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1.
Environ Sci Technol ; 55(9): 6076-6086, 2021 05 04.
Artículo en Inglés | MEDLINE | ID: mdl-33856783

RESUMEN

Despite the popularity of smartphones worldwide, persistent toxic substances (PTSs) in protective cases of mobile phones (PCMPs) and their health risks via direct skin contact have been ignored. This study investigated PTSs in PCMPs made in China with different materials and sales territory and their potential harm to human health. Polybrominated diphenyl ethers (PBDEs, 6.40 ng/g), new brominated flame retardants (NBFRs, 144 ng/g), organophosphate esters (OPEs, 10.1 µg/g), short-chain chlorinated paraffins (SCCPs, 3.58 µg/g), medium-chain chlorinated paraffins (MCCPs, 3.17 µg/g), and heavy metals (HMs, 72.3 µg/g) were detected. It was found that the different concentrations and compositions depend on the material, region, and use. Moreover, the raw materials used to fabricate PCMPs are of variable quality and may include recycled plastic waste. There are no standard quality specifications for PCMPs, and different materials have different properties, including specific surface area and adsorption ability. The risk assessment performed by Monte Carlo simulations indicated that the PTSs evaluated pose no health risks to the general population and may have adverse effects on individual high-exposure populations. According to the results of this work, it is suggested that more stringent global specifications for the selection of raw materials should be established, including the content and structural characteristics of PTSs, limitations on the use of additives in the production process, and the handling after use.


Asunto(s)
Teléfono Celular , Retardadores de Llama , China , Monitoreo del Ambiente , Retardadores de Llama/análisis , Éteres Difenilos Halogenados/análisis , Humanos
2.
4.
Artículo en Inglés | MEDLINE | ID: mdl-33807794

RESUMEN

Since the diffusion of recent models of mobile phones, anyone with an internet connection can communicate continuously and search for information. This raises some questions about the possible consequences of problematic mobile phone use (PMPU) in a complex life phase such as adolescence. Therefore, we performed a psychometric analysis of the brief version of the Test of Mobile Phone Dependence (TMD) in Italy. The sample comprised 575 Italian adolescents aged 11 to 18 years. Data were collected using the TMD-brief, the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance Short Form. Regarding test dimensionality, the best-fit measurement model included four factors: "Abstinence"; "Abuse and interference with other activities"; "Tolerance"; and "Lack of control" (Satorra-Bentler χ2 (48) = 185.96, p < 0.01; robust root mean square error of approximation (RMSEA) = 0.079 (90% confidence interval (CI): 0.067; 0.091); robust TLI = 0.904; robust comparative fit index (CFI) = 0.930). The Italian version of the TMD-brief was found to have good reliability and psychometric properties, and a four-factorial structure. PMPU predicted significant sleep disturbances and this relationship was moderated by clinical personality traits. Findings from this study support the use of the Italian version of the TMD-brief as a screening tool to investigate PMPU in Italian adolescents.


Asunto(s)
Uso del Teléfono Celular , Teléfono Celular , Adolescente , Niño , Humanos , Italia/epidemiología , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
5.
BMC Med Inform Decis Mak ; 21(1): 117, 2021 04 07.
Artículo en Inglés | MEDLINE | ID: mdl-33827552

RESUMEN

BACKGROUND: Passive sensor data from mobile devices can shed light on daily activities, social behavior, and maternal-child interactions to improve maternal and child health services including mental healthcare. We assessed feasibility and acceptability of the Sensing Technologies for Maternal Depression Treatment in Low Resource Settings (StandStrong) platform. The StandStrong passive data collection platform was piloted with adolescent and young mothers, including mothers experiencing postpartum depression, in Nepal. METHODS: Mothers (15-25 years old) with infants (< 12 months old) were recruited in person from vaccination clinics in rural Nepal. They were provided with an Android smartphone and a Bluetooth beacon to collect data in four domains: the mother's location using the Global Positioning System (GPS), physical activity using the phone's accelerometer, auditory environment using episodic audio recording on the phone, and mother-infant proximity measured with the Bluetooth beacon attached to the infant's clothing. Feasibility and acceptability were evaluated based on the amount of passive sensing data collected compared to the total amount that could be collected in a 2-week period. Endline qualitative interviews were conducted to understand mothers' experiences and perceptions of passive data collection. RESULTS: Of the 782 women approached, 320 met eligibility criteria and 38 mothers (11 depressed, 27 non-depressed) were enrolled. 38 mothers (11 depressed, 27 non-depressed) were enrolled. Across all participants, 5,579 of the hour-long data collection windows had at least one audio recording [mean (M) = 57.4% of the total possible hour-long recording windows per participant; median (Mdn) = 62.6%], 5,001 activity readings (M = 50.6%; Mdn = 63.2%), 4,168 proximity readings (M = 41.1%; Mdn = 47.6%), and 3,482 GPS readings (M = 35.4%; Mdn = 39.2%). Feasibility challenges were phone battery charging, data usage exceeding prepaid limits, and burden of carrying mobile phones. Acceptability challenges were privacy concerns and lack of family involvement. Overall, families' understanding of passive sensing and families' awareness of potential benefits to mothers and infants were the major modifiable factors increasing acceptability and reducing gaps in data collection. CONCLUSION: Per sensor type, approximately half of the hour-long collection windows had at least one reading. Feasibility challenges for passive sensing on mobile devices can be addressed by providing alternative phone charging options, reverse billing for the app, and replacing mobile phones with smartwatches. Enhancing acceptability will require greater family involvement and improved communication regarding benefits of passive sensing for psychological interventions and other health services. Registration International Registered Report Identifier (IRRID): DERR1-10.2196/14734.


Asunto(s)
Teléfono Celular , Servicios de Salud Mental , Adolescente , Adulto , Niño , Computadoras de Mano , Estudios de Factibilidad , Femenino , Humanos , Lactante , Madres , Adulto Joven
6.
PLoS One ; 16(4): e0249726, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33857208

RESUMEN

As social distancing policies and recommendations went into effect in response to COVID-19, people made rapid changes to the places they visit. These changes are clearly seen in mobility data, which records foot traffic using location trackers in cell phones. While mobility data is often used to extract the number of customers that visit a particular business or business type, it is the frequency and duration of concurrent occupancy at those sites that governs transmission. Understanding the way people interact at different locations can help target policies and inform contact tracing and prevention strategies. This paper outlines methods to extract interactions from mobility data and build networks that can be used in epidemiological models. Several measures of interaction are extracted: interactions between people, the cumulative interactions for a single person, and cumulative interactions that occur at particular businesses. Network metrics are computed to identify structural trends which show clear changes based on the timing of stay-at-home orders. Measures of interaction and structural trends in the resulting networks can be used to better understand potential spreading events, the percent of interactions that can be classified as close contacts, and the impact of policy choices to control transmission.


Asunto(s)
/epidemiología , Teléfono Celular , Trazado de Contacto , Algoritmos , Humanos , /aislamiento & purificación
7.
PLoS One ; 16(4): e0250171, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33857226

RESUMEN

Effective and rapid decision making during a pandemic requires data not only about infections, but also about human behavior. Mobile phone surveys (MPS) offer the opportunity to collect real-time data on behavior, exposure, knowledge, and perception, as well as care and treatment to inform decision making. The surveys aimed to collect coronavirus disease 2019 (COVID-19) related information in Ecuador and Sri Lanka using mobile phones. In Ecuador, a Knowledge, Attitudes and Practices (KAP) survey was conducted. In Sri Lanka, an evaluation of a novel medicine delivery system was conducted. Using the established mobile network operator channels and technical assistance provided through The Bloomberg Philanthropies Data for Health Initiative (D4H), Ministries of Health fielded a population-based COVID-19-specific MPS using Surveda, the open source data collection tool developed as part of the initiative. A total of 1,185 adults in Ecuador completed the MPS in 14 days. A total of 5,001 adults over the age of 35 in Sri Lanka completed the MPS in 44 days. Both samples were adjusted to the 2019 United Nations Population Estimates to produce population-based estimates by age and sex. The Ecuador COVID-19 MPS found that there was compliance with the mitigation strategies implemented in that country. Overall, 96.5% of Ecuadorians reported wearing a face mask or face covering when leaving home. Overall, 3.8% of Sri Lankans used the service to receive medicines from a government clinic. Among those who used the medicine delivery service in Sri Lanka, 95.8% of those who used a private pharmacy received their medications within one week, and 69.9% of those using a government clinic reported the same. These studies demonstrate that MPS can be conducted quickly and gather essential data. MPS can help monitor the impact of interventions and programs, and rapidly identify what works in mitigating the impact of COVID-19.


Asunto(s)
/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Adolescente , Adulto , Teléfono Celular , Ecuador/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Sri Lanka/epidemiología , Encuestas y Cuestionarios , Adulto Joven
8.
Arq Neuropsiquiatr ; 79(2): 139-148, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33759981

RESUMEN

BACKGROUND: The use of technological devices is growing rapidly, and the use of cell phones increases in parallel. Dependence on technological devices is a particular factor in this increased exposure. Many studies have been performed on this electromagnetic field, but no definite conclusions have been drawn. OBJECTIVE: The purpose of this research was to investigate exposure to electromagnetic field, cell phone use behaviors, the specific absorption rate (SAR) values, and changes in health occurring after exposure in university students. METHODS: A questionnaire was administered to 1,019 volunteer students aged 18-24 years at the Nigde Ömer Halisdemir and Recep Tayip Erdogan Universities in 2018-2019. The questions were based on a survey of the literature. RESULTS: The students spent an average 4-8 hours per day on their cell phones, and findings such as headache (p=0.002), concentration deficit (p=0.001), tiredness on waking in the morning (p=0.001), hyperactivity (p=0.001), general feeling of fatigue (p=0.001), and lethargy (p=0.001) increased in a statistically significant manner with length of use. CONCLUSIONS: Participants exhibited high levels of cell phone use and experienced biological, behavioral, and sleep problems. They also had very little knowledge about specific SAR values, an important criterion concerning cell phones.


Asunto(s)
Uso del Teléfono Celular , Teléfono Celular , Adolescente , Adulto , Campos Electromagnéticos/efectos adversos , Humanos , Estudiantes , Universidades , Adulto Joven
10.
Ann Agric Environ Med ; 28(1): 163-171, 2021 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-33775083

RESUMEN

INTRODUCTION: Currently, mobile phones and Wi-Fi are the most commonly used forms of telecommunication. The popularity of mobile telecommunications has made it necessary to investigate the problem more comprehensively and cautiously assess the possible risks, because never before in history has such a substantial proportion of the population been exposed to microwaves at comparably high levels. Some studies indicate that the high frequency electromagnetic radiation emitted by mobile phone and Wi-Fi connections can have a negative effect on human health, and can cause cancer. OBJECTIVE: The aim of the study was to investigate the influence of the radiofrquency electromagnetic field (RF-EMF) on the metaboloc activity and morphology of normal human cells (fibroblasts) and cancer cells (prostate cancer cells). MATERIAL AND METHODS: The cell cultures (human fibroblasts and prostate cancer cells) were exposed to RF-EMF at the frequency of 2.5 GHz for 24, 48 and 72h. To quantify changes in cell viability, the Cell Counting Kit - 8 was used. RESULTS: It was found that the RF electromagnetic field exposure caused a significant decrease in the viability of fibroblasts, and a significant increase in cancer cells. Morphological analysis did not show significant changes in both cell lines after exposure to RF-EMF. CONCLUSIONS: On the basis of the obtained results, the hypothesis can be formulated that a high frequency electromagnetic field can have harmful effects on human cells.


Asunto(s)
Línea Celular Tumoral/efectos de la radiación , Campos Electromagnéticos/efectos adversos , Fibroblastos/efectos de la radiación , Ondas de Radio/efectos adversos , Línea Celular , Teléfono Celular , Supervivencia Celular/efectos de la radiación , Exposición a Riesgos Ambientales/efectos adversos , Fibroblastos/citología , Humanos
11.
Br Dent J ; 230(6): 326, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33772169
12.
J Biomed Inform ; 116: 103722, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33705856

RESUMEN

The objectives of this study are to examine the factors affecting the intention and actual usage behavior on mHealth adoption, investigate the effect of actual usage behavior of mHealth on mental well-being of the end-users, and investigate the moderating role of self-quarantine on the intention-actual usage of mHealth under the coronavirus disease (COVID-19) pandemic situation. The required primary data were gathered from the end-users of mHealth in Bangladesh. Using the Unified Theory of Acceptance and Use of Technology (UTAUT2), this study has confirmed that performance expectancy, effort expectancy, social influence, hedonic motivation, and facilitating conditions have a positive influence on behavioral intention whereas health consciousness has an impact on both intention and actual usage behavior. mHealth usage behavior has an affirmative and meaningful effect on the mental well-being of the service users. Moreover, self-quarantine has strong influence on actual usage behavior but does not moderate the intention-behavior relationship. In addition, due to the existence of a non-linearity problem in the data set, the Artificial Neural Network (ANN) approach was engaged to sort out relatively significant predictors acquired from Structural Equation Modeling (SEM). However, this study contributes to the emergent mHealth literature by revealing how the use of the mHealth services elevates the quality of patients' mental well-being under this pandemic situation.


Asunto(s)
/psicología , Salud Mental , Pandemias , Telemedicina , Adolescente , Adulto , Bangladesh/epidemiología , /terapia , Teléfono Celular , Femenino , Conductas Relacionadas con la Salud , Humanos , Intención , Análisis de Clases Latentes , Masculino , Informática Médica , Persona de Mediana Edad , Aplicaciones Móviles , Redes Neurales de la Computación , Aceptación de la Atención de Salud/estadística & datos numéricos , Cuarentena/psicología , Cuarentena/estadística & datos numéricos , Encuestas y Cuestionarios , Telemedicina/estadística & datos numéricos , Adulto Joven
13.
Artículo en Inglés | MEDLINE | ID: mdl-33673014

RESUMEN

In recent years, personal exposure to Radiofrequency Electromagnetic Fields (RF-EMF) has substantially increased, and most studies about RF-EMF with volunteers have been developed in Europe. To the best of our knowledge, this is the first study carried out in Mexico with personal exposimeters. The main objective was to measure personal exposure to RF-EMF from Wireless Fidelity or wireless Internet connection (Wi-Fi) frequency bands in Tamazunchale, San Luis Potosi, Mexico, to compare results with maximum levels permitted by international recommendations and to find if there are differences in the microenvironments subject to measurements. The study was conducted with 63 volunteers in different microenvironments: home, workplace, outside, schools, travel, and shopping. The mean minimum values registered were 146.5 µW/m2 in travel from the Wi-Fi 2G band and 116.8 µW/m2 at home from the Wi-Fi 5G band, and the maximum values registered were 499.7 µW/m2 and 264.9 µW/m2 at the workplace for the Wi-Fi 2G band and the Wi-Fi 5G band, respectively. In addition, by time period and type of day, minimum values were registered at nighttime, these values being 129.4 µW/m2 and 93.9 µW/m2, and maximum values were registered in the daytime, these values being 303.1 µW/m2 and 168.3 µW/m2 for the Wi-Fi 2G and Wi-Fi 5G bands, respectively. In no case, values exceeded limits established by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Of the study participants (n = 63), a subgroup (n = 35) answered a survey on risk perception. According to these results, the Tamazunchale (Mexico) population is worried about this situation in comparison with several European cities; however, the risk perception changes when they are informed about the results for the study.


Asunto(s)
Teléfono Celular , Campos Electromagnéticos , Ciudades , Campos Electromagnéticos/efectos adversos , Exposición a Riesgos Ambientales , Europa (Continente) , Humanos , México , Ondas de Radio/efectos adversos
14.
Talanta ; 227: 122207, 2021 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-33714475

RESUMEN

Since December 2019, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused millions of deaths and seriously threatened the safety of human life; indeed, this situation is worsening and many people are infected with the new coronavirus every day. Therefore, it is very important to understand patients' degree of infection and infection history through antibody testing. Such information is useful also for the government and hospitals to formulate reasonable prevention policies and treatment plans. In this paper, we develop a lateral flow immunoassay (LFIA) method based on superparamagnetic nanoparticles (SMNPs) and a giant magnetoresistance (GMR) sensing system for the simultaneously quantitative detection of anti-SARS-CoV-2 immunoglobulin M (IgM) and G (IgG). A simple and time-effective co-precipitation method was utilized to prepare the SMNPs, which have good dispersibility and magnetic property, with an average diameter of 68 nm. The Internet of Medical Things-supported GMR could transmit medical data to a smartphone through the Bluetooth protocol, making patient information available for medical staff. The proposed GMR system, based on SMNP-supported LFIA, has an outstanding advantage in cost-effectiveness and time-efficiency, and is easy to operate. We believe that the suggested GMR based LFIA system will be very useful for medical staff to analyze and to preserve as a record of infection in COVID-19 patients.


Asunto(s)
Anticuerpos Antivirales/sangre , Inmunoensayo/métodos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , /inmunología , Animales , Anticuerpos Inmovilizados/química , Anticuerpos Inmovilizados/inmunología , Anticuerpos Antivirales/inmunología , Bovinos , Teléfono Celular , Humanos , Inmunoglobulina G/inmunología , Inmunoglobulina M/inmunología , Internet de las Cosas , Límite de Detección , Fenómenos Magnéticos
15.
J Med Internet Res ; 23(4): e23914, 2021 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-33760753

RESUMEN

Vulnerable populations have been identified as having higher infection rates and poorer COVID-19-related outcomes, likely due to their inability to readily access primary care, follow public health directives, and adhere to self-isolation guidelines. As a response to the COVID-19 pandemic, many health care services have adopted new digital solutions, which rely on phone and internet connectivity. However, persons who are digitally inaccessible, such as those experiencing poverty or homelessness, are often unable to use these services. In response to this newly highlighted social disparity known as "digital health inequity," emergency physicians at the University Health Network in Toronto, Canada, initiated a program called PHONE-CONNECT (Phones for Healthier Ontarians iN EDs - COvid NEeds met by Cellular Telephone). This novel approach attempts to improve patients' access to health care, information, and social services, as well as improve their ability to adhere to public health directives (social isolation and contact tracing). Although similar programs addressing the same emerging issues have been recently described in the media, this is the first time phones have been provided as a health care intervention in an emergency department. This innovative emergency department point-of-care intervention may have a significant impact on improving health outcomes for vulnerable people during the COVID-19 pandemic and beyond.


Asunto(s)
Teléfono Celular , Necesidades y Demandas de Servicios de Salud , Disparidades en Atención de Salud , Telemedicina/organización & administración , Canadá , Trazado de Contacto , Servicio de Urgencia en Hospital , Humanos , Aislamiento Social , Poblaciones Vulnerables
16.
Eur Rev Med Pharmacol Sci ; 25(5): 2449-2456, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33755984

RESUMEN

Countries responded to the COVID-19 pandemic with various levels of restrictions and lockdown in an effort to save lives and prevent the saturation and collapse of national health systems. Unfortunately, the blockades have entailed hefty socioeconomic costs. In order to contrast the spread of the virus, states have used contact tracing technology, in the form of mobile phone applications designed to track close contacts of those infected with COVID-19. Recent research has shown the effectiveness of this solution, particularly when used in conjunction with manual tracking. Nonetheless, the contact tracing app raises concerns due to the potential privacy implications. The authors have delved into the European legislation that protects privacy through the principles of proportionality and minimization, arguing that in order to quickly resolve the pandemic caused by COVID-19, one cannot blindly trust the exclusive help of technology. Instead, we need the involvement of health personnel, scientists, and no less importantly, the citizenry's sense of solidarity and the duty to abide by the rules of social distancing, the use of protective devices and hygiene rules to protect public health.


Asunto(s)
Trazado de Contacto/métodos , Infecciones por Coronavirus/prevención & control , /epidemiología , Teléfono Celular , Confidencialidad , Infecciones por Coronavirus/epidemiología , Humanos , Aplicaciones Móviles , Pandemias/prevención & control , Privacidad , Tecnología
17.
Cochrane Database Syst Rev ; 3: CD012675, 2021 03 26.
Artículo en Inglés | MEDLINE | ID: mdl-33769555

RESUMEN

BACKGROUND: Cardiovascular disease (CVD) is a major cause of disability and mortality globally. Premature fatal and non-fatal CVD is considered to be largely preventable through the control of risk factors by lifestyle modifications and preventive medication. Lipid-lowering and antihypertensive drug therapies for primary prevention are cost-effective in reducing CVD morbidity and mortality among high-risk people and are recommended by international guidelines. However, adherence to medication prescribed for the prevention of CVD can be poor. Approximately 9% of CVD cases in the EU are attributed to poor adherence to vascular medications. Low-cost, scalable interventions to improve adherence to medications for the primary prevention of CVD have potential to reduce morbidity, mortality and healthcare costs associated with CVD. OBJECTIVES: To establish the effectiveness of interventions delivered by mobile phone to improve adherence to medication prescribed for the primary prevention of CVD in adults. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, and two other databases on 7 January 2020. We also searched two clinical trials registers on 5 February 2020. We searched reference lists of relevant papers. We applied no language or date restrictions. SELECTION CRITERIA: We included randomised controlled trials investigating interventions delivered wholly or partly by mobile phones to improve adherence to cardiovascular medications prescribed for the primary prevention of CVD. We only included trials with a minimum of one-year follow-up in order that the outcome measures related to longer-term, sustained medication adherence behaviours and outcomes. Eligible comparators were usual care or control groups receiving no mobile phone-delivered component of the intervention. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures recommended by Cochrane. The main outcomes of interest were objective measures of medication adherence (blood pressure (BP) and cholesterol), CVD events, and adverse events. We contacted study authors for further information when this was not reported. MAIN RESULTS: We included 14 trials with 25,633 randomised participants. Participants were recruited from community-based primary and tertiary care or outpatient clinics. The interventions varied widely from those delivered solely through short messaging service (SMS) to those involving a combination of modes of delivery, such as SMS in addition to healthcare worker training, face-to-face counselling, electronic pillboxes, written materials, and home blood pressure monitors. Some interventions only targeted medication adherence, while others additionally targeted lifestyle changes such as diet and exercise. Due to heterogeneity in the nature and delivery of the interventions and study populations, we reported most results narratively, with the exception of two trials which were similar enough to meaningfully pool in meta-analyses. The body of evidence for the effect of mobile phone-based interventions on objective outcomes of adherence (BP and cholesterol) was of low certainty, due to most trials being at high risk of bias, and inconsistency in outcome effects. Two trials were at low risk of bias. Among five trials (total study enrolment: 5441 participants) recording low-density lipoprotein cholesterol (LDL-C), two studies found evidence for a small beneficial intervention effect on reducing LDL-C (-5.30 mg/dL, 95% confidence interval (CI) -8.30 to -2.30; and -9.20 mg/dL, 95% CI -17.70 to -0.70). The other three studies found results varying from a small reduction (-7.7 mg/dL) to a small increase in LDL-C (0.77 mg/dL). All of which had wide confidence intervals that included no effect. Across 13 studies (25,166 participants) measuring systolic blood pressure, effect estimates ranged from a large reduction (MD -12.45 mmHg, 95% CI -15.02 to -9.88) to a small increase (MD 2.80 mmHg, 95% CI 0.30 to 5.30). We found a similar range of effect estimates for diastolic BP, ranging from -12.23 mmHg (95% CI 14.03 to -10.43) to 1.64 mmHg (95% CI -0.55 to 3.83) (11 trials, 19,716 participants). Four trials showed intervention benefits for systolic and diastolic BP with confidence intervals excluding no effect, and among these were all three of the trials evaluating self-monitoring of blood pressure with mobile phone-based telemedicine. The fourth trial included SMS and provider support (with additional varied features). Seven studies (19,185 participants) reported 'controlled' BP as an outcome, and intervention effect estimates varied from negligible effects (odds ratio (OR) 1.01, 95% CI 0.76 to 1.34) to large improvements in BP control (OR 2.41, 95% CI: 1.57 to 3.68). The three trials of clinician training or decision support combined with SMS (with additional varied features) had confidence intervals encompassing benefits and harms, with point estimates close to zero. Pooled analyses of the two trials of interventions solely delivered through SMS were indicative of little or no beneficial intervention effect on systolic BP (MD -1.55 mmHg, 95% CI -3.36 to 0.25; I2 = 0%) and small increases in controlled BP (OR 1.32, 95% CI 1.06 to 1.65; I2 = 0%). Based on four studies (12,439 participants), there was very low-certainty evidence (downgraded twice for imprecision and once for risk of bias) relating to the intervention effect on combined (fatal and non-fatal) CVD events. Two studies (2535 participants) provided low-certainty evidence for the effect of the intervention on cognitive outcomes, with little or no difference between trial arms for perceived quality of care and satisfaction with treatment. There was moderate-certainty evidence (downgraded due to risk of bias) that the interventions did not cause harm, based on six studies (8285 participants). Three studies reported no adverse events attributable to the intervention. One study reported no difference between groups in experience of adverse effects of statins, and that no participants reported intervention-related adverse events. One study stated that potential side effects were similar between groups. One study reported a similar number of deaths in each arm, but did not provide further information relating to potential adverse events. AUTHORS' CONCLUSIONS: There is low-certainty evidence on the effects of mobile phone-delivered interventions to increase adherence to medication prescribed for the primary prevention of CVD. Trials of BP self-monitoring with mobile-phone telemedicine support reported modest benefits. One trial at low risk of bias reported modest reductions in LDL cholesterol but no benefits for BP. There is moderate-certainty evidence that these interventions do not result in harm. Further trials of these interventions are warranted.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Teléfono Celular , Cumplimiento de la Medicación , Prevención Primaria/métodos , Envío de Mensajes de Texto , Adulto , Sesgo , Presión Sanguínea , LDL-Colesterol/sangre , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
18.
J Vis Exp ; (168)2021 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-33616120

RESUMEN

Network Function Virtualization (NFV) has been regarded as one of the key enablers for the 5th Generation of mobile networks, or 5G. This paradigm allows to reduce the dependence on specialized hardware to deploy telecommunications and vertical services. To this purpose, it relies on virtualization techniques to softwarize network functions, simplifying their development and reducing deployment time and costs. In this context, Universidad Carlos III de Madrid, Telefónica, and IMDEA Networks Institute have developed an NFV ecosystem inside 5TONIC, an open network innovation center focused on 5G technologies, enabling the creation of complex, close to reality experimentation scenarios across a distributed set of NFV infrastructures, which can be made available by stakeholders at different geographic locations. This article presents the protocol that has been defined to incorporate new remote NFV sites into the multi-site NFV ecosystem based on 5TONIC, describing the requirements for both the existing and the newly incorporated infrastructures, their connectivity through an overlay network architecture, and the steps necessary for the inclusion of new sites. The protocol is exemplified through the incorporation of an external site to the 5TONIC NFV ecosystem. Afterwards, the protocol details the verification steps required to validate a successful site integration. These include the deployment of a multi-site vertical service using a remote NFV infrastructure with Small Unmanned Aerial Vehicles (SUAVs). This serves to showcase the potential of the protocol to enable distributed experimentation scenarios.


Asunto(s)
Teléfono Celular , Redes de Comunicación de Computadores , Geografía , Reproducibilidad de los Resultados , Programas Informáticos , Telecomunicaciones
19.
J Med Internet Res ; 23(2): e24165, 2021 02 25.
Artículo en Inglés | MEDLINE | ID: mdl-33544691

RESUMEN

BACKGROUND: Sending emergency messages via mobile phone text messaging can be a promising communication tool to rapidly disseminate information and promote preventive behavior among the public during epidemic outbreaks. The battle to overcome COVID-19 is not yet over; thus, it is essential that the public practices preventive measures to prevent the spread of COVID-19. OBJECTIVE: This study aimed to investigate the effectiveness of reading and obtaining information via emergency alert SMS text messages and their effects on the individual's practice of preventive behaviors during the early stages of the COVID-19 outbreak in South Korea. METHODS: A cross-sectional web-based survey comprising 990 participants was conducted over 3 days (March 25-27, 2020). A multivariable logistic regression analysis revealed the sociodemographic factors that might influence the behavior of reading emergency alert text messages. A hierarchical linear regression model estimated the associations between reading emergency alert text messages for each precautionary behavior practiced against COVID-19. Additionally, the indirect effects of reading the text messages on each precautionary behavior via psychological factors (ie, perceived risk and response efficacy) were calculated. All data were weighted according to the 2019 Korea census data. RESULTS: Overall, 49.2% (487/990) of the participants reported that they always read emergency alert text messages and visited the linked website to obtain more information. Factors such as female sex (odds ratio [OR] 1.68, 95% CI 1.28-2.21) and older age (30-39 years: OR 2.02, 95% CI 1.25-3.28; 40-49 years: OR 2.84, 95% CI 1.80-4.47; 50-59 years: OR 3.19, 95% CI 2.01-5.06; 60 years and above: OR 3.12, 95% CI 2.00-4.86 versus 18-29 years) were identified to be associated with a higher frequency of reading the text messages. Participants who always read the text messages practiced wearing facial masks (ß=.074, P=.01) more frequently than those who did not. In terms of social distancing, participants who reported they always read the text messages avoided crowded places (ß=.078, P=.01) and canceled or postponed social gatherings (ß=.103, P<.001) more frequently than those who did not read the text messages. Furthermore, reading text messages directly and indirectly affected practicing precautionary behaviors, as the mediation effect of response efficacy between reading text messages and practicing preventive behaviors was significant. CONCLUSIONS: Our findings suggest that emergency alert text messages sent to individuals' mobile phones are timely and effective strategies for encouraging preventive behavior in public. Sending emergency alert text messages to provide the public with accurate and reliable information could be positively considered by the health authorities, which might reduce the negative impact of infodemics.


Asunto(s)
/prevención & control , Teléfono Celular , Internet , Envío de Mensajes de Texto , Adolescente , Adulto , Comunicación , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Adulto Joven
20.
BMJ Open ; 11(2): e042649, 2021 02 05.
Artículo en Inglés | MEDLINE | ID: mdl-33550252

RESUMEN

INTRODUCTION: Global commitments have established goals of achieving universal sexual and reproductive health and rights (SRHR) access, but critical obstacles remain. Emergency contraception and induced abortion are overlooked in policy and research. Men's roles in the SRHR of others are significant, particularly as obstacles to universal SRHR. Evidence on gender, masculinities and SRHR is essential to understand and reduce the barriers faced by individuals seeking to avoid the conception or continuation of a pregnancy. METHODS AND ANALYSIS: This study aims to understand men's masculinities and their relationships with emergency contraception and abortion. The protocol presents a multimethod study of men aged over 18 years in James Town, Accra, Ghana. In response to the COVID-19 pandemic, the research will use two mobile-based methods: a survey and in-depth interviews. Using respondent-driven sampling, an estimated 789 men will be recruited to participate in the survey, asking questions on their knowledge, attitude, behaviours and roles in emergency contraception and abortion. In-depth interviews focused on constructions of masculinity will be conducted with a purposive sample of men who participated in the survey. Data will be analysed concurrently using multiple regression analyses of quantitative data and abductive analysis of qualitative data. ETHICS AND DISSEMINATION: Ethical approval has been granted by the London School of Economics and Political Science and the Ghana Health Service. The findings in this study will: engage with emerging research on masculinities and SRHR in Ghana and elsewhere; offer methodological insight for future research; and provide evidence to inform interventions to reduce obstacles for emergency contraception and abortion care seekers. Dissemination will occur at all levels-policy, academic, community-including multiple academic articles, policy briefs, workshops and presentations, conference papers, and theatre/radio-based performances of key messages.


Asunto(s)
Aborto Inducido , Teléfono Celular , Anticoncepción Postcoital , Conocimientos, Actitudes y Práctica en Salud , Masculinidad , Femenino , Ghana , Accesibilidad a los Servicios de Salud , Humanos , Entrevistas como Asunto , Londres , Masculino , Embarazo , Salud Reproductiva , Proyectos de Investigación , Encuestas y Cuestionarios
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