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2.
Epidemiol Psychiatr Sci ; 29: e100, 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32000876

RESUMO

There are tens of thousands of mental health-related apps available today - representing extreme duplication in this digital age. Instead of a plethora of apps, there is a need for a few that meet the needs of many. Focusing on transparency and free sharing of software, we argue that a collaborative approach towards apps can advance care through creating customisable and future proofed digital tools that allow all stakeholders to engage in their design and use.


Assuntos
Serviços de Saúde Mental/organização & administração , Saúde Mental , Aplicativos Móveis , Telemedicina/métodos , Tecnologia Biomédica , Humanos , Transtornos Mentais/terapia , Software
3.
Artigo em Alemão | MEDLINE | ID: mdl-31915866

RESUMO

Digital public health promises not only more comprehensive medical care, but also individual health promotion and support for positive lifestyle changes. Mobile digital health devices and services, also called mobile health (mHealth), play a key role in this. They include health-specific hardware and software applications such as smartphone apps and wearable technology for recording, monitoring, and evaluating specific health parameters. Although there is scientific evidence for the effectiveness of individual applications, most often applications are used for a relatively short amount of time. In order to achieve a higher acceptance and utilization rate, evidence is needed that is more practice oriented.This paper explains how participatory development approaches take into account the individual needs and preferences of users and can improve the quality and effectiveness of mHealth services. The sociodemographic characteristics of the target group as well as individual, social, linguistic, and cultural barriers should be considered. The wishes of users, for example personalization, transmission of real-time information, and transparency in terms of privacy should also be considered. In the co-design approach, users are therefore included directly in the product concept. However, the study situation is still limited and there are no methodical approaches.In order to increase the use of mHealth services in the future, participation processes should be systematized. In addition, a framework for classification and certification as well as procedures for promoting effective applications should be developed.


Assuntos
Aplicativos Móveis , Saúde Pública , Telemedicina , Assistência à Saúde , Alemanha , Promoção da Saúde , Humanos
5.
Medicine (Baltimore) ; 99(4): e18934, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977910

RESUMO

INTRODUCTION: Interventions aimed at addressing subthreshold depression (StD) are important to prevent the onset of major depressive disorder. Our video playback application (SPSRS) is designed to reduce depressive symptoms by presenting positive words in videos, shedding new light on the treatment of StD. However, no randomized controlled trial (RCT) has utilized this video playback application for the treatment of individuals with StD. Therefore, a pilot RCT was designed to determine the feasibility of a full-scale trial. We herein present a study protocol for investigating the utility of a video playback application intervention for individuals with StD. METHODS: This 5-week, single-blind, 2-arm, parallel-group, pilot RCT will determine the effectiveness of the video playback application by comparing individuals who had and had not been exposed to the same. A total of 32 individuals with StD will be randomly assigned to the experimental or control group at a 1:1 ratio. The experimental group will receive a 10-minute intervention containing the video playback application per day, whereas the control group will receive no intervention. The primary outcome will include changes in the Center for Epidemiologic Studies Depression Scale score after the 5-week intervention, while secondary outcomes will include changes in the Kessler Screening Scale for psychological distress and the generalized anxiety disorder 7-item scale score after the 5-week intervention. Statistical analysis using linear mixed models with the restricted maximum likelihood estimation method will then be performed. DISCUSSION: This pilot RCT will have been the first to explore the utility of SPSRS application interventions that display positive words in videos for individuals with StD. The results of this pilot trial are expected to help in the design and implementation of a full-scale RCT that investigates the effects of SPSRS applications among individuals with StD. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04136041.


Assuntos
Depressão/terapia , Aplicativos Móveis , Smartphone , Estudos de Viabilidade , Projetos Piloto , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
Int J Dent Hyg ; 18(1): 73-83, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31291683

RESUMO

OBJECTIVE: To evaluate the effectiveness of the WhiteTeeth mobile app, a theory-based mobile health (mHealth) program for promoting oral hygiene in adolescent orthodontic patients. METHODS: In this parallel randomized controlled trial, the data of 132 adolescents were collected during three orthodontic check-ups: at baseline (T0), at 6-week follow-up (T1) and at 12-week follow-up (T2). The intervention group was given access to the WhiteTeeth app in addition to usual care (n = 67). The control group received usual care only (n = 65). The oral hygiene outcomes were the presence and the amount of dental plaque (Al-Anezi and Harradine plaque index), and the total number of sites with gingival bleeding (Bleeding on Marginal Probing Index). Oral health behaviour and its psychosocial factors were measured through a digital questionnaire. We performed linear mixed-model analyses to determine the intervention effects. RESULTS: At 6-week follow-up, the intervention led to a significant decrease in gingival bleeding (B = -3.74; 95% CI -6.84 to -0.65) and an increase in the use of fluoride mouth rinse (B = 1.93; 95% CI 0.36 to 3.50). At 12-week follow-up, dental plaque accumulation (B = -11.32; 95% CI -20.57 to -2.07) and the number of sites covered with plaque (B = -6.77; 95% CI -11.67 to -1.87) had been reduced significantly more in the intervention group than in the control group. CONCLUSIONS: The results show that adolescents with fixed orthodontic appliances can be helped to improve their oral hygiene when usual care is combined with a mobile app that provides oral health education and automatic coaching. Netherlands Trial Registry Identifier: NTR6206: 20 February 2017.


Assuntos
Placa Dentária , Aplicativos Móveis , Adolescente , Índice de Placa Dentária , Humanos , Países Baixos , Higiene Bucal
9.
Arch Dis Child Fetal Neonatal Ed ; 105(1): 41-44, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31101662

RESUMO

BACKGROUND: Clinical assessment of newborn heart rate (HR) at birth has been reported to be inaccurate. NeoTapAdvancedSupport (NeoTapAS) is a free-of-charge mobile application that showed good accuracy in HR estimation. This study aimed to evaluate the impact of NeoTapAS on timing of HR communication and resuscitation interventions. METHODS: This was a randomised controlled cross-over (AB/BA) study evaluating HR assessment using auscultation plus NeoTapAS compared with auscultation plus mental computation in a high-fidelity simulated newborn resuscitation scenario. Twenty teams each including three paediatric residents were randomly assigned to AB or BA arms. The primary outcome was the timing of the first HR communication. Secondary outcomes included the timing of the following four HR communications and the timing of resuscitation interventions (positive pressure ventilation, chest compressions, intubation and administration of first dose of epinephrine). RESULTS: NeoTapAS reduced the time to the first HR communication (mean difference -13 s, 95% CI -23 to -4; p=0.009), and the time of initiation of chest compressions (mean difference -68 s, 95% CI -116 to -18; p=0.01) and administration of epinephrine (mean difference -76 s, 95% CI -115 to -37; p=0.0004) compared with mental computation. CONCLUSIONS: In a neonatal resuscitation simulated scenario, NeoTapAS reduced the time to the first HR communication and the time of initiation of chest compressions and administration of epinephrine compared with mental computation. This app can be especially useful in settings with limited availability of monitoring equipment, but further studies in clinical scenarios are warranted. TRIAL REGISTRATION NUMBER: NCT03730025.


Assuntos
Aplicativos Móveis , Ressuscitação , Asfixia Neonatal/terapia , Auscultação , Broncodilatadores/administração & dosagem , Reanimação Cardiopulmonar , Comunicação , Estudos Cross-Over , Epinefrina/administração & dosagem , Frequência Cardíaca , Humanos , Recém-Nascido , Intubação Intratraqueal , Manequins , Respiração com Pressão Positiva
13.
J Oncol Pharm Pract ; 26(1): 105-115, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30955468

RESUMO

OBJECTIVE: To design a mobile app based on the needs of the onco-hematological patient receiving oral antineoplastic agents. METHODS: A multidisciplinary working group (pharmacy-oncology-hematology) was created to design the app. The study was developed in three phases: first, we analyzed the features of patients receiving oral antineoplastic agents. We then analyzed available apps for cancer patients. Finally, we designed the app's functionalities. RESULTS: We included 51 patients with middle-advanced age (68.7 years (SD=10.7)). They were polymedicated (mean: 5.3 (SD = 2.7), with numerous drug-drug interactions and adverse effects (all patients presented adverse effects). We then analyzed 166 apps. Most apps had more than one use, the most frequent being information (39.8%) and diagnosis (38.6%). Ten apps (6%) were for registering and monitoring treatment and adverse effects. Almost half of the apps (48.8%) were developed by healthcare organizations. Finally, we designed an app (e-OncoSalud®) with the following functionalities: (a) agenda; (b) treatment and drug interactions checker; (c) continuous recording of self-controls (weight, blood pressure, general condition) and adverse effects. The management of the adverse effects are based on an algorithm which provides different recommendations according to the adverse effects severity; (d) patient-pharmacist messaging in real-time; (e) education. CONCLUSIONS: After analysis of the main problems affecting these patients and the needs not covered by the existing apps, we designed e-OncoSalud®. It integrates relevant information about their treatment, focused on drug interactions identification and the prevention, and management of adverse effects.


Assuntos
Antineoplásicos/administração & dosagem , Aplicativos Móveis , Neoplasias/tratamento farmacológico , Smartphone , Telemedicina/métodos , Administração Oral , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis/tendências , Neoplasias/diagnóstico , Smartphone/tendências , Telemedicina/tendências
15.
Afr J Reprod Health ; 23(3): 68-78, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31782633

RESUMO

The Saving Mothers Project was conducted from September 2015 to March 2017 in Bunda and Tarime Districts, Mara Region, Tanzania. The purpose of this project was to train community health workers (CHWs) to use mobile phones applications to register and educate pregnant women about safe deliveries and encourage them to access skilled health care providers for antenatal care and delivery, and to provide nurses and CHWs with clean birth kits with misoprostol to distribute to women. The birth kits were for use in case women could not access the health facility, or if the health facility was lacking supplies at the time of delivery. The overall goal of the study was to reduce the maternal mortality rate by increasing women's access to health services where possible, and to clean supplies when a non-facility birth was unavoidable. This paper reports on a mixed methods evaluation of the project including a survey of over two thousand four hundred women, and focus groups with women, community health workers, and nurses participating in the project. The results of the survey and focus groups demonstrate a high degree of satisfaction with the birth kits and misoprostol and an increase in facility birth rates where the project was implemented. Differences between the two districts illustrate that policy maker support is key to successful implementation.


Assuntos
Agentes Comunitários de Saúde/educação , Acesso aos Serviços de Saúde , Serviços de Saúde Materna/organização & administração , Mortalidade Materna , Tocologia/educação , Misoprostol/provisão & distribução , Ocitócicos/provisão & distribução , Hemorragia Pós-Parto/prevenção & controle , Adulto , Telefone Celular , Feminino , Humanos , Misoprostol/administração & dosagem , Aplicativos Móveis , Ocitócicos/administração & dosagem , Guias de Prática Clínica como Assunto , Gravidez , Resultado da Gravidez , Gestantes , Cuidado Pré-Natal , População Rural , Tanzânia , Adulto Jovem
16.
Zhonghua Nei Ke Za Zhi ; 58(12): 889-893, 2019 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-31775451

RESUMO

Objective: To evaluate the effect of mobile application (APP) based interactive peer support on glycemic control in patients with type 1 diabetes mellitus (T1DM). Methods: The data of the present study were from the largest mobile APP platform for patients with T1DM in China, Tangtangquan. Patients with T1DM who has registered in the APP for at least 1 year and had completed data entry were recruited. According to the monthly interaction index during the first year of APP registration (including four indicators: praise, comment, posting and collection), the eligible patients were divided into the high-interaction group and the low-interaction group. The changes from baseline of self-blood glucose monitoring frequency (SMBG), glycosylated hemoglobin (HbA1c), incidence of hyperglycemia and incidence of hypoglycemia were compared between the two groups after one year of using the APP. Results: A total of 238 patients with T1DM with an age of (27±8) years were included. Among them, 77.3% (184/238) were female. The baseline SMBG [the low-interaction group (1.71±1.14) times/day vs. the high-interaction group (1.82±1.15) times/day] and HbA1c [the low-interaction group (6.72±0.99)% vs. the high-interaction group (6.76±1.04)%] were comparable between the two groups. After one year use of the APP, the frequency of SMBG in the high-interaction group was significantly higher than that in the low-interaction group [ΔSMBG (0.59+2.06) times/d vs. (0.08+1.69) times/d, t=4.280, P=0.04), and the reduction of HbA1c was more obvious in the high-interaction group [ΔHbA1c (-0.40+1.10)% vs. (-0.06+1.13)%, t=5.651, P=0.018] than in the lower-interaction group. The incidence of hyperglycemia in the high-interaction group was significantly lower than that in the low-interaction group [13.19(6.22,23.19)% vs. 17.69(10.56,30.49)%, Z=2.850, P=0.005]. There was no significant difference in the incidence of hypoglycemia between the two groups [4.62(2.14, 8.03)% vs. 4.83(2.06, 8.87)%, Z=1.276, P=0.204]. The correlation analysis showed that interaction index was significantly associated with the reduction of HbA1c and incidence of hyperglycemia. Conclusion: Participation in interactive peer education via mobile APP may be beneficent for glycemic control in patients with T1DM.


Assuntos
Automonitorização da Glicemia/métodos , Diabetes Mellitus Tipo 1/sangue , Aplicativos Móveis , Grupo Associado , Adulto , Glicemia , China , Diabetes Mellitus Tipo 1/epidemiologia , Feminino , Hemoglobina A Glicada , Humanos , Hiperglicemia/epidemiologia , Incidência , Pessoa de Meia-Idade , Cooperação do Paciente
17.
Adv Exp Med Biol ; 1192: 583-627, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705515

RESUMO

Mental disorders are highly prevalent and often remain untreated. Many limitations of conventional face-to-face psychological interventions could potentially be overcome through Internet-based and mobile-based interventions (IMIs). This chapter introduces core features of IMIs, describes areas of application, presents evidence on the efficacy of IMIs as well as potential effect mechanisms, and delineates how Artificial Intelligence combined with IMIs may improve current practices in the prevention and treatment of mental disorders in adults. Meta-analyses of randomized controlled trials clearly show that therapist-guided IMIs can be highly effective for a broad range of mental health problems. Whether the effects of unguided IMIs are also clinically relevant, particularly under routine care conditions, is less clear. First studies on IMIs for the prevention of mental disorders have shown promising results. Despite limitations and challenges, IMIs are increasingly implemented into routine care worldwide. IMIs are also well suited for applications of Artificial Intelligence and Machine Learning, which provides ample opportunities to improve the identification and treatment of mental disorders. Together with methodological innovations, these approaches may also deepen our understanding of how psychological interventions work, and why. Ethical and professional restraints as well as potential contraindications of IMIs, however, should also be considered. In sum, IMIs have a high potential for improving the prevention and treatment of mental health disorders across various indications, settings, and populations. Therefore, implementing IMIs into routine care as both adjunct and alternative to face-to-face treatment is highly desirable. Technological advancements may further enhance the variability and flexibility of IMIs, and thus even further increase their impact in people's lives in the future.


Assuntos
Inteligência Artificial , Transtornos Mentais/terapia , Aplicativos Móveis , Psicoterapia/métodos , Adulto , Humanos , Internet , Telemedicina
18.
Adv Exp Med Biol ; 1192: 629-641, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705516

RESUMO

Cognitive behavioral therapy for insomnia (CBT-I) is the treatment of choice for insomnia; however, it is not widely used due to a lack of experienced therapists and its relatively high clinical cost. Recently, Internet and mobile CBT-I have been developed to replace face-to-face CBT-I, and research on this topic has been increasing. In addition, attempts have been made to use wearable devices for sleep-wake estimation. Studies on digital CBT-I thus far have shown favorable treatment effects in general, but the problem of a high dropout rate has not been sufficiently improved. In addition, more sophisticated technology is needed to develop fully automated digital CBT-I. As part of efforts to maximize the treatment effectiveness of future insomnia patients, research and development of mobile and Internet CBT-I and improvement of sleep tracker accuracy and validation studies are needed.


Assuntos
Terapia Cognitivo-Comportamental , Aplicativos Móveis , Distúrbios do Início e da Manutenção do Sono/terapia , Dispositivos Eletrônicos Vestíveis , Humanos , Internet , Sono , Resultado do Tratamento
19.
BMC Public Health ; 19(1): 1510, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718597

RESUMO

BACKGROUND: At a population level, small reductions in energy intake have the potential to contribute to a reduction in the prevalence of childhood obesity. In many school systems, there is the potential to achieve a reduction in energy intake through modest improvements in foods packed in children's school lunchboxes. This study will assess the effectiveness and cost-effectiveness of a multi-component intervention that uses an existing school-based communication application to reduce the kilojoule content from discretionary foods and drinks consumed by children from school lunchboxes whilst at school. METHODS: A Type I hybrid effectiveness-implementation cluster randomised controlled trial will be conducted in up to 36 primary schools in the Hunter New England, Central Coast and Mid North Coast regions of New South Wales, Australia. Designed using the Behaviour Change Wheel, schools will be randomly allocated to receive either a 5-month (1.5 school terms) multi-component intervention that includes: 1) school lunchbox nutrition guidelines; 2) curriculum lessons; 3) information pushed to parents via an existing school-based communication application and 4) additional parent resources to address common barriers to packing healthy lunchboxes or a control arm (standard school practices). The study will assess both child level dietary outcomes and school-level implementation outcomes. The primary trial outcome, mean energy (kJ) content of discretionary lunchbox foods packed in children's lunchboxes, will be assessed at baseline and immediately post intervention (5 months or 1.5 school terms). Analyses will be performed using intention to treat principles, assessing differences between groups via hierarchical linear regression models. DISCUSSION: This study will be the first fully powered randomised controlled trial internationally to examine the impact of an m-health intervention to reduce the mean energy from discretionary food and drinks packed in the school lunchbox. The intervention has been designed with scalability in mind and will address an important evidence gap which, if shown to be effective, has the potential to be applied at a population level. TRIAL REGISTRATION: Australian Clinical Trials Registry ACTRN:12618001731280 registered on 17/10/2018. Protocol Version 1.


Assuntos
Dieta , Promoção da Saúde/métodos , Almoço , Obesidade Pediátrica/prevenção & controle , Serviços de Saúde Escolar , Instituições Acadêmicas , Telemedicina , Criança , Pré-Escolar , Comunicação , Análise Custo-Benefício , Currículo , Dieta/normas , Ingestão de Energia , Feminino , Humanos , Masculino , Aplicativos Móveis , New South Wales , Política Nutricional , Pais , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa
20.
Rev Assoc Med Bras (1992) ; 65(10): 1321-1326, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31721966

RESUMO

BACKGROUND: Technological advances of the 21st century have provided greater communication, regardless of socioeconomic class and age group. Actions to promote the development of health applications are emerging around the world. OBJECTIVE: To provide a perspective on the viability and usability of mobile applications dedicated to radiotherapy patients for remote support to health professionals proposing solutions to encourage Brasil in the development of these digital tools. METHODS: Cross-sectional exploratory study by systematic review and literature review. We searched the PubMed, BVS, IBGE, and WHO databases, from 2014 to 2018. RESULTS: 6 articles were found with topics related to the use of mobile applications in the health area, two of which were published in Portuguese and four in the English, on oncology, from 2014 to 2018. CONCLUSIONS: We did not find an expressive number of works on this subject in Brasil. Mobile applications have the potential to assist in the remote support of radiotherapy patients. The latest studies suggest the need for a regulation of data protection protocols to be deployed.


Assuntos
Oncologia/instrumentação , Aplicativos Móveis , Radioterapia/instrumentação , Telemedicina/instrumentação , Brasil , Telefone Celular/instrumentação , Comunicação , Estudos Transversais , Pessoal de Saúde , Humanos , Interface Usuário-Computador
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