Creation of a Holistic Platform for Health Boosting Using a Blockchain-Based Approach: Development Study.

BACKGROUND: Low adherence to healthy habits, which is associated with a higher risk of disease and death, among citizens of Organization for Economic Co-operation and Development countries is a serious concern. The World Health Organization (WHO) and the physical activity (PA) guidelines for Americans provide recommendations on PA and healthy diets. To promote these habits, we suggest using a blockchain-based platform, using the PA Messaging Framework to deliver messages and rewards to users. Blockchain is a decentralized secure platform for data management, which can be used for value-added controls and services such as smart contracts (SCs), oracles, and decentralized applications (dApps). Of note, there is a substantial penetration of blockchain technologies in the field of PA, but there is a need for more implementations of dApps to take advantage of features such as nonfungible tokens. OBJECTIVE: This study aimed to create a comprehensive platform for promoting healthy habits, using scientific evidence and blockchain technology. The platform will use gamification to encourage healthy PA and eating habits; in addition, it will monitor the activities through noninvasive means, evaluate them using open-source software, and follow up through blockchain messages. METHODS: A literature search was conducted on the use of blockchain technology in the field of PA and healthy eating. On the basis of the results of this search, it is possible to define an innovative platform for promoting and monitoring healthy habits through health-related challenges on a dApp. Contact with the user will be maintained through messages following a proposed model in the literature to improve adherence to the challenges. RESULTS: The proposed strategy is based on a dApp that relies on blockchain technology. The challenges include PA and healthy eating habits based on the recommendations of the WHO and the Food and Agriculture Organization. The system is constituted of a blockchain network where challenge-related achievements are stored and verified using SCs. The user interacts with the system through a dApp that runs on their local device, monitors the challenge, and self-authenticates by providing their public and private keys. The SC verifies challenge fulfillment and generates messages, and the information stored in the network can be used to encourage competition among participants. The ultimate goal is to create a habit of healthy activities through rewards and peer competition. CONCLUSIONS: The use of blockchain technology has the potential to improve people's quality of life through the development of relevant services. In this work, strategies using gamification and blockchain are proposed for monitoring healthy activities, with a focus on transparency and reward allocation. The results are promising, but compliance with the General Data Protection Regulation is still a concern. Personal data are stored on personal devices, whereas challenge data are recorded on the blockchain.

Use of Blockchain Technology in the Domain of Physical Exercise, Physical Activity, Sport, and Active Ageing: A Systematic Review.

Blockchain technology provides a distributed support for information storage and traceability. Recently, it has been booming in a wide variety of domains: finance, food, energy, and health. In the field of physical activity, physical exercise, sport, and active ageing, this technology could also originate some interesting services introducing support for reliable repository of results, for gamification, or for secure data interchange. This systematic review explores the use of blockchain in this context. The objective is to determine to which extent this technology has fulfilled the potential of blockchain to bring these new added-value services. The authors explored 5 repositories in search of papers describing solutions applied to the above-mentioned frame. 17 papers were selected for full-text analysis, and they displayed diverse applications of blockchain, such as Fitness and healthcare, Sport, and Active ageing. A detailed analysis shows that the solutions found do not leverage all the possibilities of blockchain technology. Most of the solutions analyzed use blockchain for managing, sharing, and controlling access to data and do not exploit the possibilities of Smart Contracts or oracles. Additionally, the advantages of the blockchain model have not been fully exploited to engage users using approaches such as gamification.

Assessing the risk of using hazardous drugs in Hospital-at-Home Units: a big data study protocol.

OBJECTIVE: This article describes a study protocol for the implementation of quality and traceability control in the hazardous  medication circuit through an analysis of risks and the development and  introduction of a Big Data-based software application aimed at performing  a continuous and dynamic audit of the whole system. Method: A standardized graphical modeling tool called Business Process Model Notation will be used to generate a detailed description of each of the stages in the hazardous medication circuit with a view to  ensuring full traceability of the system. The information on each stage will  be collected in a flowchart, which will be used -together with each event's likelihood of occurrence and severity- as a basis to calculate the  criticality index of the different control points established and to determine  any control measures that may be required. The flowcharts will  also be used to develop the technological support needed to capture  all such data as may be relevant to the model. Proper quality control of the process will be ensured by client software agents intended to allow  automatic applica tion of efficient data processing tools at the different  phases. In addition, Big Data methodologies, in particular machine  learning, will be used to develop algorithms based on the repository of  generated data to come up with patterns capable of improving the  protocols to be applied. Lastly, proper operation of the process will be  ensured by means of clinicalpharmaceutical verification and a full  technical-documentary review of control and registration systems. CONCLUSIONS: The development of a risk management system based on  mobile technology will allow integration of hazardous drugs into a standardized system, ensuring the safety, quality, and traceability of the hazardous medication handling process.

Objetivo: Describir el protocolo del estudio para la instauración del control del proceso de los medicamentos peligrosos que asegure la calidad y su trazabilidad, mediante el análisis de riesgos, desarrollando e  Implantando una herramienta informatizada que, gracias a la utilización de técnicas de big data, permita conocer y auditar el conjunto del sistema de  forma continua y dinámica.Método: Mediante los procesos de notación gráfica normalizada Business Process Model Notation se desarrollarán los flujogramas  Específicos que permitan conocer las etapas del proceso de los  Medicamentos peligrosos que determinen la trazabilidad total del sistema.  Cada una de las etapas será recogida en los cuadros de gestión, donde a  través de la probabilidad del suceso y su gravedad se calculará el índice de criticidad de cada punto de control que se determine, y se establecerán las medidas de control. A partir de los cuadros de gestión se desarrollará el  soporte tecnológico para la captura de todos los datos que sean  pertinentes al modelo. Para asegurar el control de la calidad del proceso se optará por agentes software cliente, que permitan en fases posteriores  aplicar herramientas eficientes en el procesamiento de datos de modo  automático. A partir de aproximaciones metodológicas del big data, y en  particular del ámbito de machine learning, se desarrollarán algoritmos  sobre el repositorio de datos generado para poder obtener patrones que  permitan mejorar los protocolos de aplicación. Por último, para asegurar el funcionamiento del proceso se realizará la verificación clínico-farmacéutica  y la revisión completa, técnico-documental, de los sistemas de control y  registro.Conclusiones: La generación del sistema de gestión de riesgos mediante  tecnología móvil permitirá integrar los medicamentos peligrosos en un sistema normalizado, con el fin de mejorar la seguridad, calidad y  trazabilidad del proceso de manipulación de los medicamentos peligrosos.

Análisis de riesgos mediante modelos big data del uso de medicamentos peligrosos en Unidades de Hospitalización a Domicilio: protocolo de estudio / Assessing the risk of using hazardous drugs in Hospital-at-Home Units: a big data study protoco

Objetivo: Describir el protocolo del estudio para la instauración del control del proceso de los medicamentos peligrosos que asegure la calidady su trazabilidad, mediante el análisis de riesgos, desarrollando e implantando una herramienta informatizada que, gracias a la utilización de técnicas de big data, permita conocer y auditar el conjunto del sistema de formacontinua y dinámica.Método: Mediante los procesos de notación gráfica normalizada Business Process Model Notation se desarrollarán los flujogramas específicosque permitan conocer las etapas del proceso de los medicamentos peligrosos que determinen la trazabilidad total del sistema. Cada una de lasetapas será recogida en los cuadros de gestión, donde a través de laprobabilidad del suceso y su gravedad se calculará el índice de criticidadde cada punto de control que se determine, y se establecerán las medidasde control. A partir de los cuadros de gestión se desarrollará el soportetecnológico para la captura de todos los datos que sean pertinentes al modelo. Para asegurar el control de la calidad del proceso se optará poragentes software cliente, que permitan en fases posteriores aplicar herramientas eficientes en el procesamiento de datos de modo automático. Apartir de aproximaciones metodológicas del big data, y en particular delámbito de machine learning, se desarrollarán algoritmos sobre el repositorio de datos generado para poder obtener patrones que permitan mejorarlos protocolos de aplicación. Por último, para asegurar el funcionamientodel proceso se realizará la verificación clínico-farmacéutica y la revisióncompleta, técnico-documental, de los sistemas de control y registro. (AU)

Objective: This article describes a study protocol for the implementation of quality and traceability control in the hazardous medication circuitthrough an analysis of risks and the development and introduction of a BigData-based software application aimed at performing a continuous anddynamic audit of the whole system.Method: A standardized graphical modeling tool called Business Process Model Notation will be used to generate a detailed description ofeach of the stages in the hazardous medication circuit with a view to ensuring full traceability of the system. The information on each stage will becollected in a flowchart, which will be used —together with each event’slikelihood of occurrence and severity— as a basis to calculate the criticality index of the different control points established and to determine anycontrol measures that may be required. The flowcharts will also be usedto develop the technological support needed to capture all such data asmay be relevant to the model. Proper quality control of the process will be ensured by client software agents intended to allow automatic application of efficient data processing tools at the different phases. In addition,Big Data methodologies, in particular machine learning, will be used todevelop algorithms based on the repository of generated data to comeup with patterns capable of improving the protocols to be applied. Lastly,proper operation of the process will be ensured by means of clinicalpharmaceutical verification and a full technical-documentary review ofcontrol and registration systems. (AU)

A BPMN Based Notation for the Representation of Workflows in Hospital Protocols.

Flowcharts used for hospital protocols have a series of ambiguities and limitations in order to express some types of information. In this article, a notation proposal for flowcharts that partially avoids these problems is presented. This new notation is an adaptation of BPMNE2, an extension of the Business Process Model and Notation (BPMN), which allows direct modelling of procedures that follow the Hazard Analysis and Critical Control Points (HACCP) model. The new notation has been validated in the hospital context, specifically in the field of hazardous drugs (HDs). To measure usability from the perspective of the health staff and auditors, the System Usability Scale (SUS) was used. A total of 47 experts took part in the assessment, resulting in a SUS score of 71, that corresponds to an acceptable level of usability. The feedback provided by these participants allows us to discover benefits and drawbacks of the proposal. Also, it is noteworthy that 76.6% of professionals prefer to migrate to the new notation from the ISO 5807:1985 notation, the most commonly used model. In addition to the direct benefits of this notation from the human point of view, its machine-understandable nature provides the required support for its integration into software tools for intelligent monitoring and auditing.

Guidelines for safe handling of hazardous drugs: A systematic review.

OBJECTIVE: To review the scientific literature related to the safe handling of hazardous drugs (HDs). METHOD: Critical analysis of works retrieved from MEDLINE, the Cochrane Library, Scopus, CINHAL, Web of Science and LILACS using the terms "Hazardous Substances", "Antineoplastic Agents" and "Cytostatic Agents", applying "Humans" and "Guidelines" as filters. Date of search: January 2017. RESULTS: In total, 1100 references were retrieved, and from those, 61 documents were selected based on the inclusion and exclusion criteria: 24 (39.3%) documents related to recommendations about HDs; 27 (44.3%) about antineoplastic agents, and 10 (33.3%) about other types of substances (monoclonal antibodies, gene medicine and other chemical and biological agents). In 14 (23.3%) guides, all the stages in the manipulation process involving a risk due to exposure were considered. Only one guide addressed all stages of the handling process of HDs (including stages with and without the risk of exposure). The most described stages were drug preparation (41 guides, 67.2%), staff training and/or patient education (38 guides, 62.3%), and administration (37 guides, 60.7%). No standardized informatics system was found that ensured quality management, traceability and minimization of the risks associated with these drugs. CONCLUSIONS: Most of the analysed guidelines limit their recommendations to the manipulation of antineoplastics. The most frequently described activities were preparation, training, and administration. It would be convenient to apply ICTs (Information and Communications Technologies) to manage processes involving HDs in a more complete and simpler fashion.

Management of the General Process of Parenteral Nutrition Using mHealth Technologies: Evaluation and Validation Study.

BACKGROUND: Any system applied to the control of parenteral nutrition (PN) ought to prove that the process meets the established requirements and include a repository of records to allow evaluation of the information about PN processes at any time. OBJECTIVE: The goal of the research was to evaluate the mobile health (mHealth) app and validate its effectiveness in monitoring the management of the PN process. METHODS: We studied the evaluation and validation of the general process of PN using an mHealth app. The units of analysis were the PN bags prepared and administered at the Son Espases University Hospital, Palma, Spain, from June 1 to September 6, 2016. For the evaluation of the app, we used the Poststudy System Usability Questionnaire and subsequent analysis with the Cronbach alpha coefficient. Validation was performed by checking the compliance of control for all operations on each of the stages (validation and transcription of the prescription, preparation, conservation, and administration) and by monitoring the operative control points and critical control points. RESULTS: The results obtained from 387 bags were analyzed, with 30 interruptions of administration. The fulfillment of stages was 100%, including noncritical nonconformities in the storage control. The average deviation in the weight of the bags was less than 5%, and the infusion time did not present deviations greater than 1 hour. CONCLUSIONS: The developed app successfully passed the evaluation and validation tests and was implemented to perform the monitoring procedures for the overall PN process. A new mobile solution to manage the quality and traceability of sensitive medicines such as blood-derivative drugs and hazardous drugs derived from this project is currently being deployed.

Towards a Mobile-Based Platform for Traceability Control and Hazard Analysis in the Context of Parenteral Nutrition: Description of a Framework and a Prototype App.

BACKGROUND: The parenteral nutrient (PN) mixtures may pose great risks of physical, microbiological, and chemical contamination during their preparation, storage, distribution, and administration. These potential hazards must be controlled under high levels of excellence to prevent any serious complications for the patients. As a result, management control and traceability of any of these medications is of utmost relevance for the patient care, along with ensuring treatment continuity and adherence. OBJECTIVE: The aim of this study is to develop a mobile-based platform to support the control procedures and traceability services in the domain of parenteral nutrient (PN) mixtures in an efficient and nonintrusive manner. METHODS: A comprehensive approach combining techniques of software engineering and knowledge engineering was used for the characterization of the framework. Local try-outs for evaluation were performed in a number of application areas, carrying out a test/retest monitoring to detect possible errors or conflicts in different contexts and control processes throughout the entire cycle of PN. From these data, the absolute and relative frequencies (percentages) were calculated. RESULTS: A mobile application for the Android operating system was developed. This application allows reading different types of tags and interacts with the local server according to a proposed model. Also, through an internal caching mechanism, the availability of the system is preserved even in the event of problems with the network connection. A set of 1040 test traces were generated for the assessment of the system under various environments tested. Among those, 102 traces (9.81%) involved conflictive situations that were properly taken care of in this paper by suggesting solutions to overcome them. CONCLUSIONS: A mobile oriented system was generated and tested in order to allow enhanced control and quality management of PN mixtures that is easy to integrate into the daily praxis of health care processes.

QR Codes: Outlook for Food Science and Nutrition.

QR codes opens up the possibility to develop simple-to-use, cost-effective-cost, and functional systems based on the optical recognition of inexpensive tags attached to physical objects. These systems, combined with Web platforms, can provide us with advanced services that are already currently broadly used on many contexts of the common life. Due to its philosophy, based on the automatic recognition of messages embedded on simple graphics by means of common devices such as mobile phones, QR codes are very convenient for the average user. Regretfully, its potential has not yet been fully exploited in the domains of food science and nutrition. This paper points out some applications to make the most of this technology for these domains in a straightforward manner. For its characteristics, we are addressing systems with low barriers to entry and high scalability for its deployment. Therefore, its launching among professional and final users is quite simple. The paper also provides high-level indications for the evaluation of the technological frame required to implement the identified possibilities of use.

Plataforma de e-servicios para educación e higiene nutricionales, orientada a la población infantil / E-services platform for child-oriented nutritional education and health

Una buena alimentación es uno de los pilares básicos para el correcto desarrollo tanto físico como intelectual de los niños. En una sociedad en la que cada vez la edad de escolarización de los pequeños es más temprana, la coordinación entre familia y escuela adquiere un rol vital para garantizar una correcta alimentación y cuidado del niño. Este artículo presenta los fundamentos de una plataforma web multidispositivo que favorece la colaboración y formación nutricional de los diferentes agentes involucrados en los procesos de cuidado y educación de los niños (padres, educadores, especialistas), haciendo uso de los últimos avances producidos en el campo de las tecnologías semánticas para mejorar la precisión y adecuación de las recomendaciones realizadas automáticamente por el sistema.

A good diet is one of the pillars for ensuring the proper physical and intellectual development of children. In a society in which schooling is initiated at increasingly early ages, the coordination between school and family acquires a vital role in assuring proper child nourishment and care. This article presents the foundations of a multi-device web platform that fosters the collaboration and nutritional training of the different actors (parents, educators, specialists) involved in the processes of care and education of children. The platform uses the latest advances in the field of semantic technologies to improve the accuracy of the recommendations made automatically by the system.