Feasibility and acceptance of electronic quality of life assessment in general practice: an implementation study

Background Patients' health related quality of life (HRQoL) has rarely been systematically monitored in general practice. Electronic tools and practice training might facilitate the routine application of HRQoL questionnaires. Thorough piloting of innovative procedures is strongly recommended before the conduction of large-scale studies. Therefore, we aimed to assess i) the feasibility and acceptance of HRQoL assessment using tablet computers in general practice, ii) the perceived practical utility of HRQoL results and iii) to identify possible barriers hindering wider application of this approach. Methods Two HRQoL questionnaires (St. George's Respiratory Questionnaire SGRQ and EORTC QLQ-C30) were electronically presented on portable tablet computers. Wireless network (WLAN) integration into practice computer systems of 14 German general practices with varying infrastructure allowed automatic data exchange and the generation of a printout or a PDF file. General practitioners (GPs) and practice assistants were trained in a 1-hour course, after which they could invite patients with chronic diseases to fill in the electronic questionnaire during their waiting time. We surveyed patients, practice assistants and GPs regarding their acceptance of this tool in semi-structured telephone interviews. The number of assessments, HRQoL results and interview responses were analysed using quantitative and qualitative methods. Results Over the course of 1 year, 523 patients filled in the electronic questionnaires (1–5 times; 664 total assessments). On average, results showed specific HRQoL impairments, e.g. with respect to fatigue, pain and sleep disturbances. The number of electronic assessments varied substantially between practices. A total of 280 patients, 27 practice assistants and 17 GPs participated in the telephone interviews. Almost all GPs (16/17 = 94%; 95% CI = 73–99%), most practice assistants (19/27 = 70%; 95% CI = 50–86%) and the majority of patients (240/280 = 86%; 95% CI = 82–91%) indicated that they would welcome the use of electronic HRQoL questionnaires in the future. GPs mentioned availability of local health services (e.g. supportive, physiotherapy) (mean: 9.4 ± 1.0 SD; scale: 1 – 10), sufficient extra time (8.9 ± 1.5) and easy interpretation of HRQoL results (8.6 ± 1.6) as the most important prerequisites for their use. They believed HRQoL assessment facilitated both communication and follow up of patients' conditions. Practice assistants emphasised that this process demonstrated an extra commitment to patient centred care; patients viewed it as a tool, which contributed to the physicians' understanding of their personal condition and circumstances. Conclusion This pilot study indicates that electronic HRQoL assessment is technically feasible in general practices. It can provide clinically significant information, which can either be used in the consultation for routine care, or for research purposes. While GPs, practice assistants and patients were generally positive about the electronic procedure, several barriers (e.g. practices' lack of time and routine in HRQoL assessment) need to be overcome to enable broader application of electronic questionnaires in every day medical practice.

Semi-Automated Creation of Converged iTV Services: From Macromedia Director Simulations to Services Ready for Broadcast

While sound and video may capture viewers' attention, interaction can captivate them. This has not been available prior to the advent of Digital Television. In fact, what lies at the heart of the Digital Television revolution is this new type of interactive content, offered in the form of interactive Television (iTV) services. On top of that, the new world of converged networks has created a demand for a new type of converged services on a range of mobile terminals (Tablet PCs, PDAs and mobile phones). This paper aims at presenting a new approach to service creation that allows for the semi-automatic translation of simulations and rapid prototypes created in the accessible desktop multimedia authoring package Macromedia Director into services ready for broadcast. This is achieved by a series of tools that de-skill and speed-up the process of creating digital TV user interfaces (UI) and applications for mobile terminals. The benefits of rapid prototyping are essential for the production of these new types of services, and are therefore discussed in the first section of this paper. In the following sections, an overview of the operation of content, service, creation and management sub-systems is presented, which illustrates why these tools compose an important and integral part of a system responsible of creating, delivering and managing converged broadcast and telecommunications services. The next section examines a number of metadata languages candidates for describing the iTV services user interface and the schema language adopted in this project. A detailed description of the operation of the two tools is provided to offer an insight of how they can be used to de-skill and speed-up the process of creating digital TV user interfaces and applications for mobile terminals. Finally, representative broadcast oriented and telecommunication oriented converged service components are also introduced, demonstrating how these tools have been used to generate different types of services.

RailCity oder Hauptbahnhof?

In der neueren Designtheorie wird zur Zeit – auch in Bezug auf die Rhetorik – vermehrt der Aspekt der Wirkungsintention diskutiert; in Abgrenzung zur Analyse von 'Bedeutung' stehen in diesem Modell Produktion und Analyse in einem wirkungsgeleiteten Verhältnis. Ausgehend von der These, dass sich die beabsichtigten Nutzungen eines Gebäudes anhand des in und an ihm wirkenden Designs beschreiben lassen, wird am Beispiel des Berner Hauptbahnhofs ("SBB RailCity Bern") gezeigt, wie sich dessen 'design for shopping' zum 'design for transport' verhält. Die Architektur des Bahnhofs wird in diesem Setting weniger als 'gebauter Raum' verstanden als vielmehr als Träger und Auslöser von Informationsumgebungen, Blick- und Gangführungen, Stimmungsinszenierungen und Reizen – mit dem Ziel, Reisende und potentielle Konsument in ihrer jeweiligen Erlebniskette zu führen.

Mobile Games for Learning

Today, pupils at the age of 15 have spent their entire life surrounded by and interacting with diverse forms of computers. It is a routine part of their day-to-day life and by now computer-literacy is common at very early age. Over the past five years, technology for teens has become predominantly mobile and ubiquitous within every aspect of their lives. To them, being online is an implicitness. In Germany, 88% of youth aged between 12-19 years own a smartphone and about 20% use the Internet via tablets. Meanwhile, more and more young learners bring their devices into the classroom and pupils increasingly demand for innovative and motivating learning scenarios that strongly respond to their habits of using media. With this development, a shift of paradigm is slowly under way with regard to the use of mobile technology in education. By now, a large body of literature exists, that reports concepts, use-cases and practical studies for effectively using technology in education. Within this field, a steadily growing body of research has developed that especially examines the use of digital games as instructional strategy. The core concern of this thesis is the design of mobile games for learning. The conditions and requirements that are vital in order to make mobile games suitable and effective for learning environments are investigated. The base for exploration is the pattern approach as an established form of templates that provide solutions for recurrent problems. Building on this acknowledged form of exchanging and re-using knowledge, patterns for game design are used to classify the many gameplay rules and mechanisms in existence. This research draws upon pattern descriptions to analyze learning game concepts and to abstract possible relationships between gameplay patterns and learning outcomes. The linkages that surface are the starting bases for a series of game design concepts and their implementations are subsequently evaluated with regard to learning outcomes. The findings and resulting knowledge from this research is made accessible by way of implications and recommendations for future design decisions.