Supporting self-management: development and evaluation of a digital resource for adults with asthma

The problem: Around 300 million people worldwide have asthma and prevalence is increasing. Support for optimal self-management can be effective in improving a range of outcomes and is cost effective, but is underutilised as a treatment strategy. Supporting optimum self-management using digital technology shows promise, but how best to do this is not clear. Aim: The purpose of this project was to explore the potential role of a digital intervention in promoting optimum self-management in adults with asthma. Methods: Following the MRC Guidance on the Development and Evaluation of Complex Interventions which advocates using theory, evidence, user testing and appropriate modelling and piloting, this project had 3 phases. Phase 1: Examination of the literature to inform phases 2 and 3, using systematic review methods and focussed literature searching. Phase 2: Developing the Living Well with Asthma website. A prototype (paper-based) version of the website was developed iteratively with input from a multidisciplinary expert panel, empirical evidence from the literature (from phase 1), and potential end users via focus groups (adults with asthma and practice nurses). Implementation and behaviour change theories informed this process. The paper-based designs were converted to the website through an iterative user centred process (think aloud studies with adults with asthma). Participants considered contents, layout, and navigation. Development was agile using feedback from the think aloud sessions immediately to inform design and subsequent think aloud sessions. Phase 3: A pilot randomised controlled trial over 12 weeks to evaluate the feasibility of a Phase 3 trial of Living Well with Asthma to support self-management. Primary outcomes were 1) recruitment & retention; 2) website use; 3) Asthma Control Questionnaire (ACQ) score change from baseline; 4) Mini Asthma Quality of Life (AQLQ) score change from baseline. Secondary outcomes were patient activation, adherence, lung function, fractional exhaled nitric oxide (FeNO), generic quality of life measure (EQ-5D), medication use, prescribing and health services contacts. Results: Phase1: Demonstrated that while digital interventions show promise, with some evidence of effectiveness in certain outcomes, participants were poorly characterised, telling us little about the reach of these interventions. The interventions themselves were poorly described making drawing definitive conclusions about what worked and what did not impossible. Phase 2: The literature indicated that important aspects to cover in any self-management intervention (digital or not) included: asthma action plans, regular health professional review, trigger avoidance, psychological functioning, self-monitoring, inhaler technique, and goal setting. The website asked users to aim to be symptom free. Key behaviours targeted to achieve this include: optimising medication use (including inhaler technique); attending primary care asthma reviews; using asthma action plans; increasing physical activity levels; and stopping smoking. The website had 11 sections, plus email reminders, which promoted these behaviours. Feedback during think aloud studies was mainly positive with most changes focussing on clarification of language, order of pages and usability issues mainly relating to navigation difficulties. Phase 3: To achieve our recruitment target 5383 potential participants were invited, leading to 51 participants randomised (25 to intervention group). Age range 16-78 years; 75% female; 28% from most deprived quintile. Nineteen (76%) of the intervention group used the website for an average of 23 minutes. Non-significant improvements in favour of the intervention group observed in the ACQ score (-0.36; 95% confidence interval: -0.96, 0.23; p=0.225), and mini-AQLQ scores (0.38; -0.13, 0.89; p=0.136). A significant improvement was observed in the activity limitation domain of the mini-AQLQ (0.60; 0.05 to 1.15; p = 0.034). Secondary outcomes showed increased patient activation and reduced reliance on reliever medication. There was no significant difference in the remaining secondary outcomes. There were no adverse events. Conclusion: Living Well with Asthma has been shown to be acceptable to potential end users, and has potential for effectiveness. This intervention merits further development, and subsequent evaluation in a Phase III full scale RCT.

Modelo para formação dinâmica de rede de fornecedores em empresas estendidas

Supply chains have become an important focus for competitive advantage. The performance of a company increasingly depends on its ability to maintain effective and efficient relationships with its suppliers and customers. The extended enterprise (i.e. composed of several partners) needs to be dynamically formed in order to be agile and adaptable. According to the Digital Manufacturing paradigm, companies have to be able to quickly share and disseminate information regarding planning, designing and manufacturing of products. Additionally, they must be responsive to all technical and business determinants, as well as be assessed and certified for guaranteed performance. The current research intends to present a solution for the dynamic composition of the extended enterprise, formed to take advantage of market opportunities quickly and efficiently. A construction model was developed. This construction model consists of: information model, protocol model and process model. The information model has been defined based on the concepts of Supply Chain Operations Reference model (SCOR®). In this model is defined information for negotiating the participation of candidate companies in the dynamic establishment of a network for responding to a given demand for developing and manufacturing products, in seven steps as follows: request for information; request for qualification; alignment of strategy; request for proposal; request for quotation; compatibility of process; and compatibility of system. The protocol model has been elaborated and inspired in the OSI, this model provides a framework for linking customers and suppliers, indicates a sequence to be followed, in order to selecte companies to become suppliers. The process model has been implemented by means of process modeling according to the BPMN standard and, in turn, implemented as a web-based application that runs the process through its several steps, which uses forms to gather data. An application example in the context of the oil and gas industry is used for demonstrating the solution concept.

Spatial multicriteria decision analysis to potential beekeeping assessment. Case study: Montesinho Natural Park (Portugal)

The Multicriteria decision analysis is a tool to support decision-making in the identification of areas with the utmost beekeeping potential. This paper design a GIS multicriteria approach to assess the beekeeping potential. The development of a conceptual model structure requires the participation of stakeholders and experts in that process. The spatial Multicriteria Decision Analysis (MCDA) allowed defining the potential beekeeping map. The resulting maps can be used by the beekeepers associations to easily select the more suitable areas for the apiaries location or relocation and avoid prohibited areas by legal requirements.

Primer registro de Helcystogramma sp.(Lepidoptera: Gelechiidae) en Cuba.

Helcystogramma sp., es una nueva especie de microlepidóptero que afecta desde la siembra hasta la cosecha del boniato o camote (Ipomoea batatas L. Lam.) en Cuba. Debido a la falta de conocimientos y a la escasa bibliografía relacionada con las especies del género Helcystogramma en nuestro país, nos propusimos como objetivo conocer aspectos bio-ecológicos de este microlepidóptero, con la finalidad de proporcionar nuevos conocimientos para un futuro manejo de esta plaga. El trabajo se realizó desde septiembre 2013 a septiembre de 2014, en el Instituto de Investigaciones de Viandas Tropicales (INIVIT), Santo Domingo, Villa Clara, Cuba. Los insectos se estudiaron por observación directa en campos de I. batatas. La larva de este microlepidóptero es muy ágil, dobla la hoja, la cual pega con hilos de seda, creando una protección para su desarrollo hasta el estado de pupa, se alimenta dentro de esta cavidad a partir de la misma hoja, sin afectar la epidermis inferior. Sus poblaciones han aumentado considerablemente, llegando a 20 larvas/m2 en verano. La especies Helcystogramma sp., se cita por primera vez para Cuba y además se registra como una nueva especie de insecto que se alimenta del boniato. ABSTRACT. Primer registro de Helcystogramma sp. (Lepidoptera: Gelechiidae) en Cuba. Helcystogramma sp. is a new species of microlepidoptera affecting from planting to sweet potato (I. batatas L. Lam.) harvest crop in Cuba. Due to the lack of knowledgze and limited literature relate with the Helcystogramma genus in our country, the goal of this study was to know the bioecological aspects of such microlepidoptera, in order to provide new insights for future management of this pest. The study was conducted from September 2013 to September 2014 at the Research Institute of Tropical Root and Tuber Crops, Bananas and Plantains (INIVIT), Santo Domingo, Villa Clara, Cuba. Insects were studied by direct observation in sweet potato (I. batatas) fields. The microlepidoptera larvae is very agile, folds the sheet which sticks with silk threads, creating a protection for its development to the pupal stage. The larvae will feed in the cavity from the same leaf without affecting the lower epidermis. Their populations have increased significantly, reaching 20 larvae / m2 in summer. The species Helcystogramma sp., is cited for the first time in Cuba and it is reported as a new species of insect that feeds on sweet potato leaves.

Modelo institucional do processo de estruturação de empresas de desenvolvimento de software: um estudo de múltiplos casos

Some authors have shown the need of understanding the technological structuring process in contemporary firms. From this perspective, the software industry is a very important element because it provides products and services directly to many organizations from many fields. In this case, the Brazilian software industry has some peculiarities that distinguish it from other industries located in developed countries, which makes its understanding even more relevant. There is evidence that local firms take different strategies and structural configurations to enter into a market naturally dominated by large multinational firms. Therefore, this study aims to understand not only the structural configurations assumed by domestic firms but also the dynamic and the process that lead to these different configurations. To do so, this PhD dissertation investigates the institutional environment, its entities and the isomorphic movements, by employing an exploratory, descriptive and explanatory multiple cases study. Eight software development companies from the Recife's information technology Cluster were visited. Also, a form was applied and an interview with one of the main firm s professional was conducted. Although the study is predominantly qualitative, part of the data was analyzed through charts and graphs, providing a companies and environment overview that was very useful to analysis done through the interviews interpretation. As a result, it was realized that companies are structured around hybrids business models from two ideal types of software development companies, which are: software factory and technology-based company. Regarding the development process, it was found that there is a balanced distribution between the traditional and agile development paradigm. Among the traditional methodologies, the Rational Unified Process (RUP) is predominant. The Scrum is the most used methodology among the organizations based on the Agile Manifesto's principles. Regarding the structuring process, each institutional entity acts in such way that generates different isomorphic pressure. Emphasis was given to entities such as customers, research agencies, clusters, market-leading businesses, public universities, incubators, software industry organizations, technology vendors, development tool suppliers and manager s school and background because they relate themselves in a close way with the software firms. About this relationship, a dual and bilateral influence was found. Finally, the structuring level of the organizational field has been also identified as low, which gives a chance to organizational actors of acting independently

Multiwavelength observations of the blazar 1ES 1011+496 in Spring 2008

The BL Lac object 1ES 1011+496 was discovered at Very High Energy (VHE, E>100GeV) γ-rays by MAGIC in spring 2007. Before that the source was little studied in different wavelengths. Therefore a multi-wavelength (MWL) campaign was organized in spring 2008. Along MAGIC, the MWL campaign included the Mets¨ahovi radio observatory, Bell and KVA optical telescopes and the Swift and AGILE satellites. MAGIC observations span from March to May, 2008 for a total of 27.9 hours, of which 19.4 hours remained after quality cuts. The light curve showed no significant variability yielding an integral flux above 200 GeV of (1.3 ± 0.3) × 10^(−11) photons cm^(−2) s^( −1) . The differential VHE spectrum could be described with a power-law function with a spectral index of 3.3 ± 0.4. Both results were similar to those obtained during the discovery. Swift XRT observations revealed an X-ray flare, characterized by a harder-when-brighter trend, as is typical for high synchrotron peak BL Lac objects (HBL). Strong optical variability was found during the campaign, but no conclusion on the connection between the optical and VHE γ-ray bands could be drawn. The contemporaneous SED shows a synchrotron dominated source, unlike concluded in previous work based on non-simultaneous data, and is well described by a standard one–zone synchrotron self–Compton model. We also performed a study on the source classification. While the optical and X-ray data taken during our campaign show typical characteristics of an HBL, we suggest, based on archival data, that 1ES 1011+496 is actually a borderline case between intermediate and high synchrotron peak frequency BL Lac objects.

¿Es Necesario un Nuevo Nombre para el Bibliotecario?

A pesar de que conservamos el nombre arcaico, ligado a la concepción del libro y de la biblioteca como depósito de libros, frente a un acelerado desarrollo que involucro tecnologías y materiales digitales en el manejo de información, es un hecho que en las últimas décadas el prestigio del bibliotecario como erudito y especialista ha cambiado por el de ser un buscador y un proveedor ágil y especializado en la amplia gama de recursos informativos que nos rodea.La tendencia más seguida es que la profesión debe cambiar pasando a enfatizar otras habilidades como la gerencia, puesto que las bibliotecas serán evaluadas por los servicios que ofrecen y no tanto por los acervos que poseen. Sin embargo, que las bibliotecas como tal persisten es un hecho que se comprueba con la famosa Biblioteca de París, que está diseñada en forma de libro precisamente.

Embedding sustainability into the new computer science curriculum for English schools

The primary goals of this study are to: embed sustainable concepts of energy consumption into certain part of existing Computer Science curriculum for English schools; investigate how to motivate 7-to-11 years old kids to learn these concepts; promote responsive ICT (Information and Communications Technology) use by these kids in their daily life; raise their awareness of today’s ecological challenges. Sustainability-related ICT lessons developed aim to provoke computational thinking and creativity to foster understanding of environmental impact of ICT and positive environmental impact of small changes in user energy consumption behaviour. The importance of including sustainability into the Computer Science curriculum is due to the fact that ICT is both a solution and one of the causes of current world ecological problems. This research follows Agile software development methodology. In order to achieve the aforementioned goals, sustainability requirements, curriculum requirements and technical requirements are firstly analysed. Secondly, the web-based user interface is designed. In parallel, a set of three online lessons (video, slideshow and game) is created for the website GreenICTKids.com taking into account several green design patterns. Finally, the evaluation phase involves the collection of adults’ and kids’ feedback on the following: user interface; contents; user interaction; impacts on the kids’ sustainability awareness and on the kids’ behaviour with technologies. In conclusion, a list of research outcomes is as follows: 92% of the adults learnt more about energy consumption; 80% of the kids are motivated to learn about energy consumption and found the website easy to use; 100% of the kids understood the contents and liked website’s visual aspect; 100% of the kids will try to apply in their daily life what they learnt through the online lessons.

Metodología ágil para equipos pequeños usando plataformas Microsoft

Con el objetivo de mejorar el rendimiento de los equipos de desarrollo de software se han definido muchas metodologías de desarrollo, entre las que se encuentran las prescriptivas y las ágiles. Pese a esto, los equipos no suelen emplear ninguna por no encontrarlas ajustadas a su contexto particular, y se van directamente a la tarea de programar. En este artículo se propone una metodología de desarrollo de software ligera y adaptada a un contexto preciso y bien definido, que alinea Microsoft Solutions Framework for Agile Software Development (MSF4ASD) con los lineamientos de gestión de proyectos presentados en la Guía del PMBOK. Además, se brindan elementos para la implementación de una plataforma Microsoft de desarrollo de software en equipo para soportarla.

O touro na mitologia egípcia : Ápis, cerimónias, insígnias e epítetos reais

Os antigos Egípcios acreditavam que o touro poderoso representava a personalidade do próprio faraó. O touro estava, de facto, intimamente associado ao Estado faraónico, estando presente ao nível dos regalia (cauda taurina) e significativamente nos próprios epítetos reais (ka nakht). Na mitologia egípcia, de todos os touros sagrados o que maior projecção alcançou, como deus agrário da fecundidade, da vegetação renascida e da ressurreição, foi, seguramente, o touro Ápis, associado em Mênfis aos deuses Ptah e Osíris. Na sua condição de touro ágil, vigoroso e viril, Ápis era um intermediário consistente entre o mundo dos vivos e o dos mortos, além de ser um propiciador de fertilidade e renascimento quando associado ao deus-Sol. A sua participação, literalmente ao lado do faraó, na «corrida ritual», importante cerimónia no âmbito da concepção ideológica do poder real, reforçou ainda mais a sua importância no seio do panteão egípcio.

Intelligence, Surveillance & Reconnaissance como Agente de Mudança

O século XXI introduziu profundas mudanças no espaço onde a atuação militar se desenvolve. Esta mutação, que agora inclui o domínio físico e cognitivo na ação militar, impõe a adoção de novos conceitos de operação e estruturas organizacionais mais ágeis, de forma a fazerem face a um ambiente altamente volátil, imprevisível e complexo. Tal contexto torna as organizações, hoje mais do que nunca, dependentes de informação (e dos sistemas que as geram), e no âmbito das organizações militares, uma capacidade em particular assume, na atualidade, uma preponderância fulcral para o sucesso destas, que se designa por Intelligence, Surveillance & Reconnaissance (ISR). Considerando a complexidade de sistemas, processos e pessoas que envolvem toda esta capacidade, torna-se relevante estudar como a Força Aérea Portuguesa (FAP) está a acomodar este conceito no interior da sua estrutura, uma vez que a sua adaptação requer uma organização da era da informação, onde o trabalho em rede assume particular destaque. A presente investigação analisa formas de estruturas organizacionais contemporâneas e cruza-as com as recomendações da Organização do Tratado do Atlântico Norte (também designada por Aliança), comparando-as posteriormente com a atualidade da FAP. No final, são efetuadas propostas tangíveis, que podem potenciar as capacidades existentes, de onde se destaca a criação de uma matriz de análise quanto à eficiência organizacional, uma nova forma de organização das capacidades residentes no que ao ISR concerne, bem como o modo de potenciar o trabalho em rede com base nos meios existentes. Abstract: The 21st century has caused profound changes in the areas where military action takes place. This mutation, which now includes the physical and cognitive domain in military action, requires the adoption of new concepts of operation and more agile organizational structures in order to cope with a highly volatile, unpredictable and complex environment. Thus, more than ever, this makes the present organizations dependent of information (and the systems that generate them), in the case of military organizations, a particular capability undertakes today a strong impact on the success of military organizations. It is known as Intelligence, Surveillance& Reconnaissance (ISR). Taking into account the complexity of systems, processes and people involving all this capability, it is relevant to study how the Portuguese Air Force (PAF) is accommodating this concept within its structure, since the adaptation requires an organization adapted to the information era, where networking is particularly prominent. This research aims to analyze contemporary forms of organizational structures and cross them with the recommendations of the North Atlantic Treaty Organization (also known as Alliance), later comparing them with today's PAF. At the end of this investigation, some tangible proposals are made which can enhance existing capabilities: we can highlight the creation of an analysis matrix for organizational efficiency, a new form of organization of the resident capabilities in the ISR concerns, as well as the way of enhancing networking, based on existing means.

The Sensing Enterprise: Towards the Next Generation Dynamic Virtual Organisations

Part 6: Engineering and Implementation of Collaborative Networks

The visibility/invisibility paradox of trust: Developing distributed educational leadership for online communities

A visibility/invisibility paradox of trust operates in the development of distributed educational leadership for online communities. If trust is to be established, the team-based informal ethos of online collaborative networked communities requires a different kind of leadership from that observed in more formal face-to-face positional hierarchies. Such leadership is more flexible and sophisticated, being capable of encompassing both ambiguity and agile response to change. Online educational leaders need to be partially invisible, delegating discretionary powers, to facilitate the effective distribution of leadership tasks in a highly trusting team-based culture. Yet, simultaneously, online communities are facilitated by the visibility and subtle control effected by expert leaders. This paradox: that leaders need to be both highly visible and invisible when appropriate, was derived during research on 'Trust and Leadership' and tested in the analysis of online community case study discussions using a pattern-matching process to measure conversational interactions. This paper argues that both leader visibility and invisibility are important for effective trusting collaboration in online distributed leadership. Advanced leadership responses to complex situations in online communities foster positive group interaction, mutual trust and effective decision-making, facilitated through the active distribution of tasks.

Fotografía histórica y contemporánea herramientas para la valoración del patrimonio caso de estudio: El Barranco Cuenca-Ecuador

La fotografía histórica como herramienta visual testimonial ha sido considerada como un elemento secundario dentro de temas históricos. Los arquitectos, historiadores he investigadores entre otros la han utilizado en un plano provisional con la función de uso para ilustración o complementación de documentos literarios, que han hecho que pierdan su protagonismo. Por esta razón esta investigación pretende corroborar que las imágenes históricas son una herramienta indispensable para la reconstrucción de valores patrimoniales y de la memoria histórica de una comunidad, siendo testigos visuales de las realidades pasadas. Funciona como herramienta de valoración patrimonial pues a través de ella se pueden reconocer los distintos valores para recuperar, conservar o mantener un bien, ayuda a complementar la información histórica de manera más ágil con la que se puede construir parte de la historia, aprehender valores patrimoniales y destacar el poder testimonial que tienen las imágenes. Este documento abordará sobre el potencial de las fotografías a través teorías contemporáneas de la valoración patrimonial, la elaboración de un catálogo razonado para una re- valoración patrimonial de edificaciones y tramos urbanos del sector El Barranco en la ciudad de Cuenca.