'Why don't you try it again?' A comparison of parent led, home based interventions aimed at increasing children's consumption of a disliked vegetable

Previous research suggests that the use of modelling and non-food rewards may be effective at increasing tasting, and consequential liking and acceptance, of a previously disliked food. Although successful school-based interventions have been developed, there is a lack of research into home-based interventions using these methods. This study aimed to develop and investigate the efficacy of a parent led home-based intervention for increasing children's acceptance of a disliked vegetable. A total of 115 children aged 2-4 years were allocated to one of four intervention groups or to a no-treatment control. The four intervention conditions were: repeated exposure; modelling and repeated exposure; rewards and repeated exposure; or modelling, rewards and repeated exposure. Children in all of the intervention conditions were exposed by a parent to daily offerings of a disliked vegetable for 14 days. Liking and consumption of the vegetable were measured pre and post-intervention. Significant increases in post-intervention consumption were seen in the modelling, rewards and repeated exposure condition and the rewards and repeated exposure condition, compared to the control group. Significant post-intervention differences in liking were also found between the experimental groups. Liking was highest (>60%) in the modelling, rewards and repeated exposure group and the rewards and repeated exposure group, intermediate (>26%) in the modelling and repeated exposure and repeated exposure groups, and lowest in the control group (10%). Parent led interventions based around modelling and offering incentives may present cost efficient ways to increase children's vegetable consumption.

Predictors of caregiver burden across the home-based palliative care trajectory in Ontario, Canada

Family caregivers of patients enrolled in home-based palliative care programmes provide unpaid care and assistance with daily activities to terminally ill family members. Caregivers often experience caregiver burden, which is an important predictor of anxiety and depression that can extend into bereavement. We conducted a longitudinal, prospective cohort study to comprehensively assess modifiable and non-modifiable patient and caregiver factors that account for caregiver burden over the palliative care trajectory. Caregivers (n = 327) of patients with malignant neoplasm were recruited from two dedicated home-based palliative care programmes in Southern Ontario, Canada from 1 July 2010 to 31 August 2012. Data were obtained from bi-weekly telephone interviews with caregivers from study admission until death, and from palliative care programme and home-care agency databases. Information collected comprised patient and caregiver demographics, utilisation of privately and publicly financed resources, patient clinical status and caregiver burden. The average age of the caregivers was 59.0 years (SD: 13.2), and almost 70% were female. Caregiver burden increased over time in a non-linear fashion from study admission to patient death. Increased monthly unpaid care-giving time costs, monthly public personal support worker costs, emergency department visits and low patient functional status were associated with higher caregiver burden. Greater use of hospice care was associated with lower burden. Female caregivers tended to report more burden compared to men as death approached, and burden was higher when patients were male. Low patient functional status was the strongest predictor of burden. Understanding the influence of modifiable and non-modifiable factors on the experience of burden over the palliative trajectory is essential for the development and targeting of programmes and policies to support family caregivers and reduce burden. Supporting caregivers can have benefits such as improved caregiver health outcomes, and enhancing their ability to meet care-giving demands, thereby potentially allowing for longer patient care in the home setting.

Behaviour change techniques in home-based cardiac rehabilitation: a systematic review

BACKGROUND: Cardiac rehabilitation (CR) programmes offering secondary prevention for cardiovascular disease (CVD) advise healthy lifestyle behaviours, with the behaviour change techniques (BCTs) of goals and planning, feedback and monitoring, and social support recommended. More information is needed about BCT use in home-based CR to support these programmes in practice.

AIM: To identify and describe the use of BCTs in home-based CR programmes.

DESIGN AND SETTING: Randomised controlled trials of home-based CR between 2005 and 2015 were identified by searching MEDLINE(®), Embase, PsycINFO, Web of Science, and Cochrane Database.

METHOD: Reviewers independently screened titles and abstracts for eligibility. Relevant data, including BCTs, were extracted from included studies. A meta-analysis studied risk factor change in home-based and comparator programmes.

RESULTS: From 2448 studies identified, 11 of good methodological quality (10 on post-myocardial infarction, one on heart failure, 1907 patients) were included. These reported the use of 20 different BCTs. Social support (unspecified) was used in all studies and goal setting (behaviour) in 10. Of the 11 studies, 10 reported effectiveness in reducing CVD risk factors, but one study showed no improvement compared to usual care. This study differed from effective programmes in that it didn't include BCTs that had instructions on how to perform the behaviour and monitoring, or a credible source.

CONCLUSION: Social support and goal setting were frequently used BCTs in home-based CR programmes, with the BCTs related to monitoring, instruction on how to perform the behaviour, and credible source being included in effective programmes. Further robust trials are needed to determine the relative value of different BCTs within CR programmes.

Motivations and mitigating business limitations in Scottish rural home-based businesses.

This paper details a qualitative exploratory study of rural home-based businesses. Little is known about the formation or operation of home-based businesses in rural areas despite their high incidence rate.in-depth cases are presented and, by employing a methodology designed to elicit rich narratives, the stories of eight participants are told. emergent themes include the motivations for and the realities of operating a rural home-based business, the importance of a contextual factors, and the use of technology.

Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial

Objectives To determine whether a home based exercise programme can improve outcomes in patients with knee pain. Design Pragmatic, factorial randomised controlled trial of two years' duration. Setting Two general practices in Nottingham. Participants 786 men and women aged >45 years with self reported knee pain. Interventions Participants were randomised to four groups to receive exercise therapy, monthly telephone contact, exercise therapy plus telephone contact, or no intervention. Patients in the no intervention and combined exercise and telephone groups were randomised to receive or not receive a placebo health food tablet. Main outcome measures Primary outcome was self reported score for knee pain on the Western Ontario and McMaster universities (WOMAC) osteoarthritis index at two years. Secondary outcomes included knee specific physical function and stiffness (scored on WOMAC index), general physical function (scored on SF­36 questionnaire), psychological outlook (scored on hospital anxiety and depression scale), and isometric muscle strength. Results 600 (76.3%) participants completed the study. At 24 months, highly significant reductions in knee pain were apparent for the pooled exercise groups compared with the non­exercise groups (mean difference –0.82, 95% confidence interval –1.3 to –0.3). Similar improvements were observed at 6, 12, and 18 months. Regular telephone contact alone did not reduce pain. The reduction in pain was greater the closer patients adhered to the exercise plan. Conclusions A simple home based exercise programme can significantly reduce knee pain. The lack of improvement in patients who received only telephone contact suggests that improvements are not just due to psychosocial effects because of contact with the therapist.

Home-based urinary HPV DNA testing in women who do not attend cervical cancer screening clinics

International audience

Councellors' Experience During Training and Home Based HIV Councelling and Testing in Zomba District, Malawi

Introduction In 2007, St Luke’s Mission Hospital initiated a district-wide Door to Door HIV counselling and testing (HCT) programme in Zomba district. The intent of the programme was to provide quality HCT services to people in their homes and effectively those found to be HIV positive referred to appropriate services. Methodology This was a cross sectional study using a questionnaire consecutively administered to a sample of 105 counsellors who had resided in the community for a period of over one year. The questionnaire sought to establish, knowledge gained, experiences and recommendations on how the programme has been implemented and assist running of similar future programmes. Data analysis was done manually using both qualitative and quantitative methodologies. Results We report that nearly 23% of the counsellors thought that during their training as a door to door HTC councelor they had benefited in learning to working with communities; an aspect they found to be highly applicable in discharge of their duties. The major setbacks during the training were lack daily allowances, less amount of time spent on understanding child councelling and the manual used was diffucult to follow. Over 32% of the councellors were satisfied with the participation of their clients during pre-test counselling sessions, however, the major challenge they had was the misconception that they were blood suckers, a view reported by nearly 17% of the counsellors. Close to 72% reported not to have met any problems during post-test counselling compared to 24% who reported to have found challenges. Conclusion The study has revealed that there is a need to re-look child children counselling especially in training door to door HCT counsellors. It has also revealed the prevalent allowance culture despite the benefits of training. The common challenges were refusal of test Results and failure to understand discordance. Misconceptions may still exist in the community regarding anything dealing with removing blood. There is still need for more information regarding discordance especially among couples in the community.

Coaching or gaming? Implications of strategy choice for home based stroke rehabilitation

Background: The enduring aging of the world population and prospective increase of age-related chronic diseases urge the implementation of new models for healthcare delivery. One strategy relies on ICT (Information and Communications Technology) home-based solutions allowing clients to pursue their treatments without institutionalization. Stroke survivors are a particular population that could strongly benefit from such solutions, but is not yet clear what the best approach is for bringing forth an adequate and sustainable usage of home-based rehabilitation systems. Here we explore two possible approaches: coaching and gaming. Methods: We performed trials with 20 healthy participants and 5 chronic stroke survivors to study and compare execution of an elbow flexion and extension task when performed within a coaching mode that provides encouragement or within a gaming mode. For each mode we analyzed compliance, arm movement kinematics and task scores. In addition, we assessed the usability and acceptance of the proposed modes through a customized self-report questionnaire. Results: In the healthy participants sample, 13/20 preferred the gaming mode and rated it as being significantly more fun (p < .05), but the feedback delivered by the coaching mode was subjectively perceived as being more useful (p < .01). In addition, the activity level (number of repetitions and total movement of the end effector) was significantly higher (p <.001) during coaching. However, the quality of movements was superior in gaming with a trend towards shorter movement duration (p=.074), significantly shorter travel distance (p <.001), higher movement efficiency (p <.001) and higher performance scores (p <.001). Stroke survivors also showed a trend towards higher activity levels in coaching, but with more movement quality during gaming. Finally, both training modes showed overall high acceptance. Conclusions: Gaming led to higher enjoyment and increased quality in movement execution in healthy participants. However, we observed that game mechanics strongly determined user behavior and limited activity levels. In contrast, coaching generated higher activity levels. Hence, the purpose of treatment and profile of end-users has to be considered when deciding on the most adequate approach for home based stroke rehabilitation.

Coaching or gaming? Implications of strategy choice for home based stroke rehabilitation

Background: The enduring aging of the world population and prospective increase of age-related chronic diseases urge the implementation of new models for healthcare delivery. One strategy relies on ICT (Information and Communications Technology) home-based solutions allowing clients to pursue their treatments without institutionalization. Stroke survivors are a particular population that could strongly benefit from such solutions, but is not yet clear what the best approach is for bringing forth an adequate and sustainable usage of home-based rehabilitation systems. Here we explore two possible approaches: coaching and gaming. Methods: We performed trials with 20 healthy participants and 5 chronic stroke survivors to study and compare execution of an elbow flexion and extension task when performed within a coaching mode that provides encouragement or within a gaming mode. For each mode we analyzed compliance, arm movement kinematics and task scores. In addition, we assessed the usability and acceptance of the proposed modes through a customized self-report questionnaire. Results: In the healthy participants sample, 13/20 preferred the gaming mode and rated it as being significantly more fun (p < .05), but the feedback delivered by the coaching mode was subjectively perceived as being more useful (p < .01). In addition, the activity level (number of repetitions and total movement of the end effector) was significantly higher (p <.001) during coaching. However, the quality of movements was superior in gaming with a trend towards shorter movement duration (p=.074), significantly shorter travel distance (p <.001), higher movement efficiency (p <.001) and higher performance scores (p <.001). Stroke survivors also showed a trend towards higher activity levels in coaching, but with more movement quality during gaming. Finally, both training modes showed overall high acceptance. Conclusions: Gaming led to higher enjoyment and increased quality in movement execution in healthy participants. However, we observed that game mechanics strongly determined user behavior and limited activity levels. In contrast, coaching generated higher activity levels. Hence, the purpose of treatment and profile of end-users has to be considered when deciding on the most adequate approach for home based stroke rehabilitation.

Healthcare Computer Reasoning Addressing Chronically Ill Societies Using IoT: Deep Learning AI to the Rescue of Home-Based Healthcare

The authors present a proposal to develop intelligent assisted living environments for home based healthcare. These environments unite the chronical patient clinical history sematic representation with the ability of monitoring the living conditions and events recurring to a fully managed Semantic Web of Things (SWoT). Several levels of acquired knowledge and the case based reasoning that is possible by knowledge representation of the health-disease history and acquisition of the scientific evidence will deliver, through various voice based natural interfaces, the adequate support systems for disease auto management but prominently by activating the less differentiated caregiver for any specific need. With these capabilities at hand, home based healthcare providing becomes a viable possibility reducing the institutionalization needs. The resulting integrated healthcare framework will provide significant savings while improving the generality of health and satisfaction indicators.

Improved Employment Data for Transportation Planning, 1998

Transportation planners typically use census data or small sample surveys to help estimate work trips in metropolitan areas. Census data are cheap to use but are only collected every 10 years and may not provide the answers that a planner is seeking. On the other hand, small sample survey data are fresh but can be very expensive to collect. This project involved using database and geographic information systems (GIS) technology to relate several administrative data sources that are not usually employed by transportation planners. These data sources included data collected by state agencies for unemployment insurance purposes and for drivers licensing. Together, these data sources could allow better estimates of the following information for a metropolitan area or planning region: · Locations of employers (work sites); · Locations of employees; · Travel flows between employees’ homes and their work locations. The required new employment database was created for a large, multi-county region in central Iowa. When evaluated against the estimates of a metropolitan planning organization, the new database did allow for a one to four percent improvement in estimates over the traditional approach. While this does not sound highly significant, the approach using improved employment data to synthesize home-based work (HBW) trip tables was particularly beneficial in improving estimated traffic on high-capacity routes. These are precisely the routes that transportation planners are most interested in modeling accurately. Therefore, the concept of using improved employment data for transportation planning was considered valuable and worthy of follow-up research.

Työtyytyväisyys etätyössä

Työn ydinpiirteiden vaikutus työtyytyväisyyteen.

Viviendas productivas

El presente trabajo recoge los resultados de una investigación sobre la «vivienda productiva», es decir, de la casa como lugar de trabajo. Dicha investigación se ha ocupado de explorar cómo influyen las cotidianeidades doméstico-laborales actuales —junto con sus arquitecturas y los urbanismos que estas generan— en la sociedad, en especial en temas sociales centrales como la construcción de las subjetividades, y de una vida en comunidad. Asimismo, explora cómo podrían influir en un futuro. La hipótesis sobre la que se trabaja, y que finalmente se intenta demostrar, consiste en que, en la territorialidad múltiple de lo laboral, la vivienda, como plataforma doméstica multiusos, productiva y reproductiva de la que muchas personas disponen, desempeña un papel nodal, y es posible que en el futuro su papel sea aún más importante y más visible. La vivienda productiva funciona como una infraestructura urbana desde la cual se construyen diferentes tipos de bienes materiales e inmateriales, pero sobre todo formas de relación, sociales y productivas con otros, además de imaginarios y afectos. La vivienda como infraestructura productiva y reproductiva es tanto «fábrica fundamental de lo social», como nos enseña Silvia Federici, como «fábrica de lo urbano». El trabajo en casa, como parte de diferentes dinámicas «dispersas» del trabajo que se dan en la actualidad, presenta tanto problemáticas y desafíos importantes, como capitales y posibilidades sociales. Por un lado, puede facilitar una absorción de tipo «24/7» vinculada a las lógicas de producción dispersa y consumo dominantes además de la que se da por las dinámicas patriarcales tradicionales, y en múltiples casos situaciones de evidente asimetría y de explotación laboral. También puede propiciar situaciones socialmente extendidas o impuestas de soledad y aislamiento. Sin embargo, está asimismo vinculado al surgimiento de espacios de experimentación tanto en soledad como en compañía, de cooperación y de intercambio, además de a la evidente posibilidad de construir rutinas propias y, por tanto, una subjetividad laboral propia. Por otro lado, frente a la idea general y homogénea del trabajador casero como un sujeto mayoritariamente aislado de su entorno, las jornadas de trabajo de los trabajadores caseros estudiados presentan una gran diversidad. Estas pueden conllevar aislamiento y exclusión, así como acompañar diferentes formas de construcción de una ciudadanía activa, tanto en solitario, como mediante formas de participación activa en la construcción de una vida en comunidad. En esta investigación se analizan, pues, desafíos y oportunidades de estas espacialidades del trabajo y, a través de este análisis, se indaga en el papel de los marcos físicos, organizativos y simbólicos actuales para la vivienda y para la ciudad pensada desde los trabajadores caseros. Al mismo tiempo se exploran nuevos tipos de vivienda y urbanismos que puedan quizás acompañar procesos sociales de inclusión, así como de emancipación, cooperación e intercambio y, en general, nuevas formas de vecindad y bienestar compartido en los ámbitos doméstico-productivos. Metodológicamente, las singularidades presentes en las realidades estudiadas invitan además a explorar protocolos de análisis, métodos de diseño, de gestión y gobierno que, desde lo micro, puedan dialogar con lo cotidiano y sus singularidades. Diego Barajas, autor de la tesis, es arquitecto dedicado a la práctica, a la investigación y la docencia. Su trabajo se focaliza en explorar el carácter mediador de la arquitectura frente a lo cotidiano y sus microrrealidades. Es profesor de proyectos de urbanismo en la IE School of Architecture y es miembro de Husos, una plataforma de investigación y diseño orientada a la innovación en arquitectura y urbanismo, con sede en Madrid. Es el autor del libro Dispersion, A Study of Global Mobility and the Dynamics of a Fictional Urbanism (Episode Publishers, Róterdam, 2003). Sus trabajos teóricos y de investigación han aparecido en libros y revistas internacionales tales como The Domestic and The Foreign in Architecture (010 Publishers, 2008), Public Spheres, a Europan Discussion (Europan9, 2007), Photoespaña 05 (La Fábrica, Madrid, 2005), Domus, Volume, Abitare, Architese, Plot, y Summa+. Su trabajo se ha expuesto en la Bienal de Venecia (selección principal), la Bienal de Róterdam, la Fundación Tapies, Photoespaña, entre otros y es parte de la colección permanente del FRAC Centre en Orleans y del Historisch Museum de Róterdam entre otros. Antes de estudiar en Róterdam, se gradúa con Honores en la Universidad de los Andes en 1999 y su tesis de grado de arquitectura recibe la máxima distinción como proyecto de Grado Meritorio. ABSTRACT The present study records an investigation into the «productive house», or the home as a workplace. This investigation looks at how working from home, its architectures, and the urban dynamics generated around it influence daily life and the construction of society. It also explores what influences home-based work might have in the future, particularly in central themes such as the biopolitical construction of subjectivities and community life. The central hypothesis revolves around the idea that the home, as a multi-use infrastructure that most of us have access to, plays a fundamental role in the contemporary work sphere, due to —or even in spite of— the omnipresence of work in practically every moment and area of our daily lives, and might play a main role in the future. The home functions as a kind of hub from which we create different kinds of material and immaterial goods, but above all relationships with others, both social and productive, as well as imaginaries and affections. The home, as a machine for production and reproduction, is as much a main «factory of the social» as Silvia Federici describes it, as a «factory of the urban». Working from home, as one of several «dispersed» work dynamics that are part of the contemporary world of work, presents as many important problematics and challenges as it does possibilities and social capital. On the one hand, it can contribute to kind of «24/7» absorption linked both to the logistics of the current dispersed production and consumption, and to that of traditional patriarchal dynamics, and in some cases even clearly asymmetrical situations that exploit the workforce. It can also lead to the socially widespread phenomena of isolation and loneliness, at times imposed upon home-based workers. However, by the same token, it is also linked to the growth of experimental spaces of cooperation and exchange, both solitary and in company, as well as the clear possibility of constructing individualised routines and, therefore, a personal laboural subjectivity. On the other hand, contrary to the generalised, homogenous idea of a home-based worker who is mostly isolated from his or her environment, the working days of those we studied went hand in hand with different ways of building subjectivities. This could be as much in exclusion and isolation as through building an active citizenship, at times in solitary and at times actively participating in the construction of communal life. In this investigation, therefore, the challenges and opportunities of the home as workplace have been analysed, and through this analysis we have inquired into the role of current physical, organisational and symbolic frameworks for the home and for the city from the perspective of home workers. At the same time we have explored new types of homes and of town planning that could perhaps accompany social processes of diversity and inclusion as well as emancipation, cooperation and exchange and, in general, new forms of shared welfare in productive domestic environments. Methodologically, the singularities present in the cases studied also invite us to explore protocols of analysis, methods of design, management and government that, from the micro level, could dialogue with the peculiarities of day-to-day life. The author of this thesis, Diego Barajas, is an architect dedicated to practice, investigation and teaching. His work is focussed on exploring the mediating nature of architecture and the built environment in terms of daily life and its microrealities. He is professor of urban projects at the IE School of Architecture and member of Husos, a platform for investigation and town planning based in Madrid. He is the author of the book Dispersion, A Study of Global Mobility and the Dynamics of a Fictional Urbanism (Episode Publishers, Rotterdam, 2003) and his theoretical works and investigations have appeared in books such as The Domestic and The Foreign in Architecture (010 Publishers, 2008), Public Spheres, a Europan Discussion (Europan9, 2007), Photoespaña 05 (La Fábrica, Madrid, 2005), and in international magazines such as Domus, Volume, Abitare, Architese, Plot and Summa+. His work has been exhibited in places such as the Venice Biennial (main selection), the Rotterdam Biennial, the Tapies Foundation and Photoespaña, among others, and forms part of the permanent collection of the FRAC Centre in Orleans and the Historisch Museum of Rotterdam. Before studying in Rotterdam, he graduated with Honours from the University of the Andes in 1999, and his architecture degree thesis received the maximum distinction of Meritorious Graduation Project.