups. Results. Seventy participants completed the 12-week RCT (32 intervention, 38 control, mean age 59 (SD) years). After completion there was a significant between-group difference in the "knowledge and beliefs scale" of the DOQ. Two-thirds of the intervention group rated the program as either good or very good, 92% would recommend the program to others, and 96% agreed that the information within the program was clear and easy to understand. Conclusions. The computer-program resulted in a small but statistically significant improvement in diet-related knowledge and user satisfaction was high. With some further development, this computer-based educational tool may be a useful adjunct to diabetes self-management. This trial is registered with clinicaltrials.gov NCT number NCT00877851.

Computer-simulated environment for training : challenge of efficacy evaluation

Computer-assisted instruction has been around for decades. There has been much speculation about the benefits of computer-mediated learning. Numerous applications have been developed in different domains incorporated with emerging technologies. In recently years, advanced technologies, such as Augmented Reality (AR) and Virtual Reality (VR), have received much attention in their potential of creating interactive learning experience for the users. However, related literature and empirical studies indicated that learning effects in computer-simulated environments or Virtual Environments (VEs) are not systematically tested. Furthermore, the performance and learning in computer-simulated learning environment need to be evaluated through more rigorous methods. This paper suggests that 1) the efficacy of VEs is subject to a close examination, not only in terms of how VE-based training systems are easy of use, but also in terms of how effective learning is; 2) evaluation of learning in computer simulated learning environments is required to be reconsidered in terms of theoretical basis and evaluation methodologies that are relevant to the measurement of training effectiveness in computer-simulated virtual learning environment. This paper explains on how learning can be assessed in VEs through the lens of training evaluation.

Home-based resistance training is not sufficient to maintain improved glycemic control following supervised training in older individuals with type 2 diabetes

OBJECTIVE—To examine whether improvements in glycemic control and body composition resulting from 6 months of supervised high-intensity progressive resistance training could be maintained after an additional 6 months of home-based resistance training.

RESEARCH DESIGN AND METHODS—We performed a 12-month randomized controlled trial in 36 sedentary, overweight men and women with type 2 diabetes (aged 60–80 years) who were randomly assigned to moderate weight loss plus high-intensity progressive resistance training (RT&WL group) or moderate weight loss plus a control program (WL group). Supervised gymnasium-based training for 6 months was followed by an additional 6 months of home-based training. Glycemic control (HbA_1c), body composition, muscle strength, and metabolic syndrome abnormalities were assessed at 0, 3, 6, 9, and 12 months.

RESULTS—Compared with the WL group, HbA_1c decreased significantly more in the RT&WL group (–0.8%) during 6 months of supervised gymnasium-based training; however, this effect was not maintained after an additional 6 months of home-based training. In contrast, the greater increase in lean body mass (LBM) observed in the RT&WL group compared with the WL group (0.9 kg, P < 0.05) after the gymnasium-based training tended to be maintained after the home-based training (0.8 kg, P = 0.08). Similarly, the gymnasium-based increases in upper body and lower body muscle strength in the RT&WL group were maintained over the 12 months (P < 0.001). There were no between-group differences for changes in body weight, fat mass, fasting glucose, or insulin at 6 or 12 months.

CONCLUSIONS—In older adults with type 2 diabetes, home-based progressive resistance training was effective for maintaining the gymnasium-based improvements in muscle strength and LBM but not glycemic control. Reductions in adherence and exercise training volume and intensity seem to impede the effectiveness of home-based training for maintaining improved glycemic control.

Haptically enable interactive virtual assembly training system development and evaluation

Virtual training systems are attracting paramount attention from the manufacturing industries due to their potential advantages over the conventional training practices. Significant cost savings can be realized due to the shorter times for the development of different training-scenarios as well as reuse of existing designed engineering (math) models. In addition, use of computer based virtual reality (VR) training systems can shorten the time span from computer aided product design to commercial production due to non-reliance on the hardware parts for training. Within the aforementioned conceptual framework, a haptically enabled interactive and immersive virtual reality (HIVEx) system is presented. Unlike existing VR systems, the presented idea tries to imitate real physical training scenarios by providing comprehensive user interaction, constrained within the physical limitations of the real world. These physical constrains are imposed by the haptics devices in the virtual environment. As a result, in contrast to the existing VR systems that are capable of providing knowledge generally about assembly sequences only, the proposed system helps in cognitive learning and procedural skill development as well, due to its high physically interactive nature.

An interval type-2 fuzzy logic system-based method for prediction interval construction

This paper introduces a new non-parametric method for uncertainty quantification through construction of prediction intervals (PIs). The method takes the left and right end points of the type-reduced set of an interval type-2 fuzzy logic system (IT2FLS) model as the lower and upper bounds of a PI. No assumption is made in regard to the data distribution, behaviour, and patterns when developing intervals. A training method is proposed to link the confidence level (CL) concept of PIs to the intervals generated by IT2FLS models. The new PI-based training algorithm not only ensures that PIs constructed using IT2FLS models satisfy the CL requirements, but also reduces widths of PIs and generates practically informative PIs. Proper adjustment of parameters of IT2FLSs is performed through the minimization of a PI-based objective function. A metaheuristic method is applied for minimization of the non-linear non-differentiable cost function. Performance of the proposed method is examined for seven synthetic and real world benchmark case studies with homogenous and heterogeneous noise. The demonstrated results indicate that the proposed method is capable of generating high quality PIs. Comparative studies also show that the performance of the proposed method is equal to or better than traditional neural network-based methods for construction of PIs in more than 90% of cases. The superiority is more evident for the case of data with a heterogeneous noise. © 2014 Elsevier B.V.

Evaluation of a comprehensive interactive training system for investigative interviewers of children

This article reports on the evaluation of an interactive interviewer training system with a large, heterogeneous sample of investigative interviewers of children. The system, delivered predominantly through computer-assisted learning activities, focused on how to elicit important evidential details from child witnesses in a narrative format. Two studies are reported, each adopting a pre-versus posttraining design. Study 1 examined the effect of the training on trainees' (N = 92) performance, using mock interviews where an actor played the role of the child in a highly controlled manner. Study 2 examined the effect of the training on field interviews (N = 156) conducted prior to and after the training. Five measures were analyzed: (a) proportion of interviewer question types, (b) proportion of desirable interviewer behaviors, (c) adherence to the interview protocol, (d) interview length, and (e) the quality of evidential information sought. Overall, the findings provide clear support for the utility of the training system. Irrespective of the type of interview or measure, adherence to best-practice interviewing increased from pre- to posttraining, with some evidence supporting sustained performance 12 months after there had been no intervening training or supervision. The implication is that there is now an evidence-based alternative to the traditional classroom-based training system for investigative interviewers. Suggestions for future research are also discussed.

Online video-based resistance training improves the physical capacity of junior basketball athletes

Junior basketball athletes require a well-designed resistance training program to improve their physical development. Lack of expert supervision and resistance training in junior development pathways may be overcome by implementing an online video-based program. The aim of this study was to compare the magnitude of improvement (change) in physical performance and strength and functional movement patterns of junior basketball athletes using either a fully supervised or an online video-based resistance training program. Thirty-eight junior basketball athletes (males, n = 17; age, 14 ± 1 year; height, 1.79 ± 0.10 m; mass, 67 ± 12 kg; females, n = 21; age, 15 ± 1 year; height, 1.70 ± 0.07 m; mass, 62 ± 8 kg) were randomly assigned into a supervised resistance training group (SG, n = 13), video training group (VG, n = 13) or control group (CG, n = 12) and participated in a 6-week controlled experimental trial. Pre- and posttesting included measures of physical performance (20-m sprint, step-in vertical jump, agility, sit and reach, line drill, and Yo-Yo intermittent recovery level 1), strength (15 s push-up and pull-up), and functional movement screening (FMS). Both SG and VG achieved 3-5% ± 2-4% (mean ± 90% confidence limits) greater improvements in several physical performance measures (vertical jump height, 20-m sprint time, and Yo-Yo endurance performance) and a 28 ± 21% greater improvement in push-up strength compared with the CG. The SG attained substantially larger gains in FMS scores over both the VG (12 ± 10%) and CG (13 ± 8%). Video-based training appears to be a viable option to improve physical performance and strength in junior basketball athletes. Qualified supervision is recommended to improve functional movement patterns in junior athletes.

Coaches' perceptions of golf swing kinematics

Using a computer-based videotape analysis system, a randomized series of golf swings was presented to 10 professional and 10 amateur golf coaches in an attempt to determine differences m their internal model of golf swing kinematics. A global measure was obtained by having coaches independently inspect the swings of eight golfers and estimate their golf handicaps. A micro level of analysis was undertaken by requiring participants to indicate what they considered to be 'ideal' swing characteristics using 17 predetermined limb, club, and body position angles for various phases of the swing Videotaped swings for a highly skilled and beginner level golfer were used for this task. Although the training requirements for professional coaches are much more demanding and their playing ability higher, evidence of internal model differences was not found in the handicap estimation task. It was also established that a golfer's swing may be perceived to have deficiencies but still produce sufficient accuracy to engender a low handicap On the second task, only one of the 17 estimated swing angles showed a significant difference between the coach groups. When, however, the two coach groups indicated their preferred angles for the highly skilled golfer and the beginner, 6 of the 17 angles were significantly different. The implications of these findings are that the two coach groups had similar ability to identify fundamental characteristics of the golf swing, but their model of the ideal swing was influenced by the observed golfer's skill level.

A risk analysis model to reduce computer security risks among healthcare organizations

The paper describes the on-going development of a new computer-based security risk analysis methodology that may be used to determine the computer security requirements of medical computer systems. The methodology has been developed for use within healthcare, with particular emphasis placed upon protecting medical information systems. The paper goes on to describe some of the problems with existing automated risk analysis systems, and how the ODESSA system may overcome the majority of these problems. Examples of security scenarios are also presented.

Does high-intensity resistance training maintain bone mass during moderate weight loss in older overweight adults with type 2 diabetes?

The aim was to investigate whether the addition of supervised high intensity progressive resistance training to a moderate weight loss program (RT+WLoss) could maintain bone mineral density (BMD) and lean mass compared to moderate weight loss (WLoss) alone in older overweight adults with type 2 diabetes. We also investigated whether any benefits derived from a supervised RT program could be sustained through an additional home-based program. This was a 12-month trial in which 36 sedentary, overweight adults aged 60 to 80 years with type 2 diabetes were randomized to either a supervised gymnasium-based RT+WLoss or WLoss program for 6 months (phase 1). Thereafter, all participants completed an additional 6-month home-based training without further dietary modification (phase 2). Total body and regional BMD and bone mineral content (BMC), fat mass (FM) and lean mass (LM) were assessed by DXA every 6 months. Diet, muscle strength (1-RM) and serum total testosterone, estradiol, SHBG, insulin and IGF-1 were measured every 3 months. No between group differences were detected for changes in any of the hormonal parameters at any measurement point. In phase 1, after 6 months of gymnasium-based training, weight and FM decreased similarly in both groups (P<0.01), but LM tended to increase in the RT+WLoss (n=16) relative to the WLoss (n=13) group [net difference (95% CI), 1.8% (0.2, 3.5), P<0.05]. Total body BMD and BMC remained unchanged in the RT+WLoss group, but decreased by 0.9 and 1.5%, respectively, in the WLoss group (interaction, P<0.05). Similar, though non-significant, changes were detected at the femoral neck and lumbar spine (L2-L4). In phase 2, after a further 6 months of home-based training, weight and FM increased significantly in both the RT+WLoss (n=14) and WLoss (n=12) group, but there were no significant changes in LM or total body or regional BMD or BMC in either group from 6 to 12 months. These results indicate that in older, overweight adults with type 2 diabetes, dietary modification should be combined with progressive resistance training to optimize the effects on body composition without having a negative effect on bone health.

The Australasian triage scale: examining emergency department nurses' performance using computer and paper scenarios

Study objective: The purpose of this study is to examine emergency nurses' performance using triage scenarios characterized by type of patient population (adult versus pediatric) and mode of delivery (paper versus computer). Methods:   A combination of paper-based (script alone) and computer-based (script plus still photographs) triage scenarios were used. Of the 28 scenarios used, half were written and half were computer based. Within each subgroup, there were 7 adult and 7 pediatric scenarios. Participants were asked to allocate an Australasian Triage Scale category for each triage scenario. Results: One hundred sixty-seven participants completed a total of 2,349 adult scenarios, and 161 participants completed 2,265 pediatric scenarios. Sixty-one percent of the triage decisions made by the nurses were “expected” triage decisions, 18% were “undertriage,” decisions, and 21% were “overtriage” decisions. Nurse triage allocation decisions for the scenarios containing still photographs delivered by computer demonstrated a higher average agreement percentage of 66.2% (κ=0.56; τb=0.77; P<.0001) compared with the average agreement percentage of 55.4% (κ=0.42; τb=0.75; P<.0001) using paper-based (text-only) scenarios. Conclusion: The mode of delivery appeared to have an effect on the nurses' triage performance. It is unclear whether the use of simple still photographs used in the computer mode of delivery resulted in a higher incidence of expected triage decisions and, thus, improved performance. The use of cues such as photographs and video footage to enhance the fidelity of triage scenarios may be useful not only for the education of triage nurses but also the conduct of research into triage decisionmaking. However, further exploration and research in this area are warranted.

Usage of a computer conferencing system by on- and off-campus engineering students

This paper reports on the introduction of a computer conferencing  component into a first year study unit in Technology Management at Deakin University, Australia. It was found that significant variations in computer  usage were correlated to student study mode, including source of computer access, source of Internet access, hours per week computer usage, regular use of email, regular use of the Internet, and number of times the conference was accessed. Other moderate differences were also noted. Following  exposure to the computer conference, on-campus students were more likely to agree computers could assist their learning, and off-campus students  were less likely to agree that learning from computers would be better than classes/lectures.

Challenges in designing culturally-adaptive ICT-based learning environments

This paper argues that two of the major problems facing local courseware developers and educators in creating culturally-sensitive lCT-based learning environments are the difficulties of representing cultural artefacts in courseware and of having a model of 'culture' that can be implemented in lCT-based systems. A developing learning-object model is presented; one that can be adopted to address aspects of this problem by providing a systematic way to approach implementing and representing cultural artefacts in courseware. This also provides a basis for some aspects of computer-based cultural preservation initiatives. While this approach may have higher short term development costs, the potential long term cultural benefits to the society far outweigh short term considerations.

Effects of high-intensity progressive resistance training on self-reported health status in older persons with type 2 diabetes

Purpose: To evaluate the influence of high-intensity progressive resistance training (PRT) on self-reported physical and mental health in older persons with type 2 diabetes.

Methods: We performed a 12-month RCT with 36 overweight men and women with type 2 diabetes (aged 60-80 years) who were randomly assigned to a moderate weight-loss diet plus PRT (PRT&WL) or a moderate weight-loss diet plus a control (stretching) program (WL). Gymnasium-based training for 6 months was followed by an additional 6 months of home-based training. The SF-36 (v1) questionnaire was used to obtain physical (PCS) and mental (MCS) health component summary scores at baseline, 6 and 12 months.

Results: Subject retention was 81% and 72% after 6 and 12 months respectively. Exercise adherence during gymnasium- and home-based training was 88% and 73% for the PRT&WL group, and 85% and 78.1% for the WL group respectively. In a regression model adjusted for age and sex, PCS improved in the PRT&WL group compared to the WL group after 6 months of gymnasium-based training (2.3 versus -2.0, p = 0.05), which persisted after 12 months training (0.7 versus -4.1, p = 0.03). There were no between-group differences at 6 or 12 months for the MCS.

Conclusion: High-intensity PRT was effective in improving self-reported physical health, but not mental health. PRT provides an effective exercise alternative in lifestyle management for older adults with type 2 diabetes.

Haptically enabled interactive virtual reality prototype for general assembly

Desktop computers based virtual training systems are attracting paramount attention from manufacturing industries due to their potential advantages over the conventional training practices. Significant cost savings can be realized due to the shorter training-scenarios development times and reuse of existing engineering models. In addition, by using computer based virtual reality (VR) training systems, the time span from the product design to commercial production can be shortened due to non-reliance on hardware parts. Within the aforementioned conceptual framework, a haptically enabled interactive and immersive virtual reality (HIIVR) system is presented. Unlike existing VR systems, the presented idea tries to imitate real physical training scenarios by providing comprehensive user interaction, constrained within the physical limitations of the real world imposed by the haptics devices within the virtual environment. As a result, in contrast to the existing VR systems, capable of providing knowledge generally about assembly sequences only, the proposed system helps in procedural learning and procedural skill development as well, due to its high physically interactive nature.