The present investigation examined the effects of a parent's intervention to teach students with autism self-management to decrease their stereotypic behaviors. A time-lagged ABA (A represents the first baseline, B does intervention, and A does the second baseline) design was used. Three mothers of children with autism were trained to reduce their children's stereotypic behaviors using a self-monitoring strategy. The training for the parent was conducted in two settings after the first baseline condition. A classroom was used for the first training session and the home was used for the second training session. The intervention by the parent was conducted in the child's natural home. The results of this study revealed the following. First, the intervention decreased the students ' stereotypic behaviors. Second, two students maintained the decreased frequency of stereotypic behavior in a nonintervention condition, the second baseline, when the parent withdrew the intervention for a month. Third, the students showed slight behavior change on their interactive behaviors with their family members after the intervention was withdrawn.

Gamification, the use of game elements in non-game contexts, is an increasingly popular way to incentivize self-management procedures. Despite the growing popularity of such programs, little objective research has been done in the area. This study evaluated the use of a web-based gamification program called HabitRPG through a multiple-baseline across participants design. HabitRPG is designed to increase the productivity of its users. Baseline procedures included parental scoring of task completion. Intervention consisted of training on using HabitRPG. Target behaviors were scored with data sheets provided to parents of the participants. The intervention increased the percentage of compliance for all participants.

The growing number of school-aged children displaying challenging behavior has increased the need for effective interventions. School-based consultants (SBC) report using behavioral consultation to assist teachers in designing behavior intervention plans (BIP) that help students engage in appropriate behavior in the classroom. Research indicates that direct training methods increase teacher's implementation of the BIP. One commonly used direct training method, performance feedback (PF), is used to assess teachers' treatment integrity. Research also indicates that checklists (non-direct measures) are more cost efficient methods. The purpose of this paper was to evaluate a direct training method used to train teachers to self-monitor their own implementation of their student's BIP in an effort to increase accuracy of self-report and sustainable treatment integrity outcomes. Two educators who worked with children with challenging behavior participated in this study. The effect of using self-monitoring on both educators' implementation of BIPs was evaluated. Results indicated that both educators' implementation increased and maintained into the maintenance phase. Also, results indicated that educator's accuracy of reporting was similar to independent observers.

Previous researchers have identified that participation in a pulmonary rehabilitation program improves health outcomes yet, continuation in a weekly maintenance program yielded mixed results. Self-management programs have had reported use in chronic obstructive pulmonary disease (COPD). A meta analysis has identified that no self-management program had evaluated the effect of this type of intervention on the functional status of the participant with COPD. Reduced functional status is well reported as an indicator of disease progression in COPD. Adjuvant therapies for people with COPD need to demonstrate an effect in this domain. The Stanford model chronic disease self-management program (CDSMP) had been reported as a program that may optimise the health of people with chronic health conditions. However, its utility has not been formally evaluated for people with COPD. There have not been any reports of a comparison of the Stanford model CDSMP with pulmonary rehabilitation via a randomised controlled study in COPD. Aim: To compare and evaluate the health outcomes from participation in nurse ledwellness-promoting interventions conducted in the ambulatory care setting of a metropolitan hospital. Participants were randomised to either a six-week behavioural intervention: the Stanford model CDSMP or, a six-week pulmonary rehabilitation program and results compared to usual care (a historical control group). The efficacy of the interventions was measured at week seven and repeated at week 26 and 52. Following the week seven evaluation, the pulmonary rehabilitation program participants were rerandomised to usual care or, weekly maintenance pulmonary rehabilitation for 18 weeks and, followed up until the study completion at week 52.Little is reported about the costs of care for people with COPD in Australia. This study prospectively evaluated the costs of the interventions and health resource for the 52 weeks and undertook a cost utility analysis. Methods: Walking tests (The Incremental Shuttle Walking Test) and questionnaires asking participants about their health related quality of life, mood status, dyspnoea and self efficacy were assessed prior to randomisation to either six week intervention and repeated at weeks 7, 26 and 52. The implementation of these adjuvant therapies enabled all costs associated with the interventions to be prospectively examined and compared. Results: During the two years of recruitment 252 people (54% males) with a mean age 71 years (SD 11, range 39-93 years) were referred to the study. Student’s ttests identified that there were no statistically significant differences (P=0.16) between all those referred by age and gender as compared to all those admitted to Hospital A with an exacerbation of COPD. Ninety-seven people (51% male) with a mean age of 68 years (SD 9, range 39-87 years) agreed to participate in the study. Follow up in the study continued for 12 months following enrolment with only a modest level of attrition by week seven (3%) and week 52 (25%). Following the six-week interventions, both the pulmonary rehabilitation and CDSMP groups recorded statistically significant increases in functional capacity, self-efficacy and health related quality of life.Functional performance was additionally evaluated in the intervention arms with participants wearing pedometers for the six-week period of the interventions. There were no statistically significant differences between steps per week (P=0.15) and kilometres per week (P=0.17) walked between these two groups in functional performance. The Spearman rho statistic identified no statistically significant relationship between functional performance and the severity of COPD (rs (33) = 0.19, P = 0.26). No significant correlation between functional capacity and functional performance was identified (rs (32) = 0.19, P = 0.29). This suggests that other factors contribute to daily functional performance. The largest cost of care for people with COPD has been reported to be unplanned admissions due to an exacerbation of COPD.In this study there were no statistically significant differences between the three intervention groups in the prospective measurement of ambulatory care visits, Emergency Department presentations and admissions to hospital. The calculation of costs illuminated the costs of care in COPD are greater than the population norm. In addition, maintenance pulmonary rehabilitation generated a greater quality adjusted life year (QALY) than a six-week program. Despite the strength of the participants preferences (as measured by the QALY) for maintenance PRP, there were no significant differences in use of hospital resources throughout the study period by the three intervention groups, which suggests some degree of equivalence.

<p>A2B Electronics AB is a company that develops and manufactures products and technology for digital cable television. A2B's new EXM-product family translates digital television channels from multiple source networks into a single destination network. Multiple EXM-units are connected in a system to provide a custom set of TV channels. To minimize the administrative effort, the units in a system should be able to interact and collaborate without manual intervention. The purpose of this thesis is to propose an underlying system that supports seamless interaction and collaboration between units.</p><p>The autonomic system concept has served as a foundation for the proposed solution. The requirements for the EXM-system proved to be similar to many properties of an autonomic system. The proposed solution was elaborated by answering five reseach questions. The answers describe how an autonomic system can be implemented with the prerequisites of the EXM-system. Solutions for service availability, configuration preservation, system state changes and automatic addressing and communication are provided.</p><p>The project has resulted in a proposal of a general autonomic system. The solution has also been implemented as prototype that runs both in a simulator and on the EXM-hardware. The simulator was also developed in the scope of this project as a side-effect of the limited access to EXM-hardware.</p><p>The proposed solution together with the prototype can hopefully serve as a base for projects with prerequisites similar to the project described in this thesis.</p>

As an effect of increased living standards and improved health care, life expectancy has risen in many parts of the world. At the same time, welfare diseases such as diabetes and obesity increases. As the number of elderly and long-term sick rises, so will the medical care needs. E-health applications are often presented as a way to meet future medical and doing so within the scope of existing resources. By facilitating health communication and widen access to health services by offering them online, e-health applications encourages people to become more engaged in their own health, thus working proactively towards a healthier population. However, e-health applications often fail to reach their full potential. The purpose of this study is to explore how health care providers and health care recipients perceives e-health applications and their usefulness and thus being able to identify factors significant for successful introduction and use of e-health services. Two e-health applications have been analysed and six important aspects have been identified and discussed. In order to be successful, an e-health application must facilitate behaviour change and be integrated in the everyday life of the user. Substantial and adequate evaluation is essential to make sure that the application meet the requirements from both health care providers and health care recipients. An understanding of the possibilities technology has to offer is needed in order to fully exploit the potential of e-health applications in health care. Instructions for health care providers on how to use the applications are essential not only to ensure their proper usage but also to make sure that applications are being presented to recipients in a satisfactory way and that care providers can offer the support and help recipients may need. Finally, when discussing e-health applications it is important to remember that there are people who does not want to get involved and that there is still a demand for face-to-face interaction in health care. Therefore, e-health services must be complemented with alternatives providing different types of interaction opportunities.

Syfte: Syftet med studien var att undersöka hur patienter med diabetes typ 2 utförde sin egenvård och hur de upplevde sin livskvalitet utifrån utförda egenvårdsåtgärder. Metod: Detta arbete var en explorativ studie och utformad efter en kvalitativ metod. Datainsamlingen genomfördes på en vårdcentral där nio patienter med diabetes typ 2 intervjuades. Patienterna fick själva avgöra deltagande genom att kontakta vårdcentralen. Data strukturerades med en innehållsanalys. Resultat: Studien resulterade i fyra kategorier vilka var upplevelse av egenvård, upplevelse av livskvalitet, egenvårdsåtgärder och livskvalitet samt diabetes typ 2 och livskvalitet. De utförda egenvårdsåtgärderna var främst kost och fysisk aktivitet men även fotvård, synundersökningar, stresshantering, blodsockermätning, hålla en konstant vikt och undvika visceralt fett samt vara uppdaterad inom diabetes typ 2. Majoriteten av informanterna upplevde att deras livskvalitet inte påverkades negativt av egenvårdsåtgärderna. En minoritet kände en viss påfrestning av att behöva ha dessa egenvårdsåtgärder i åtanke. Det framgick även att enstaka upplevde bättre livskvalitet relaterat till sjukdomen. Slutsats: Diabetes typ 2 är en folksjukdom vilken kommer att öka nationellt och internationellt. De vanligaste egenvårdsåtgärderna en patient med diabetes utför är fysisk aktivitet och kost. Sammanfattningsvis upplevdes egenvårdsåtgärder inte påverka patienternas livskvalitet. Däremot upplevde enstaka patienter en viss påfrestning gällande utförandet av egenvårdsåtgärder. / Aim: The aim of the study was to investigate how patients with diabetes type 2 performed their self-management and how they experienced their quality of life related to the fulfilled self-management. Method: This study was an explorative study composed after a qualitative method. The data were gathered at a care center with interviews and remained of nine patients who had diabetes type 2. The patients decided participation by contacting the care center. The data were processed with a content analysis. Result: The study was classified in four categories; experience of self-management, experience of quality of life, intervention of self-management with quality of life and diabetes type 2 with quality of life. The most common interventions were diet and physical activity, also care of the feet, vision screening, stress management, measure the blood glucose, not gain any more weight or avoid visceral fat and to be updated within the subject. The majority of the informants perceived that their quality of life not was affected adversely by the interventions. Some felt distress having to think about all the essential interventions. It also appeared that some informants experienced a better quality of life related to the disease. Conclusion: Diabetes type 2 is a widespread disease which will increase all over the world. The most common and most important interventions of self-management is diet and physical activity. In summary the interventions did not influence on the patients quality of life. However, some patients experienced tension to do the interventions of self-management.

According to a recent report that in Taiwan, more than 50% health problems were due to unhealthy and harmful life styles. Most people, especially at workplace, either live under pressure, work sedentarily, exercise their body little or have a unhealthy diet. The subsequent problems of the overweight, sleeplessness and a declined condition of physical fitness all lead to health problems. A Quasi-experimental design of purposive samples was conducted using 51 participants from employees or faculty members from one school and one hospital. The purpose of this study is to investigate the effects of health self-management program with nutritional and exercise intervention to improve the participants¡¦ physical and psychological health status. Research measuring tools include a structural questionnaire, SF-36 scale, laboratory examination (blood test), physical fitness test administrated to the participants, and a 12-week follow-up test. After the intervention of health self-management, there were significant differences in sleep pattern and diet behavior. On health belief congnition, perceived susceptibility, perceived seriousness, and percieived barriers were increased. On the SF-36 scale, higher scores were attained on mental health dimension. Furthermore, Cholesterol, SGOT, SGPT, B.U.N, Crattinine, Uric acid and blood sugar were significantly decreased. As for body composition, fat mass and waist-hip-ratio were significantly reduced, while for physical fitness, muscular strength endurance and cardiorespiratory endurance were much improved among participants. The results suggest well-designed health self-management activities can reduce unhealthy habit and improve mental and physical health status. Furthermore, it can serve as one important component of health promotion stratigies.

Despite the efficacy of pulmonary rehabilitation programs which assist patients in managing chronic obstructive pulmonary disease (COPD), the high costs and lack of availability of such programs pose considerable barriers for underserved COPD patients, such as those living in rural communities. Because of this, patients are encouraged to actively self-manage COPD. Unfortunately, COPD patients have reported dissatisfaction with the self-management education they are provided. This mixed methods study assessed the self-management learning needs of COPD patients treated at a Certified Federal Rural Health Clinic through conducting focus group interviews (n = 2) to inform the development a targeted self-management education DVD. The effectiveness of 3 distinct educational treatments (DVD vs. Pamphlet vs. DVD Pamphlet) was evaluated by comparing outcomes related to informational needs, self-management self-efficacy, and generic/lung-specific HRQoL in a randomly-assigned, multiple-group pretestposttest design with a control group (n = 41). Focus group data was analyzed using three qualitative analysis tools. Findings from the interviews indicated that patients viewed self-management as simply taking prescribed medications and reducing activity. Patients reported a lack of knowledge and skill development related to rehabilitative activities such as controlled breathing and stress reduction. A multivariate analysis of covariance was conducted to determine the effect of 3 educational treatments on multiple outcome measures. Three nontrend orthogonal planned contrasts were tested to determine selected contrast effects. The data analysis revealed that participants receiving a DVD reported statistically significantly higher levels of lung-specific physical functioning as compared to those in the Pamphlet group. Additionally, the DVD group revealed clinically significant improvements on the physical ( 19.01) and emotional ( 10.74) functioning dimensions of lung-specific HRQoL; whereas, no such improvement occurred within the Pamphlet and control groups. Results also suggested that providing patients with a Pamphlet alone was more effective than providing participants with both interventions concurrently to increase self-management self-efficacy. The simultaneous provision of both interventions did, however, enhance generic HRQoL more so than the provision of one of the two treatments alone. Finally, any type of self-management education as compared to usual care did not statistically significantly improve outcome variables among this small sample of rural patients.

Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 120-130). Available also in a digital version from Dissertation Abstracts.