E-health Dietary Interventions for Participants of SNAP and WIC: A Systematic Review.

The migration of federal assistance services to online platforms during the COVID-19 pandemic sparked interest in digital nutrition education for individuals participating in the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) programs. With federal government investing in the modernization of the nutrition education components of both programs, there is a need to identify science-backed electronic health (e-health) dietary interventions to improve health outcomes in this population. Therefore, the objective of this systematic literature review was to summarize the effectiveness, acceptability, and feasibility of e-health dietary interventions among individuals participating in WIC or SNAP. Keyword searches were performed in Google Scholar, PubMed, and Science Direct. The search included peer-reviewed literature from 2014 to 2023 and a few articles offering context about interventions used long-term by the nutrition assistance programs. PRISMA guidelines were followed to conduct this systematic literature review, which resulted in 36 articles eligible for extraction. The studies evaluated e-health (52.8%), short message service/text messaging (27.8%), and smartphone application interventions (19.4%) delivered to WIC or SNAP participants. The interventions identified aimed to modify food choice, eating behavior, and dietary intake among SNAP participants, SNAP-eligible adults, and WIC participants. Most interventions were developed using content delivery and health behavior theoretical frameworks (77.8%) and evidence-based nutritional recommendations (59.3%). Review findings show a high level of acceptability and feasibility for e-health and mobile health dietary interventions among WIC and SNAP participants but varying levels of effectiveness. Level of engagement, dosage, retention, and adherence were strong predictors of positive dietary behavior change regardless of the mode of intervention delivery. Future studies need to prioritize health equity by recruiting samples representative of food nutrition assistance participants and addressing digital health literacy as a potential barrier to intervention effectiveness, as none of the present studies measured literacy among participants.

A Smartphone-Based M-Health Monitoring System for Arrhythmia Diagnosis.

Deep learning technology has been widely adopted in the research of automatic arrhythmia detection. However, there are several limitations in existing diagnostic models, e.g., difficulties in extracting temporal information from long-term ECG signals, a plethora of parameters, and sluggish operation speed. Additionally, the diagnosis performance of arrhythmia is prone to mistakes from signal noise. This paper proposes a smartphone-based m-health system for arrhythmia diagnosis. First, we design a cycle-GAN-based ECG denoising model which takes real-world noise signals as input and aims to produce clean ECG signals. In order to train its two generators and two discriminators simultaneously, we explore an unsupervised pre-training strategy to initialize the generator and accelerate the convergence speed during training. Second, we propose an arrhythmia diagnosis model based on the time convolution network (TCN). This model can identify 34 common arrhythmia events using eight-lead ECG signals, and we deploy such a model on the Android platform to develop an at-home ECG monitoring system. Experimental results have demonstrated that our approach outperforms the existing noise reduction methods and arrhythmia diagnosis models in terms of denoising effect, recognition accuracy, model size, and operation speed, making it more suitable for deployment on mobile devices for m-health monitoring services.

Bright light therapy versus physical exercise to prevent co-occurring depression in adolescents and young adults with attention-deficit/hyperactivity disorder: a multicentre, three-arm, randomised controlled, pilot phase-IIa trial.

Depression is common in attention-deficit/hyperactivity disorder (ADHD), but preventive behavioural interventions are lacking. This randomised controlled, pilot phase-IIa trial aimed to study a physical exercise intervention (EI) and bright light therapy (BLT)-both implemented and monitored in an individual, naturalistic setting via a mobile health (m-health) system-for feasibility of trial design and interventions, and to estimate their effects on depressive symptoms in young people with ADHD. Two hundred seven participants aged 14-45 years were randomised to 10-week add-on intervention of either BLT (10,000 lx; daily 30-min sessions) (n = 70), EI (aerobic and muscle-strengthening activities 3 days/ week) (n = 69), or treatment-as-usual (TAU) (n = 68), of whom 165 (80%) were retained (BLT: n = 54; EI: n = 52; TAU: n = 59). Intervention adherence (i.e. ≥ 80% completed sessions) was very low for both BLT (n = 13, 22%) and EI (n = 4, 7%). Usability of the m-health system to conduct interventions was limited as indicated by objective and subjective data. Safety was high and comparable between groups. Changes in depressive symptoms (assessed via observer-blind ratings, Inventory of Depressive Symptomatology) between baseline and end of intervention were small (BLT: -0.124 [95% CI: -2.219, 1.971], EI: -2.646 [95% CI: -4.777, -0.515], TAU: -1.428 [95% CI: -3.381, 0.526]) with no group differences [F(2,153) = 1.45, p = 0.2384]. These findings suggest that the m-health approach did not achieve feasibility of EI and BLT in young people with ADHD. Prior to designing efficacy studies, strategies how to achieve high intervention adherence should be specifically investigated in this patient group. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03371810, 13 December 2017.

Digital health to promote adherence to antiretroviral treatment in patients with HIV/AIDS: Meta review. / Salud digital para promover la adherencia al tratamiento antirretroviral en pacientes con VIH/sida: metarevisión.

INTRODUCTION: Digital health or "e-Health" is a set of applications based on Information and Communication Technologies that can be used to promote self-care and medication adherence in patients with chronic diseases. The aim of this study was to carry out a review of systematic reviews (meta-review) on efficacy studies of e-Health interventions to promote adherence to antiretroviral therapy in people living with HIV/AIDS. METHOD: A review of systematic reviews ("meta-review") was performed using the Medline-PubMed database on efficacy studies of e-Health components to promote adherence to antirretroviral therapy, in patients with HIV/AIDS, proposing a structured search strategy (PICO question). A selection process for systematic reviews was conducted based on inclusion and exclusion criteria. Subsequently, the corresponding data were extracted, and the analysis was accomplished in descriptive tables. RESULTS: A total of 29 systematic reviews were identified, from which 11 were selected. These reviews comprised 55 randomized controlled therapies with different e-Health interventions and enrolled a total of 15,311 HIV/AIDS patients. Studies included a total of 66 comparisons (experimental group vs. control group) in indirect adherence measurements based on different measurement techniques (36 statistically significant); 21 comparisons of viral load measurements (10 statistically significant); and 8 comparisons of CD4+ cell count measurements (3 statistically significant). m-Health was the most studied component followed by the telephone call and e-Learning. CONCLUSIONS: Evidence was found that supports that some e-Health interventions are effective in promoting adherence to antirretroviral therapy and improving health outcomes in patients with HIV/AIDS, although it is identified that more studies are needed for more robust evidence.

Effectiveness of an occupational self-analysis intervention through a mobile application (OcupApp) in people with anxiety or depression: a randomised controlled trial protocol.

The main objective of this protocol is to understand the effectiveness of the use of a mobile application (OcupApp) to generate a personal self-analysis about meaningful activities in a population of adults aged between 50 and 70 years with low or moderate depression/anxiety. A randomised study will be carried out comparing the effects of the use of the OcupApp application with a control intervention on health-related quality of life, mental health, frequency of participation on meaningful activities, and perceived occupational balance. This is the first study to use occupational self-analysis in m-health to improve occupational balance, mental health, frequency of participation in meaningful activities and health-related quality of life. The app was co-created with a population whose characteristics are similar to those of the target users, and it was tested in both the intervention itself and the presentation, thus it is expected to be effective.Trial Registration Number: Clinical Trial B1-2020_25.

This is the first study to evaluate the impact of an app on occupational participation in people older than 50 years with mild-moderate anxiety and/or depressionIntroducing an occupational self-analysis app that helps people become aware of their occupations can improve health-related quality of life, mental health, frequency of participation on meaningful activities, and perceived occupational balance.OcupApp will allow people to go under occupational self-analysis process from home or any other place, maintaining the principles of the original programme.

Technological development in telemedicine: bibliometric analysis, research gaps, and literature trends / Desenvolvimento tecnológico na telemedicina: análise bibliométrica, lacunas de pesquisa e tendências na literatura / Desarrollo tecnológico en telemedicina: análisis bibliométrico, lagunas en la investigación y tendencias en la literatura

The aim of this article was to analyze the literature on technological development in telemedicine through bibliometrics, by identifying the state of the art, research gaps, and trends in the literature. The analysis covers a total of 67 articles related to the field of study, published between 2010-2020 in the Springer Link, Science Direct, Wiley Online Library, Web of Science, and Scopus databases. The data was processed using the software StArt, Excel, IBM SPSS Statistics, and Iramuteq. The results presented bibliometric analysis of the articles, classified into the areas of Management (52.2%), IT (25.4%), and Medicine (22.4%), along with a Table of 34 suggestions for future research. Literature trends encompassed six study clusters (health, study, service, technology, patient, and telemedicine), which further subdivided into nine research themes (digital platform, telemedicine service management, telemedicine service operation, end-user perception, business opportunities, healthcare professional perception, covid-19, regulation, and robotics). An observed outcome was a significant increase in the number of publications in the area due to covid-19.

O objetivo deste artigo foi analisar a literatura acerca do desenvolvimento tecnológico na telemedicina, por meio da bibliometria, ao identificar o estado da arte, lacunas de pesquisa e tendências na literatura. Analisou-se 67 artigos relacionados ao campo de estudo, publicados entre 2010-2020 nas bases de dados Springer Link, Science Direct, Wiley Online Library, Web of Science e Scopus. O tratamento dos dados se deu por meio dos softwares StArt, Excel, IBM SPSS Statistics e Iramuteq. Os resultados apresentaram a análise bibliométrica dos artigos, classificados nas áreas de Gestão (52,2%), TI (25,4%) e Medicina (22,4%), e uma tabela com 34 sugestões para pesquisas futuras. As tendências da literatura envolveram seis classes de estudo (saúde, estudo, serviço, tecnologia, paciente e telemedicina), que se subdividiram em nove temas de pesquisa (plataforma digital, gestão do serviço de telemedicina, operação do serviço de telemedicina, percepção do usuário final, oportunidades de negócios, percepção de profissionais de saúde, covid-19, regulamentação e robótica). Observou-se aumento significativo no número de publicações na área devido à covid-19.

El objetivo de este artículo fue analizar la literatura sobre el desarrollo tecnológico en la telemedicina me-diante bibliometría, identificando el estado del arte, las lagunas de investigación y las tendencias en la literatura. Se analizaron un total de 67 artículos relacionados con el campo de estudio, publicados entre 2010-2020 en las bases de datos de Springer Link, Science Direct, Wiley Online Library, Web of Science y Scopus. Los datos fueron procesados utilizando los programas StArt, Excel, IBM SPSS Statistics e Iramuteq. Los resultados presentaron un análisis bibliométrico de los artículos, clasificados en las áreas de Gestión (52,2%), TI (25,4%) y Medicina (22,4%), junto con una tabla de 34 sugerencias para futuras investiga-ciones. Las tendencias en la literatura abarcaron seis clases de estudio (salud, estudio, servicio, tecnología, paciente y telemedicina), que se subdividieron en nueve temas de investigación (plataforma digital, gestión del servicio de telemedicina, operación del servicio de telemedicina, percepción del usuario final, oportuni-dades de negocio, percepción de los profesionales de la salud, covid-19, regulación y robótica). Un resultado observado fue un aumento significativo en el número de publicaciones en el área debido al covid-19.

Lifestyle intervention in children with obesity and nonalcoholic fatty liver disease (NAFLD): study protocol for a randomized controlled trial in Ningbo city (the SCIENT study).

BACKGROUND: The increasing prevalence of childhood obesity has become an urgent public health problem, evidence showed that intervention for childhood obesity bring enormous health benefits. However, an effective individualized intervention strategy remains to be developed, and the accompanying remission of related complications, such as nonalcoholic fatty liver disease (NAFLD), needs to be assessed. This study aimed to develop an m-Health-assisted lifestyle intervention program targeting overweight/obese children and assess its effectiveness on indicators of adiposity and NAFLD. METHODS: This is a cluster-randomized controlled trial that conducted in children with overweight/obesity in Ningbo city, Zhejiang Province, China. Students in Grade 3 (8-10 years old) were recruited from six primary schools, with three be randomized to intervention group and three to usual practice group. The intervention program will last for one academic year and consists of health education, dietary guidance, and physical activity reinforcement. This program is characterized by encouraging four stakeholders, including School, Clinic, famIly, and studENT (SCIENT), to participate in controlling childhood obesity, assisted by m-Health technology. Assessments will be conducted at baseline and 3 months, 9 months, 24 months, and 36 months after baseline. The primary outcome will be the differences between the two groups in students' body mass index and fatty liver index at the end of the intervention (9 months after baseline). During the implementation process, quality control methods will be adopted. DISCUSSION: The program will test the effectiveness of the m-Health-assisted lifestyle intervention on children with obesity and NAFLD. The results of this study will provide evidence for establishing effective lifestyle intervention strategy aimed at childhood obesity and NAFLD and may help develop guidelines for the treatment of obesity and NAFLD in Chinese children. TRIAL REGISTRATION: Clinicaltrials.gov NCT05482191. Registered on July 2022.

Is telehealth useful in the management of placenta accreta spectrum in low-resource settings? Results of an exploratory survey.

OBJECTIVE: The optimal management of placenta accreta spectrum (PAS) requires the participation of multidisciplinary teams that are often not locally available in low-resource settings. Telehealth has been increasingly used to manage complex obstetric conditions. Few studies have explored the use of telehealth for PAS management, and we aimed evaluate the usage of telehealth in the management of PAS patients in low-resource settings. METHODS: Between March and April 2023, an observational, survey-based study was conducted, and obstetricians-gynecologists with expertise in PAS management in low- and middle-income countries were contacted to share their opinion on the potential use of telehealth for the diagnosis and management of patients at high-risk of PAS at birth. Participants were identified based on their authorship of at least one published clinical study on PAS in the last 5 years and contacted by email. This is a secondary analysis of the results of that survey. RESULTS: From 158 authors contacted we obtained 65 responses from participants in 27 middle-income countries. A third of the participants reported the use of telehealth during the management obstetric emergencies (38.5%, n = 25) and PAS (36.9%, n = 24). Over 70% of those surveyed indicated that they had used "informal" telemedicine (phone call, email, or text message) during PAS management. Fifty-nine participants (90.8%) reported that recommendations given remotely by expert colleagues were useful for management of patients with PAS in their setting. CONCLUSION: Telehealth has been successfully used for the management of PAS in middle-income countries, and our survey indicates that it could support the development of specialist care in other low resource settings.

Randomised Controlled Trial of a Customised Text Messaging and Activity Monitor Program for Lifestyle Improvement after Gestational Diabetes.

Gestational diabetes (GDM) is associated with a long-term risk of diabetes. We aimed to determine whether a text-messaging-based lifestyle support program would improve diabetes risk factors following GDM. Women with GDM were randomised following delivery to receive four text messages per week supporting a healthy lifestyle and parenting for 6 months, with feedback from an activity monitor (intervention), or to receive the activity monitor only (control). The primary outcome was a composite of weight, physical activity and dietary goals. There were 177 women randomised, with 88 intervention and 89 control participants. All the participants experienced COVID-19 lockdowns during the study. Six-month primary outcome data were obtained for 57 intervention participants and 56 controls. There were 7/57 (12%) intervention and 6/56 (11%) control participants who met the primary outcome (relative risk, 1.08; 95%CI, 0.63-1.85; p = 0.79). Two intervention participants met the dietary goals compared to none of the control participants (p = NS). The intervention participants were more likely to record >1000 steps/day (on 102 ± 59 vs. 81 ± 59 days, p = 0.03). When analysed monthly, this was not initially different but became significant 3-6 months post-partum. Interviews and surveys indicated that with the Intervention, healthier choices were made, but these were negatively impacted by COVID-19 restrictions. Participants found the messages motivational (74%) and the activity monitor useful (71%). In conclusion, no improvement in the diabetes risk factors occurred among the women receiving the text messaging intervention when affected by COVID-19 restrictions.

Feasibility and outcomes of a community-based, mobile health system-monitored lifestyle intervention in chronic stroke: A pilot study.

BACKGROUND: People with disabilities face challenges in daily life during the COVID-19 pandemic, including limited access to care, exposure to lifestyle-related diseases, and difficulties in regular exercise. Therefore, it is important to establish health safety nets using Information and Communication Technology (ICT) in communities. OBJECTIVE: This study aimed to develop an m-Health-based personalized lifestyle intervention algorithm targeting high-risk groups of lifestyle-related diseases (including hypertension, diabetes, and obesity) among people with hemiplegic disabilities, and to verify its feasibility. METHODS: Six people at a high risk of lifestyle-related diseases participated in an 8-week lifestyle intervention using a wearable device and the S-Health program. The self-health management areas included walking, moderate-intensity exercise, weight, blood pressure, blood sugar, diet, calorie intake, heart rate, sobriety, no smoking. Health, physical, psychological, and social changes were measured before and after the study. RESULTS: The intervention had a positive impact on the participants' health, with statistically significant differences found in fasting blood glucose, highest systolic blood pressure, grip strength, and motor function assessment. Quality of life, health-related quality of life, and self-efficacy improved post-intervention. CONCLUSION: Our findings can be used as preliminary evidence for establishing m-Health-based health safety net systems for people with disabilities who live in communities.

Determinants of mobile health (M-Health) application adoption, usage and discontinuity among corporate workers diagnosed with hypertension and diabetes.

PURPOSE: This study examined the determinants of mobile health (M-Health) application, adoption, usage and discontinuation among corporate workers diagnosed with hypertension and diabetes in Ghana. DESIGN/METHODOLOGY/APPROACH: The diffusion innovation and reasoned action theories were employed using an exploratory design. Three hundred corporate workers diagnosed with diabetes and hypertension from three health facilities for the past six months were sampled for the study using a multi-stage sampling technique and administered questionnaires. Descriptive statistics and logistic regression tools were employed in the analysis of data. FINDINGS: The study found a significant number of factors influencing m-health applications adoption, usage and discontinuity. These factors include nature and demand of job, perceived advantage, compatibility, complexity, triability, aesthetics and trust. Aesthetics emerged as the strongest predictive factor for the adoption, usage and discontinuity of use among diabetic and hypertensive corporate workers. With the adoption of M-Health applications, compatibility, as well as nature and demand of job, were significant predictors. With the usage of M-Health applications, complexity, triability, aesthetics and trust were significant predictors. Moreover, perceived advantage, compatibility, complexity and triability influenced significantly the choice to discontinue using M-Health applications. The study concluded that M-Health application functionalities play a valuable role in patients' intention to adopt, use and discontinue the use of an M-Health application in Ghana. ORIGINALITY/VALUE: This exploratory study offers in-depth insight into how major M-Health application features affect its adoption, usage and discontinuity, providing crucial information for future research and the improvement of chronic condition healthcare delivery.

Mobile Applications to Support Multiple Sclerosis Communities: The Post-COVID-19 Scenario.

Introduction: The increase in the use of mobile apps since the COVID-19 pandemic, even among people with multiple sclerosis (PwMS) and health care providers (HCPs), has enabled access to reliable information, symptoms monitoring and management, and social connections. The pandemic has undoubtedly contributed to the acceleration of the "digital revolution." But how far has it progressed for the MS communities? Methods: Italian Google Play and App Store were queried, selecting MS-specific apps in English or Italian language and usable by a wide public. Results: Fifty-four (n = 54) MS-specific apps were identified; most were PwMS-oriented (83%), free of charge (94%), and in English language (76%). The 45 PwMS-oriented apps focused on increasing MS knowledge (71%), tracking symptoms (33%), and promoting networking with peers or HCPs (38%). The 13 HCPs-oriented tools addressed education and updates on MS (62%), disease assessment and management (54%), and research (15%). Google Search tool was also queried to find non-MS-specific apps to fulfill some unmet domains (as sleep, pain, sexual or mental health). Twenty-four additional apps were listed to provide a valuable contribution. Conclusion: The "digital revolution" led to increasingly customized tools for PwMS, especially as m-health or social-networking apps. However, apps to support other specific MS-relevant domains, appealing HCPs-oriented apps, and specific mobile tools for MS caregivers are still lacking. The absence of data assessing the usability and quality of MS apps in ecologically contexts leads to not reliable conclusions about potential benefits. A strong dialogue between MS communities and the digital industry is encouraged to fill this gap.

Utilization of smart devices and the evolution of customized healthcare services focusing on big data: a systematic review.

Background: Currently, smart devices can prevent diseases by continuously collecting user information and providing health-related feedback. Smart devices big data provide personalized, faster, and more accurate health care. By examining existing studies, we suggest a new healthcare evolution and health promotion through information technology (IT) convergence. A big data systematic review examined the evolution of new health care and their potential for health promotion by monitoring physical activities, preventing diseases, and analyzing health data smart devices. Methods: Therefore, this evaluates whether a new healthcare industry combining smart devices and big-data-based customized health care services can promote health. This study searched PubMed, Google Scholar, Scopus, and Research Information Sharing Service (RISS) for keywords related to big data, smart devices, healthcare, customized health services, health apps, and mobile health. This study comprised 43 of 453 publications from 2007 to 2023. Among them, a total of 43 articles were successfully completed in this study using the PRISMA flowchart in the final stage. Results: Smart devices centered on big data enable personalized health care, and app technologies that promote well-being to prepare for aging society have many applications in clinical, prevention, public health, and rehabilitation settings. Smart devices and tailored healthcare services using big data to inform individuals about exercise, health status, diagnosis, and health information will expand into major sectors. By reviewing previous studies, the convergence of the IT technology field, which allows you to easily identify individual health and receive faster and more accurate medical services through customized health care services, has future-oriented values as, new health care services evolve. The systematic review of big data herein can monitor physical activity and prevent diseases using smart devices, thus promoting a healthy lifestyle. Conclusions: Smart devices that analyze data to provide personal exercise and health conditions, checkups, and information, are making our lives easier. The information service using big data will continue to evolve into a personalized management service and provide basic healthcare data as it grows into an expected industry in the future.

Assessing the Hands-on Usability of the Healthy Jeart App Specifically Tailored to Young Users.

BACKGROUND: The widespread adoption of mobile devices by adolescents underscores the potential to harness these tools to instill healthy habits into their daily lives. An exemplary manifestation of this initiative is the Healthy Jeart app, crafted with the explicit goal of fostering well-being. METHODOLOGY: This study, framed within an applied investigation, adopts an exploratory and descriptive approach, specifically delving into the realm of user experience analysis. The focus of this research is a preliminary examination aimed at understanding users' perceived usability of the application. To glean insights, a comprehensive questionnaire was administered to 101 teenagers, seeking their evaluations on various usability attributes. The study took place during 2022. RESULTS: The findings reveal a considerable consensus among users regarding the evaluated usability aspects. However, the areas for improvement predominantly revolve around managing the information density, particularly for a subset of end users grappling with overwhelming content. Additionally, recommendations are put forth to streamline the confirmation process for user suggestions and comments. CONCLUSION: This analysis illuminates both the strengths of the app and areas ripe for refinement, paving the way for a more user-centric and efficacious Healthy Jeart application.

Mother's milk-mother's gift: Mobile-based training to increase self-efficacy of nursing women during postpartum and puerperium: A quasi-experimental study.

BACKGROUND: The World Health Organization recommends exclusive breastfeeding for 6 months followed by continued breastfeeding with complementary food up to 2 years of age or beyond. This study aimed to investigate the effect of mobile -based education on the self-efficacy of lactating women in the postpartum period. METHODS: A quasi-experimental study was carried out in 2018 in Shirvan, Iran among 69 postpartum women. Participants were assigned to intervention (n = 33) and control (n = 36) groups on the first day after delivery by random allocation. Intervention group received the mobile-based training for 4 weeks in the form of text messages, photos, video clips, and audio files. The control group received routine hospital care and training. Data were collected on demographic characteristics, delivery information, and the breastfeeding self-efficacy. Self-efficacy was measured in two groups at three time points; the first day after delivery, 4 weeks after delivery and 8 weeks after delivery. FINDINGS: The mean and standard deviation of breastfeeding self-efficacy score was higher in the intervention than control group 4 weeks (155.30 ± 10.93 vs 132.52 ± 19.70, P < 0.001) and 8 weeks after delivery (160.18 ± 11.33 vs 132.30 ± 24.09, P < 0.001). Compared to the control group, the rate of exclusive breastfeeding in the intervention group was significantly higher 4 and 8 weeks after the delivery (Pall < 0.05). DISCUSSION: The findings from this study showed a substantial increase in breastfeeding self-efficacy and exclusive breastfeeding in the group who received training through mobile-based education compared to the group that received routine care. APPLICATION TO PRACTICE: Mobile-based breastfeeding education might be a promising strategy to increase breastfeeding self-efficacy. It is suggested that midwives include the design of mobile-based educational programs as part of their educational strategies and use the advantages of this educational method during pregnancy and after childbirth. TRAIL REGISTRATION: This article has been registered in Iran's Clinical Trial Center with the code: 2 N20171024036972 IRCT.

Ayudando a la toma de decisiones en el diagnóstico, tratamiento y seguimiento de úlceras de etiología vascular mediante el empleo de una aplicación móvil / A mobile decision support system for diagnosis, treatment and follow-up of vascular ulcers

Introducción y objetivo: los sistemas de ayuda a la decisión médica (SADM) son sistemas computacionales que utilizan dispositivos inteligentes, lo que facilita el diagnóstico y el tratamiento de múltiples patologías, transformando la atención sanitaria en un sistema dinámico y de precisión. Las úlceras de etiología vascular representan un importante problema de salud que suponen un gran consumo de recursos. La transformación digital puede mejorarla calidad de los diagnósticos, de los tratamientos y de los seguimiento de los pacientes, mejorando la eficacia y la eficiencia de la asistencia sanitaria. El objetivo es desarrollar una aplicación móvil que facilite el diagnóstico y el tratamiento de úlceras de etiología vascular. Métodos: para desarrollar este SADM se elaboraron algoritmos para los diagnósticos y los tratamientos capaces de generar una respuesta correcta, guiando al usuario hacia un diagnóstico más probable o a la aplicación del tratamiento específico. En Android se empleó el entorno de programación Android Studio y el lenguaje de programación JAVA, y para el desarrollo en iOS se empleó XCode y el lenguaje de programación Swift. El diagnóstico de úlceras de etiología vascular incluye: úlcera neuropática, isquémica, neuroisquémica, venosa o flebostática, úlceramixta y úlcera hipertensiva o de Martorell. Resultados: UlcerAPP es visual e intuitiva. Orientará en el diagnóstico en respuesta a los algoritmos desarrollados. Además, podrá accederse al tratamiento específico de cada una de ellas. Incluirá recomendaciones de seguimiento y criterios de derivación. Conclusiones: UlcerAPP es un proyecto desarrollado para mejorar el manejo clínico de las úlceras en el entorno de la Atención Primaria y potenciar el conocimiento de la patología vascular y del tratamiento de las úlceras de dicha etiología. (AU)

Introduction and objective: decision support systems (DSS) are computer systems that use computer devicesor smartphones, facilitating the diagnosis and properly treatment of multiple pathologies, transforming healthcare into a dynamic, preventive and precision system. Vascular ulcers represent an important health problem, witha great consumption of resources. Digital transformation can improve the quality of diagnoses, treatments andpatient follow-up, and therefore improve the effectiveness and efficiency of healthcare. This paper aims to develop UlcerApp, a totally new mobile DSS for vascular ulcers management, which facilitates the diagnosis, treatment andmonitoring of ulcers of vascular etiology, in the primary health care. Methods: for achieving the main purpose of this research work, a decision algorithm will be developed and implemented by an Android (Android Studio- JAVA) and iOS (XCode- Switf ) mobile applications. Results: the App developed which implements the algorithms UlcerApp is capable of diagnose 6 kind of vascularulcers: neuropathic, ischemic, neuroischemic, venous ulcer, mixed ulcer and hypertensive or Martorell ulcer. UlcerAPP is a visual and intuitive application that will guide the user to correct diagnosis. After them, users will be able to access the specific treatment. It will include follow-up recommendations as well as referral criteria. Conclusions: UlcerAPP is a project developed to improve the clinical management of vascular ulcers in the primary health care, enhance knowledge of vascular pathology and treatment of ulcers of said etiology. (AU)

A Smartphone App for Real-Time Assessment of Malaria Prophylaxis Adverse Events.

Background: Growth of international travel to malarial areas over the last decades has contributed to more travelers taking malaria prophylaxis. Travel-related symptoms may be wrongly attributed to malaria prophylaxis and hinder compliance. Here, we aimed to assess the frequency of real-time reporting of symptoms by travelers following malaria prophylaxis using a smartphone app. Method: Adult international travelers included in this single-center study (Barcelona, Spain) used the smartphone Trip Doctor® app developed by our group for real-time tracking of symptoms and adherence to prophylaxis. Results: Six hundred four (n = 604) international travelers were included in the study; 74.3% (449) used the app daily, and for one-quarter of travelers, malaria prophylaxis was prescribed. Participants from the prophylaxis group traveled more to Africa (86.7% vs. 4.3%; p < 0.01) and to high travel medical risk countries (60.8% vs. 18%; p < 0.01) and reported more immunosuppression (30.8% vs. 23.1% p < 0.01). Regarding symptoms, no significant intergroup differences were observed, and no relationship was found between the total number of malarial pills taken and reported symptoms. Conclusions: In our cohort, the number of symptoms due to malaria prophylaxis was not significantly higher than in participants for whom prophylaxis was not prescribed, and the overall proportion of symptoms is higher compared with other studies.

Parenting Styles and Psychosocial Factors of Mother-Child Dyads Participating in the ENDORSE Digital Weight Management Program for Children and Adolescents during the COVID-19 Pandemic.

Childhood obesity is a complex disease with multiple biological and psychosocial risk factors. Recently, novel digital programs were developed with growing evidence for their effectiveness in pediatric weight management studies. The ENDORSE platform consists of mobile applications, wearables, and serious games for the remote management of childhood obesity. The pilot studies included 50 mothers and their children aged 6-14 years and resulted in a clinically significant BMI z-score reduction over 4 to 5 months. This secondary analysis of the ENDORSE study focuses on parenting styles and psychosocial factors. METHODOLOGY: Semi-structured clinical interviews were conducted with all participating mothers pre-and post-intervention. The Parenting Styles and Dimensions Questionnaire (PSDQ) evaluated the mothers' parenting styles. The psychosocial functioning of the participating children was assessed with the parental version of the Strengths and Difficulties Questionnaire (SDQ). The relationship between parenting styles, psychosocial parameters, and weight outcomes was investigated using a linear regression analysis. RESULTS: Weight-related stigma at school (56%), body image concerns (66%), and difficulties in family relationships (48%) were the main concerns documented during the initial psychological interviews. According to the SDQ, there was a significant decrease in children's conduct problems during the study's initial phase (pre-pilot group). A decrease in maternal demandingness (i.e., strict parenting style) was associated with a decrease in BMI z-score (beta coefficient = 0.314, p-value = 0.003). CONCLUSION: Decreasing parental demandingness was associated with better weight outcomes, highlighting the importance of assessing parenting factors in pediatric weight management programs.

Web-Based Intervention for Multilingual Family Carers of People with Dementia: Insights from the DrawCare Study.

Addressing the needs of ethnically diverse multilingual people can be challenging in environments that are non-native to them. The consequences of this issue become more significant in healthcare contexts. Insights from the DrawCare study-an Australian study that explores the effectiveness of a web-based intervention for multilingual family carers of people with dementia-are presented illustrating the enabling role of digital health.