Search

This article presents the findings of a comparative study of values-based adult learning and education (ALE) fields; specifically, in Austria, critical-emancipatory adult basic education; Scotland, learner-centered, community-based adult learning; and South Tyrol, Italy, the "Winterschule," a radical-critical popular education format. We studied the voices of experienced practitioners to understand their challenges and constraints and how they resisted changes that did not reflect their values. It highlights local practices to promote visibility, create dialogue, and strengthen the understanding and recognition of these fields in which practitioners are unequivocally committed to social justice. Our findings highlighted repertoires of resistance, affirmed pedagogy as a values-based endeavor, and elucidated practitioners' commitments to holistic approaches that re-negotiate ideas of social justice for people and the planet. Our analysis shows that when ideas of social justice are shared amongst allies, practitioners can effectively maintain their values-based approaches and thus re-affirm and protect democratic ALE practice.

This article argues for the beneficial interconnectedness of adult basic education as an educational practice, community-based participatory research as a methodological approach, and the framework of transformative learning, for exploring and theorizing about adult learning and education. It is elaborated that these three approaches are connected by shared core values that counter the dominant economistic discourse on adult basic education. A community-based participatory research project, comprising researchers with an adult basic education learners' background, adult basic education practitioners, and the two authors as university-based researchers, serves as a local empirical example. Selected data from the research process illustrate how these three approaches complement each other and can show their inherent potential. Together, these three approaches establish a "democratic space of learning" and thus act as a "resource of hope" for education and research aimed at (self-) empowerment, emancipation, participation, and collective action toward humanization, democratization, and social justice.

Chronic wounds present a significant healthcare challenge in Austria as well as in other countries. The interdisciplinary approach to wound treatment involving various caregivers, doctors, and relatives, poses challenges in documentation and information exchange. To overcome these barriers and promote patient-centered care, a new telehealth-supported treatment pathway for chronic wounds has been developed. The primary focus was to regularly update the status of the chronic wound by responding to predefined questions and transmitted images of the chronic wound. This was achieved by an interdisciplinary team of experts in chronic wound care, providing a new perspective for digital implementation in the healthcare system.

The aim of this paper was to evaluate the effect of telemedical care of gestational diabetes mellitus (GDM) patients with the digital treatment pathway model DiabCare Tirol., Methods: 27 courses of patients with GDM, who were telemonitored through the integrated care program DiabCare Tirol in a diabetes outpatient clinic in Tyrol, Austria during the COVID-19 pandemic in 2020, were analyzed. In addition, randomized controlled trials (RCTs) on telemedicine interventions for GDM were researched, and their results were used for comparison with this disease management method. The patient outcome analysis was used to examine the effects of the integrated care program involving telemonitoring support and compared them to the results of RCTs in which participants were randomly assigned to one of two groups, either mobile monitored or standard treatment group., Results: The feasibility of the digital treatment pathway model was confirmed in practice, as the trend analysis of the 27 GDM patients involved showed significantly improved glycaemic control. Results of RCT studies tend to support the findings of DiabCare Tirol., Conclusion: Benefits of telemonitoring with integrated care to support conventional therapy cannot be dismissed, especially in times of the pandemic. Continuous outcome research with larger patient numbers will be necessary to confirm the effectiveness of telemonitoring in a regular care setting.

Digitalized healthcare services offer remote and cost-effective treatment of diabetes patients. Thus, the present online study analyzed the readiness to use telemonitoring among Austrian diabetes patients. We developed and validated a German version of the patient telehealth readiness assessment tool and performed quantitative context analysis of free-text comments on perceived barriers and benefits of telemonitoring. Participants (n = 41, 42.6% females) achieved a medium average readiness level for telemonitoring. The three top benefits were intensified care, shorter travel and waiting times, and better therapy adjustment. The top three barriers were data privacy issues, loss of personal communication and focus on blood sugar, and teledoctor competence. Diabetes patients represent a suitable target group for remote treatment opportunities. However, a shift from traditional face-to-face medical care to exclusive telemonitoring treatment from diagnosis to consultation and treatment requires fundamental new legal framework conditions.

Background: Telemonitoring services could dramatically improve the care of diabetes patients by enhancing their quality of life while decreasing healthcare expenditures. However, the potential for implementing innovative treatment options in the Austrian public and private health system is not known yet. Thus, we analyzed the readiness to use telemonitoring in diabetes care among Austrian practitioners., Methods: We conducted an online survey among a purposive sample of Austrian practitioners (n = 41) using an adapted German version of the practitioner telehealth readiness assessment tool. We assessed three readiness domains for telemonitoring in the context of diabetes care, i.e. core readiness, engagement readiness, and structural readiness, and validated the German tool using principal components analysis., Results: Study subjects perceived themselves as open to innovations and also expressed optimistic attitudes towards telemonitoring in general and offering telemonitoring-based services for their patients. Participants achieved a medium average readiness level for telemonitoring (58.2, 95% CI 53.9-62.5) and were thus in a good position to use telemonitoring, although some arguments may adversely affected its use. The top three perceived benefits of telemonitoring were enhanced quality of treatment, better therapy adjustment, and reduced travel and waiting times for patients. The top three barriers were reduced personal communication, practitioner time expenditure and equally placed poor financial compensation as well as data security and privacy issues., Conclusion: Our data revealed that Austrian practitioners showed a quite moderate readiness to use telemonitoring in diabetes care. To further advance telemonitoring readiness among all pillars of diabetes care in Austria, joint efforts among healthcare stakeholders are required to overcome existing financial, organizational, and technical obstacles.

Background: Public health authorities and healthcare professionals are obliged to ensure high quality health service. Because of the high variability of the utilisation of blood and blood components, benchmarking is indicated in transfusion medicine., Objectives: Implementation and validation of a benchmarking framework for Patient Blood Management (PBM) based on the report from the second Austrian Benchmark trial., Methods: Core modules for automatic report generation have been implemented with KNIME (Konstanz Information Miner) and validated by comparing the output with the results of the second Austrian benchmark trial., Results: Delta analysis shows a deviation <0.1% for 95% (max. 1.4%)., Conclusion: The framework provides a reliable tool for PBM benchmarking. The next step is technical integration with hospital information systems.

Heart failure (HF) is approaching epidemic proportions worldwide and is the leading cause of hospitalization in the elderly population. High rates of readmission contribute substantially to excessive health care costs and highlight the fragmented nature of care available to HF patients. Disease management programs (DMPs) have been implemented to improve health outcomes, patient satisfaction, and quality of life, and to reduce health care costs. Telemonitoring systems appear to be effective in the vulnerable phase after discharge from hospital to prevent early readmissions. DMPs that emphasize comprehensive patient education and guideline-adjusted therapy have shown great promise to result in beneficial long-term effects. It can be speculated that combining core elements of the aforementioned programs may substantially improve long-term cost-effectiveness of patient management.We introduce a collaborative post-discharge HF disease management program (HerzMobil Tirol network) that incorporates physician-controlled telemonitoring and nurse-led care in a multidisciplinary network approach.

Continuous medication monitoring is essential for successful management of heart failure patients. Experiences with the recently established heart failure network HerzMobil Tirol show that medication monitoring limited to heart failure specific drugs could be insufficient, in particular for general practitioners. Additionally, some patients are confused about monitoring only part of their prescribed drugs. Sometimes medication will be changed without informing the responsible physician. As part of the upcoming Austrian electronic health record system ELGA, the eMedication system will collect prescription and dispensing data of drugs and these data will be accessible to authorized healthcare professionals on an inter-institutional level. Therefore, we propose two concepts on integrated medication management in mHealth applications that integrate ELGA eMedication and closed-loop mHealth-based telemonitoring. As a next step, we will implement these concepts and analyze--in a feasibility study--usability and practicability as well as legal aspects with respect to automatic data transfer from the ELGA eMedication service.

Patients with diabetes were enrolled into a telemonitoring programme. They were offered the choice of collecting their health data either by using Near Field Communication (NFC) enabled mobile phones equipped with a dedicated application (App), or by means of a web-browser based user interface (Web). At the end of the study, each patient was categorized as belonging to either the App or Web group, based on the proportion of data they had transmitted using each method. Of the 403 patients, there were 291 in the App group and 112 in the Web group. The two groups were similar in their demographics, except for gender distribution where 68% of men preferred using the App method in contrast to 95% for women (P < 0.001). Kaplan-Meier analysis showed a steady decline of the compliance rate for both groups, at a similar rate during the first year. It also showed a more rapid decline of the compliance rate thereafter for the Web group, which resulted in a significantly higher rate for the App group over the whole observation period (P = 0.03). We conclude that different types of data acquisition technologies may have an important effect on patients' willingness to participate in telehealth programmes in the long-term.

Patients with psoriasis who are being treated with biologics require intensive monitoring. However, the monitoring tool teledermatology is not commonly used. We investigated the applicability of a mobile phone based teledermatological system for monitoring psoriasis patients on biologic therapy. Nineteen patients were given mobile phones with built-in cameras, in order to transmit health status data and images (mobile visits) weekly for a 6-month period. Face-to-face visits were carried out at weeks 0, 4, 12 and 24. Image quality, the Psoriasis Area and Severity Index (PASI), the handling of adverse events, and patients' feedback questionnaires were evaluated. Ninety-five percent of the images were of sufficient quality to enable accurate assessment of the PASI. The distance between the interpolated face-to-face PASIs and the corresponding mobile visit PASIs was 0.46 ± 2.15 (median ± interquartile range). All 155 adverse events were handled correctly by the system. This teledermatological system represents a reliable tool for management of psoriasis patients who are on systemic treatment.