¿Cómo usan el teléfono móvil los niños de Castilla y León? / How do children in Castilla y León use their mobile phones?

Introducción: los teléfonos móviles suponen una gran herramienta de comunicación entre iguales, pero un uso inapropiado puede repercutir en las relaciones familiares, sociales y en el rendimiento escolar. Objetivos: el objetivo principal del trabajo fue estudiar el uso del teléfono móvil en la población pediátrica de varias áreas de salud de Castilla y León. Material y métodos: estudio multicéntrico prospectivo en varios centros de salud y un hospital comarcal. Se pasó una encuesta a padres de niños que acudían a consulta y a los adolescentes que lo desearon, quienes también respondieron a un test de dependencia (TDM). Resultados: el móvil es el dispositivo electrónico que más usaban los niños para navegar por Internet. La media de edad en la que tuvieron el primer móvil propio fue de 10,35 años; la mayoría, con acceso a Internet. El 68% de ellos accedía sin ningún control parental. El 70% de padres establecieron unas normas al proporcionárselo. Un tercio reconocían que estas no se cumplían. El número de horas diarias de uso aumentaba según la edad de los niños. De los adolescentes, más del 50% lo usaba más de dos horas al día. Los más pequeños lo utilizaban para ver vídeos y los mayores para chatear y redes sociales. El uso del móvil se relacionaba con el uso de gafas, pero no con el rendimiento académico, problemas de sueño ni práctica de deporte. En el TDM se observaron muchas respuestas positivas en los ítems de los cuatro apartados en los que se divide el test, especialmente en el de falta de control. Conclusiones: la media de edad de adquisición del primer teléfono móvil propio es menor de la recomendada. Su abuso puede generar conductas con rasgos de adicción (AU)

Introduction: mobile phones are a great communication tool between equals, but inappropriate use can affect family and social relationships and school performance.Objectives: the main objective of this work was to study the use of mobile phones in the pediatric population of several health areas in Castilla y León.Material and methods: prospective multicenter study in several health centers and a regional hospital.A survey was passed to parents of children who attended the consultation, and to adolescents who wished to, who also responded to a dependency test (TDM).Results: the mobile is the electronic device that children used the most to surf the Internet. The average age at which they had their first mobile phone was 10.35 years, most of them with Internet access.68% of them accessed without any parental control. 70% of parents established rules of operating. A third recognized that these rules were not fulfilled.The number of hours per day of use increased with the age of the children. More than 50% of the adolescents used it for more than two hours a day. The little ones used it to watch videos and the older ones to chat and social networks.The use of the mobile phone was related to the use of glasses, but not with academic performance, sleep problems or sports practice.In the TDM many positive responses were observed in the items of the four sections into which the test is divided, especially in the lack of control.Conclusions: the average age for acquiring their first mobile phone is lower than the recommended age. Its abuse can generate behaviors with traits of addiction. (AU)

Effect of Smartphone App Postoperative Home Monitoring After Oncologic Surgery on Quality of Recovery: A Randomized Clinical Trial.

Importance: There has been an increase in health care-focused smartphone apps, including those for encouraging healthy behaviors and managing chronic conditions, but app-assisted postsurgical care has yet to be fully explored. Objective: To compare quality of recovery and patient satisfaction between conventional in-person follow-up and smartphone app-assisted follow-up for patients following Enhanced Recovery After Surgery Society (ERAS) protocols. Design, Setting, and Participants: This randomized clinical trial, conducted from June 2019 to April 2021, included women older than 18 years undergoing oncologic breast reconstruction or major gynecologic oncology surgery following ERAS protocols with the care of 2 surgeons at an academic tertiary care center. Interventions: Patients were randomized 1:1 to receive smartphone app-assisted follow-up or conventional in-person follow-up. The smartphone group used a surgeon-monitored app to record Quality of Recovery 15 (QoR15) scores, European Organisation for Research and Treatment of Cancer-selected adverse events, drain outputs, and surgical site photographs over 6 weeks. Patient satisfaction scores were assessed using validated Patient Satisfaction Questionnaire III (PSQ-III) subscales at 2 and 6 weeks postoperatively. The conventional follow-up group also completed the QoR15 and PSQ-III questionnaires at these intervals. Main Outcomes and Measures: The primary outcomes were quality of recovery and patient satisfaction, as measured by the QoR15 and PSQ-III, respectively. Secondary outcomes were costs of follow-up; the number of contacts with the medical system, complications, and surgeons' contacts with patients; and surgeons' perceptions of app-assisted care. Results: Of 72 patients included in the trial, 36 underwent breast reconstruction (mean [SD] age, 45.30 [9.13] years) and 36 underwent gynecologic oncology surgery (mean [SD] age, 54.90 [11.18] years). Three patients dropped out (2 who underwent breast reconstruction [1 in the app group, 1 in the control group], 1 who underwent gynecologic oncology surgery [control group]). The app group had significantly higher mean (SD) QoR15 scores than the control group (2 weeks: 127.58 [22.03] vs 117.68 [17.52], P = .02; 6 weeks: 136.64 [17.53] vs 129.76 [16.42], P = .03). Patients were equally satisfied between groups in all subsets of the PSQ-III at these intervals. The mean (SD) number of complications was similar in both groups, and a similar number of surgeon contacts per patient occurred (1.6 [1.2] vs 2.1 [2.0], P = .16). Surgeons appreciated early identification of complications with the app. Conclusions and Relevance: In this randomized clinical trial, postoperative follow-up for patients undergoing breast reconstruction and gynecologic oncology surgery using smartphone app-assisted monitoring led to improved quality of recovery and equal satisfaction with care compared with conventional in-person follow-up. Trial Registration: ClinicalTrials.gov Identifier: NCT03456167.

Why patients diagnosed with bipolar disorder start, continue or discontinue health-related apps supporting their self-management.

WHAT IS KNOWN ABOUT THE SUBJECT?: Self-management is essential in the treatment of those who have bipolar disorder. There are many apps to support self-management, but we know that these apps only sometimes cover the users' needs. WHAT IS ADDED TO EXISTING KNOWLEDGE?: In our research, we made an inventory of apps that people with bipolar disorder use to cover their needs in self-management. We also have searched for the reasons to start, continue, switch or quit the use of those apps. We found that 44% (n = 18) of our respondents use health-related apps for self-management purposes. Apps for physical activity, planning and structure and apps for relaxation were most used. In the use of apps, the "freedom of choice" and user-friendliness are the most important in continuing the use of apps, while malfunctioning and "not fitting in individual needs" the main reasons were for quitting the use of apps. IMPLICATIONS FOR PRACTICE: Various apps can be used for self-management purposes as long as these apps meet the individual user's requirements. Clinicians and patients should have a broad view when looking for suitable apps and not limit the search to just professional apps. In developing new apps, patients, clinicians and developers should collaborate in the development process, requirements and design. ABSTRACT: INTRODUCTION: Self-management is one of the cornerstones in the treatment of bipolar disorder (BD). Complementing interventions by apps are seen as a good opportunity to support self-management. However, there is insufficient knowledge about understanding the use of health-related applications by consumers with BD for self-management purposes. AIM: The study aims to gain insight from patients diagnosed with BD about reasons to use, continue or discontinue health-related apps. METHOD: This study employed a mixed-method design in which 41 participants diagnosed with BD participated in a quantitative survey, and 11 participants also participated in an in-depth interview. RESULTS: The survey showed that 44% (n = 18) of the participants use health-related apps, and 26.8% (n = 11) use those apps consistently. Interviews revealed that adjustability, usability, trustworthiness and the guarantee of privacy were the main reasons determining whether participants used or terminated the use of a health-related app. IMPLICATIONS FOR PRACTICE: Although we found that a substantial number of patients diagnosed with BD use one or more apps to support self-management, their use is often discontinued due to content that needs more robust to address their needs. Besides appropriate content, tailoring and persuasive technologies will likely promote the continued use of an app for self-management purposes. Cooperation between those diagnosed with bipolar disorder and health professionals (like mental health nurses) in developing and designing applications that are aimed to support self-management in BD is necessary for successful implementation and adaptation.

Mobile Health Interventions for Improving Health Outcomes in Childhood: A Scoping Review Protocol / Intervenções de saúde móvel para melhorar os resultados de saúde na infância: um protocolo de revisão de escopo

Introdução: O uso de dispositivos móveis para atendimento à saúde tem sido cada vez mais frequente nos últimos anos. Estudos mostram o imenso potencial dessa tecnologia como instrumento para o desenvolvimento de habilidades pessoais e sociais, no sentido de adquirir maior controle e poder de decisão sobre o cuidado à saúde. Objetivo: Mapear as intervenções móveis de saúde para melhorar os resultados de saúde na infância Metodologia: A revisão considerará estudos que incluem o uso de dispositivos móveis de saúde por profissionais de saúde ou familiares para cuidar da saúde da criança. Esta revisão de escopo incluirá desenhos de estudos observacionais experimentais, quase experimentais e descritivos com abordagem quantitativa ou qualitativa. Dissertações serão consideradas, mas resumos de conferências, pôsteres, editoriais, comentários e artigos de opinião serão excluídos. A pesquisa será limitada a estudos publicados em inglês, espanhol e português, a partir de 2010. As bases de dados a serem pesquisadas incluem PubMed (MEDLINE), CINAHL (via EBSCO), Embase, PsycINFO (via EBSCO), Scielo, Web of Science, LILACS, Health System Evidence e bancos de dados de literatura cinzenta, como o banco de dados ProQuest Dissertations and Theses Global, OpenGrey, EThOS e PaperFirst. Após a triagem dos resumos/títulos para inclusão por dois pesquisadores independentes, os estudos em texto completo serão selecionados os dados serão extraídos dos artigos incluídos, utilizando o instrumento de extração de dados. Resultados: Serão apresentados em forma de tabelas e quadros, de acordo com o PRISMA-ScR. Conclusões: Este estudo fornecerá evidências sobre o desenvolvimento e implementação de ferramentas online de promoção da saúde infantil.

Introduction: The use of mobile devices for health care has been increasingly frequent in recent years. Studies show the immense potential of this technology as an instrument to favor the development of personal and social skills, in the sense of acquiring greater control and decision-making power over health care. Aim: The objective of this scoping review is to map the mobile health interventions for improving health outcomes in childhood. Method: This protocol was carried out in according to Joanna Briggs Institute methodology and Preferred checklist Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), according to the following steps: review question; eligibility criteria (PCC); literature search strategy; study selection; data extraction and data presentation. The review question is: How are mHealth interventions being applied to improve childhood health outcomes (disease prevention, monitoring or diagnosis)? The review will include experimental, quasi-experimental and descriptive observational study designs with quantitative or qualitative approach. Dissertations will be considered, but conference abstracts, posters, editorials, commentaries, and opinion papers will be excluded. The search will be limited to studies published in English, Spanish and Portuguese in the last 10 years. The databases to be searched include PubMed, CINAHL, Embase, Scielo, Web of Science, LILACS, Health System Evidence, and gray literature databases. Results: The result of the selection flow will be presented in the form of tables and figure, according to PRISMA-ScR. Conclusion: This study will provide evidence on the development and implementation of online tools to promote children's health.

Introducción: El uso de dispositivos móviles para el cuidado de la salud ha sido cada vez más frecuente en los últimos años. Los estudios muestran el inmenso potencial de esta tecnología como instrumento para favorecer el desarrollo de habilidades personales y sociales, en el sentido de adquirir un mayor control y poder de decisión sobre la atención de la salud. Objetivo: El objetivo de esta revisión de alcance es mapear las intervenciones de salud móvil para mejorar los resultados de salud en la infancia. Método: La revisión considerará estudios que incluyan el uso de la salud móvil por parte de profesionales de la salud o miembros de la familia para cuidar la salud infantil. Esta revisión de alcance incluirá diseños de estudios observacionales experimentales, cuasiexperimentales y descriptivos con un enfoque cuantitativo o cualitativo. Se considerarán disertaciones, pero se excluirán los resúmenes de congresos, carteles, editoriales, comentarios y artículos de opinión. La búsqueda se limitará a los estudios publicados en inglés, español y portugués después de 2010. Las bases de datos que se buscarán incluyen PubMed (MEDLINE), CINAHL (a través de EBSCO), Embase, PsycINFO (a través de EBSCO), Scielo, Web of Science, LILACS, Health System Evidence y bases de datos de literatura gris como la base de datos ProQuest Dissertations and Theses Global, OpenGrey, EThOS y PaperFirst. Después de la selección de resúmenes / títulos para su inclusión por dos investigadores independientes, se seleccionarán los estudios de texto completo y se proporcionarán las razones de la exclusión. Los datos serán extraídos de los artículos incluidos en la revisión por dos investigadores independientes, utilizando el instrumento de extracción de datos. Resultados: Se presentarán en forma de tablas según PRISMA-ScR. Conclusiones: Este estudio proporcionará evidencia sobre el desarrollo e implementación de herramientas en línea para promover la salud infantil.

Measuring emotional preoperative stress by an app approach and its applicability to predict postoperative pain.

BACKGROUND: The Brief Measure of Emotional Preoperative Stress (B-MEPS) was developed to evaluate the preoperative individual vulnerability to emotional stress. To obtain a refined version of B-MEPS suitable for an app approach, this study aimed: (i) to identify items with more discriminant properties; (ii) to classify the level of preoperative emotional stress based on cut-off points; (iii) to assess concurrent validity through correlation with the Central Sensitization Inventory (CSI) score; (iv) to confirm whether the refined version of B-MEPS is an adequate predictive measure for identification of patients prone to intense postoperative pain. METHODS: We include 1016 patients who had undergone surgical procedures in a teaching hospital. The generalized partial credit model of item response theory and latent class model were employed, respectively, to reduce the number of items and to create cut-off points. We applied the CSI and assessed pain by Visual Analog Scale (0-10) and by the amount of postoperative morphine consumption. RESULTS: The refined B-MEPS shows satisfactory reliability (Cronbach's alpha 0.79). Preoperative emotional stress, according to the cut-off points, is classified into categories: low, intermediate or high stress. The refined B-MEPS exhibited a linear association with the CSI scores (r2 = 0.53, p < 0.01). Patients with higher levels of emotional stress displayed a positive association with moderate to severe pain and greater morphine consumption. CONCLUSION: The refined version of B-MEPS, along with an interface of easy applicability, assess emotional vulnerability at the bedside before surgery. This app may support studies focused on intervening with perioperative stress levels.

Joint analysis of the intention to vaccinate and to use contact tracing app during the COVID-19 pandemic.

Pharmacological and non-pharmacological measures will overlap for a period after the onset of the pandemic, playing a strong role in virus containment. We explored which factors influence the likelihood to adopt two different preventive measures against the COVID-19 pandemic. An online snowball sampling (May-June 2020) collected a total of 448 questionnaires in Italy. A Bayesian bivariate Gaussian regression model jointly investigated the willingness to get vaccinated against COVID-19 and to download the national contact tracing app. A mixed-effects cumulative logistic model explored which factors affected the motivation to adopt one of the two preventive measures. Despite both COVID-19 vaccines and tracing apps being indispensable tools to contain the spread of SARS-CoV-2, our results suggest that adherence to the vaccine or to the national contact tracing app is not predicted by the same factors. Therefore, public communication on these measures needs to take in consideration not only the perceived risk associated with COVID-19, but also the trust people place in politics and science, their concerns and doubts about vaccinations, and their employment status. Further, the results suggest that the motivation to comply with these measurements was predominantly to protect others rather than self-protection.

Criação de um aplicativo móvel e questionários WEB como estratégia de ensino e avaliação em Odontologia / Creating a mobile APP and WEB questionnaires as teaching and assessment strategies in Dentistry

O presente estudo relata a experiência da criação do aplicativo móvel (APP) RUBOND e o uso de questionários WEB como estratégia de ensinoe avaliação em Odontologia. A criação do aplicativo móvel ocorreu por meio da plataforma Fábrica de Aplicativos, sendo definido a temática dos Sistemas Adesivos Universais como tema central. A elaboração dos questionários para avaliação dos conhecimentos adquiridos por meio do material disponibilizado no APP se deu por meio da plataforma Online Pesquisa. As questões utilizadas foram retiradas de provas do Exame Nacional de Desempenho dos Eestudantes. O acesso aos questionários aconteceuvia linkdisponível no aplicativo móvel.A criação do aplicativo móvel RUBOND e questionários WEB como estratégia de ensino e avaliação em Odontologia podem ser uma ferramenta viável na prática docente e discente, desde que corretamente utilizados. Sugere-se que mais estudos sejam realizados para confirmar as vantagens dos aplicativos móveis e questionários WEB no ensino e avaliação em Odontologia (AU).

The present study reports the experience of creating the RUBOND mobile application (APP) and the use of WEB questionnaires asteaching and assessmentstrategiesin Dentistry. The creation of the mobile application took place through theFábrica de Aplicativos platform, with the theme of Universal Adhesive Systems being defined as a central subject. The preparation of questionnaires to assess the knowledge acquired through the material available in the APP occurredin the Online Pesquisa platform. The questions used were taken fromtests of the National Student Performance Exam(ENADE). The questionnaires wereaccessed via a direct link attached to the mobile APP. The creation of the RUBOND mobile application and WEB questionnaires as a teachingand assessment strategy in Dentistry can be a viable tool in student and teaching practice, as long as they are correctlyused. Further studies are needed to confirm the benefits of mobile APPand WEB questionnaires in teaching and assessment in Dentistry (AU).

Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study.

BACKGROUND: COVID-19 vaccines show excellent efficacy in clinical trials and effectiveness in real-world data, but some people still become infected with SARS-CoV-2 after vaccination. This study aimed to identify risk factors for post-vaccination SARS-CoV-2 infection and describe the characteristics of post-vaccination illness. METHODS: This prospective, community-based, nested, case-control study used self-reported data (eg, on demographics, geographical location, health risk factors, and COVID-19 test results, symptoms, and vaccinations) from UK-based, adult (≥18 years) users of the COVID Symptom Study mobile phone app. For the risk factor analysis, cases had received a first or second dose of a COVID-19 vaccine between Dec 8, 2020, and July 4, 2021; had either a positive COVID-19 test at least 14 days after their first vaccination (but before their second; cases 1) or a positive test at least 7 days after their second vaccination (cases 2); and had no positive test before vaccination. Two control groups were selected (who also had not tested positive for SARS-CoV-2 before vaccination): users reporting a negative test at least 14 days after their first vaccination but before their second (controls 1) and users reporting a negative test at least 7 days after their second vaccination (controls 2). Controls 1 and controls 2 were matched (1:1) with cases 1 and cases 2, respectively, by the date of the post-vaccination test, health-care worker status, and sex. In the disease profile analysis, we sub-selected participants from cases 1 and cases 2 who had used the app for at least 14 consecutive days after testing positive for SARS-CoV-2 (cases 3 and cases 4, respectively). Controls 3 and controls 4 were unvaccinated participants reporting a positive SARS-CoV-2 test who had used the app for at least 14 consecutive days after the test, and were matched (1:1) with cases 3 and 4, respectively, by the date of the positive test, health-care worker status, sex, body-mass index (BMI), and age. We used univariate logistic regression models (adjusted for age, BMI, and sex) to analyse the associations between risk factors and post-vaccination infection, and the associations of individual symptoms, overall disease duration, and disease severity with vaccination status. FINDINGS: Between Dec 8, 2020, and July 4, 2021, 1 240 009 COVID Symptom Study app users reported a first vaccine dose, of whom 6030 (0·5%) subsequently tested positive for SARS-CoV-2 (cases 1), and 971 504 reported a second dose, of whom 2370 (0·2%) subsequently tested positive for SARS-CoV-2 (cases 2). In the risk factor analysis, frailty was associated with post-vaccination infection in older adults (≥60 years) after their first vaccine dose (odds ratio [OR] 1·93, 95% CI 1·50-2·48; p<0·0001), and individuals living in highly deprived areas had increased odds of post-vaccination infection following their first vaccine dose (OR 1·11, 95% CI 1·01-1·23; p=0·039). Individuals without obesity (BMI <30 kg/m2) had lower odds of infection following their first vaccine dose (OR 0·84, 95% CI 0·75-0·94; p=0·0030). For the disease profile analysis, 3825 users from cases 1 were included in cases 3 and 906 users from cases 2 were included in cases 4. Vaccination (compared with no vaccination) was associated with reduced odds of hospitalisation or having more than five symptoms in the first week of illness following the first or second dose, and long-duration (≥28 days) symptoms following the second dose. Almost all symptoms were reported less frequently in infected vaccinated individuals than in infected unvaccinated individuals, and vaccinated participants were more likely to be completely asymptomatic, especially if they were 60 years or older. INTERPRETATION: To minimise SARS-CoV-2 infection, at-risk populations must be targeted in efforts to boost vaccine effectiveness and infection control measures. Our findings might support caution around relaxing physical distancing and other personal protective measures in the post-vaccination era, particularly around frail older adults and individuals living in more deprived areas, even if these individuals are vaccinated, and might have implications for strategies such as booster vaccinations. FUNDING: ZOE, the UK Government Department of Health and Social Care, the Wellcome Trust, the UK Engineering and Physical Sciences Research Council, UK Research and Innovation London Medical Imaging and Artificial Intelligence Centre for Value Based Healthcare, the UK National Institute for Health Research, the UK Medical Research Council, the British Heart Foundation, and the Alzheimer's Society.

Análise de questionários de avaliação de aplicativos na área da saúde: uma revisão sistemática / Evaluation of mobile application questionnaires in the health care setting: a systematic review

Este estudo teve como objetivo identificar modelos de questionários para avaliação de aplicativos móveis na área da saúde. Trata-se de uma Revisão sistemática da literatura, em que a busca foi realizada em julho de 2021, nas bases de dados PubMed, ScienceDirect, Scopus, SciELO e Web of Science. Foram utilizados os descritores: "mobile", "mhealth", "evaluation", "questionnaire", "guide", "assessing", "validation" e "assessment", sendo necessárias adaptações para atender as especificidades das bases. Foram identificados 1.786 estudos e após aplicar os critérios de seleção, 37 publicações alcançaram o nível de qualidade para inclusão e síntese. Os artigos revisados apresentam perguntas significativas para os usuários, sobre os aplicativos avaliados. Este estudo é recomendado para auxiliar nos estudos de pesquisa visando o aumento da qualidade dos aplicativos móveis na saúde.

The objective of this study was to identify questionnaire models for the evaluation of mobile health applications. We conducted a systematic literature review in July 2021 in PubMed, ScienceDirect, Scopus, SciELO, and Web of Science databases using the following descriptors: "mobile," "mhealth," "evaluation," "questionnaire," "guide," "evaluating," "validation," and "evaluation." Adaptations were required to meet database specificities. Of 1,786 studies initially identified, only 37 met the quality criteria for inclusion and synthesis. All studies analyzed in this review asked relevant app-related questions to users. This study is intended to assist scientific research in the development of quality mobile health applications.

O uso de aplicativo de celular para medir frequência cardíaca e saturação periférica de oxigênio / The use of cellular application to measure heart rate and peripheral oxygen saturation

Avaliar a associação da medida de frequência cardíaca (FC) e saturação periférica de oxigênio (SpO2 ) utilizando um aplicativo de celular e um monitor multiparamétrico. Métodos: Estudo experimental e randomizado entre participantes saudáveis. Investigou o aplicativo Samsung Health® e o monitor multiparamétrico da marca Midway®, modelo: PM-60. O estudo foi estruturado em quatro etapas. Para análise estatística, aplicou correlação de Pearson e Spearman, com nível de significância de 5%. Resultados: Dos 150 participantes a idade média foi de 22,3±4,5 anos, o sexo feminino foi predominante (71,3%). Verificouse forte correlação da FC medida pelo monitor com a FC do aplicativo de celular (r=0,93) indicando correlação positiva (p<0,001). A SpO2 medida por monitor multiparamétrico e pelo aplicativo de celular revelou um r=0,05 (p=0,51), o que atesta uma correlação nula e não significativa. Conclusão: Não houve correlação entre a medida da SpO2 do monitor multiparamétrico e do aplicativo Samsung Health®, não sendo confiável a utilização deste aplicativo para monitorar e gerenciar o sinal vital SpO2 em pessoas saudáveis. A FC medida com o aplicativo é significativa, e pode ser utilizada para monitorar e gerenciar esse sinal vital.

Assess the association of the measure of heart rate (HR) and oxygen saturation (SpO2 ) using a mobile application and a multiparameter monitor. Methods: Study experimental and randomized healthy participants. Investigated the application Samsung Health® and multiparameter monitor Midway® make, model: PM-60. The study was divided into four stages. Statistical analysis was applied Pearson and Spearman correlation with 5% significance level. Results: Of the 150 participants average age was 22.3±4.5 years, females were predominant (71.3%). There was a strong correlation HR measured by the monitor application to cell FC (r=0.93) indicating a positive correlation (p<0.001). SpO2 measured by multiparameter monitor and the mobile application revealed r=0.05 (p=0.51), which demonstrates a zero and no significant correlation. Conclusion: There was no correlation between the SpO2 measurement of the multiparameter monitor and the Samsung Health® app, not being trusted to use this application to monitor and manage the vital sign SpO2 in healthy people. The HR measured with the application is significant, and can be used to monitor and manage this vital sign.

The relationship between objective app engagement and medication adherence in asthma and COPD: a retrospective analysis.

Digital health tools can promote disease self-management, but the association of smartphone app engagement and medication adherence is unclear. We assessed the relationship between objective smartphone app engagement and controller medication use in adults with asthma and COPD. We retrospectively analyzed data from participants enrolled in a digital self-management platform for asthma and COPD. Eligible adults had a smartphone and a paired electronic medication monitor (EMM). Longitudinal, mixed-effects logistic regressions estimated the relationship between daily app engagement (app opens, session duration) and daily controller medication use. Data from 2309 participants (71% asthma; 29% COPD) was analyzed. Opening the app (vs. not opening the app) was associated with significantly greater odds (OR (95% CI)) of using controller medications in asthma (2.08 (1.98, 2.19)) and COPD (1.61 (1.49, 1.75). Longer session duration was also associated with greater odds of using controller medications in asthma and COPD, but the odds of use attenuated with longer session duration in COPD. This study presents a novel assessment of the relationship between objectively-measured smartphone app engagement and controller medication use in asthma and COPD. Such insights may help develop targeted digital health tools and interventions.

Écart de mobilité : estimation des seuils de mobilité requis pour maîtriser le SRAS-CoV-2 au Canada.

CONTEXTE: Les interventions non pharmacologiques demeurent le principal moyen de maîtriser le coronavirus du syndrome respiratoire aigu sévère 2 (SRAS-CoV-2) d'ici à ce que la couverture vaccinale soit suffisante pour donner lieu à une immunité collective. Nous avons utilisé des données de mobilité anonymisées de téléphones intelligents afin de quantifier le niveau de mobilité requis pour maîtriser le SRAS-CoV-2 (c.-à-d., seuil de mobilité), et la différence par rapport au niveau de mobilité observé (c.-à-d., écart de mobilité). MÉTHODES: Nous avons procédé à une analyse de séries chronologiques sur l'incidence hebdomadaire du SRAS-CoV-2 au Canada entre le 15 mars 2020 et le 6 mars 2021. Le paramètre mesuré était le taux de croissance hebdomadaire, défini comme le rapport entre les cas d'une semaine donnée et ceux de la semaine précédente. Nous avons mesuré les effets du temps moyen passé hors domicile au cours des 3 semaines précédentes à l'aide d'un modèle de régression log-normal, en tenant compte de la province, de la semaine et de la température moyenne. Nous avons calculé le seuil de mobilité et l'écart de mobilité pour le SRAS-CoV-2. RÉSULTATS: Au cours des 51 semaines de l'étude, en tout, 888 751 personnes ont contracté le SRAS-CoV-2. Chaque augmentation de 10 % de l'écart de mobilité a été associée à une augmentation de 25 % du taux de croissance des cas hebdomadaires de SRAS-CoV-2 (rapport 1,25, intervalle de confiance à 95 % 1,20­1,29). Comparativement à la mobilité prépandémique de référence de 100 %, le seuil de mobilité a été plus élevé au cours de l'été (69 %, écart interquartile [EI] 67 %­70 %), et a chuté à 54 % pendant l'hiver 2021 (EI 52 %­55 %); un écart de mobilité a été observé au Canada entre juillet 2020 et la dernière semaine de décembre 2020. INTERPRÉTATION: La mobilité permet de prédire avec fiabilité et constance la croissance des cas hebdomadaires et il faut maintenir des niveaux faibles de mobilité pour maîtriser le SRAS-CoV-2 jusqu'à la fin du printemps 2021. Les données de mobilité anonymisées des téléphones intelligents peuvent servir à guider le relâchement ou le resserrement des mesures de distanciation physique provinciales et régionales.

Assessment of Hypertension Control Among Adults Participating in a Mobile Technology Blood Pressure Self-management Program.

Importance: It is unclear whether mobile technology hypertension self-management programs are associated with blood pressure (BP) control. Objective: To examine whether engagement with a hypertension self-management program with a BP monitor and connected smartphone application with clinically based digital coaching was associated with BP control during a follow-up period of as long as 3 years. Design, Setting, and Participants: This cohort study enrolled US adults with elevated BP or hypertension between January 1, 2015, and July 1, 2020. The hypertension self-management program was provided through the participant's (or their spouse's) employer health plan. Exposures: Program engagement, defined by average number of application sessions. Main Outcomes and Measures: Systolic and diastolic BP measured by a US Food and Drug Administration-cleared BP monitor, with categories defined as normal (systolic BP, <120 mm Hg), elevated (systolic BP, 120-129 mm Hg), stage 1 hypertension (systolic BP, 130-139 mm Hg), and stage 2 hypertension (systolic BP ≥140 mm Hg). Other measures included age, gender, depression, anxiety, diabetes, high cholesterol, smoking, geographic region, area deprivation index, self-reported weight, and device-measured physical activity (steps per day). Results: Among 28 189 participants (median [IQR] age, 51 [43-58] years; 9424 women [40.4%]; 13 902 men [59.6%]), median (IQR) baseline systolic BP was 129.5 mm Hg (120.5-139.6 mm Hg) and diastolic BP was 81.7 mm Hg (75.7-88.4 mm Hg). Median systolic BP at 1 year improved at least 1 category for 495 of 934 participants (53.0%) with baseline elevated BP, 673 of 966 (69.7%) with baseline stage 1 hypertension, and 920 of 1075 (85.7%) with baseline stage 2 hypertension. Participants in the program for 3 years had a mean (SEM) systolic BP reduction of 7.2 (0.4), 12.2 (0.7), and 20.9 (1.7) mm Hg compared with baseline for those starting with elevated, stage 1 hypertension, and stage 2 hypertension, respectively. Greater engagement was associated with lower systolic BP over time (high-engagement group: 131.2 mm Hg; 95% CI, 115.5-155.8 mm Hg; medium-engagement group: 133.4 mm Hg; 95% CI 116.3-159.5 mm Hg; low-engagement group: 135.5 mm Hg; 95% CI, 117.3-164.8 mm Hg; P < .001); these results persisted after adjusting for age, gender, depression, anxiety, diabetes, high cholesterol, smoking, area deprivation index rank, and US region, which was partially mediated by greater physical activity. A very high BP (systolic BP >180 mm Hg) was observed 11 637 times from 3778 participants. Greater engagement was associated with lower risk of very high BP; the estimated probability of a very high BP was greater in the low-engagement group (1.42%; 95% CI, 1.26%-1.59%) compared with the medium-engagement group (0.79%; 95% CI, 0.71%-0.87%; P < .001) and the high-engagement group (0.53%; 95% CI, 0.45%-0.60%; P < .001 for comparison with both groups). Conclusions and Relevance: The findings of this study suggest that a mobile technology hypertension self-management program can support long-term BP control and very high BP detection. Such programs may improve real-world BP monitoring and control.

Adherence and Association of Digital Proximity Tracing App Notifications With Earlier Time to Quarantine: Results From the Zurich SARS-CoV-2 Cohort Study.

Objectives: We aimed to evaluate the effectiveness of the SwissCovid digital proximity tracing (DPT) app in notifying exposed individuals and prompting them to quarantine earlier compared to individuals notified only by manual contact tracing (MCT). Methods: A population-based sample of cases and close contacts from the Zurich SARS-CoV-2 Cohort was surveyed regarding SwissCovid app use and SARS-CoV-2 exposure. We descriptively analyzed app adherence and effectiveness, and evaluated its effects on the time between exposure and quarantine among contacts using stratified multivariable time-to-event analyses. Results: We included 393 SARS-CoV-2 infected cases and 261 close contacts. 62% of cases reported using SwissCovid and among those, 88% received and uploaded a notification code. 71% of close contacts were app users, of which 38% received a warning. Non-household contacts notified by SwissCovid started quarantine 1 day earlier and were more likely to quarantine earlier than those not warned by the app (HR 1.53, 95% CI 1.15-2.03). Conclusion: These findings provide evidence that DPT may reach exposed contacts faster than MCT, with earlier quarantine and potential interruption of SARS-CoV-2 transmission chains.

Sociodemographic characteristics determine download and use of a Corona contact tracing app in Germany-Results of the COSMO surveys.

During the SARS-CoV-2 pandemic mobile health applications indicating risks emerging from close contacts to infected persons have a large potential to interrupt transmission chains by automating contact tracing. Since its dispatch in Germany in June 2020 the Corona Warn App has been downloaded on 25.7 Mio smartphones by February 2021. To understand barriers to download and user fidelity in different sociodemographic groups we analysed data from five consecutive cross-sectional waves of the COVID-19 Snapshot Monitoring survey from June to August 2020. Questions on the Corona Warn App included information on download, use, functionality, usability, and consequences of the app. Of the 4,960 participants (mean age 45.9 years, standard deviation 16.0, 50.4% female), 36.5% had downloaded the Corona Warn App. Adjusted analysis found that those who had downloaded the app were less likely to be female (Adjusted Odds Ratio for men 1.16 95% Confidence Interval [1.02;1.33]), less likely to be younger (Adjusted Odds Ratio for age 18 to 39 0.47 [0.32;0.59] Adjusted Odds Ratio for age 40 to 64 0.57 [0.46;0.69]), less likely to have a lower household income (AOR 0.55 [0.43;0.69]), and more likely to live in one of the Western federal states including Berlin (AOR 2.31 [1.90;2.82]). Willingness to disclose a positive test result and trust in data protection compliance of the Corona Warn App was significantly higher in older adults. Willingness to disclose also increased with higher educational degrees and income. This study supports the hypothesis of a digital divide that separates users and non-users of the Corona Warn App along a well-known health gap of education, income, and region.

Does Google Fit provide valid energy expenditure measurements of functional tasks compared to those of Fibion accelerometer in healthy individuals? A cross-sectional study.

BACKGROUND AND AIMS: Smartphone applications (e.g., Google Fit) may be a good alternative tool for accelerometers in estimating energy expenditure of physical activities because they are affordable, easy to use, and freely downloadable on smartphones. We aimed to determine the concurrent validity of the Fibion and Google Fit for measuring energy expenditure of functional tasks in healthy individuals. METHODS: In this cross-sectional study, 28 healthy individuals (21.25 ± 1.84 years) performed certain tasks (lying, standing, 6-min walk test, treadmill walking, stair climbing and cycling) for ∼90 min, while wearing a Fibion accelerometer on their thigh and having the Google Fit application in a smartphone placed in their trouser pocket. Concurrent validity between the energy expenditure data of the Google Fit and Fibion was assessed using the Spearman rho correlation coefficient (data were not normally distributed), Bland-Altman plots and linear regression. RESULTS: Neither energy expenditure for the whole duration nor for the tasks, except sitting + treadmill walking (r = 0.419, p = 0.027), showed significant correlations between the Google Fit and Fibion measurements. A proportional bias was evident for almost all comparisons. CONCLUSIONS: The Google Fit did not provide valid energy expenditure measurements compared to the Fibion for most of the investigated tasks in healthy individuals.

Development and usability testing of mobile application on diet and oral health.

In several nations, caries in pre-school children remain a significant oral health issue. In an outbreak period such as the Coronavirus disease 2019 (COVID-19), remote contact and education aimed at the prevention of oral diseases and the preservation of children's oral health are more relevant than ever. Currently, the amount of published applications is far higher than the published scientific studies while the problems of usability remains vulnerable. The goal of this paper was to comprehensively document the phase of development and usability testing of a mobile application for diet and oral health, namely Gigiku Sihat, which was primarily intended to be used by parents and guardians of pre-school children. The mobile application was developed using the System Development Life Cycle principle. Apart from searching for the available oral health application on Android platform, the initial requirement gathering process consisted of situational analysis, concept generation, content development, and features and functional requirement determination. The mobile application design and implementation evolved at each phase before being finalised. Gigiku Sihat was successfully developed in the Bahasa Malaysia. Finalised Gigiku Sihat was installed on mobile devices to determine the usability using translated and validated System Usability Scale questionnaire namely Skala Kebolehgunaan Aplikasi Mudah Alih (SKAMA). The mean score usability with score of 68 and above was deemed to have good usability. This study found that Gigiku Sihat mean (SD) usability score was 77.0 (14.18). The results were promising as they showed that Gigiku Sihat had a good usability. Thus, the development of this mobile application focusing on diet and oral health served as a new source of oral health education and provided a necessary foundation in developing future improved mobile application development for parents in the prevention of early childhood caries.

Local- and regional-scale racial and ethnic disparities in air pollution determined by long-term mobile monitoring.

Disparity in air pollution exposure arises from variation at multiple spatial scales: along urban-to-rural gradients, between individual cities within a metropolitan region, within individual neighborhoods, and between city blocks. Here, we improve on existing capabilities to systematically compare urban variation at several scales, from hyperlocal (<100 m) to regional (>10 km), and to assess consequences for outdoor air pollution experienced by residents of different races and ethnicities, by creating a set of uniquely extensive and high-resolution observations of spatially variable pollutants: NO, NO2, black carbon (BC), and ultrafine particles (UFP). We conducted full-coverage monitoring of a wide sample of urban and suburban neighborhoods (93 km2 and 450,000 residents) in four counties of the San Francisco Bay Area using Google Street View cars equipped with the Aclima mobile platform. Comparing scales of variation across the sampled population, greater differences arise from localized pollution gradients for BC and NO (pollutants dominated by primary sources) and from regional gradients for UFP and NO2 (pollutants dominated by secondary contributions). Median concentrations of UFP, NO, and NO2 are, for Hispanic and Black populations, 8 to 30% higher than the population average; for White populations, average exposures to these pollutants are 9 to 14% lower than the population average. Systematic racial/ethnic disparities are influenced by regional concentration gradients due to sharp contrasts in demographic composition among cities and urban districts, while within-group extremes arise from local peaks. Our results illustrate how detailed and extensive fine-scale pollution observations can add new insights about differences and disparities in air pollution exposures at the population scale.

Industry and workplace characteristics associated with the downloading of a COVID-19 contact tracing app in Japan: a nation-wide cross-sectional study.

BACKGROUND: To combat coronavirus disease 2019 (COVID-19), many countries have used contact tracing apps, including Japan's voluntary-use contact-confirming application (COCOA). The current study aimed to identify industry and workplace characteristics associated with the downloading of this COVID-19 contact tracing app. METHODS: This cross-sectional study of full-time workers used an online survey. Multiple logistic regression analysis was used to evaluate the associations of industry and workplace characteristics with contact tracing app use. RESULTS: Of the 27,036 participants, 25.1% had downloaded the COCOA. Workers in the public service (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] 1.14-1.45) and information technology (aOR = 1.38, 95% CI 1.20-1.58) industries were more likely to use the app than were those in the manufacturing industry. In contrast, app usage was less common among workers in the retail and wholesale (aOR = 0.87, 95% CI 0.76-0.99) and food/beverage (aOR = 0.81, 95% CI 0.70-0.94) industries, but further adjustment for company size attenuated these associations. Workers at larger companies were more likely to use the app. Compared with permanent employees, the odds of using the app were higher for managers and civil servants but lower for those who were self-employed. CONCLUSIONS: Downloading of COCOA among Japanese workers was insufficient; thus, the mitigating effect of COCOA on the COVID-19 pandemic is considered to be limited. One possible reason for the under-implementation of the contact tracing app in the retail and wholesale and food/beverage industries is small company size, as suggested by the fully adjusted model results. An awareness campaign should be conducted to promote the widespread use of the contact tracing app in these industries.