This project is aimed to assess feasibility of a novel patient-centered education model combining behavioral theories and interactive computer media to promote patient-driven care. The following specific features of the proposed model has been implemented: I) the educational intervention targets specific constructs, shown to facilitate patient self-care, in a unique way which accounts for psycho-social profile, disease history and personal preferences; 2) the educational intervention is linked and coordinated with patient electronic medical record; 3) computer-assisted education is driven by theories of adult learning and could be adapted to different levels of education, cognition or individual disabilities; 4) specific components has been included to achieve sustainability of benefits attained by initial patient education. Feasibility of the model in patients with multiple sclerosis has been evaluated.

Recent studies demonstrated that successful chronic disease management requires a coordinated effort that includes health care providers who follow recent clinical guidelines in their every day practice, educated patients who are adherent to their prescribed treatment plans and comprehensive patient-provider communication. Studies employing telecommunication technologies have been successful in affecting the major components of chronic disease care including physician practice patterns, patient adherence to therapy, and patient-provider communication. These studies were focused mainly on an improvement of a single component of clinical care process. To date there have been no studies targeting a comprehensive coordinated approach that concurrently employs all of these components in an integrated framework linked to primary care. In this study we propose a multi-component telemanagement system providing an integrated support both to clinicians and patients in implementing hypertension treatment guidelines promulgated by the Seventh Report of the Joint National Committee on Prevention detection, Evaluation, and Treatment of High Blood Pressure.

The Internet-based home automated telemanagement (HAT) system has been designed to support a multi-disciplinary approach in patient self-management which includes regular patient assessment, disease-specific education, control of patient compliance with treatment plans, implementation of health behavior change models and social support both for patients and caregivers. The goals of this project were: (1) To refine the HAT program to fully implement the multidisciplinary model for telemanagement of COPD patients; (2) To evaluate in a pilot study feasibility and acceptance of HAT by COPD patients. The COPD HAT interface can be operated by a mouse, keyboard or voice. Specific features have been introduced into presentation and navigation of the HAT home unit to accommodate for possible limitations in vision, motion or cognition by the potential HAT users. Feasibility evaluation showed that the COPD patients were able to use the COPD HAT system successfully regardless of their age, education or prior experience in using computers.

The Home Asthma Telemonitoring (HAT) System provides assistance to asthma patients in following self-care plans prescribed by their physicians, and notifies health care personnel if any negative trends are detected. This allows early recognition of potentially dangerous situations and timely intervention. The design of the HAT System is discussed.

Gaming platforms have been recognized for user-friendly interface which does not require previous computer-related experience. Easy to use and wide availability of these platforms at patient households make them an attractive means to facilitate consumer health. The potential of such widely used platforms as Xbox for self-management of chronic health conditions has not yet been fully uncovered. We developed a Home Automated Telemanagement (HAT) system which utilizes Xbox to access personal health record, receive self-care support and exchange information with health care providers. The system questions patients with congestive heart failure (CHF) to monitor symptoms, weight changes, medication adherence and quality of life while educating the patient on their disease. The patients receive an instant feedback on their condition in the form of a 3-zone CHF action plan. The patient self-management information can be reviewed by a provider on a designated web site. The system is programmed to run on the Microsoft Xbox videogame console using an active internet connection and a connection to a computer running Windows Media Center. The system is designed to be as simple as possible making it usable by patients with no prior computer or videogame experience. The feasibility of this approach was tested in ten adults with no previous Xbox experience who completed attitudinal surveys and semi-structured qualitative interviews after using the system. All participants claimed that they did not have any problems in using the system and that they would use the system in the future if necessary. An Xbox-based telemanagement system has potential to optimize the care of patients with CHF and other chronic conditions.

The home asthma telemonitoring (HAT) system provides assistance to asthma patients in following self-care plans prescribed by their physicians, and notifies heath care personnel if any negative trends are detected. This allows early recognition of potentially dangerous situations and timely intervention. The design of the HAT system is discussed.

Recent studies demonstrated that successful chronic disease management requires a coordinated effort that includes health care providers who follow recent clinical guidelines in their every day practice, educated patients who are adherent to their prescribed treatment plans and comprehensive patient-provider communication. Studies employing telecommunication technologies have been successful in affecting the major components of chronic disease care including physician practice patterns, patient adherence to therapy, and patient-provider communication. These studies were focused mainly on an improvement of a single component of clinical care process. To date there have been no studies targeting a comprehensive coordinated approach that concurrently employs all of these components in an integrated framework linked to primary care. In this study we propose a multi-component telemanagement system providing an integrated support both to clinicians and patients in implementing hypertension treatment guidelines promulgated by the Seventh Report of the Joint National Committee on Prevention detection, Evaluation, and Treatment of High Blood Pressure

For a wide range of phenomena, current computational ability does not always allow for atomistic simulations of high-dimensional molecular systems to reach time scales of interest. Coarse-graining (CG) is an established approach to alleviate the impact of computational limits while retaining the same algorithms used in atomistic simulations. It is important to understand how algorithms such as Langevin integrators perform on non-trivial CG molecular systems, and in particular how large of an integration time step can be used without introducing unacceptable amounts of error into averaged quantities of interest. To investigate this, we examined three different Langevin integrators on a CG polymer melt: the recently developed BAOAB method by Leimkuhler and Matthews [J. Chem. Phys. 138 (17), 05B601_1 (2013)], the Gronbech-Jensen and Farago method [Mol. Phys. 111 (8), 983-991 (2013)], or G-JF, and the frequently used Brunger-Brooks-Karplus integrator [Chem. Phys. Lett. 105 (5), 495-500 (1984)], known as BBK. We compute and analyse key statistical properties for each. Our results indicate that the integrators perform similarly for a small friction parameter; however outside this regime, the use of large integration steps produces significant deviations from the predicted diffusivity and steady-state distributions for all methods examined with the exception of G-JF.

The aim of this project was construction of a universal platform for rapid development of interactive computer-based health education programs. Pocket PC was used to pilot test the platform and to implement two educational curricula: for asthma and anticoagulant therapy. Qualitative analysis of the system acceptance in 46 patients showed that computer-assisted education can be successfully implemented on the basis of a handheld computer.