Mobile Digital Health Intervention to Promote Nutrition and Physical Activity Behaviors Among Long-term Unemployed in Rural Areas: Protocol for a Randomized Controlled Trial.

BACKGROUND: Long-term unemployed have poor nutritional and physical activity statuses, and, therefore, special health promotion needs. Particularly in rural areas, however, they often do not have access to health promotion service. Thus, new promising strategies to improve the health of long-term unemployed are needed. Hence, a digital health intervention to promote nutritional and physical health behaviors was conceived, and the effectiveness of the intervention in combination with face-to-face sessions will be evaluated in a randomized controlled trial. OBJECTIVE: The aim of this study is to elucidate the effectiveness of a mobile digital health intervention to promote the nutritional and physical activity behaviors of long-term unemployed in the rural areas of Germany. METHODS: The 9-week intervention aims to promote nutritional or physical activity behavior by improving drinking habits, increasing the consumption of fruits, vegetables, and whole grains, increasing daily step count, strengthening muscles, and improving endurance. The intervention design is based on the transtheoretical model and is implemented in a mobile app using the MobileCoach open-source platform. The effectiveness of the intervention will be elucidated by a 9-week, 2-armed, parallel-designed trial. Therefore, long-term unemployed will be recruited by employees of the German social sector institutions and randomized either to receive information brochures; the digital intervention in the form of a mobile app; and 3 face-to-face sessions regarding technical support, healthy eating, and physical activity (n=100) or to receive a control treatment consisting of solely the hand over of information brochures (n=100). The effectiveness of the intervention will be assessed using questionnaires at baseline, after 9 weeks in face-to-face appointments, and after a 3-month follow-up period by postal contact. The use of the mobile app will be monitored, and qualitative interviews or focus groups with the participants will be conducted. Incentives of €50 (US $49.7) will be paid to the participants and are tied to the completion of the questionnaires and not to the use of the mobile app or progress in the intervention. RESULTS: The effectiveness of the intervention in promoting the nutritional and physical activity behaviors of long-term unemployed participants will be elucidated. The adherence of the participants to and the acceptance and usability of the mobile device app will be evaluated. Recruitment started in March 2022, and the final publication of the results is expected in the first half of 2023. CONCLUSIONS: Positive health-related changes made by the intervention would display the potency of digital health interventions to promote nutritional and physical activity behaviors among long-term unemployed in the rural areas of Germany, which would also contribute to an improved health status of the German population in general. TRIAL REGISTRATION: German Clinical Trials Register DRKS00024805; https://www.drks.de/DRKS00024805. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/40321.

Best Practice Guidance for Creation and Management of Innovations in Health care and Information and Communications Technologies.

Governments and publics in Europe and around the world have turned to innovation in response to the manifold economic, environmental, and societal challenges we are facing. However, innovations often end up in what is popularly termed as the "valley of death" between upstream creation and downstream product development and implementation. Consequently, the benefits of innovation do not always reach the citizens. In addition, critically informed governance of innovations matter because it allows steering of innovations in response to the values and end points desired by society. With the COVID-19 pandemic, we have witnessed the rise of digital health and new information and communications technologies (ICTs). The pandemic underscored the need for innovation governance between global North and the global South. We report and discuss, in this study, the development of the innXchange innovation wheel to improve innovation creation and management, using a case study of cooperation between Europe and Africa. The innovation wheel offers best practice guidance and framework to build capacity for innovation dimensions such as partnership mobilization, evaluation, and monitoring, not to mention innovation literacy. The framework emphasizes active engagement of all key stakeholders from the very beginning, also referred to as "systematic early dialog." We propose the incorporation of systematic early dialog as the best practice guidance in global South and global North cooperation for health care and ICT innovation. The framework is a novel instrument to help overcome the current barriers in planetary health innovation management and consequently, bring breakthrough discoveries in ICTs and innovative ideas to the people.

Introducing RAPTOR: RevMan Parsing Tool for Reviewers.

BACKGROUND: Much effort is made to ensure Cochrane reviews are based on reliably extracted data. There is a commitment to wide access to these data-for novel processing and/or reuse-but delivering this access is problematic. AIM: To describe a proof-of-concept programme to extract, curate and structure data from Cochrane reviews. METHODS: One student of Applied Sciences (16 weeks full time), access to pre-publication review files and use of 'Eclipse' to create an open-access tool (RAPTOR) using the programming language Java. RESULTS: The final software batch processes hundreds of reviews in seconds, extracting all study data and automatically tidying and unifying presentation of data for return into the source review, reuse, or export for novel analyses. CONCLUSIONS: This software, despite being limited, illustrates how the efforts of reviewers meticulously extracting study data can be improved, disseminated and reused with little additional effort.

The Creation and Management of Innovations in Healthcare and ICT: The European and African Experience.

The purpose of the study was to gain new insights into innovation systems by comparing state-of-the-art of existing approaches of innovation creation and innovation management in healthcare and ICT. It is unique, in that it compares countries in Africa with countries in Europe in order to identify similarities and differences regarding the creation and management of innovations. The main similarity is that early dialogue between different stakeholders was underrepresented during the whole innovation process in all countries. Our results also indicated that the various stakeholders often work in silos. The main difference was that the countries face problems at different stages of the innovation process. Whereas European countries face more problems in the innovation creation process, African countries experience difficulty sustaining and managing innovation. To overcome barriers, we suggest the application of systematic early dialogue between all key stakeholders.

Working towards personalization in medicine: main obstacles to reaching this vision from today's perspective.

Rapid advances in 'omics' sciences and technologies have elevated the relevance of personalized medicine. This article reviews the current advances in the application of personalized medicine, outlines and summarizes the key areas that still need to be addressed and gives recommendations in this direction. Eighteen relevant high-level reports on personalized medicine were reviewed in order to identify the gaps and needs that are present for the implementation of personalized medicine. We identify 12 key areas that represent the main obstacles on the road towards the personalization of medicine and divide these 12 key areas into four domains, namely: scientific research and stakeholder collaboration; translational tools; regulations and systematic early dialog with regulators; and uptake into healthcare systems. All of the evaluated reports agree on the imperative need for intensive collaboration among all stakeholders with early active participation and changes in the current healthcare infrastructure.

Frontline health care can be improved by bringing research into the clinic.

Progress in clinical research has played a huge role in the great improvements in frontline health care achieved over the last 50 years, both in general practice and in hospitals.

Effects of unoprostone and endothelin 1 on L-type channel currents in human trabecular meshwork cells.

BACKGROUND: The trabecular meshwork (TM) is a smooth muscle-like tissue with contractile properties and by this mechanisms involved in the regulation of aqueous humor outflow. Isopropyl unoprostone (Rescula, Novartis Ophthalmics), a synthetic docosanoid, reduces intraocular pressure in glaucoma patients and normal subjects. In isolated TM strips, unoprostone reduces TM contractility in the presence of endothelin 1 (ET-1). However, the signal transduction pathway of unoprostone still remains unclear. Since L-type channel currents are known to influence the contractility of TM, we examined the effects of unoprostone and ET-1 on L-type channel currents of TM cells. METHODS: The effects of unoprostone, ET-1 and the tyrosine kinase inhibitor herbimycin A on L-type channel currents of cultured human TM cells were investigated using the perforated patch configuration of the patch-clamp technique. RESULTS: Application of ET-1 had no effect on L-type channel currents. Unoprostone led to a dose-dependent reduction of control currents. The effect of unoprostone is independent of ET-1. After preincubation of cells with herbimycin A, unoprostone had no effect on the L-type channel current amplitude. Human TM cells preincubated with herbimycin A showed a reduced current density compared with control cells. Both substances, unoprostone and herbimycin A, increased the inactivation time constant of L-type channel currents. CONCLUSION: We conclude that unoprostone reduces the activity of L-type Ca2+ channels. This effect seems to be independent of ET-1. The signal transduction pathway seems to be mediated by tyrosine kinases.