RESUMEN
Infectious diseases significantly contribute to global morbidity and mortality, highlighting the critical need for robust disease surveillance systems. The rapid and accurate identification of infection hotspots is crucial for effective disease control and eliminating vector reservoirs. Traditional methods, reliant on patient-reported data, are vague, slow, and non-integrative, presenting substantial barriers to fully understanding the underlying causes of infection transmission. The widespread usage of smartphones presents a unique opportunity to access, analyze, and monitor digital data. Particularly, location data can offer potential insights into infectious disease dynamics, which has remained largely unexplored. Firstly, the present study leverages location history data from smartphones of malaria patients in Manaus, Amazonas region, to pinpoint mosquito-breeding sites. Upon quantifying the location data, the primary transmission hotspots were identified to be concentrated on the outskirts of the city of Manaus. Additionally, the quantification and hotspot validation confirmed that newly visited locations during the exposure period were potential sources of infection transmission. Secondly, the current study also employs a novel digital contact investigation method for a human-to-human transmission infection such as tuberculosis to measure the exposure risk between the active index cases and their close contacts. The digital contact investigation revealed varied exposure durations between the recruited paired index and close contact participants based on the outcome of close contact. To summarize, the present study determines distinct mobility patterns associated with both these infectious diseases, potentially aiding in drafting targeted public health strategies and policies for digital epidemiological surveillance
As doenças infecciosas são um dos principais contribuintes para a morbidade e a mortalidade globais, enfatizando a necessidade crítica de sistemas robustos de vigilância de doenças. A identificação rápida e precisa dos pontos críticos de infecção é fundamental para o controle eficaz de doenças e a eliminação de reservatórios de vetores. Os métodos tradicionais, que dependem de dados relatados por pacientes, são vagos, lentos e não integrativos, apresentando barreiras significativas para a compreensão total das causas subjacentes da transmissão de infecções. O uso generalizado de dispositivos móveis apresenta uma oportunidade única de acessar, analisar e monitorar dados digitais. Especialmente, dados de localização podem oferecer informações úteis sobre a dinâmica de doenças infecciosas, que permanecem em grande parte inexploradas. Primeiramente, o presente estudo utiliza dados de histórico de localização de smartphones de pacientes com malária em Manaus, na região do Amazonas, para identificar locais de reprodução de mosquitos. Ao quantificar os dados de localização, identificaram-se os principais pontos de transmissão concentrados nos arredores da cidade de Manaus. Além do mais, a quantificação e a validação em campo confirmaram que os locais recém-visitados durante o período de exposição eram potenciais fontes de transmissão da infecção. Em segundo lugar, o estudo atual também emprega um inovador método de investigação digital de contato para uma infecção por transmissão de humano para humano, como a tuberculose, a fim de medir o risco por exposição entre os casos índice ativos e seus contatos próximos. A investigação digital de contato revelou períodos de exposição variados entre os participantes recrutados em pares de casos índice e contatos próximos, com base no resultado do contato próximo. Em resumo, o presente estudo identifica padrões distintos de mobilidade associados a ambas essas doenças infecciosas, auxiliando potencialmente na elaboração de estratégias e políticas de saúde pública direcionadas para a vigilância epidemiológica digital
Asunto(s)
Pacientes/clasificación , Enfermedades Transmisibles/clasificación , Teléfono Celular/instrumentación , Tuberculosis/patología , Sistemas de Información Geográfica , Malaria/patologíaRESUMEN
Crianças e adolescentes usam a tecnologia móvel para diversas finalidades, como lazer, entretenimento, estudos e comunicação. No entanto, faz-se necessário o controle e mediação parental pois o uso inadequado pode gerar danos à saúde. Existem aplicativos voltados para esta tarefa e com funcionalidades e características variadas. Diante disso, este estudo teve como objetivo analisar as aplicações móveis disponíveis para download na plataforma Google Play Store por meio de uma revisão narrativa e com auxílio do software IRAMUTEQ para revisão dos dados, analisar os comentários deixados pelos usuários. Foram investigadas as informações de 138 aplicativos, boa parte deles realizam funções essenciais, como controlar o tempo de acesso, bloquear sites e apps indesejados, porém, há muitas críticas relacionadas a problemas técnicos, aplicabilidade e prejuízos gerados pelo excessivo controle dos pais. A investigação mostrou que cinco softwares para o controle parental apresentavam as principais funções de acordo com a aplicabilidade (limite de tempo, filtros, localizador GPS, monitoramento de chamadas e mensagens), nota acima de 3,0 e ano de atualização em 2021. A análise dos comentários feita pelo software IRAMUTEQ, destacou as palavras "App" (referente à aplicativo), "filho", "celular", "bloquear", "funcionar", "criança", "instalar" e "desinstalar" como as mais importantes pelos usuários.
Children and teenagers use mobile technology for different purposes, such as leisure, entertainment, studies and communication. However, parental control and mediation is necessary, as inappropriate use can cause health damage. There are applications aimed at this task and with varied functionalities and characteristics. Therefore, this study aimed to analyze the mobile applications available for download on the Google Play Store platform through a narrative review and with the help of the IRAMUTEQ software to review the data, analyze the comments left by users. Information from 138 applications was investigated, most of which perform essential functions, such as controlling access time, blocking unwanted websites and apps, however, there are many criticisms related to technical problems, applicability and damage caused by excessive parental control. The investigation showed that five parental control software had the main functions according to applicability (time limit, filters, GPS locator, call and message monitoring), grade above 3.0 and year of update in 2021. The analysis of the comments made by the IRAMUTEQ software, highlighted the words "App" (referring to the application), "son", "cell phone", "block", "work", "child", "install" and "uninstall" as the most important for users.
Los niños y adolescentes utilizan la tecnología móvil para diferentes fines, como el ocio, el entretenimiento, los estudios y la comunicación. Sin embargo, es necesario el control y la mediación parental, ya que un uso inadecuado puede causar daños a la salud. Existen aplicaciones destinadas a esta tarea y con funcionalidades y características variadas. Por lo tanto, este estudio tuvo como objetivo analizar las aplicaciones móviles disponibles para su descarga en la plataforma Google Play Store a través de una revisión narrativa y con la ayuda del software IRAMUTEQ para revisar los datos, analizar los comentarios dejados por los usuarios. Se investigó la información de 138 aplicaciones, la mayoría de las cuales cumplen funciones esenciales, como controlar el tiempo de acceso, bloquear sitios web y apps no deseadas, sin embargo, existen muchas críticas relacionadas con problemas técnicos, de aplicabilidad y daños causados por el excesivo control parental. La investigación mostró que cinco programas de control parental tenían las funciones principales según aplicabilidad (límite de tiempo, filtros, localizador GPS, monitorización de llamadas y mensajes), grado superior a 3.0 y año de actualización en 2021. El análisis de los comentarios realizados por el software IRAMUTEQ, destacó las palabras "App" (refiriéndose a la aplicación), "hijo", "móvil", "bloquear", "trabajar", "niño", "instalar" y "desinstalar" como las más importantes para los usuarios.
Asunto(s)
Humanos , Masculino , Femenino , Consentimiento Paterno , Aplicaciones Móviles , Programas Informáticos/tendencias , Niño , Conducta del Adolescente , Teléfono Celular/instrumentación , Teléfono Inteligente/instrumentaciónRESUMEN
Abstract To evaluate the effectiveness of an anticoagulation protocol adapted in a mobile application (appG) for patients using warfarin. This was a cluster randomized controlled clinical trial carried out in basic health centers of Ijui, RS, Brazil, between April and October 2017. The appG was installed on the cell phones of all physicians belonging to the intervention group. Primary outcomes were bleeding and thrombosis, and secondary outcomes were changes in the dose of warfarin, use of new drugs, drug interactions, search for health services, and remaining on the target international normalized ratio. Thirty-three patients belonging to 11 basic health centers were included in this study. From these, 15 patients were in the intervention group which used the appG, and 18 were in the control group. After 6 months, patients in the appG group had fewer bleeding events (7% versus 50%, p-value=0.028) and a lower weekly dose of warfarin (29.3 ± 9.7 mg versus 41.7 ± 12.5 mg, p-value=0.030) when compared to the control group. The anticoagulation protocol adapted in a mobile app reduced bleeding in patients using warfarin.
Asunto(s)
Médicos , Warfarina/efectos adversos , Monitoreo Ambulatorio/instrumentación , Teléfono Celular/instrumentación , Aplicaciones Móviles/clasificación , Pacientes , Centros de Salud , Medicamentos de ReferenciaRESUMEN
ABSTRACT: To compare the performance of margin assessment of specimen mammography (SM) in patients with breast-conserving surgery (BCS) on mobile devices and 5-megapixel (5M) thin film transistor liquid crystal display (TFT-LCD) monitors based on the safety margin for pathologic results.This retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. A total of 105 consecutive breast cancer SM samples from 104 women who underwent BCS were included in the study. The SM were independently reviewed by two radiologists using mobile devices and by two additional radiologists using 5M TFT-LCD monitor. Each reader was asked to measure the shortest distance between the lesion and the lesion margin. The interpretation time was recorded. The sensitivity, specificity, and interobserver agreement were analyzed.In total, 19% (20/105) breast specimens had a positive surgical margin (<1âmm). The mean absolute difference from the pathologic margin was 0.60â±â0.57âcm and 0.54â±â0.47âcm using the 5âM TFT-LCD monitor and the mobile device, respectively (without any statistical significance, Pâ=â.273). The mean interpretation time was 49.5 and 47.6âs for the 5M TFT-LCD monitor and the mobile device, respectively (Pâ=â.012). The pooled sensitivity and specificity were 60% and 74% for 5M TFT-LCD monitor, and 60% and 69% for the mobile device (Pâ=â1.00 and Pâ=â.190, respectively). The kappa coefficient indicated moderate agreement for both the displays.The diagnostic performance for margin assessment of SM in BCS patients on mobile devices and 5M TFT-LCD monitors are showed not statistically difference. The findings of the study provide evidence of the benefit of the mobile device for SM interpretation in patients who underwent BCS. However, a large sample size study is warranted before using a mobile device for margin evaluation on SM.The mobile device showed comparable diagnostic performance with 5M TFT-LCD monitor in the evaluation of SM margin in patients with BCS and could be used as a display tool for immediate assessment when a dedicated LCD monitor is unavailable.
Asunto(s)
Teléfono Celular/normas , Mamografía/métodos , Márgenes de Escisión , Mastectomía Segmentaria/normas , Área Bajo la Curva , Mama/cirugía , Teléfono Celular/instrumentación , Humanos , Imagen por Resonancia Magnética/métodos , Mamografía/instrumentación , Mastectomía Segmentaria/métodos , Mastectomía Segmentaria/estadística & datos numéricos , Curva ROC , Estudios Retrospectivos , Seúl , Tomografía Computarizada por Rayos X/métodosRESUMEN
An ever-increasing number of medical staff use mobile phones as a work aid, yet this may pose nosocomial diseases. To assess and report via a survey the handling practices and the use of phones by paediatric wards healthcare workers. 165 paediatric healthcare workers and staff filled in a questionnaire consisting of 14 questions (including categorical, ordinal and numerical data). Analysis of categorical data used non-parametric techniques such as the Chi-squared test. Although 98% of respondents (165 in total) report that their phones may be contaminated, 56% have never cleaned their devices. Of the respondents that clean their devices, 10% (17/165) had done so with alcohol swabs or disinfectant within that day or week; and an additional 12% respondents (20/165) within that month. Of concern, 52% (86/165) of the respondents use their phones in the bathroom, emphasising the unhygienic environments in which mobile phones/smartphones are constantly used. Disinfecting phones is a practice that only a minority of healthcare workers undertake appropriately. Mobile phones, present in billions globally, are therefore Trojan Horses if contaminated with microbes and potentially contributing to the spread and propagation of micro-organisms as per the rapid spread of SARS-CoV-2 virus in the world.
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Aparatos Sanitarios/virología , COVID-19/prevención & control , Teléfono Celular/instrumentación , Infección Hospitalaria/prevención & control , Atención a la Salud/métodos , Desinfección/métodos , Hospitales Pediátricos , Personal de Hospital , SARS-CoV-2 , COVID-19/virología , Infección Hospitalaria/virología , Servicio de Urgencia en Hospital , Femenino , Higiene de las Manos , Humanos , Unidades de Cuidado Intensivo Neonatal , Masculino , Factores de Riesgo , AutoinformeRESUMEN
We introduce an approach to expand the eye-box in a retinal-projection-based near-eye display. The retinal projection display has the advantage of providing clear images in a wide depth range; however, it has difficulty in practical use with a narrow eye-box. Here, we propose a method to enhance the eye-box of the retinal projection display by generating multiple independent viewpoints, maintaining a wide depth of field. The method prevents images projected from multiple viewpoints from overlapping one other in the retina. As a result, our proposed system can provide a continuous image over a wide viewing angle without an eye tracker or image update. We discuss the optical design for the proposed method and verify its feasibility through simulation and experiment.
Asunto(s)
Imagenología Tridimensional/instrumentación , Retina/diagnóstico por imagen , Teléfono Celular/instrumentación , Simulación por Computador , Diseño de Equipo , Humanos , Procesamiento de Imagen Asistido por Computador , Imagenología Tridimensional/métodos , Dispositivos ÓpticosRESUMEN
As a high-impact educational practice, cooperative learning uses a structured group study to promote students' active learning. Currently, it lacks economical yet effective tools to facilitate the interactive nature of structured cooperative learning in regular classrooms. Here, we have established a mobile technology-based cooperative learning (MBCL) platform that comprises the 2018 iPad, Apple Pencil, LiveBoard, Google Forms, and Google Drive. We tested the MBCL platform in multiple undergraduate biology courses. During semester-long MBCL studies, the students engaged in cooperative learning to discuss a real-life issue or chapter-based contents. With the MBCL platform, the students' group study processes were shown on shared, visible electronic whiteboards that were updated in real-time, generating visible thinking and instant, interactive communication. The instructor was able to guide the students promptly to conduct knowledge integration and knowledge synthesis using tables and diagrams. The deep learning outcome was evident in the examples and quantitative analyses of students' whiteboard study results and team presentations. Thus, integrating innovative mobile technologies into high-impact teaching practices, exemplified by the MBCL platform, promotes deep learning in higher education.
Asunto(s)
Biología/educación , Tecnología Biomédica/métodos , Teléfono Celular/instrumentación , Instrucción por Computador/métodos , Conducta Cooperativa , Tecnología Educacional/normas , Aprendizaje Basado en Problemas/métodos , HumanosRESUMEN
In this study, the effects of GSM 1800 band radiation on composition, structure and bioactivity of exopolysaccharides (EPSs) produced by Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus were determined. For this, GSM 1800 band radiation was applied to both cultures and characteristics of EPSs extracted from the control groups (K) and the radiation stressed groups (R) were determined. An alteration in the chemical composition of the EPSs was observed and EPS production levels and molecular weights of the EPSs increased following the GSM 1800 band radiation application. Alterations in the functional groups, thermal and morphological characteristics of EPSs following the GSM 1800 band radiation application were confirmed by FTIR, TGA and SEM analysis, respectively. Importantly no alterations in the antioxidant and antibacterial activity of the EPSs were observed following the radiation application. These results suggested the effects of the GSM radiation on final characteristics of EPSs from yogurt starter cultures.
Asunto(s)
Teléfono Celular/instrumentación , Radiación Electromagnética , Polisacáridos Bacterianos/metabolismo , Polisacáridos Bacterianos/efectos de la radiación , Yogur/microbiología , Fermentación/efectos de la radiación , Lactobacillus delbrueckii/metabolismo , Streptococcus thermophilus/metabolismo , Yogur/análisisRESUMEN
BACKGROUND: The QUiPP app is a free, validated mobile phone application (app) that supports clinical decision-making for women in threatened preterm labour by providing an individualised risk of delivery within clinically important time points. Alongside generating a percentage risk score, the QUiPP app also provides the risk score in an infographic donut chart, allowing the clinician to communicate with the woman in an easy to understand format. Informing women of their risk status using the QUIPP app may help to reduce anxiety in women and decrease decisional conflict. METHOD: A subset of participants from the EQUIPTT study [REC Ref. 17/LO/1802] were asked to complete a questionnaire booklet which was used to evaluate decisional conflict and anxiety. Seven sites were randomised to the QUiPP app intervention (to use as a decision and communication tool) and six sites were randomised to the control (continued their normal practice). The first section of the questionnaire booklet was completed by the woman before her assessment, and the second section after. The pre and postassessment anxiety scores utilised the Visual Analogue Scale for Anxiety (Hornblow and Kidson, 1976). The Decisional Conflict Scale (O'Connor, 1995) measured decisional conflict post assessment. The data were then analysed to determine the impact of the QUiPP App on the anxiety and decisional conflicts faced by women in threatened preterm labour. RESULTS: Questionnaires were completed by 221 women from 12 of the potential 13 sites. After exclusions 202 questionnaires were included in the analysis. There was a significant reduction in difference between anxiety scores before and after clinical assessment. While there were reductions in anxiety and decisional conflict for women who were aware of the QUiPP app use, this failed to reach statistical significance. CONCLUSIONS: The QUiPP app has potential to reduce anxiety and decisional conflict in women who are aware that it is being used in their care. Additional work is required to ensure clinicians are aware of the QUiPP app and optimise using it as a communication tool when counselling women.
Asunto(s)
Ansiedad/prevención & control , Aplicaciones Móviles/normas , Trabajo de Parto Prematuro/psicología , Análisis de Varianza , Ansiedad/psicología , Teléfono Celular/instrumentación , Teléfono Celular/normas , Teléfono Celular/estadística & datos numéricos , Análisis por Conglomerados , Técnicas de Apoyo para la Decisión , Inglaterra , Femenino , Humanos , Recién Nacido , Aplicaciones Móviles/estadística & datos numéricos , Embarazo , Psicometría/instrumentación , Psicometría/métodos , Psicometría/normas , Medición de Riesgo/métodos , Medición de Riesgo/estadística & datos numéricos , Encuestas y CuestionariosRESUMEN
The December 2019 outbreak of a novel respiratory virus, SARS-CoV-2, has become an ongoing global pandemic due in part to the challenge of identifying symptomatic, asymptomatic, and pre-symptomatic carriers of the virus. CRISPR diagnostics can augment gold-standard PCR-based testing if they can be made rapid, portable, and accurate. Here, we report the development of an amplification-free CRISPR-Cas13a assay for direct detection of SARS-CoV-2 from nasal swab RNA that can be read with a mobile phone microscope. The assay achieved â¼100 copies/µL sensitivity in under 30 min of measurement time and accurately detected pre-extracted RNA from a set of positive clinical samples in under 5 min. We combined crRNAs targeting SARS-CoV-2 RNA to improve sensitivity and specificity and directly quantified viral load using enzyme kinetics. Integrated with a reader device based on a mobile phone, this assay has the potential to enable rapid, low-cost, point-of-care screening for SARS-CoV-2.
Asunto(s)
Prueba de Ácido Nucleico para COVID-19/métodos , Teléfono Celular/instrumentación , Imagen Óptica/métodos , ARN Viral/análisis , Carga Viral/métodos , Animales , Prueba de Ácido Nucleico para COVID-19/economía , Prueba de Ácido Nucleico para COVID-19/instrumentación , Sistemas CRISPR-Cas , Línea Celular , Proteínas de la Nucleocápside de Coronavirus/genética , Humanos , Nasofaringe/virología , Imagen Óptica/instrumentación , Fosfoproteínas/genética , Pruebas en el Punto de Atención , Interferencia de ARN , ARN Viral/genética , Sensibilidad y Especificidad , Carga Viral/economía , Carga Viral/instrumentaciónAsunto(s)
Acrilatos/efectos adversos , Canfanos/efectos adversos , Teléfono Celular/instrumentación , Dermatitis Alérgica por Contacto/etiología , Dermatitis Profesional/etiología , Dermatosis de la Mano/inducido químicamente , Adulto , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Profesional/diagnóstico , Femenino , Dermatosis de la Mano/diagnóstico , Humanos , Pruebas del ParcheRESUMEN
BACKGROUND: Personal health records (PHRs) can be useful in the emergency department, as they provide patient information in an accurate and timely manner and enable it to be used actively. This has an effect on patients' health outcomes and patient experience. Despite the importance of PHRs in emergencies, there are only a few studies related to PHRs in emergencies that evaluate patient experience. OBJECTIVE: This study aims to introduce the novel mobile PHR (mPHR) platform to emergency environments and assess user experience. METHODS: The study was conducted from October 2019 to November 2019. In total, 1000 patients or carers in the emergency departments of 3 hospitals were provided an application-based service called FirstER, which was developed to collect and utilize medical information for patients in the emergency department. This study was performed as a mixed methods study. After using FirstER, we investigated its usability and conducted a survey on the experience of obtaining medical information with a legacy system and with FirstER. Additionally, we interviewed 24 patients to gain insight into their experiences regarding medical information using FirstER. For the quantitative analysis, the survey results were analyzed using descriptive statistics (mean and standard deviation). For the qualitative analysis, we determined the keywords and their frequencies from each survey question and interview question. RESULTS: In total, 1000 participants, consisting of both patients and carers, were recruited in this study. Their mean age was 41.4 (SD 13.3) years. We ascertained participants' satisfaction with FirstER and their mPHR needs through a survey and an in-depth interview. With the current system, participants were not well aware of their health conditions and medical information, and they were passive in the use of their medical information and treatment. However, they wanted their medical information for several reasons, such as information sharing and managing their health conditions. FirstER provided participants with their needed information and an easy way to access it. The mean System Usability Scale (SUS) value was 67.1 (SD 13.8), which was considered very near to acceptable. CONCLUSIONS: This study is the first to implement mPHRs in the emergency department of large tertiary hospitals in the Republic of Korea. FirstER was found to enhance user experience in emergencies, as it provided necessary medical information and proper user experience. Moreover, the average SUS was 67.1, which means that participants found FirstER to be very near to acceptable. This is very encouraging in that FirstER was developed within a very short time, and it was a pilot study. TRIAL REGISTRATION: Clinicaltrials.gov NCT04180618; https://clinicaltrials.gov/ct2/show/NCT04180618.
Asunto(s)
Teléfono Celular/instrumentación , Sistemas de Registros Médicos Computarizados/instrumentación , Adulto , Teléfono Celular/estadística & datos numéricos , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Sistemas de Registros Médicos Computarizados/estadística & datos numéricos , Persona de Mediana Edad , Proyectos Piloto , República de Corea , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The advent of portable nanopore sequencing devices has enabled DNA and RNA sequencing to be performed in the field or the clinic. However, advances in in situ genomics require parallel development of portable, offline solutions for the computational analysis of sequencing data. Here we introduce Genopo, a mobile toolkit for nanopore sequencing analysis. Genopo compacts popular bioinformatics tools to an Android application, enabling fully portable computation. To demonstrate its utility for in situ genome analysis, we use Genopo to determine the complete genome sequence of the human coronavirus SARS-CoV-2 in nine patient isolates sequenced on a nanopore device, with Genopo executing this workflow in less than 30 min per sample on a range of popular smartphones. We further show how Genopo can be used to profile DNA methylation in a human genome sample, illustrating a flexible, efficient architecture that is suitable to run many popular bioinformatics tools and accommodate small or large genomes. As the first ever smartphone application for nanopore sequencing analysis, Genopo enables the genomics community to harness this cheap, ubiquitous computational resource.
Asunto(s)
Betacoronavirus/genética , Biología Computacional/métodos , Genoma Humano , Genoma Viral , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Secuenciación Completa del Genoma/métodos , Betacoronavirus/patogenicidad , COVID-19 , Teléfono Celular/instrumentación , Biología Computacional/instrumentación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/virología , Metilación de ADN , Secuenciación de Nucleótidos de Alto Rendimiento/instrumentación , Humanos , Nanoporos , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/virología , SARS-CoV-2 , Secuenciación Completa del Genoma/instrumentaciónRESUMEN
BACKGROUND: Adherence to weight-loss medication is suboptimal, leading to poor health outcomes. Short message service (SMS) can potentially improve adherence. METHODS: A total of 3,994 participants with overweight or obesity in Australia receiving Saxenda® (liraglutide 3.0 mg) were enrolled from September 1, 2017, to February 28, 2018, through doctors, pharmacists, or websites and were randomly assigned to receive none, three, or five SMS per week. Participants were additionally offered a face-to-face consultation with a diabetes educator or a call from a dietitian. Medication adherence was measured as whether the total scripts claimed were at least as many as the total claims expected by March 31, 2018, and was modeled adjusting for age, sex, baseline BMI, residential region, enrolment channel, the total number of SMS, and additional patient support. RESULTS: Participants receiving five SMS (OR, 6.25; 95% CI: 4.28-9.12) had greater adherence than those receiving three SMS (OR, 3.67; 95% CI: 2.67-5.03) or zero SMS per week. The effectiveness of SMS on adherence decreased as participants received more SMS over time. Moreover, the odds of adhering to liraglutide were higher for participants enrolled with pharmacists compared with those enrolled with doctors (OR, 2.28; 95% CI: 1.82-2.86) and for participants who received a face-to-face consultation (OR, 3.10; 95% CI: 1.82-5.29) or a call (OR, 1.31; 95% CI: 1.02-1.68) compared with those who received no extra support. CONCLUSIONS: Integration of SMS into routine clinical practice should consider not only the frequency and content of reminders but also additional patient support to achieve higher and more sustained adherence to medication and health behavior changes.
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Teléfono Celular/instrumentación , Hipoglucemiantes/uso terapéutico , Liraglutida/uso terapéutico , Cumplimiento de la Medicación/estadística & datos numéricos , Telemedicina/métodos , Envío de Mensajes de Texto/normas , Adulto , Femenino , Conductas Relacionadas con la Salud , Humanos , Hipoglucemiantes/farmacología , Liraglutida/farmacología , Masculino , Persona de Mediana EdadRESUMEN
The aim of this study was to assess the effects of radiofrequency electromagnetic field (RF EMF) on heart rate variability (HRV) in rabbits with intensity slightly exceeding the limits for occupations. Totally 21 New Zealand white rabbits divided into two groups were used in this double-blind study. The first group of animals without general anesthesia was subjected to HRV examination under exposure to a device generated RF EMF source (frequency 1788 MHz, intensity 160 V/m, lasting 150 min.). The second group (premedications + alpha chloralose mg/kg) underwent the same protocol under the exposure to the real RF EMF signal from the base stations of mobile providers (frequency range 1805 - 1870 MHz - corresponding to the downlink signal of Slovak mobile providers, 160 V/m, 150 min., respectively). Individual 5 min records were used to analyze the HRV parameters: heart rate and root Mean Square of the Successive Differences (rMSSD) for time domain analysis and spectral powers in the low (LF-VFS) and high frequency (HF-VFS) bands for frequency domain analysis. Our study revealed the increased in HRV parameters (HF-HRV, rMSSD) associated with lower heart rate indicating increased cardiac vagal control under the exposure to RF EMF in experimental methods.
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Arritmias Cardíacas/etiología , Teléfono Celular/instrumentación , Campos Electromagnéticos/efectos adversos , Exposición a Riesgos Ambientales/efectos adversos , Frecuencia Cardíaca/efectos de la radiación , Ondas de Radio/efectos adversos , Animales , Arritmias Cardíacas/patología , Método Doble Ciego , Frecuencia Cardíaca/fisiología , Modelos Animales , Conejos , Distribución AleatoriaRESUMEN
OBJECTIVES: Patient-reported outcome measures (PROMs) are widely applied to assess perceived health status. To date, no transplant-specific PROM is available for generating a single, standardized score regarding the health status of transplant recipients. The objective of this study is to generate health items for a new patient-centered PROM for organ recipients: the Transplant PROM (TXP). STUDY DESIGN AND SETTING: A five-phase, mixed-method approach was applied to identify and select the health items: scoping literature review, expert meetings, focus-group meetings with organ recipients, a special judgmental task within an online survey, and expert meetings for final selection of health items. RESULTS: Based on a previously published scoping literature review, a first round of expert meetings, and a total of four focus-group meetings with kidney, lung, and liver transplant recipients (N = 18), a list of 83 relevant health items relating to post-transplant life was selected. In an online survey, 183 transplant recipients selected the 10 most important health items from this list. After evaluating the frequency of selected health items and combining items that assess closely related or similar concepts in the second round of expert meetings, nine health items were chosen to be included in TXP: fatigue, skin, worry/anxiety, self-reliance, activities, weight, sexuality, stooling, and memory/concentration. CONCLUSION: The nine TXP health items reflect the most prominent issues transplant recipients experience. The TXP can be administered by means of a mobile phone app.
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Teléfono Celular/instrumentación , Participación del Paciente/psicología , Atención Dirigida al Paciente/métodos , Receptores de Trasplantes/psicología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Grupos Focales , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Participación del Paciente/estadística & datos numéricos , Medición de Resultados Informados por el Paciente , Atención Dirigida al Paciente/normas , Calidad de Vida/psicología , Encuestas y Cuestionarios , Receptores de Trasplantes/estadística & datos numéricosRESUMEN
PURPOSE: The aim of this study is to investigate the effects of electromagnetic waves (EMWs) emitted by a mobile phone on the intraocular pressure (IOP) in the eyeball. METHODS: This quasi-experimental study was conducted on 166 eyes from 83 individuals in the 40-70 age range who referred to "Khatam-al-Anbia Hospital, Mashhad, Iran" in 2016. There were two groups of participants, and the first one consisted of 41 participants who had normal eyes, whereas the second one comprised 42 participants who suffered from open-angle glaucoma disease. The IOP in both groups was measured and recorded by a specialist before and after talking 5 min on the cellphone with the help of the Goldman method. Statistical analysis such as paired t-test and analysis of variance was performed and all tests are statistically significant at (P < 0.05). For this purpose, the SPSS software (version 16) was applied. RESULTS: IOP in the glaucoma eye (42 eyes) ipsilateral to mobile phone before and after the intervention was 18.64 ± 6.7 and 23.53 ± 6.3, respectively (P < 0.001). However, IOP in the control group (41 eyes) ipsilateral to mobile phone before and after the intervention was 12.95 ± 3.5 and 13.39 ± 2.8, respectively (P = 0.063). IOP change in the opposite glaucomatous eye to mobile phone in glaucoma group (39 eyes) and normal group (44 eyes) was not significantly different before and after the phone call (P = 0.065 and P = 0.85, respectively). CONCLUSION: We found that the acute effects of EMWs emitted from the mobile phones can significantly increase the IOP in glaucoma eye, while such changes were not observed in normal eyes.
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Teléfono Celular/instrumentación , Campos Electromagnéticos/efectos adversos , Radiación Electromagnética , Glaucoma de Ángulo Abierto/etiología , Presión Intraocular/efectos de la radiación , Adulto , Anciano , Femenino , Glaucoma de Ángulo Abierto/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Tonometría OcularRESUMEN
BACKGROUND: Although the most effective methods of contraception are available in Bolivia, unmet need for contraception among women aged 15 to 19 years is estimated to be 38% (2008), and the adolescent fertility rate is 71 per 1000 women (2016). Mobile phones are a popular mode to deliver health behavior support. We developed a contraceptive behavioral intervention for young Bolivian women delivered by mobile phone and guided by behavioral science. The intervention consists of short instant messages sent through an app over 4 months. OBJECTIVE: This trial aimed to evaluate the effect of the intervention on young Bolivian women's use of and attitudes toward the effective contraceptive methods available in Bolivia. METHODS: This was a parallel group, individually randomized superiority trial with a 1:1 allocation ratio. Women were eligible if they were aged 16 to 24 years, owned a personal Android mobile phone, lived in La Paz or El Alto, reported an unmet need for contraception, and could read Spanish. The target sample size was 1310 participants. Participants allocated to the intervention had access to an app with standard family planning information and intervention messages. Participants allocated to the control group had access to the same app and control messages. Coprimary outcomes were use of effective contraception and acceptability of at least one method of effective contraception at 4 months. Secondary outcomes were use of effective contraception during the study, acceptability of the individual methods, service uptake, unintended pregnancy, and abortion. Process outcomes included knowledge, perceived norms, personal agency, and intention. Outcomes were analyzed using logistic and linear regression. We also asked participants about physical violence. RESULTS: A total of 640 participants were enrolled, and 67.0% (429) of them contributed follow-up data for the coprimary outcome, the use of effective contraception. There was no evidence that use differed between the groups (33% control vs 37% intervention; adjusted odds ratio [OR] 1.19, 95% CI 0.80 to 1.77; P=.40). There was a borderline significant effect regarding acceptability (63% control vs 72% intervention; adjusted OR 1.49, 95% CI 0.98 to 2.28; P=.06). There were no statistically significant differences in any of the secondary or process outcomes. The intervention dose received was low. In the control group, 2.8% (6/207) reported experiencing physical violence compared with 1.9% (4/202) in the intervention group (Fisher exact test P=.75). CONCLUSIONS: This trial was unable to provide definitive conclusions regarding the effect of the intervention on use and acceptability of effective contraception because of under recruitment. Although we cannot strongly recommend implementation, the results suggest that it would be safe and may increase the acceptability of effective contraception if the intervention messages were offered alongside the download of the app. TRIAL REGISTRATION: ClinicalTrials.gov NCT02905526; https://clinicaltrials.gov/ct2/show/NCT02905526.
Asunto(s)
Teléfono Celular/instrumentación , Anticoncepción/métodos , Dispositivos Anticonceptivos/normas , Adolescente , Adulto , Bolivia , Femenino , Humanos , Medios de Comunicación Sociales , Adulto JovenRESUMEN
The use of cell phones can have a negative effect on nursing students' academic performance. The purpose of this study was to identify the effects that problematic cell phone use and nomophobia have on learning in nursing students. A quasi-experimental study was carried out among nursing students, with a control group (n = 61, 49.2%) and an experimental group (n = 63, 50.8%). The experimental group left their cell phones, in sound or vibration mode, as they normally kept them, on a table located in the corner of the classroom. Both groups showed higher-than-average levels of nomophobia at the beginning of the class. As for problematic cell phone use and attention, it was found that there were statistically significant differences in both cases (U = 1355.500, Z = -2.830, P = .005; U = 1449.000, Z = -2.363, P = .018, respectively), and the experimental group had higher average scores, as well as in those related to knowledge. A relationship has been found between nomophobia and problematic cell phone use. Students who do not have access to their cell phones during class perceive more problematic cell phone usage, in addition to paying closer attention during class. Because of this, it is important to create policies and norms restricting cell phone use during all types of academic training among nursing students.