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Introduction: Anxiety and depression are major causes of disability in Arab countries, yet resources for mental health services are insufficient. Mobile devices may improve mental health care delivery (mental m-Health), but the Arab region's mental m-Health app landscape remains under-documented. This study aims to systematically assess the features, quality, and digital safety of mental m-Health apps available in the Arab marketplace. We also contrast a set of recommended Australian apps to benchmark current strategies and evidence-based practices and suggest areas for improvement in Arabic apps. Methods: Fifteen Arab country-specific iOS Apple Stores and an Android Google Play Store were searched. Apps that met the inclusion criteria were downloaded and evaluated using the Mobile App Rating Scale (MARS) and the Mobile App Development and Assessment Guide (MAG). Results: Twenty-two apps met the inclusion criteria. The majority of apps showed no evidence of mental health experts being involved in the app design processes. Most apps offered real-time communication with specialists through video, text, or audio calls rather than evidence-based self-help techniques. Standardized quality assessment showed low scores for design features related to engagement, information, safety, security, privacy, usability, transparency, and technical support. In comparison to apps available in Australia, Arabic apps did not include evidence-based interventions like CBT, self-help tools and crisis-specific resources, including a suicide support hotline and emergency numbers. Discussion: In conclusion, dedicated frameworks and strategies are required to facilitate the effective development, validation, and uptake of Arabic mental mHealth apps. Involving end users and healthcare professionals in the design process may help improve app quality, dependability, and efficacy. [ABSTRACT FROM AUTHOR]

Background: This pilot study aimed to provide supportive evidence for the feasibility of conducting a full-scale intervention trial with patients newly diagnosed with head and neck cancer (HNC). This included assessing the acceptability and potential usefulness of the PTSD Coach mobile app as an early self-management intervention that gives information about anxiety symptoms, offers self-assessment of symptoms with feedback, tools to self-manage anxiety, and connects to support. Methods: A three-arm randomized controlled trial was conducted. The primary pilot study questions related to feasibility were: (1) can we recruit enough (i.e., n = 60 over 8 months or 8/month) and retain a sufficient proportion (i.e., ≥ 85% at three months post-randomization, having completed the primary outcome) of patients with HNC in all trial arms? (2) Will there be at least a 90% completion rate of PTSD Coach within 3 weeks from randomization? (3) Will at least 85% of the content for each module of PTSD Coach be completed? (4) Will there be at least a 90% completion rate of the attention-control tasks (i.e., 45 min/week over 3 weeks)? (5) What would be the anticipated sample size for a full study? (6) We also explored a signal for intervention effects on 1-, 3-, and 6-month levels of cancer-related anxiety, quality of life, anxiety and depression, self-stigma of seeking help, and professional psycho-oncology service uptake. Results: Participants comprised 39 patients (11 experimental group (EG), 13 attention-control (AC), 15 usual care (UC)), primarily male (82%). Enrolment was lower than expected, with strategies implemented to increase the study's participation rate (i.e., shortening the questionnaire, more relevant AC games, pacing study components, and enlarging eligibility to 4 weeks post-diagnosis instead of 2). Retention rates, intervention completion rates, and completion time were adequate. The intervention was acceptable with all patients (100%) who received PTSD Coach reporting it a positive experience and that they would recommend it to others. When compared to UC, there was a signal for the PTSD Coach group to report lower 3-month cancer-related anxiety (PCL-S; eta squared = 0.013), lower anxiety and depression (HADS; eta squared = 0.015), anxiety (HADS-A; eta squared = 0.028), and higher functional wellbeing (FACT-FW; eta squared = 0.09), based on effect sizes calculated across all three groups. The sample size for a full study was estimated to be 118 to 154 per group. Conclusion: A repeat pilot study with an expanded oncology population is warranted to further investigate feasibility prior to a full Phase III study. PTSD Coach could be a valuable self-management tool as an initial stepped-care approach intervention in patients newly diagnosed with HNC. Trial registration: ClinicalTrials.gov, NCT03651570. Registered June 26, 2018. [ABSTRACT FROM AUTHOR]

Background: Reminders via digital technology offer a novel and efficient means to address medication forgetfulness, as they are easily accessible and user-friendly for patients. In particular mobile text message reminders are more suitable for chronic patients, as they require few technical skills, can operate without internet connectivity, and are less expensive than other technologies. This study aimed to assess the intention to use mobile text message reminders for medication adherence among hypertensive patients at the Gondar City health facilities. Methods: A facility-based cross-sectional study was conducted. A simple random sampling method was used to select 423 hypertensive patients. Data was collected from April 1 to May 15, 2023. Data was collected using Kobo Toolbox, and the collected data was exported to MS Excel. Subsequently, the data was imported and analyzed using the SPSS version 20. Binary and multivariable logistic regression analysis was employed to assess factors associated with the outcome variable. Result: The finding indicates that 64.5% of the patients have an Intention to use mobile text message reminders for medication adherence. Perceived usefulness (AOR = 2.53: 95%CI: 1.41, 4.52), perceived ease of use (AOR = 3.28: 95% CI: 1.81, 5.95), forgetting to take medication (AOR = 2.20: 95%CI: 1.38, 3.50) and patient holds their mobile phone always (AOR = 1.96: 95%CI: 1.04, 3.68) were associated factors with outcome variable. Conclusion: Forget taking medication, the patient holds their mobile phone always, Perceived ease of use and Perceived usefulness were significantly associated with the outcome variable. We recommend designing and implementing user-friendly text message reminder systems and educating hypertensive patients about the system's benefits. [ABSTRACT FROM AUTHOR]

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 IMPLICATIONS FOR REHABILITATION: 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 depression Introducing 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. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the impact of Mobile health (M-health) on medication time adherence among people living with HIV/AIDS (PLWHA). Methods: The study included all PLWHA who were receiving care at the Federal University Teaching Hospital Owerri (FUTH) and Imo State Specialist Hospital (ISSH) Umugumma during the study duration. The test group (FUTH) received a 2-way text message sent three times a week and a once-a-week phone call, while the control group (ISSH) received only the standard care. Findings: The result shows that the adherence was higher among PLWHA in the test group compared to those in the control group (P = 0.000, χ2 = 168.62, 95% confidence interval (CI): 7.22 to 16.19). Conclusion: M-health intervention significantly improved the medication time adherence among the participants in the test group compared to those in the control group. [ABSTRACT FROM AUTHOR]

Copyright of Hoitotiede is the property of Hoitotieteiden Tutkimusseura HTTS r.y. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Issue Addressed: Australian children fall short of meeting the dietary, physical activity and sedentary behaviour guidelines. This study aimed to test the feasibility, acceptability and potential efficacy of a parental text message and social media program on, primarily, their school‐aged children's vegetable consumption and movement behaviours, and, secondarily, their own. Methods: Between August and November 2022, we conducted a two‐armed randomised controlled trial with 242 parents/caregivers of primary school‐aged children in New South Wales. The 'Adventure & Veg' intervention ran for 8 weeks, promoting vegetable eating behaviours, local outdoor physical activity opportunities and ideas for reducing screen time. Feasibility and acceptability were assessed via recruitment and retention data, intervention metrics and self‐reported participant data. Vegetable intake and movement behaviour data were collected via online‐surveys and effect sizes were examined. Results: Most participants reported that they enjoyed receiving the text messages (88%) and the delivery frequency was acceptable (94%). Limitations to Facebook as a delivery platform were reported. The majority of participants used the text messages to influence the vegetable eating (65%) and movement (77%) behaviours of their child. Significant effects were observed among intervention child participants compared with control for mean daily vegetable consumption (0.45 serves, CI:.19;.71, p =.001, d =.5); weekly vegetable variety (1.85, CI:.25; 3.45, p <.001, d =.6); and weekly physical activity variety (.64 CI:.09; 1.19, p =.022, d =.3). Parents in the intervention group increased their daily vegetable intake by.44 serves (CI:.11;.78, p =.01, d =.4). Conclusions: A parental text message and social media program has potential to support children's vegetable intake and movement behaviours. Further research is required to explore different online delivery methods to promote local outdoor activity options. So What?: The Adventure & Veg program holds promise as a stand‐alone health promotion intervention or as a useful adjunct to current family or school‐based healthy lifestyle programs. [ABSTRACT FROM AUTHOR]

Background: Pediatric obesity treatment is based on high-intensity lifestyle counseling. However, high dropout rates and low effectiveness have been reported, even in specialized centers. Mobile health technologies have been used to overcome these limits with contrasting results. This study aims at evaluating the effectiveness of a six-month intervention with a mobile app for the treatment of pediatric obesity at 6 and 12 months of follow-up. Methods: Seventy-five patients were randomly assigned to standard care or standard care plus mobile app (2:1) using an online randomizer system. The mobile app delivered high-intensity lifestyle counseling for diet and physical activity. Results: At six months of follow-up, the M-App group showed significantly lower dropout rates compared to standard care (p = 0.01). The risk of dropout was significantly higher in controls compared to the intervention group (OR 3.86, 95% C.I. 1.39–10.42, p = 0.01). After one year, we observed lower albeit non-statistically significant dropout rates in the M-App compared to the standard care group (p = 0.24). No differences were observed in z-score BMI and percentage of BMI reduction between the two groups. Conclusions: Our findings suggest that the mobile app might help in the clinical management of children and adolescents with obesity in terms of dropout reduction. [ABSTRACT FROM AUTHOR]

In recent years, increasing attention has been paid to identifying new approaches to improve workplace well-being and manage stress with the help of m-health solutions. The primary purpose of this review is to provide an overview of the current use of smartphone applications integrated with wearable technologies in stress management and the promotion of well-being in the workplace. A key terms literature search was performed using multiple electronic databases. The review process followed the international PRISMA statement guidelines. A quality assessment was conducted using the Mixed Methods Appraisal Tool. A total of 25 eligible papers published between 2016 and 2023 were included. Interventions proposed were heterogeneous and primarily based on smartphone applications (72%). 84% of the interventions had background theories, with a high preference for Mindfulness. Interventions were reported as generally significant, and the combined use of smartphone applications and wearable technologies increased awareness at the individual and collective levels. In conclusion, the review demonstrates how the interventions developed through the synergy of technologies can effectively promote well-being and reduce stress in the workplace context, decreasing the stigma still related to mental health and increasing peer support strategies. This work opens the doors to several possibilities for future research. It could be interesting to indagate more in-depth the value of integration between technologies and, eventually, the integration with more traditional type of interventions, e.g., face-to-face activities, evaluating if this synergy can amplify and strengthen the results. Protocol registration: The review protocol was registered with PROSPERO: CRD42023423126 (May 2nd, 2023). [ABSTRACT FROM AUTHOR]

Background: Interest in mental health smartphone applications has grown in recent years. Despite their effectiveness and advantages, special attention needs to be paid to two aspects to ensure app engagement: to include patients and professionals in their design and to guarantee their usability. The aim of this study was to analyse the perceived usability and quality of the preliminary version of RegulEm, an app based in the Unified Protocol, as part of the second stage of the app development. Methods: A parallel mixed methods study was used with 7 professionals and 4 users who were previously involved in the first stage of the development of the app. MARS, uMARS and SUS scales were used, and two focus groups were conducted. Descriptive statistical analysis and a thematic content analysis were performed in order to gather as much information as possible on RegulEm's usability and quality as well as suggestions for improvement. Results: RegulEm's usability was perceived through the SUS scale scores as good by users (75 points) and excellent by professionals (84.64 points), while its quality was perceived through the uMARS and MARS scales as good by both groups, with 4 and 4.14 points out of 5. Different areas regarding RegulEm's usability and suggestions for improvement were identified in both focus groups and 20% of the suggestions proposed were implemented in the refined version of RegulEm. Conclusion: RegulEm's usability and quality were perceived as good by users and professionals and different identified areas have contributed to its refinement. This study provides a more complete picture of RegulEm's usability and quality prior analysing its effectiveness, implementation and cost-effectiveness in Spanish public mental health units. [ABSTRACT FROM AUTHOR]

Background: The quantification of self-triage effectiveness, guided by mobile applications, in urgent direct-to-consumer telemedicine (TM) encounters requires further investigation. The objective of this study was to evaluate the outcomes of referral guidance provided by a symptom-based self-management mobile application decision algorithm in the context of remote urgent care assessments. Methods: An observational retrospective single-center study was conducted from May 2022 to December 2023. The inclusion criteria encompassed individuals aged >18 years old, and those spontaneously seeking virtual emergency care through the EINSTEIN CONECTA application. Patients experiencing connectivity issues, preventing completion of the encounter, were excluded. The primary outcomes included the rate of patient concurrence with the algorithm's recommendation for seeking in-person emergency care and the referral rate to face-to-face assessment among cases evaluated through TM. The application's algorithm employs scientific evidence based on symptoms to recommend referrals to emergency departments (EDs). Results: Out of 88,834 patients connected to the TM Center, self-triage obviated the need for virtual physician assessment in 53,302 (60%) encounters. A total of 35,532 patients were remotely evaluated by 316 on-duty physicians, resulting in 1,125 ICD-coded diagnoses. Among these, 21,722 (61.1%) were initially advised by self-triage to visit the ED, with subsequent medical assessment leading to in-person referrals in 6,354 (29.3%) of the evaluations. Of the 13,810 patients recommended to continue with virtual care post-self-triage, 157 (1.1%) were referred for in-person assessment. Conclusions: Self-triage effectively reduced the need for physician encounters in approximately three-fifths of TM consultations. Despite being based on scientific evidence, symptom-based referral algorithms demonstrated high sensitivity but poor correlation with physician decision-making. [ABSTRACT FROM AUTHOR]

Purpose: Strabismus is a common ocular condition requiring precise quantification of gaze deviation and qualification of strabismus category. Telemedicine refers to the use of technology to remotely diagnose and treat medical conditions. This narrative review aimed to assess the efficacy of a variety of telemedicine modalities for the assessment of strabismus. A secondary objective was to quantify overall accuracy, sensitivity, and specificity of automated methods using meta-analysis of available data. Methods: A literature search was conducted using the Ovid MEDLINE, Embase, and Cochrane Library data libraries. Keywords, including "strabismus," "phoria," "telemed*," and "telehealth," were used to locate relevant studies, with Medical Subject Headings terms, free text, and synonyms. No year restrictions were applied. Studies not in English were excluded. Risk of bias was assessed using the QUADAS-2 tool. Results: Thirty-four studies were included. All outcomes relating to accuracy and reliability of telemedicine versus a reference standard were extracted, as well as qualitative observations. High sensitivity, specificity, accuracy, and agreement were consistently shown across studies. Meta-analysis of two subsets featuring automated methods, for which relevant data were available, revealed a pooled accuracy of 0.877 (0.806–0.949), sensitivity of 0.856 (0.805–0.907), and specificity of 0.900 (0.845–0.954). Subcategories "remote standard assessment," "digital image analysis," "wearable devices," "mobile health (mHealth)," and "artificial intelligence" were independently examined. Conclusions: The majority of systems achieved parity with standard physician assessment, with the added benefit of eliminating subjectivity. Meta-analysis results suggest potential introduction of remote automated assessment where conventional assessment is unavailable, although accuracy of current technologies remains limited compared to in-person examination. Telemedicine modalities described offer convenience for patients, shorter examination times, and the potential to go beyond in-person assessments. The evidence gathered in this review supports the beginning of telemedicine integration into the world of strabismus diagnosis. [ABSTRACT FROM AUTHOR]

People with minor medical conditions in China tend to prefer healthcare consultation in the emergency department of tertiary hospitals and avoid public sector community health centers (PS-CHC). The reason behind this is the trust deficit in the quality of medical care at PS-CHC. On the other hand, Chinese m-health companies have a surprising number of registered users and daily healthcare queries. However, the lack of physical check-ups causes a lack of trust in the quality of prescribed treatments for m-health users. One such m-health company entered into a joint venture with a local government body. In this joint venture, the doctors from tertiary hospitals can provide healthcare consultation to m-health users at PS-CHC. This study investigates m-health users' intention to use m-health services equipped with PS-CHC, an emerging public-private joint venture in China. We extended the technology acceptance model with government support and trust to predict the adoption of such technology-based public-private joint ventures in a better way. The data were collected from 432 m-health users in Hefei and analyzed using Smart-PLS. All eight direct, but only three mediating relationships were to be found significant. This study has implications for researchers, government healthcare authorities, and m-health service providers. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Syntax Literate is the property of Ridwan Institute and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aims to investigate the effect of e-service quality (ESQ) in m-Health application on loyalty (LOY), focusing on the mediating customer satisfaction (SAT) and the moderating role of gender and domicile area on user loyalty. The study used quantitative research and the population of this study was m-Health application users with 260 respondents using the purposive sampling method. The analysis method used is PROCESS Macro Mediated Moderation Model 14 by SPSS 29. The results indicate that e-service quality positively and significantly affects user loyalty. Additionally, e-service quality has a positive and significant impact on consumer satisfaction and also the quality of consumer satisfaction has a positive and significant impact on loyalty. The study also found that customer satisfaction mediates the relationship of e-service quality on user loyalty. However, the demographic variables, gender, and domicile area were found have no impact on the relationship between consumer satisfaction and loyalty. [ABSTRACT FROM AUTHOR]

Health and exercise technology may promote a healthy lifestyle during pregnancy. The objective of this cross-sectional study was to understand and involve the perspective of pregnant women as users in the design of a framework for future e-health and exercise interventions during pregnancy. Pregnant women replied to a questionnaire aimed at understanding their physical activity patterns, needs, and preferences regarding the use of mobile applications (apps). The main results showed that one-third of the women did not practice any type of exercise during pregnancy. Women preferred to exercise in a gym, outdoors, or at home. The majority already had or were currently using a fitness app, but never used any pregnancy-specific app. Most women agreed that it was important to have a specific app for pregnancy to improve knowledge about recommendations on lifestyle, have direct contact with health and exercise professionals, have social interaction with other mothers, and have guidance on preparation for childbirth and postpartum recovery. Understanding and involving the perspective of pregnant women as users will allow researchers to improve the design of a pregnancy-specific app and future e-health and exercise interventions during pregnancy. These preliminary results will lead to the development of the "active pregnancy app" focused on the promotion of an active and healthy lifestyle during pregnancy and postpartum. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Medianae is the property of Acta Medica Medianae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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. [ABSTRACT FROM AUTHOR]

A healthy lifestyle comprising regular physical activity and an adequate diet is imperative for the prevention of non‐communicable diseases such as hypertension and some cancers. Advances in information computer technology offer the opportunity to provide personalised lifestyle advice directly to the individual through devices such as smartphones or tablets. The overall aim of the PROTEIN project (Wilson‐Barnes et al., 2021) was to develop a smartphone application that could provide tailored and dynamic nutrition and physical activity advice directly to the individual in real time. However, to create this mobile health (m‐health) smartphone application, a knowledge base of reference ranges for macro‐/micronutrient intake, anthropometry, biochemical, physiological and sleep parameters was required to underpin the parameters of the recommender systems. Therefore, the principal aim of this emerging research paper is to describe the process by which experts in nutrition and physiology from the PROTEIN consortium collaborated to develop the nutritional and physical activity requirements, based upon existing recommendations, for 10 separate population groups living within the EU including, but not limited to healthy adults, adults with type 2 diabetes mellitus, cardiovascular disease, excess weight, obesity and iron deficiency anaemia. A secondary aim is to describe the development of a library of 24‐h meal plans appropriate for the same groups and also encompassing various dietary preferences and allergies. Overall, the consortium devised an extensive nutrition and physical activity knowledge base that is pertinent to 10 separate EU user groups, is available in 7 different languages and is practically implemented via a library of culturally appropriate, 24‐h meal plans. [ABSTRACT FROM AUTHOR]

Introduction: Neuromuscular diseases (NMDs) entail a group of mostly inherited genetic disorders with heterogeneous phenotypes impacting muscles, the central or peripheral nervous system. They can lead to severe disabilities and shortened lifespans. Despite their severity, NMDs often lack in public awareness and appropriate medical and social support. Telemedicine can improve patients' and caregivers' lives by enhancing continuity of and access to care. The first aim of this systematic review was to summarise the status quo of telemedicine services for patients with NMDs. Secondly, barriers and facilitators of the respective implementation processes should be analysed. Methods: The databases PubMed, Web of Science and CENTRAL by Cochrane were searched in May 2022. To be truly explorative, any original evidence from any setting was included. Two independent researchers completed the screening process. Data was extracted and analysed using the taxonomy of Bashshur et al. (2011) and the Consolidated Framework for Implementation Research (CFIR). Results: Fifty-seven original papers were included in the systematic review. The results showed a high representation of teleconsultations and remote monitoring studies. Teleconsultations replaced in person appointments and telemonitoring mostly focused on ventilation. Physical therapy, pulmonology, neurology, and psychology were the most represented medical specialties. We found barriers and facilitators relating to implementation mainly referred to the intervention and the individuals involved. Technical errors and inaccessibility due to a lack of technical devices or the patient's disability were stated as hindrances. A positive mindset of users as well as patient empowerment were necessary for the adoption of new technology. Technophobia or uncertainty around technology negatively impacted the implementation process. Discussion: This systematic review provides an overview of the current use of telemedicine in patients with NMDs. The distribution of telemedicine interventions between the defined domains was very heterogenous. Previous research has neglected to fully describe the implementation process of telemedicine for NMDs. Conclusion: The evidence shows that telemedicine can benefit patients with NMDs in a multitude of ways. Therefore, health policies should endorse and incentivise the uptake of telemedicine by institutions and health care workers. Further research needs to be conducted to confirm the current evidence and close existing research gaps. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The HIV/AIDS pandemic is a global issue that has unequally affected several countries. Due to the complexity of this condition and the human drama it represents to those most affected by it, several fields have contributed to solving or at least alleviating this situation, and the information systems (IS) field has not been absent from these efforts. With the importance of antiretroviral therapy (ART) as a starting point, several initiatives in the IS field have focused on ways to improve the adherence and effectiveness of this therapy: mobile phone reminders (for pill intake and appointments), and mobile interfaces between patients and health workers are popular contributions. However, many of these solutions have been difficult to implement or deploy in some countries in the Global South, which are among the most affected by this pandemic. This paper presents one such case. Using a case‐study approach with an extreme‐case selection technique, the paper studies an m‐health system for HIV patients in the Kalangala region of Uganda. Using Heeks' design—reality gap model for data analysis, the paper shows that the rich interaction between social context and technology should be considered a central concern when designing or deploying such systems. [ABSTRACT FROM AUTHOR]

In recent years, the integration of game-like elements into non-gaming contexts has shown promise in enhancing user engagement and motivation. This study assesses the impact of gamification elements on data collection efficacy in mhealth applications. An ad-hoc mobile application was developed and used in a randomized two-arm pilot study. Participants interacted either with the gamified meal-logging application or with its non-gamified version for ten days. The results from this study emphasize the benefits of incorporating gamification techniques into health applications embedded in digital platforms. While both versions were wellreceived, reaching high System Usability Scale (SUS) scores (91 and 93.5) and generally positive feedback, the gamified app demonstrated a distinct advantage in promoting user engagement and consistent data logging. This highlights the importance of gamification in health research, suggesting its potential to ensure thorough and consistent data collection, which is essential for producing reliable research outcomes. [ABSTRACT FROM AUTHOR]

Purpose of Review: To review randomized controlled trials (RCTs) published from 2021–2023 that reported the effects of peer support interventions on outcomes in patients with type 2 diabetes (T2DM). Recent Findings: Literature searches yielded 137 articles and nine RCTs were ultimately reviewed. The reviewed trials involved in-person support groups, peer coach/mentor support, cultural peer support by community health workers, peer support during shared medical appointments (SMAs) including virtual reality-based SMAs, telehealth-facilitated programs, and telephone peer support. Most interventions combined two or more peer support strategies. Peer support was associated with significant decreases in HbA1c in 6 of the 9 reviewed studies. The largest statistically significant improvements in HbA1c were reported in a study of community health workers in Asia (-2.7% at 12 months) and a Canadian study in which trained volunteer peer coaches with T2DM met with participants once and subsequently made weekly or biweekly phone calls to them (-1.35% at 12 months). Systolic blood pressure was significantly improved in 3 of 9 studies. Summary: The findings suggest that peer support can be beneficial to glycemic control and blood pressure in T2DM patients. Studies of peer support embedded within SMAs resulted in significant reductions in HbA1c and suggest that linkages between healthcare systems, providers, and peer support programs may enhance T2DM outcomes. [ABSTRACT FROM AUTHOR]

Many people are unaware of the severity of melanoma disease even though such a disease can be fatal if not treated early. This research aims to facilitate the diagnosis of melanoma disease in people using a mobile health application because some people do not prefer to visit a dermatologist due to several concerns such as feeling uncomfortable by exposing their bodies. As such, a skincare application was developed so that a user can easily analyze a mole at any part of the body and get the diagnosis results quickly. In the first phase, the corresponding image is extracted and sent to a web service. Later, the web service classifies using the pre-trained model built based on a deep learning algorithm. The final phase displays the confidence rates on the mobile application. The proposed model utilizes the Convolutional Neural Network and provides 84% accuracy and 72% precision. The results demonstrate that the proposed model and the corresponding mobile application provide remarkable results for addressing the specified health problem. [ABSTRACT FROM AUTHOR]

This study was based on the Kano model and rely on the Internet hospital to build a day surgery patient full-process nursing service platform. Based on the Internet hospital's HIS system, nursing Yuanzhuo system, patient mobile terminal (WeChat) and other information systems. The platform was designed by following the WHO's conceptual framework for developing a scaling-up strategy. It was tested and refined by a pilot in a hospital in China. The full-process care platform for day surgery patients realizes information interconnection and interoperability of patient surgical consultation, surgical inquiries, and postoperative follow-up. It consists of a WeChat applet (client) and an online website (server). Pre-experiment results show that patients are more likely to recommend the hospital's day surgery to others. The mHealth-based perioperative full-process nursing service platform for day surgery patients can initially meet the health education needs, surgical consultation needs and follow-up needs of day surgery patients. [ABSTRACT FROM AUTHOR]

Efficacious, effective and efficient communication between healthcare professionals (HCP) and patients is essential to achieve a successful therapeutic alliance. Telemedicine (TM) has been used for decades but during the COVID‐19 pandemic its use has become widespread. This position paper aims to describe the terminology and most important forms of TM among HCP and patients and review the existing studies on the uses of TM for asthma and allergy. Besides, the advantages and risks of TM are discussed, concluding that TM application reduces costs and time for both, HCP and patients, but cannot completely replace face‐to‐face visits for physical examinations and certain tests that are critical in asthma and allergy. From an ethical point of view, it is important to identify those involved in the TM process, ensure confidentiality and use communication channels that fully guarantee the security of the information. Unmet needs and directions for the future regarding implementation, data protection, privacy regulations, methodology and efficacy are described. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Electronic health (e-Health), refers to technologies that can be utilized to enhance patient care as well as collect and share health information. e-Health comprises several umbrella terms, including telehealth, mobile health, e-Health, wearables, and artificial intelligence. The types of e-Health technologies being utilized in lymphedema (LE) care are unknown. Method: In this narrative review, a search of published research on the utilization of e-Health technologies in LE-related care was conducted. Results: Five different types of e-Health modalities were found (robotics, artificial intelligence, electronic medical records, smart wearable devices, and instructive online information) spanning 14 use cases and 4 phases of care (preventative, diagnostic, assessment, and treatment phases). Broad e-Health utilization examples were found including robotic-assisted surgery to reduce the likelihood of LE after lymphadenectomy, machine learning to predict patients at risk of filarial-related LE, and a novel wearable device prototype designed to provide lymphatic drainage. Conclusions: e-Health has reported merit in the prevention, diagnoses, assessment, and treatment of LE with utilization demonstrating cutting edge applicability of e-Health for achieving optimal patient care and outcomes. As technology continues to advance, additional research into the utilization of e-Health in LE care is warranted. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has transformed health care delivery through the rise of telehealth solutions. Though telemedicine-based care has been identified as safe and feasible in postoperative care, data on initial surgical consultations in the preoperative setting are lacking. We sought to compare patient characteristics, anticipated downstream care utilization, and patient-reported experiences (PREs) for in-person versus telemedicine-based care conducted for initial consultation encounters at a hernia and abdominal wall center. Methods: Patients evaluated at an abdominal wall reconstruction center from August 2021 to August 2022 were prospectively surveyed. Patient characteristics, anticipated downstream care utilization, and PREs were compared. Results: Of the 176 respondents, 50.6% (n = 89) utilized telemedicine-based care and had similar demographic and disease characteristics to those receiving in-person care. Telemedicine-based care saved a median of 47 min [interquartile range 20–112.5 min] of round-trip travel time per patient, with 10.1% of encounters resulting in supplemental in-person evaluation. A large proportion of telemedicine-based and in-person encounters resulted in recommendations for operative intervention, 38.2% versus 55.2%, respectively. Indirect costs of care were significantly lower for patients utilizing telemedicine-based services. Patient satisfaction related to encounters was non-inferior to in-person care. Overall, the majority of patients responded that they preferred future care to be delivered via telemedicine-based services, if offered. Conclusions: Preoperative telemedicine-based care was associated with significant cost-savings over in-person care related with comparable patient satisfaction. Health systems should continue to dedicate resources to optimizing and expanding perioperative telemedicine capabilities. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The objective of this study was to improve the measurement of physical activity self-efficacy (PASE) in adults with obesity. To accomplish this objective, a latent variable approach was used to explore dimensionality, temporal invariance, and external validity of responses to a newly developed battery of PASE scales. Data (Nbaseline = 461 and N30 days postbaseline = 427) from the Well-Being and Physical Activity Study (ClinicalTrials.gov, identifier: NCT03194854), which deployed the Fun For Wellness intervention, were analyzed. A two-dimensional factor structure explained responses to each PASE scale at baseline. There was strong evidence for at least partial temporal measurement invariance for this two-dimensional structure in each PASE scale. There was mixed evidence that the effectiveness of the Fun For Wellness intervention exerted a direct effect on latent PASE in adults with obesity at 30 days postbaseline (i.e., external validity) of this two-dimensional structure. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the validity of evidence for self-efficacy to regulate physical activity scale (SERPA) measurement using an exploratory latent variable approach. The objectives were to explore the dimensionality, temporal invariance, and external validity of scores produced by the SERPA, a modified version of the barriers self-efficacy scale. Data (Nbaseline= 461 and N30 days post-baseline = 427) from the Well-Being and Physical Activity Study (ClinicalTrials.gov, identifier: NCT03194854), which deployed the Fun For Wellness intervention, were analyzed. A two-dimensional factor structure explained responses to the SERPA at baseline. There was evidence for at least partial strict temporal measurement invariance for this two-dimensional structure. There was evidence for external validity of the SERPA measurement as evidenced by group assignment (i.e. the intervention) exerting a direct effect on the proposed two-dimensional structure of latent self-efficacy to regulate physical activity in adults with obesity at 30 days post-baseline. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Healthcare is the foremost concern for any country. UN has also fixed 'good health' and well‐being' as its third sustainable development goal. CoVID‐19 era has shown the vulnerability of health infrastructure worldwide. As per WHO, aging population of the world would put enormous pressure on health infrastructure in coming decades. With lack of healthcare professionals and limited budget to achieve UNSDG goal‐3, IoMT with its huge umbrella of medical services and applications can address these issues. 5G has been deployed in many countries and vision for 6G have been finalized by different research groups. 6G will help Internet of Medical Things to realize its full potential. In this work, an open '6G enabled IoMT' architecture has been presented. It can integrate a wide number of services. The limitations of 5G in catering to such a network are also highlighted. The challenges and open issues are presented in the light of services and applications that can be provided by the purposed architecture. A brief overview of 6G is also provided. [ABSTRACT FROM AUTHOR]

This study examined the effectiveness of a theory-based mHealth intervention on the quality of life (QOL) of people living with HIV. A randomized controlled trial was performed at two outpatient clinics in Hanoi, Vietnam. There were 428 patients with HIV/AIDs in selected clinics and were divided into the intervention arm (receiving HIV-assisted smartphone application and usual care) and the control arm (receiving only usual care). The WHOQOLHIV-BREF instrument was utilized to measure QOL. An intention-to-treat approach using Generalized Linear Mixed Model analysis was performed. The trial showed significant improvements in Physical health, Psychological health, and Level of Dependence among patients in the intervention arm compared to the control arm. However, the Environment and Spirituality/Personal beliefs improvements would require additional interventions, both individual, organizational, or governmental. This study explored the utility of a smartphone mobile application for individuals with HIV, and how the resultant application could improve the overall QOL. [ABSTRACT FROM AUTHOR]

Background. Considering the widespread influence of mobile phones in life and its various features, it is necessary to use value-added services of mobile phones in the field of treatment and health. This study aimed to identify and categorize the factors affecting the use of mobile value-added services in the field of health. Methods. This qualitative research was conducted using thematic analysis. A total of 74 articles were extracted from scientific databases. Next, 51 related articles were fully reviewed using thematic analysis method. After that, basic, organizing, and inclusive themes were extracted, and the model was implemented. Validity of the research was confirmed by experts according to the degree of connection between the components and the mobile value-added services model in the field of health. The reliability coefficient was 97%, which indicated a high reliability. Results. Based on the review and analysis of the articles, the final model consisted of 64 basic themes, 16 organizing themes (understanding benefits, understanding well-being, user values, customer outcomes, community outcomes, organizational outcomes, technology infrastructure, reducing fear of technology, learning and development, occupational factors, support and incentives, technical reliability, human reliability, risk reduction, attitude, and expectation), and six global themes (user understanding, effects and consequences, technology development, environmental influencing conditions, reliability, and mindset and expectations). Conclusion. According to the factors identified in this research, policy makers and health managers can have the right planning for the use of mobile value-added services in the field of health. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: There is a lack of e-health systems that integrate the complex variety of aspects relevant for diabetes self-management. We developed and field-tested an e-health system (POWER2DM) that integrates medical, psychological and behavioural aspects and connected wearables to support patients and healthcare professionals in shared decision making and diabetes self-management. Methods: Participants with type 1 or type 2 diabetes (aged >18 years) from hospital outpatient diabetes clinics in the Netherlands and Spain were randomised using randomisation software to POWER2DM or usual care for 37 weeks. This RCT assessed the change in HbA1c between the POWER2DM and usual care groups at the end of the study (37 weeks) as a primary outcome measure. Participants and clinicians were not blinded to the intervention. Changes in quality of life (QoL) (WHO-5 Well-Being Index [WHO-5]), diabetes self-management (Diabetes Self-Management Questionnaire – Revised [DSMQ-R]), glycaemic profiles from continuous glucose monitoring devices, awareness of hypoglycaemia (Clarke hypoglycaemia unawareness instrument), incidence of hypoglycaemic episodes and technology acceptance were secondary outcome measures. Additionally, sub-analyses were performed for participants with type 1 and type 2 diabetes separately. Results: A total of 226 participants participated in the trial (108 with type 1 diabetes; 118 with type 2 diabetes). In the POWER2DM group (n=111), HbA1c decreased from 60.6±14.7 mmol/mol (7.7±1.3%) to 56.7±12.1 mmol/mol (7.3±1.1%) (means ± SD, p<0.001), compared with no change in the usual care group (n=115) (baseline: 61.7±13.7 mmol/mol, 7.8±1.3%; end of study: 61.0±12.4 mmol/mol, 7.7±1.1%; p=0.19) (between-group difference 0.24%, p=0.008). In the sub-analyses in the POWER2DM group, HbA1c in participants with type 2 diabetes decreased from 62.3±17.3 mmol/mol (7.9±1.6%) to 54.3±11.1 mmol/mol (7.1±1.0%) (p<0.001) compared with no change in HbA1c in participants with type 1 diabetes (baseline: 58.8±11.2 mmol/mol [7.5±1.0%]; end of study: 59.2±12.7 mmol/mol [7.6±1.2%]; p=0.84). There was an increase in the time during which interstitial glucose levels were between 3.0 and 3.9 mmol/l in the POWER2DM group, but no increase in clinically relevant hypoglycaemia (interstitial glucose level below 3.0 mmol/l). QoL improved in participants with type 1 diabetes in the POWER2DM group compared with the usual care group (baseline: 15.7±3.8; end of study: 16.3±3.5; p=0.047 for between-group difference). Diabetes self-management improved in both participants with type 1 diabetes (from 7.3±1.2 to 7.7±1.2; p=0.002) and those with type 2 diabetes (from 6.5±1.3 to 6.7±1.3; p=0.003) within the POWER2DM group. The POWER2DM integrated e-health support was well accepted in daily life and no important adverse (or unexpected) effects or side effects were observed. Conclusions/interpretation: POWER2DM improves HbA1c levels compared with usual care in those with type 2 diabetes, improves QoL in those with type 1 diabetes, improves diabetes self-management in those with type 1 and type 2 diabetes, and is well accepted in daily life. Trial registration: ClinicalTrials.gov NCT03588104. Funding: This study was funded by the European Union's Horizon 2020 Research and Innovation Programme (grant agreement number 689444). [ABSTRACT FROM AUTHOR]

The Internet of Things (IoT) has positioned itself globally as a dominant force in the technology sector. IoT, a technology based on interconnected devices, has found applications in various research areas, including healthcare. Embedded devices and wearable technologies powered by IoT have been shown to be effective in patient monitoring and management systems, with a particular focus on pregnant women. This study provides a comprehensive systematic review of the literature on IoT architectures, systems, models and devices used to monitor and manage complications during pregnancy, postpartum and neonatal care. The study identifies emerging research trends and highlights existing research challenges and gaps, offering insights to improve the well-being of pregnant women at a critical moment in their lives. The literature review and discussions presented here serve as valuable resources for stakeholders in this field and pave the way for new and effective paradigms. Additionally, we outline a future research scope discussion for the benefit of researchers and healthcare professionals. [ABSTRACT FROM AUTHOR]

Daily steps could be a valuable indicator of real-world ambulation in Parkinson's disease (PD). Nonetheless, no study to date has investigated the minimum number of days required to reliably estimate the average daily steps through commercial smartwatches in people with PD. Fifty-six patients were monitored through a commercial smartwatch for 5 consecutive days. The total daily steps for each day was recorded and the average daily steps was calculated as well as the working and weekend days average steps. The intraclass correlation coefficient (ICC) (3,k), standard error of measurement (SEM), Bland–Altman statistics, and minimum detectable change (MDC) were used to evaluate the reliability of the step count for every combination of 2–5 days. The threshold for acceptability was set at an ICC ≥ 0.8 with a lower bound of CI 95% ≥ 0.75 and a SAM < 10%. ANOVA and Mann–Whitney tests were used to compare steps across the days and between the working and weekend days, respectively. Four days were needed to achieve an acceptable reliability (ICC range: 0.84–0.90; SAM range: 7.8–9.4%). In addition, daily steps did not significantly differ across the days and between the working and weekend days. These findings could support the use of step count as a walking activity index and could be relevant to developing monitoring, preventive, and rehabilitation strategies for people with PD. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effectiveness of the Fun For Wellness (FFW) online intervention to increase well-being actions in adults with obesity in the United States in relatively uncontrolled settings. The FFW intervention is guided by self-efficacy theory. The study design was a large-scale, prospective, double-blind, and parallel-group randomized controlled trial. Data collection occurred at baseline, 30 days after baseline, and 60 days after baseline. Participants (N = 667) who were assigned to the FFW group (nFFW = 331) were provided with 30 days of 24-hr access to FFW. Supportive evidence was provided for the effectiveness of FFW in real-world settings to promote, either directly or indirectly, three dimensions of well-being actions: community, occupational, and psychological. This study shows that theory-based intervention may be effective in promoting well-being actions in adults with obesity in the United States. [ABSTRACT FROM AUTHOR]

Evidence suggests that low carbohydrate dietary (LCD) approaches can improve glycaemic control and may result in type 2 diabetes mellitus (T2DM) remission. This systematic literature review (SLR) aimed to assess the effectiveness of technology-enabled LCD interventions in the management of people with prediabetes or T2DM. Data sources included Medline, Embase, CINAHL, and Web of Science. Randomised (RCTs) or non-randomised (non-RCTs) controlled trials investigating the effect of technology-enabled LCDs (<130 g/day) or very low carbohydrate diets (VLCDs < 50 g/day) on glycosylated haemoglobin A1c (HbA1c) for at least three months and published in English between 2009 and 2023 were included. Risk of bias assessment, data extraction, and synthesis were conducted using standard tools and procedures. Six studies (two RCTs and four non-RCTs, total sample, n = 1519) were identified and included in the SLR. Two studies examining LCDs reported significant reductions in mean HbA1c (0.4% and −1.2%) and weight loss (−3.8 kg and −7.5 kg) at one year. Three studies examining VLCDs reported significant reductions in mean HbA1c (−0.8% to −1.3%) and weight loss (−12 kg to −14 kg) up to two years. Technology-enabled LCD or VLCD interventions can be a novel approach in helping people with prediabetes or T2DM self-manage their condition and possibly achieve remission. However, further research is required to determine the sustainability, effectiveness, and safety of this approach. [ABSTRACT FROM AUTHOR]

Background: Current health care demonstrates an insufficient provision and utilization of physical exercises despite their recommendation as a first-line treatment in clinical guidelines for patients with knee osteoarthritis (OA). Mobile health (m-health) technologies offer new opportunities to guide and monitor home-based exercise programs by using mobile devices and inertial sensors in combination with a digital application (app). This study will evaluate patient benefits resulting from the use of the specific digital health application re.flex for patients with knee OA. Methods: This monocentric, two-arm, randomized controlled parallel-group trial will evaluate the effectiveness of the app- and sensor-guided exercise program re.flex for patients with moderate-to-severe knee OA. We aim to recruit 200 participants via newspapers, newsletters and information events. Participants will be randomly allocated to the intervention group and the control group in a 1:1 ratio. Participants in the control group will not receive any study intervention or instruction for any change to their previous health care utilization. Despite this, they are allowed to make use of usual care provided by their treating physician. The intervention group comprises a 12-week home training program with three sessions per week in addition to usual care. Exercises will be guided and monitored by use of the training app (re.flex) and two accelerometers that are attached proximally and distally to the affected knee joint. Pre- and postmeasurements will take place at baseline (t0) and after 12 weeks (t1). Primary outcomes will be osteoarthritis-specific pain and physical function measured with the Knee Osteoarthritis Outcome Score (KOOS) subscales Pain and Function in daily living (ADL). Second, further self-reported health outcomes, a performance measurement, app logfiles and safety will be assessed. Intervention effects will be calculated by baseline-adjusted analysis of covariance (ANCOVA) using an intention-to-treat approach. Multiple imputation will be applied. Discussion: Re.flex can bridge part of the gap between recommendations for strengthening exercises in patients with knee OA and the insufficient actual care situation. This randomized controlled trial is designed to provide conclusions on the effectiveness of the health application re.flex for the population under study and will provide further insight into adherence rates and the safety of its use. Trial registration: The trial was registered on 20/01/2023 at www.drks.de (ID: DRKS00030932). [ABSTRACT FROM AUTHOR]

The dataset was generated from Scopus database for the study due to its compatibility with bibliometrix R package. The dataset shows that there is a gradual increase in publication of research articles on digital health and mobile health till 2016 before a sudden rise in number of publications from 2017 onwards. This paper contributes by providing a consolidation of fragmented literature in the research domain giving us information on significant sources, authors and documents. The analysis of conceptual structure reveals that the topics of study have evolved from mobile health to digital health, e-health, technology acceptance model, privacy, implementation and self-management. [ABSTRACT FROM AUTHOR]

Aim: Sedentary behavior poses a serious health risk. Students in particular are highly affected by prolonged, uninterrupted periods of sitting due to routines in everyday university life, such as attending lectures, self-study periods in the library, etc. Whereas university students are mostly young and therefore appear to be healthy, evidence-based consequences of prolonged sitting may come to pass in prospective times. Therefore, primary prevention must be initiated to shield university students from the occurrence of non-communicable diseases (NCDs). Consequently, the study aims to evaluate a messenger-based intervention designed to reduce sedentary time among university students. Subjects and Methods: The effectiveness of the intervention was assessed in a randomized controlled trial with a convenience sample of thirty-four German university students. ActivPal devices (Pal Technologies Ltd., Glasgow) were applied to measure sedentary behavior objectively before and after a 3-week intervention of messages to interrupt sedentary time. An additional evaluation of the messages was carried out. Results: Sedentary behavior decreased by about one hour in the intervention group. Explorative analysis shows a statistically significant, negative correlation between sedentary time at baseline and the change of sedentary behavior over time in the intervention group (r = −.81) indicating effectiveness of the intervention for the participants with the highest sedentary times at baseline. Additionally, the messages were considered appropriate by the participants. Conclusion: A reduction of sedentary time of one hour per day in the intervention group is practically significant. The current investigation had similar findings with prior studies where promising results for the reduction of sedentary behavior were observed through mobile-based interventions. The detected effects of the intervention in this pilot study demonstrate an opportunity for further research in this field. [ABSTRACT FROM AUTHOR]