This thesis describes the role of internet-based support in the delivery of an asthma self management program. First, the compliance and reliability of home lung function monitoring, one of the key... Show moreThis thesis describes the role of internet-based support in the delivery of an asthma self management program. First, the compliance and reliability of home lung function monitoring, one of the key features of asthma self-management, was studied and appeared to be high over a 4-week period. Second, we explored intrinsic barriers to current asthma management and revealed possible benefits from internet-based asthma self-management. Participants considered feasible electronic monitoring, easily accessible information, e-mail communication and the use of an electronic action plan to be the main benefits of internet-based asthma self-management. Third, we assessed the clinical effectiveness and cost effectiveness of an internet-based asthma self-management program over a period of 1 year. Internet-based self-management improved asthma related quality of life, asthma control, symptom-free days and lung function, but did not decrease the number of exacerbations. The benefits gained were attained at reasonable costs from a societal perspective and even more so from a health care perspective. Show less
The concept of distance is a fundamental notion that forms a basis for the orientation in space. It is related to the scientific measurement process: quantitative measurements result in numerical... Show moreThe concept of distance is a fundamental notion that forms a basis for the orientation in space. It is related to the scientific measurement process: quantitative measurements result in numerical values, and these can be immediately translated into distances. Vice versa, a set of mutual distances defines an abstract Euclidean space. Each system is thereby represented as a point, whose Euclidean distances approximate the original distances as close as possible. If the original distance measures interesting properties, these can be found back as interesting patterns in this space. This idea is applied to complex systems: The act of breathing, the structure and activity of the brain, and dynamical systems and time series in general. In all these situations, optimal transportation distances are used; these measure how much work is needed to transform one probability distribution into another. The reconstructed Euclidean space then permits to apply multivariate statistical methods. In particular, canonical discriminant analysis makes it possible to distinguish between distinct classes of systems, e.g., between healthy and diseased lungs. This offers new diagnostic perspectives in the assessment of lung and brain diseases, and also offers a new approach to numerical bifurcation analysis and to quantify synchronization in dynamical systems. Show less
