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Mobile-health (m-health) is described as the application of medical sensors and mobile computing to the healthcare provision. While 5G networks can support a variety of m-health services, applications such as telesurgery, holographic communications, and augmented/virtual reality are already emphasizing their limitations. These limitations apply to both the Quality of Service (QoS) and the Quality of Experience (QoE). However, 6G mobile networks are predicted to proliferate over the next decade in order to solve these limitations, enabling high QoS and QoE. Currently, academia and industry are concentrating their efforts on the 6G network, which is expected to be the next major game-changer in the telecom industry and will significantly impact all other related verticals. The exponential growth of m-health multimedia traffic (e.g., audio, video, and images) creates additional challenges for service providers in delivering a suitable QoE to their customers. As QoS is insufficient to represent the expectations of m-health end-users, the QoE of the services is critical. In recent years, QoE has attracted considerable attention and has established itself as a critical component of network service and operation evaluation. This article aims to provide the first thorough survey on a promising research subject that exists at the intersection of two well-established domains, i.e., QoE and m-health, and is driven by the continuing efforts to define 6G. This survey, in particular, creates a link between these two seemingly distinct domains by identifying and discussing the role of 6G in m-health applications from a QoE viewpoint. We start by exploring the vital role of QoE in m-health multimedia transmission. Moreover, we examine how m-health and QoE have evolved over the cellular network’s generations and then shed light on several critical 6G technologies that are projected to enable future m-health services and improve QoE, including reconfigurable intelligent surfaces, extended radio communications, terahertz communications, enormous ultra-reliable and low-latency communications, and blockchain. In contrast to earlier survey papers on the subject, we present an in-depth assessment of the functions of 6G in a variety of anticipated m-health applications via QoE. Multiple 6G-enabled m-health multimedia applications are reviewed, and various use cases are illustrated to demonstrate how 6G-enabled m-health applications are transforming human life. Finally, we discuss some of the intriguing research challenges associated with burgeoning multimedia m-health applications.

Purpose: To determine the level of awareness, beliefs and experience of healthcare professionals (HCPs) regarding mobile applications for self-management of type 2 diabetes mellitus. Methods: This review was done by searching the literature using three databases viz: PubMed, Web of Science and Scopus. Assessment of quality of studies was carried out using the scale of the Agency for Healthcare Research and Quality. The results were presented in accordance with the PRISMA 2020 guidelines. Results: The search strategy identified 725 unique research papers, 4 of which were included. A survey among pharmacists showed that 56 % of participants were aware of the existence of mobile health applications, and that 60 % of those who were aware recommended their use. In the multi-HCPs setting, depending on the study, apps recommendation rate varied from 45.5 to 62 %. Most of the participants (88 %) agreed that a mobile app would help strengthen their treatment recommendations to the patients (88 %), and 84 % also agreed that it would help patients manage diabetes better. Conclusion: Not much research has been done on this topic. Available data suggest that the awareness of HCPs regarding mobile applications is unsatisfactory, and that those familiar with these apps find them useful and are ready to recommend them to patients. There is need for further research and measures to increase awareness and knowledge of HCPs about available mobile applications, in order to ensure adequate support to patients with diabetes.

Digital technology is now an integral part of medicine. Tools for detecting, screening, diagnosis, and monitoring health-related parameters have improved patient care and enabled individuals to identify issues leading to better management of their own health. Wearable technologies have integrated sensors and can measure physical activity, heart rate and rhythm, and glucose and electrolytes. For individuals at risk, wearables or other devices may be useful for early detection of atrial fibrillation or sub-clinical states of cardiovascular disease, disease management of cardiovascular diseases such as hypertension and heart failure, and lifestyle modification. Health data are available from a multitude of sources, namely clinical, laboratory and imaging data, genetic profiles, wearables, implantable devices, patient-generated measurements, and social and environmental data. Artificial intelligence is needed to efficiently extract value from this constantly increasing volume and variety of data and to help in its interpretation. Indeed, it is not the acquisition of digital information, but rather the smart handling and analysis that is challenging. There are multiple stakeholder groups involved in the development and effective implementation of digital tools. While the needs of these groups may vary, they also have many commonalities, including the following: a desire for data privacy and security; the need for understandable, trustworthy, and transparent systems; standardized processes for regulatory and reimbursement assessments; and better ways of rapidly assessing value.

International audience; Aged macular degeneration (AMD) leads to a progressive decline in visual acuity until reaching blindness. It is considered as an irreversible pathology where an early diagnosis remains crucial. However, the lack of ophthalmologists, the permanent increase in elderly people, and their limited mobility involves a delay in AMD diagnosis. In this paper, we propose an automated method for AMD screening. The proposed processing pipeline consists in applying the well-known Radon transform to the macula region in order to model the AMD lesions even with a moderate quality of smartphone-captured fundus images. Thereby, the relevant features are carefully selected, related to the main proprieties of drusens, and then provided to an SVM classifer. The implementation of the method into a smartphone associated to a fundus image capturing device leads to a mobile CAD system that performs higher performance AMD screening. Within this framework and to achieve a real-time implementation, an optimization approach is suggested in order to reduce the processing workload. The evaluation of our method is carried out through the three public STARE, REFUGE, and RFMiD databases. A 4-fold cross-validation approach is used to evaluate the method performance where accuracies of 100%, 95.2%, and 94.3% are respectively obtained with STARE, REFUGE, and RFMiD databases. Comparisons with the state-of-the-art methods in the literature are done. Thereafter, the robustness of the proposed method was evaluated and proved. We note that 100% accuracy was preserved despite the use of degraded quality fundus images as noisy and blurred. Moreover, the propounded method was implemented in S7-Edge and S9 Smartphone devices, where the execution times of 19 and 15 milliseconds were respectively achieved, which proves the AMD real-time detection. Taking advantage of its mobility, cost-efective, detection performance, andreduced execution time, our proposed method seems a good solution for real-time AMD screening on mobile devices.

In recent years, deep learning in healthcare applications has attracted considerable attention from research community. They are deployed on powerful cloud infrastructures to process big health data. However, privacy issue arises when sensitive data are offloaded to the remote cloud. In this paper, we focus on pervasive health monitoring applications that allow anywhere and anytime monitoring of patients, such as heart diseases diagnosis, sleep apnea detection, and more recently, early detection of Covid-19. As pervasive health monitoring applications generally operate on constrained client-side environment, it is important to take into consideration these constraints when designing privacy-preserving solutions. This paper aims therefore to review the adequacy of existing privacy-preserving solutions for deep learning in pervasive health monitoring environment. To this end, we identify the privacy-preserving learning scenarios and their corresponding tasks and requirements. Furthermore, we define the evaluation criteria of the reviewed solutions, we discuss them, and highlight open issues for future research.

Considering the increasing need for oral and dental care in the elderly, teledentistry has been proposed to improve the education of elderly patients in oral health maintenance and risk factor control, identify patients’ concerns in advance, facilitate monitoring, and save time and money. The present cross-sectional analysis of Google search data through real-time surveillance with Google Trends aimed to determine Google users’ interest in oral and dental needs and teledentistry applications in the elderly, and to compare search volumes before and after the COVID-19 outbreak. Extracted CVS data were qualitatively analyzed. Pearson and Spearman correlation analyses were performed between searches for “elderly” and “teledentistry”, and all the oral and dental needs and teledentistry applications. The Mann–Whitney U test compared search volumes in the 36 months before and after the beginning of the COVID-19 pandemic. Google users’ interest in the elderly and related oral and dental needs was diffusely medium–high, while teledentistry and its applications were of lower interest. Interest in teledentistry and its applications was strongly related to interest in the older population, which is consistent with the assumption that older adults represent the population segment that could benefit most from these tools. A positive correlation was also found between searches for “Elderly” and searches for almost all oral and dental needs typical of the geriatric population. Search volumes increased significantly after the outbreak of the COVID-19 pandemic. More information about teledentistry should be disseminated to increase knowledge and awareness, especially among older patients, about its indications, applications, and advantages.

Background: Although it is well known that regular physical activity and exercise, as well as maintaining adequate nutritional status is important to delaying symptom development and maintaining physical capacity and function in people with Parkinson's Disease (PD), many are unable to follow self-management recommendations. Active interventions have shown short-term effects, but there is a need for interventions that facilitate self-management over the course of the disease. Until now, no studies have combined exercise and nutritional interventions with an individual self-management approach in PD. Thus, we aim to examine the effect of a six-month mobile health technology(m-health)-based follow-up programme, focusing on self-management in exercise and nutrition, after an in-service interdisciplinary rehabilitation programme.Methods: A single-blinded, two-group randomised controlled trial. Participants are Adults aged 40 or older, with idiopathic PD, Hoehn and Yahr 1-3, living at home. The intervention group receives a monthly, individualized, digital conversation with a PT, combined with use of an activity tracker. People at nutritional risk get additional digital-follow-up from a nutritional specialist. The control group receives usual care. The primary outcome is physical capacity, measured by 6-min walk test (6MWT). Secondary outcomes are nutritional status, Health related quality of life (HRQOL), physical function and exercise adherence. All measurements are performed at baseline, after 3 months and after 6 months. Sample size, based on primary outcome, is set at 100 participants randomized into the two arms, including an estimated 20% drop out.Discussion: The increasing prevalence of PD globally makes it even more important to develop evidence-based interventions that can increase motivation to stay active, promote adequate nutritional status and improve self-management in people with PD. The individually tailored digital follow-up programme, based on evidence-based practice, has the potential to promote evidence-based decision-making and to empower people with PD to implement exercise and optimal nutrition in their daily lives and, hopefully, increase adherence to exercise and nutritional recommendations. Background: Although it is well known that regular physical activity and exercise, as well as maintaining adequate nutritional status is important to delaying symptom development and maintaining physical capacity and function in people with Parkinson’s Disease (PD), many are unable to follow self-management recommendations. Active interventions have shown short-term effects, but there is a need for interventions that facilitate self-management over the course of the disease. Until now, no studies have combined exercise and nutritional interventions with an individual self-management approach in PD. Thus, we aim to examine the effect of a six-month mobile health technology(m-health)-based follow-up programme, focusing on self-management in exercise and nutrition, after an in-service interdisciplinary rehabilitation programme. Methods: A single-blinded, two-group randomised controlled trial. Participants are Adults aged 40 or older, with idiopathic PD, Hoehn and Yahr 1–3, living at home. The intervention group receives a monthly, individualized, digital conversation with a PT, combined with use of an activity tracker. People at nutritional risk get additional digital-follow-up from a nutritional specialist. The control group receives usual care. The primary outcome is physical capacity, measured by 6-min walk test (6MWT). Secondary outcomes are nutritional status, Health related quality of life (HRQOL), physical function and exercise adherence. All measurements are performed at baseline, after 3 months and after 6 months. Sample size, based on primary outcome, is set at 100 participants randomized into the two arms, including an estimated 20% drop out. Discussion: The increasing prevalence of PD globally makes it even more important to develop evidence-based interventions that can increase motivation to stay active, promote adequate nutritional status and improve self-management in people with PD. The individually tailored digital follow-up programme, based on evidence-based practice, has the potential to promote evidence-based decision-making and to empower people with PD to implement exercise and optimal nutrition in their daily lives and, hopefully, increase adherence to exercise and nutritional recommendations. Trial registration: ClinicalTrials.gov (NCT04945876). First registration 01.03.2021.

The demand for mobile e-health technologies (m-health) continues with constant growth, stimulating the technological advancement of such devices. However, the customer needs to perceive the utility of these devices to incorporate them into their daily lives. Hence, this study aims to identify users’ perceptions regarding the acceptance of m-health technologies based on a synthesis of meta-analysis studies on the subject in the literature. Using the relations and constructs proposed in the UTAUT2 (Unified Theory of Acceptance and Use of Technology 2) technology acceptance model, the methodological approach utilized a meta-analysis to raise the effect of the main factors on the Behavioral Intention to Use m-health technologies. Furthermore, the model proposed also estimated the moderation effect of gender, age, and timeline variables on the UTAUT2 relations. In total, the meta-analysis utilized 84 different articles, which presented 376 estimations based on a sample of 31,609 respondents. The results indicate an overall compilation of the relations, as well as the primary factors and moderating variables that determine users’ acceptance of the studied m-health systems.

Transgender women (TGW) in India, especially those who engage in sex work, are at high risk for HIV. Guided by the information-motivation-behavioral skills model and qualitative formative research findings, Sakhi (girlfriend), a 3-week smartphone-based pilot intervention consisting of short videos (one/week) and text messages (two/week), was implemented using a one-group pre- and post-test design to test its efficacy in promoting condom use and HIV testing among TGW (n = 50) who engage in sex work in Chennai. Changes in outcomes were assessed by conducting multivariable analyses using generalized estimating equations. Participants’ mean age was 26 years, and the mean monthly income was INR 21700 (USD 292). About one-third completed college, and 96% were HIV-negative. Significant changes in the desired direction were observed in the primary outcomes: condom use – decrease in the engagement of condomless anal sex with male partners (12% to 2%, p < 0.05) and HIV testing – increase in intentions to undergo HIV testing every 6 months (34% to 86%, p < 0.001); and in some of the secondary outcomes: decrease in alcohol use before sex, increase in intentions to use condoms consistently and increase in the well-being score. This study demonstrated the feasibility, acceptability, and preliminary efficacy of the Sakhi intervention and warrants a larger randomized trial among diverse subgroups in diverse settings.

Background Rates of maternal mortality and morbidity in Africa remain unacceptably high, as many women deliver at home, without access to skilled birth attendants and life-saving medications. In rural Tanzania, women face significant barriers accessing health care facilities for their deliveries. Methods From January 2017 to February 2019 we conducted a multiple baseline (interrupted time series) trial within the four divisions of Rorya District, Tanzania. We collected baseline data, then sequentially introduced a complex intervention in each of the divisions, in randomized order, over 3 month intervals. We allowed for a 6 month transition period to avoid contamination between the pre- and post-intervention periods. The intervention included using community health workers to educate about safe delivery, distribution of birth kits with misoprostol, and a transport subsidy for women living a distance from the health care facility. The primary outcome was the health facility birth rate, while the secondary outcomes were the rates of antenatal and postpartum care and postpartum hemorrhage. Outcomes were analyzed using fixed effects segmented logistic regression, adjusting for age, marital status, education, and parity. Maternal and baby morbidity/mortality were analyzed descriptively. Results We analyzed data from 9565 pregnant women (2634 before and 6913 after the intervention was implemented). Facility births increased from 1892 (71.8%) before to 5895 (85.1%) after implementation of the intervention. After accounting for the secular trend, the intervention was associated with an immediate increase in the odds of facility births (OR = 1.51, 95% CI 1.14 to 2.01, p = 0.0045) as well as a small gradual effect (OR = 1.03 per month, 95% CI 1.00 to 1.07, p = 0.0633). For the secondary outcomes, there were no statistically significant immediate changes associated with the intervention. Rates of maternal and baby morbidity/mortality were low and similar between the pre- and post-implementation periods. Conclusions Access to health care facilities can be improved through implementation of education of the population by community health workers about the importance of a health care facility birth, provision of birth kits with misoprostol to women in late pregnancy, and access to a transport subsidy for delivery for women living at a distance from the health facility. Clinical trials registration NCT03024905 19/01/2017.

Resumen Introduccion Ante la pandemia por la COVID-19 son necesarias nuevas herramientas de trabajo a nivel sanitario para la evaluacion precoz de las personas sospechosas de haber sido infectadas. La tecnologia de la informacion y comunicacion (TIC) puede dar solucion a este nuevo escenario. El objetivo de este estudio es conocer que TIC hay en Espana. Metodos Revision de la TIC (aplicaciones moviles y paginas web) de las comunidades autonomas de Espana, listando las caracteristicas recogidas de cada una de ellas. Resultados Se han analizado seis aplicaciones moviles correspondientes a cinco comunidades autonomas y una del Ministerio de Sanidad, ademas de cuatro test en paginas web de la Consejeria de Salud de la comunidad autonoma correspondiente. De las TIC observadas, existen muchas diferencias entre ellas, tanto en la informacion recogida como en los recursos dedicados al ciudadano. Si bien todas ellas preguntan por la triada clasica de sintomas COVID-19: fiebre, tos y disnea. Conclusiones A pesar de tener un organo organizador comun en la crisis de la COVID-19 en Espana, el Ministerio de Sanidad, se han observado diferentes metodos de aplicacion en la tecnologia de la informacion y comunicacion en los territorios autonomicos de Espana.

Mobile health enables users to track their health, monitor their medical data, receive reminders about treatment processes, and monitor their daily activities and lifestyles. Today, the use of mobile devices has become one of the most important tools in maintaining the healthy lifestyle. Mobile devices, which have become a part of our lives, are used for mobile health purposes and enable users to easily monitor their health status. In this study, QuaVita healthy living mobile application is developed to track the healthy wellness. The developed QuaVita mobile application aims to support users’ healthy lifestyle. QuaVita enables users to store their health data, measure their heart rhythms, remind their medication, tracks their daily steps and water consumptions. Users will also be able to access all the pharmacies on duty in Turkey through the application. Users of all ages can easily follow their healthy life goals with the QuaVita application. Thus, users will be more attentive about their health and increase their awareness of healthy lifestyles., Mobil sağlık, kullanıcıların sağlıklarını takip etmelerini, tıbbi verilerini izlemelerini, tedavi süreçleri ile ilgili hatırlatma uyarılarını almalarını, günlük aktivitelerini ve yaşam biçimlerini izlemelerini sağlamaktadır. Günümüzde mobil cihaz kullanımı sağlıklı yaşam biçiminin sürdürülmesindeki en önemli araçlardan biri haline gelmiştir. Hayatımızın bir parçası haline gelmiş olan mobil cihazlar, mobil sağlık amacı ile kullanılmakta ve kullanıcıların sağlık durumlarını kolaylıkla takip edebilmelerini sağlamaktadır. Bu çalışmada, sağlıklı yaşam sürecinin izlenmesini sağlamak için QuaVita sağlıklı yaşam mobil uygulaması geliştirilmiştir. Geliştirilen QuaVita mobil uygulaması ile kullanıcıların sağlıklı bir yaşam süreçlerine destek olmak amaçlanmaktadır. QuaVita, kullanıcıların sağlık verilerini saklamalarını, kalp ritimlerini ölçebilmelerini, ilaç alarmı, günlük adım takibi ve su tüketim takibi yapabilmelerini sağlamaktadır. Kullanıcılar ayrıca, Türkiye’deki tüm nöbetçi eczanelere uygulama üzerinden erişebileceklerdir. QuaVita uygulaması ile her yaştan kullanıcının sağlıklı yaşam hedeflerini kolay bir şekilde takip edebilmeleri amaçlanmıştır. Böylelikle, kullanıcılar sağlıkları konusunda daha bilinçli olabilecekler ve sağlıklı yaşam biçimlerine yönelik farkındalıklarını arttırabileceklerdir.

Background As smartphones become more widespread, software applications for occupational health, safety and well-being (OHS&W) at work are increasing. There is sparse knowledge about the available apps and the research evidence of their effects. This study aims to identify available smartphone applications designed to improve OHS&W at workplaces, and examine to what extent the apps are scientifically validated. Methods We searched the Danish App Store and Google Play for free OHS&W apps. Apps were included if they targeted OHS&W and were designed for workplace use. After categorizing the apps, we searched bibliographic databases to identify scientific studies on the ‘intervention apps’. Results Altogether, 57 apps were included in the study; 19 apps were categorized as digital sources of information, 37 apps contained an intervention designed for workplace changes, and one app had too sparse information to be classified. Based on the publicly available information about the 37 intervention apps, only 13 had references to research. The bibliographic database search returned 531 publications, resulting in four relevant studies referring to four apps aimed at ergonomic measures, noise exposure, and well-being, which showed either limited effect or methodological limitations. Conclusion There is no conceptual clarity about what can be categorized as an OHS&W app. Although some of the apps were developed based on scientific research, there is a need to evaluate the apps’ effects in promoting OHS&W. The sparse documentation of evidence should be kept in mind when applying apps to improve OHS&W.

This scoping review aims to explore how digital health applicate in patient safety for children and their parents, describe which technologies are used. P(Population) - Children and Parent, C(Concept) - Patient Safety, C(Context) - Digital Health.

Introduction: Keeping HIV-infected adults away from the health care system during the COVID-19 travel restrictions, presents a challenge to HIV treatment adherence. Methods: This study focused on the initial two phases where Phase 1 designed a Makerere College of Health Sciences (MakCHS) Unstructured Supplementary Service Data (USSD)-based application; and Phase 2 piloted patient enrolment onto the application and determined the feasibility of remote follow-up of patients receiving long-term antiretroviral therapy (ART). Results: A off/online user application, MakCHS Health app, was developed. Overall, 112 patients [(66(59%) female] receiving ART at Mulago ISS clinic, Kampala, were enrolled onto the MakCHS Health app. Up to 89 (80%) utilized the app to access medical help. Patients’ medical queries included needs for drug refills, missed taking HIV medication, medical illnesses, access to COVID-19 vaccination and other personal needs that required clinicians’ attention. Conclusion: Piloting a MakCHS Health application for patient follow-up was feasible and well-received by HIV treatment providers and patients receiving ART. We recommend scale up of the application to enroll all patients receiving long-term treatment for HIV/AIDS, and subsequently expand to. other HIV treatment programs in similar settings. Keywords: M-Health; patient follow up; Chronic HIV treatment; Antiretroviral therapy.

Noot AlOtaibi,1 Sarah Alsaleebi,2 Fahad Alanezi,3 Hala Alhodaib,4 Bashair AlThani,5 Duaa Aljabri,1 Demah Alsalman,1 Asma Al-Fayez,1 Amjad Saadah,1 Sumaiah Alrawiai,1 Norah Alyousif,6 Turki Alanzi1 1Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Blood Bank, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 3Community College, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyad, Saudi Arabia; 5College of Business Administration, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 6Information Technology Department, Saudi Aramco, Dhahran, Saudi ArabiaCorrespondence: Turki AlanziDepartment of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, 31441, Saudi ArabiaTel +966 133331211Email talanzi@iau.edu.saPurpose: The main objective of this research was to investigate the opinion of the population of Saudi Arabia on the use and acceptability of the Wateen application.Methods: This research was a quantitative cross-sectional study in which an online questionnaire was distributed among the target population who were healthy people over 18 years of age that had used or known about the Wateen application. A total of 352 participants responded to the questionnaire. The data collection was carried out between November and December 2020. A basic descriptive statistical analysis was used to analyze the data.Results: The participants had used the Wateen app to follow the donation record, as a reminder of donation dates, to find lists and blood bank locations, to request blood donation, and to find donation requests on social media. After receiving the blood donation request from the Wateen app, majority of the respondents felt encouraged, motivated, and educated to donate blood, and about blood donation, respectively. Participants also indicated that the application helped them to find donors. Besides, majority of the respondents stated that the Wateen app had reduced the gap between blood donors and the need for blood. However, few participants expressed that they had not received or observed a post about the Wateen application on social media networks.Conclusion: The results of this research indicated that there is a general acceptance of the use of the Wateen app among the participants of this study. However, the importance of the Wateen app needs to be further advertised so that it can be used in the blood donation process in all regions of Saudi Arabia. In this way, the people of Saudi Arabia will be more aware of the importance of the Wateen app in the blood donation process, and the goal of the Ministry of Health of bridging the gap between donation centers and blood donors could be achieved.Keywords: Wateen application, blood donation, m-health, Saudi Arabia, user acceptability

Noot AlOtaibi,1 Sarah Alsaleebi,2 Fahad Alanezi,3 Hala Alhodaib,4 Bashair AlThani,5 Duaa Aljabri,1 Demah Alsalman,1 Asma Al-Fayez,1 Amjad Saadah,1 Sumaiah Alrawiai,1 Norah Alyousif,6 Turki Alanzi1 1Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Blood Bank, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 3Community College, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyad, Saudi Arabia; 5College of Business Administration, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 6Information Technology Department, Saudi Aramco, Dhahran, Saudi ArabiaCorrespondence: Turki AlanziDepartment of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, 31441, Saudi ArabiaTel +966 133331211Email talanzi@iau.edu.saPurpose: The main objective of this research was to investigate the opinion of the population of Saudi Arabia on the use and acceptability of the Wateen application.Methods: This research was a quantitative cross-sectional study in which an online questionnaire was distributed among the target population who were healthy people over 18 years of age that had used or known about the Wateen application. A total of 352 participants responded to the questionnaire. The data collection was carried out between November and December 2020. A basic descriptive statistical analysis was used to analyze the data.Results: The participants had used the Wateen app to follow the donation record, as a reminder of donation dates, to find lists and blood bank locations, to request blood donation, and to find donation requests on social media. After receiving the blood donation request from the Wateen app, majority of the respondents felt encouraged, motivated, and educated to donate blood, and about blood donation, respectively. Participants also indicated that the application helped them to find donors. Besides, majority of the respondents stated that the Wateen app had reduced the gap between blood donors and the need for blood. However, few participants expressed that they had not received or observed a post about the Wateen application on social media networks.Conclusion: The results of this research indicated that there is a general acceptance of the use of the Wateen app among the participants of this study. However, the importance of the Wateen app needs to be further advertised so that it can be used in the blood donation process in all regions of Saudi Arabia. In this way, the people of Saudi Arabia will be more aware of the importance of the Wateen app in the blood donation process, and the goal of the Ministry of Health of bridging the gap between donation centers and blood donors could be achieved.Keywords: Wateen application, blood donation, m-health, Saudi Arabia, user acceptability

Objetivo: Este trabalho busca compreender se a Influência Social está relacionada a intenção de uso das plataformas de e-health. Metodologia: Para a análise do modelo proposto, foi utilizada a técnica de modelagem de equações estruturais, utilizando os construtores de percepção de facilidade, utilidade percebida e a Influência Social na intenção de uso das plataformas de e-health. A análise dos dados foi realizada utilizando o software estatístico Stata e a aplicação de questionário foi produzida na plataforma Qualtrics com uma amostra não probabilística. Resultados: O estudo revelou que a utilidade percebida de uso e a Influência Social exerceram impactos positivos sobre a intenção de uso de plataformas e-health. Por outro lado, a percepção de facilidade de uso não teve efeito estatisticamente significante. Limitações: Dentre as limitações, podemos citar duas: a aplicação e a divulgação do questionário somente online, delimitando o público respondente e a amostra não probabilística, o que impossibilitou a generalização dos resultados, ou seja, nem todas as pessoas tiveram a oportunidade de responder ao questionário proposto. Contribuições práticas: O estudo trouxe como contribuição prática a constatação de que a intenção de uso dos serviços de e-health pode ser influenciada socialmente, proporcionando benefícios que podem ser obtidos mediante a implementação de políticas de uso das TIC para promover qualidade, acesso, equidade e eficiência no setor de saúde e nos setores relacionados em um país, região ou cidade, melhorando o processo decisório dos gestores públicos, médicos e pacientes. Contribuições Acadêmicas: A perspectiva da intenção de uso dos serviços de e-health e como a Influência Social motiva a intenção de uso, sugerindo um aumento na produção científica por ser um tema atual e relevante e apresenta oportunidades para o desenvolvimento de novos estudos com ênfase nessa temática. Originalidade: A temática relacionada ao uso plataformas de e-health para o cuidado da saúde ainda é incipiente na produção acadêmica nacional. Dessa forma, a realização deste estudo permitirá a ampliação das discussões sobre como a Influência Social pode aumentar a intenção de uso das plataformas de e-health.

Mental health screening and diagnostic applications (apps) are becoming increasingly popular. Despite there being promise in their acceptability by users, many mental health apps on the market still suffer from high dropout due to a multitude of issues. Understanding user opinions towards currently available mental health apps beyond star ratings alone can provide a wealth of knowledge which has potential to inform the development of future mental health screening or diagnostic assessment apps. A scoping review of the iOS and Google Play app stores was performed to identify apps which met our inclusion criteria. The most helpful reviews from the last year were shortlisted for sentiment and thematic analysis. The first objective of this study is to perform sentiment analysis of user reviews to understand the overall experience of mental health screening or diagnostic app users. The second aim of the study is to identify features which app users perceived to be benefits or barriers to app use. Following analysis, recommendations will be made for improving mental health screening or diagnostic apps based off user review insights.

The overall goal of this project is to systematically design and develop a guided, internet-based infant sleep intervention, using current state-of-the-art knowledge, clinical, and user experiences. The project consists of four work packages for intervention design and development, of which "Sleep Well, Litte Sweetheart! - Work Package 4 (Implementation)" is the pre-registration form for work package 4 (WP4). In WP4, we apply a stakeholder-driven approach to program planning by using concept mapping to identify implementation strategies to enhance uptake and integration of Sleep Well, Little Sweetheart in well-baby and community clinics. The results will be used to devise recommendations for future research, dissemination, and implementation in healthcare services.

The overall goal of this project is to systematically design and develop a guided, internet-based infant sleep intervention, using current state-of-the-art knowledge, clinical, and user experiences. The project consists of four work packages for intervention design and development, of which "Sleep Well, Litte Sweetheart! - Work Package 3 (Clinical Trialing)" is the pre-registration form for work package 3 (WP3). In WP3, we aim to evaluate whether the intervention with guidance from health professionals can be useful for treating sleep problems in children aged 6 months to 3 years and promote parent sleep and mental health. The results will be used to make necessary improvements and changes to the program for future research, dissemination, and implementation in healthcare services.

The overall goal of this project is to systematically design and develop a guided, internet-based infant sleep intervention, using current state-of-the-art knowledge, clinical, and user experiences. The project consists of four work packages for intervention design and development, of which "Sleep Well, Litte Sweetheart! - WP1" is the pre-registration form for work package 1 (WP1). In WP 1, we will conduct focus groups to assess parent needs and nursing practices for infant sleep problems.

The overall goal of this project is to systematically design and develop a guided, internet-based infant sleep intervention, using current state-of-the-art knowledge, clinical, and user experiences. The project consists of four work packages for intervention design and development, of which "Sleep Well, Litte Sweetheart! - Work Package 2 (Prototyping)" is the pre-registration form for work package 2 (WP2). In WP2, we will develop prototypes of intervention components and test these online in terms of their acceptance, appropriateness, feasibility, and usability, among parents and health professionals/volunteers.

Background The number of e-health interventions developed for breast cancer survivors continues to increase. However, issues with engagement and retention are common. This study aimed to explore e-health literacy rates and access to smartphones and tablets in a large sample of breast cancer survivors. Methods In study 1, women were recruited from outpatient breast clinics across England and Wales. Eligible women were asked to complete a questionnaire pack to assess their access to devices and their e-health literacy. Multiple regression analyses were run to assess the relationship between technology access and e-health literacy with sociodemographic variables such as age, social deprivation, and education. Study 2 presents a smaller sample recruited through social media who answered a questionnaire relating to use of mobile devices and e-health, and apps. Results Two thousand nine women participated in the study. Seventy-one percent had access to a smartphone, 54% had access to a tablet, and 20% did not have access to either device. Multiple logistic regressions showed that women who were younger, had higher levels of education, and who were from less deprived areas were more likely to have access to either device. Poorer e-health literacy was associated with being older, having less education, and not having access to a mobile device. Conclusions Whilst the results show relatively widespread access to mobile devices, there is evidence of a digital divide across some groups. Online interventions should be developed with consideration of individuals who are less e-health-literate and less technologically adept in order to increase the likelihood of engagement.

Although mobile health (m-health) has great potential to reduce the cost of medical care and improve its quality and efficiency, it is not widely accepted by consumers. In addition, there is still a lack of comprehensive insight into m-health acceptance, especially among consumers with different demographic characteristics. This study aimed to explore the factors affecting consumers’ acceptance and usage behaviors of m-health and to examine whether their roles differ by demographic characteristics. A comprehensive m-health acceptance model was proposed by integrating factors from the Self-Determination Theory, Task–Technology Fit, and Technology Acceptance Model. Survey data were collected from 623 Chinese adults with at least 6 months of m-health usage experience and analyzed using structural equation modeling techniques. Multi-group analyses were performed to assess whether the model relationships were different across gender, age, and usage experience. The results indicated that relatedness and competence were significant motivational antecedents of perceived ease of use. Task–technology fit and the perceived ease of use significantly affected the perceived usefulness. The perceived ease of use and perceived usefulness were significant determinants of consumer usage behaviors of m-health and together explained 81% of its variance. Moreover, the relationships among autonomy, perceived usefulness, and usage behaviors of m-health were moderated by gender. Consumer usage behaviors of m-health were affected by factors such as self-motivation (i.e., relatedness and competence), technology perceptions (i.e., perceived ease of use and perceived usefulness), and task–technology fit. These findings provide a theoretical underpinning for future research on m-health acceptance and provide empirical evidence for practitioners to promote the better design and use of m-health for healthcare activities.

Worldwide, population aging and unhealthy lifestyles have increased the incidence of high-risk health conditions such as cardiovascular diseases, sleep apnea, and other conditions. Recently, to facilitate early identification and diagnosis, efforts have been made in the research and development of new wearable devices to make them smaller, more comfortable, more accurate, and increasingly compatible with artificial intelligence technologies. These efforts can pave the way to the longer and continuous health monitoring of different biosignals, including the real-time detection of diseases, thus providing more timely and accurate predictions of health events that can drastically improve the healthcare management of patients. Most recent reviews focus on a specific category of disease, the use of artificial intelligence in 12-lead electrocardiograms, or on wearable technology. However, we present recent advances in the use of electrocardiogram signals acquired with wearable devices or from publicly available databases and the analysis of such signals with artificial intelligence methods to detect and predict diseases. As expected, most of the available research focuses on heart diseases, sleep apnea, and other emerging areas, such as mental stress. From a methodological point of view, although traditional statistical methods and machine learning are still widely used, we observe an increasing use of more advanced deep learning methods, specifically architectures that can handle the complexity of biosignal data. These deep learning methods typically include convolutional and recurrent neural networks. Moreover, when proposing new artificial intelligence methods, we observe that the prevalent choice is to use publicly available databases rather than collecting new data.

Background:HIV infection is an increasingly complex chronic disease associated with numerous medical, psychological, and social problems. The life expectancy of affected patients has increased considerably. Medical apps could also play a role in prevention and management of comorbid conditions in the HIV-infected population. Objectives:To determine the usefulness of an app designed specifically for HIV-infected patients aged 60 years or older and to assess changes in patient satisfaction, adherence to treatment, and quality of health care. Methods:A randomized clinical trial was conducted, including 100 patients (50 per group): (1) an experimental group comprising patients using the app + routine medical care (app group) and (2) with routine medical care (control group). The usability of the app and patient satisfaction were evaluated in the app group at week 48. Quality of life, adherence to treatment, and clinical parameters were compared between both groups at 48 weeks, as well as the number of face-to-face visits. Results:We found that 52.2% and 73.8% of patients in the app group used the app at weeks 24 and 48, respectively. Patients used the app for a mean of 23.7 (+/- 2.84) days over the 48 weeks. The most visited screens were health counseling and medical records (24.8% and 22.2%, respectively). At week 48, 85.2% of patients thought that the app was useful and 91.4% would recommend the app to friends or relatives. The app was well valued by participants (4.79 [+/- 0.21] of 5.00) and 64.6% thought that the app improved their health care.

Background: The utility of long-term intermittent heart rhythm monitoring after atrial fibrillation (AF) ablation remains undear. Therefore, we compared the efficacy and usability of long-term intermittent (AliveCor Kardia (R) (ACK)) versus short continuous (Hotter) heart rhythm monitoring for the detection of AF recurrences after AF ablation and evaluated ACK accuracy to detect AF.Methods: Patients were provided with Hotter (for >= 24 h) simultaneously with an ACK (4 weeks) used three times a day and in case of symptoms. The primary endpoint was the difference in proportion of patients diagnosed with recurrent AF by ACK as compared to Holier monitoring. Secondary endpoints were the usability (System Usability Scale and a four-item questionnaire) of ACK and Holler monitoring; and the accuracy of the ACK algorithm for AF detection.Results: Out of 126 post-ablation patients, 115 (91.3%; 35 females, median age 64.0 [58.0-68.0] years) transmitted overall 7838 ACK ECG recordings. ACK and Holler monitoring detected 29 (252%) and 17 (14.8%) patients with AF recurrences, respectively (p < 0.001). More than 2 weeks of ACK monitoring did not have additional diagnostic yield for detection of AF recurrences. Patients graded ACK higher than Hotter monitoring and found ACK more convenient in daily usage than Holler (p < 0.001). Sensitivity and specificity of ACK for AF detection were 95.3% and 97.5%, respectively.Conclusions: Long-term intermittent monitoring by ACK more effectively detects AF recurrences after AF ablation and has a higher patients' usability than short continuous Holter monitoring. ACK showed a high accuracy to detect AF. (C) 2021 Elsevier B.V. All rights reserved.

espanolEste estudio es una revision de la literatura desarrollada para investigar el uso de instrumentos de vigilancia y rastreo del retraso del desarrollo infantil a traves de la tecnologia movil. Asimismo, el objetivo fue caracterizar las metodologias utilizadas, muestras de participantes, ya sean clinicas o no; ademas del contexto de investigacion y la finalidad del uso del instrumento. Tres jueces realizaron una busqueda de articulos en las bases de datos indexadas en la BVS, PUBMED/MEDLINE y APA PsyNET. Las recomendaciones de PRISMA se utilizaron para esta revision. Segun los criterios de inclusion/exclusion, cinco articulos fueron recuperados y analizados. Los dos tipos de instrumentos fueron: vigilancia y deteccion, se presentaron en tres categorias de estudio: 1. descriptivo; 2. viabilidad/ usabilidad y 3. validez. Se concluyo que son necesarios mas estudios, especialmente para evaluar el impacto y la efectividad del uso de instrumentos de vigilancia y rastreo del retraso en el desarrollo infantil en formato de tecnologia movil. EnglishThis study is a literature review designed to investigate the use of monitoring and screening instruments for child developmental delay using mobile technology. In addition, the aim was to characterize the methodologies used, samples of participants, whether clinical or not, the research context and the purpose of the instrument use. Articles were searched by three judges in the databases indexed in the BVS, PUBMED/MEDLINE and APA PsyNET. The PRISMA recommendations were used for this review. After applying the inclusion/exclusion criteria, five articles were retrieved and analyzed. The two types of instruments: monitoring and screening, were presented in three study categories: 1. descriptive; 2. viability/usability and 3. validity. Further studies are needed to assess the impact and effectiveness of the use of mobile format instruments for the monitoring and screening for childhood developmental delays. portuguesEste estudo e uma revisao de literatura desenvolvida para investigar o uso de instrumentos de vigilância e rastreio para atraso do desenvolvimento infantil por meio de tecnologia movel. Alem disso, objetivou-se caracterizar as metodologias utilizadas, amostras de participantes, se clinicas ou nao, contexto de pesquisa, bem como a finalidade do uso instrumento. Foi realizada a busca de artigos, por tres juizes, nas bases de dados indexadas na BVS, PUBMED/MEDLINE e APA PsyNET. Utilizaram-se as recomendacoes do PRISMA para essa revisao. A partir de criterios de inclusao/exclusao, foram recuperados e analisados cinco artigos. As duas modalidades de instrumentos: vigilância e rastreio, apresentaram-se em tres categorias de estudo: 1. descritivo; 2. viabilidade/usabilidade e 3. validade. Conclui-se que mais estudos sejam necessarios, especialmente para avaliar o impacto e eficacia do uso de instrumentos de vigilância e rastreio para atraso no desenvolvimento infantil em formato de tecnologia movel.

Permasalahan pemantauan tumbuh kembang pada anak masih banyak terjadi. Banyak orangtua yang tidak memahami isi dari buku pemantauan dan hanya digunakan sebagai pencatatan jadwal imunisasi. Oleh karena itu dibutuhkan metode baru dalam pemantauan kesehatan dan tumbuh kembang anak. Studi ini menggunakan metode Scoping Review dimulai mengidentifikasi pertanyaan penelitian dan studi yang relevan, memilih artikel, memetakan data serta menyusun, meringkas dan melaporkan hasil. Hasil penelitian membuktikan bahwa teknologi dapat digunakan untuk pemantauan kesehatan dan tumbuh kembang anak, meningkatkan pengetahuan, keterampilan dan kepercayaan diri ibu, meningkatkan interaksi anatara ibu bidan, meningkatkan peran kader posyandu, serta sebagai deteksi dini status gizi balita.

Introduction: There are few studies on e-Health interventions directed at parents that analyse their costs and any potential savings that may occur. The aims of this study consisted of calculating the costs of the development and maintenance of a paediatric web site for parents, including the costs per visit and per visitor, and the potentially savings made as regards medical visits avoided as a result of its use. Methods: The technology costs as well as the work of the professionals were considered as costs of the web site. The calculation of the cost of the professionals and the potential savings were based on the official fees and public prices of the Andalusian Public Health Service. Results: During 5 years and 6 months of the study, the total cost of the web site was €45,201.56. The cost per visit received was €0.0155€, and €0.0186 for each single visitor. Among the 516 users that took part in the study, face-to-face visits to Primary Care paediatric clinics were avoided, as well as those to Paediatric Emergency Department, at a savings of €22,263.89. Conclusions: The costs of developing a paediatric e-Health website for parents written in Spanish, using existing and free technologies, are low compared to other forms of e-Health development. Furthermore, the costs are considerably low if they are divided by the total number of visits or the number of visitors. There is also a considerable potential financial saving on contributing to avoid face-to-face visits. Resumen: Introducción: Son pocas las intervenciones de eSalud dirigidas a padres que analizan sus costes y el ahorro potencial que pueden generar. Los objetivos de este trabajo consistieron en calcular los costes de desarrollo y mantenimiento de una web de pediatría para padres, el coste por visita y por visitante, y el ahorro potencial generado en función de las visitas médicas evitadas como consecuencia de su uso. Métodos: Para los costes de la web se consideraron los costes tecnológicos y del trabajo de los profesionales. El cálculo del coste de los profesionales y de ahorro potencial se basaron en los honorarios oficiales y en los precios públicos del Sistema Sanitario Público de Andalucía. Resultados: Durante los 5 años y 6 meses del estudio el coste total de la web fue de 45.201,56€. El coste por visita recibida fue de 0,0155€, y por cada visitante único, de 0,0186€. Entre los 516 usuarios que participaron en el estudio se evitaron visitas presenciales a las consultas de pediatría de atención primaria y a los servicios de urgencias de pediatría por un valor de 22.263,89€. Conclusiones: Los costes de desarrollo de una web de eSalud de pediatría para padres escrita en español, usando tecnología existente y gratuita, son bajos en comparación a otras formas de desarrollo de eSalud. Además, los costes son considerablemente bajos si se dividen entre el número de visitas totales o el número de visitantes. También existe un potencial considerable de ahorro económico al contribuir a evitar visitas presenciales.

Resumen: Introducción: Son pocas las intervenciones de eSalud dirigidas a padres que analizan sus costes y el ahorro potencial que pueden generar. Los objetivos de este trabajo consistieron en calcular los costes de desarrollo y mantenimiento de una web de pediatría para padres, el coste por visita y por visitante, y el ahorro potencial generado en función de las visitas médicas evitadas como consecuencia de su uso. Métodos: Para los costes de la web se consideraron los costes tecnológicos y del trabajo de los profesionales. El cálculo del coste de los profesionales y de ahorro potencial se basó en los honorarios oficiales y en los precios públicos del Sistema Sanitario Público de Andalucía. Resultados: Durante los 5 años y 6 meses del estudio el coste total de la web fue de 45.201,56€. El coste por visita recibida fue de 0,0155€, y por cada visitante único, de 0,0186€. Entre los 516 usuarios que participaron en el estudio se evitaron visitas presenciales a las consultas de pediatría de atención primaria y a los servicios de urgencias de pediatría por un valor de 22.263,89€. Conclusiones: Los costes de desarrollo de una web de eSalud de pediatría para padres escrita en español, usando tecnología existente y gratuita, son bajos en comparación a otras formas de desarrollo de eSalud. Además, los costes son considerablemente bajos si se dividen entre el número de visitas totales o el número de visitantes. También existe un potencial considerable de ahorro económico al contribuir a evitar visitas presenciales. Abstract: Introduction: There are few studies on e-Health interventions directed at parents that analyse their costs and any potential savings that may occur. The aims of this study consisted of calculating the costs of the development and maintenance of paediatric web site for parents, including the costs per visit and per visitor, and the potentially savings made as regards medical visits avoided as a result of its use. Methods: The technology costs as well as the work of the professionals were considered as costs of the web site. The calculation of the cost of the professionals and the potential savings were based on the official fees and public prices of the Andalusian Public Health Service. Results: During 5 years and 6 months of the study, the total cost of the web site was €45,201.56. The cost per visit received was €0.0155€, and €0.0186 for each single visitor. Among the 516 users that took part in the study, face-to-face visits to Primary Care paediatric clinics were avoided, as well as those to Paediatric Emergency Department, at a savings of €22,263.89. Conclusions: The costs of developing a paediatric e-Health website for parents written in Spanish, using existing and free technologies, are low compared to other forms of e-Health development. Furthermore, the costs are considerably low if they are divided by the total number of visits or the number of visitors. There is also a considerable potential financial saving on contributing to avoid face-to-face visits.

Our study examines the acceptability and feasibility of Moshi, an audio-based mobile application, among children 3–8 years old using a parent–child dyadic approach. Our 10-day within-subject pre–post study design consisted of five nights of a normal bedtime routine and a subsequent five nights exposed to one story on the Moshi application during the intervention. Each five-night period spanned three weeknights and two weekend nights. The Short-Form Children’s Sleep Habits Questionnaire (SF-CSHQ) was used to measure children’s sleep at baseline and post-intervention. The PROMIS, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were used to assess parents’ sleep. Among the 25 child–parent dyads, the mean child age was 4 (SD = 1.23) and 63% were male (n = 15). Mean parent age was 35 (SD = 5.83), 84% were female (n = 21), and 48.0% were Black (n = 12). For child-only comparisons, mean post-SF-CSHQ measures were lower compared to baseline. A trend in parent sleep is reported. This study shows the potential of an audio-based mobile sleep aid to improve sleep health in a racially diverse parent and child dyad sample.

Using m-Health apps can provide researchers and others with an effective way for improving physical activity (PA) and healthy lifestyle behaviors. The promotion of health should move from a model focused on the physical and biological basis of illness and towards a focus on the behavioral changes that support health. Therefore, the aims of the current study were to improve PA (step-counts) and body weight using a theory-based m-Health app. A 12-week randomized treatment trial was carried out at Texas A&M University, Texas, college station. College students (n = 130) were recruited. They were randomized in an equal ratio of 1:1 to intervention (m-Health app) (n = 65) and control (n = 65) conditions. The response rate was (87.6%). Both groups utilized a Smartphone app. The intervention group received PA goals of (10,000 steps/day), using an m-Health app. The control group was provided with information related to daily recommended PA levels. The primary change was daily step count between the baseline and follow-up. The secondary outcome was the body mass index (BMI). Descriptive statistics were used to summarize the baseline differences between the control and intervention groups. Independent sample t-test were used for comparison between the intervention and control groups. Post-intervention PAs were higher for the intervention group (mean = 54,896.) vs. control group (mean = 45,530.12; p < 0.05). The intervention group’s step-counts increased significantly (pre-mean = 40,320.38 steps per week; post-mean = 54,896.27 steps per week, p < 0.05). The body-weight changes were significant among the intervention group (p < 0.05). m-Health apps can increase PA and improve body weight, with goal setting and feedback as key intervention components. Future studies should personalize PA goals and feedback.

Nowadays, the emerging information technologies in smart handheld devices are motivating the research community to make use of embedded sensors in such devices for healthcare purposes. In particular, inertial measurement sensors such as accelerometers and gyroscopes embedded in smartphones and smartwatches can provide sensory data fusion for human activities and gestures. Thus, the concepts of the Internet of Healthcare Things (IoHT) paradigm can be applied to handle such sensory data and maximize the benefits of collecting and analyzing them. The application areas contain but are not restricted to the rehabilitation of elderly people, fall detection, smoking control, sportive exercises, and monitoring of daily life activities. In this work, a public dataset collected using two smartphones (in pocket and wrist positions) is considered for IoHT applications. Three-dimensional inertia signals of thirteen timestamped human activities such as Walking, Walking Upstairs, Walking Downstairs, Writing, Smoking, and others are registered. Here, an efficient human activity recognition (HAR) model is presented based on efficient handcrafted features and Random Forest as a classifier. Simulation results ensure the superiority of the applied model over others introduced in the literature for the same dataset. Moreover, different approaches to evaluating such models are considered, as well as implementation issues. The accuracy of the current model reaches 98.7% on average. The current model performance is also verified using the WISDM v1 dataset.

Context: With the increasing trend of adopting e-Health technologies, the need for evidence for assessing e-Health technologies has become crucial. The appraisal of the e-Health program is important as this could provide guidance on further e-Health investment and adoption. Aims: The aim of the study was to provide an articulated body of literature on the current state of knowledge about the assessment of e-Health interventions. Settings and Design: Scoping review was conducted based on the framework provided by Arksey and O'Malley (2005) and considering enhancements proposed by Peters et al. (2015). Subjects and Methods: We searched the electronic databases and available gray literature from inception until the last week of October 2019. PRISMA flowchart for the study selection process was used to guide reporting. Data extraction included information on study design, authors, year of study, country, and key findings in terms of approaches used for assessment of e-Health programs. Data were compiled and summarized narratively. Results: Searches were performed between October and December 2019. Seventy-one relevant papers published between the years until the last week of October 2019 were reviewed and analyzed. After considering all the eligibility criteria, 15 papers were included. We identified 15 approaches for assessing e-Health programs, which were summarized and tabulated. Conclusions: This review showed that available literature on the assessment of e-Health programs is heterogeneous in terms of the methodology used. e-Health interventions are highly contextual; therefore; the phase of maturity and objective of the assessment should be considered while carrying out the assessment of e-Health programs.

People with special nutritional needs must monitor their food intake as accurately as possible. One of the problems with food-intake monitoring is a correct estimation of portion sizes. This paper presents an open-source solution to the problem of portion-size estimation consisting of a pocket-sized kitchen scale and a demo mobile application. It is implemented as a soft real-time, low-power consuming embedded system with a Bluetooth connection to the smartphone. Releasing both the hardware and software of the system as open source paves the way towards accurate nutrition tracking and personalized nutrition. This can lead to important advances in the field of nutrition research, as well as practice. This is demonstrated with a proof-of-concept integration of our solution with a commercial mobile application that helps users to keep track of their health and lifestyle goals.

Introduction Diabetes Mellitus is a major chronic disease associated with many complications and high morbidity. The need for lifestyle modification and regular adherent treatment makes the management of the disease difficult. This study examines the scope of m-Health in the management of type 2 diabetes mellitus in terms of glycemic control. Methods A randomized controlled study was performed among the patients attending the outpatient department of a tertiary care hospital in Mysuru city. A mobile application named DIAGURU, mainly focusing on lifestyle modification and medication management was used for a period of 6 months from April 2019 to September 2019 by 150 patients in the study group while another 150 participants served as controls. The change in glycosylated haemoglobin levels was assessed after six months. Results The mean HbA1C levels at the starting of the study was found to be 7.36% ± 1.04 in the study group and 7.84% ± 1.33% in the control group. A repeat HbA1c test after six months showed a mean level of 7.10% ± 0.96% among the participants who received the intervention and 7.97% ± 1.37% among the control group. The values were showing a trend of reduction in the intervention group, with a median reduction HbA1c of −0.2% (−0.3% to −0.2%). Among the participants who did not receive our intervention, a median increase of 0.1% (0%–0.2%) in HbA1c was noticed. Mann Whitney U test was performed, and it showed a statistically significant association with a p value less than 0.001. Conclusion From this study, we conclude that an intervention with a mobile application aimed at lifestyle modification and medication management in addition to regular medical treatment for type 2 diabetes mellitus patients resulted in a better glycemic control compared to a control group who did not receive the adjuvant intervention. CTRI registration number CTRI/2020/02/023115.

Turki Alanzi Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Turki Alanzi Email talanzi@iau.edu.saPurpose: The objective of this paper was to review the functionalities and effectiveness of the free mobile health applications available in the Google Play and App stores used in Saudi Arabia, Italy, Singapore, the United Kingdom, USA, and India during the COVID-19 outbreak.Methods: This study adopted a systematic search strategy to identify the free mobile applications available in the App and Google Play stores related to the COVID-19 outbreak. According to the PRISMA flowchart of the search, only 12 applications met the inclusion criterion.Results: The 12 mobile applications that met the inclusion criterion were: Mawid, Tabaud, Tawakkalna, Sehha, Aarogya setu, TraceTogether, COVID safe, Immuni, COVID symptom study, COVID watch, NHS COVID-19, and PathCheck. The following features and functionalities of the apps were described: app overview (price, ratings, android, iOS, developer/owner, country, status), health tools (user status-risk assessment, self-assessment, E-pass integration, test results reporting, online consultation, contact tracing), learning options (personalized notes, educational resources, COVID-19 information), communication tools (query resolution, appointments, social network, notifications), app design (data visualization, program plan), networking tools (location mapping – GPS, connectivity with other devices), and safety and security options (alerts, data protection). Also, the effectiveness of the apps was analyzed.Conclusion: The analysis revealed that various applications have been developed for different functions like contact tracing, awareness building, appointment booking, online consultation, etc. However, only a few applications have integrated various functions and features such as self-assessment, consultation, support and access to information. Also, most of the apps are focused on contact tracing, while very few are dedicated to raising awareness and sharing information about the COVID-19 pandemic. Likewise, the majority of applications rely on GPS and Bluetooth technologies for relevant functions. No apps were identified that had built-in social media features. It is suggested to design and develop an integrated mobile health application with most of the features and functionalities analyzed in this study.Keywords: COVID-19, pandemic, healthcare, m-health, e-health, mobile applications, virtual care, telehealth

Blood donation (BD) is one of the most significant contributions that a person can make towards the society. The growing android technology has made the process of BD easier and hassle-free. The Nineveh blood bank is an android application made for such great and noble cause. The application connects the givers and the requesters of blood who live in the Nineveh province, Iraq. The blood requester can serach from a list of all donors who have the same blood group and directly contact them without any third-party involvement. The Nineveh Blood application creates giver’s/requester’s profile through the Google Firebase Real-time database. In which, a one WebSocket two-way channel can constantly send the data back-and-forth between the server and the clients, and store the data as a JavaScript Object Notation (JSON) file.

It is critical for developing countries to create national EHR systems. Interoperability of EHR systems at a national level is inadequate even in developed countries. Integration of EHR systems should include all national healthcare entities across all layers of healthcare, resulting in a centralized, National e-Health System (NeHS). Diabetes related information has to be part of the NeHS. The NeHS was introduced in the Republic of North Macedonia since 01-July-2013. Implementation of the NeHS has been praised internationally as a key platform for improving the performance of the national healthcare system. Introduction of NeHS provided the first opportunity for evaluation of prevalence of diagnosed diabetes cases, unlike the previous data based on extrapolations from other countries in the region. The NeHS could be used for monitoring of risk factors and development of diabetes complications. The NeHS has served as a human resources management tool by identifying the need of additional human resources in diabetes care. The NeHS was essential in discovering prescribers who were violating the guidelines, and played a crucial role in the rationalization of diabetes costs. Implementation of NeHS requires strong political leadership and support from the medical community.

The postnatal period is a critical phase in both the lives of the mothers and the newborns. Due to all the inherent changes that occur during this period, quality care is crucial during this period to enhance the wellbeing of the mothers and the newborns. In Morocco, the neglection of postnatal care services are often associated to poor communication, financial difficulties and cultural barriers. Mobile technology constitutes therefore a promising approach to bridge this gap and promote postnatal care. In order to improve the effectiveness of mobile technology, gamification has become a powerful feature to boost motivation and induce fun and interactivity into the mobile solutions’ tasks. Based on a previous review on mobile applications for postnatal care available in app repositories, a set of requirements have been identified to build a comprehensive mobile solution that cater the needs of both the mothers and the newborns. These requirements have, then, been enriched with real needs elicited at maternity Les orangers that belongs to the University Hospital Avicenne of Rabat. Along with the functional and non-functional requirements, gamification aspects have been also analyzed. After the analysis and design phases, a pilot version of the solution called ‘Mamma&Baby’ has been implemented using android framework. ‘Mamma&Baby’ is a mobile solution dedicated to assist new mothers during their postnatal period. As future work, it is expected to fully integrate the gamification elements into the solution and conduct an empirical evaluation of the overall quality and the potential of the solution with real puerperal women.

Background: Patients often need multiple fine-tuning appointments with their hearing health care provider to achieve satisfactory hearing aid outcomes. A smartphone app that enables patients to remotely request and receive new hearing aid settings could improve hearing health care access and efficiency. Introduction: We assessed the usability of ReSound Assist™, (ReSound America, Bloomington, MN) the remote communication feature of a hearing aid app, and investigated whether hearing aid outcomes are influenced by app-based versus in-person patient-provider communication. Materials and Methods: Thirty adults were fit bilaterally with hearing aids and randomized to intervention and control groups. During a 6-week field trial, participants reported hearing aid problems via ReSound Assist (intervention) or at a scheduled face-to-face follow-up appointment (control). Usability of ReSound Assist was assessed with a questionnaire and interview. Hearing aid performance, benefit, satisfaction, and daily usage were compared for both groups. Results: ReSound Assist was rated as highly usable. Participants identified specific aspects of effectiveness and efficiency that could be improved. Similar problems were reported by intervention and control participants regardless of communication mode (app-based vs. in-person). However, almost half the requests received via ReSound Assist were for problems that required advice from the provider or physical modifications to the hearing aids rather than fine-tuning, highlighting the continued importance of in-person hearing health care. There was no significant difference in hearing aid outcomes between intervention and control participants. Conclusions: Apps enabling remote patient-provider communication are a viable method for hearing aid users to seek and receive help with hearing aid problems that can be addressed through fine-tuning.

Demah Alsalman, Zahra M Bu Ali, Zainab F Alnosaier, Norah A Alotaibi, Turki M Alanzi Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Turki M AlanziHealth Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam 31441, Saudi ArabiaTel/ Fax +966 133332703Email talanzi@iau.edu.saPurpose: The objective of this study was to review most of the existing free m-Health applications (Apps) that use the gamification approach to manage diabetes type 1 in both App and Google Play stores.Methods: Free mobile health applications “apps” that were related to diabetes mellitus have been identified in both App and Google Play stores. In order to cover all the mentioned applications, the following keywords, “game for type 1 diabetes” and “gamification for type 1 diabetes” were used in English and Arabic languages. All applications that were collected in the inclusion process were carefully analyzed, and the game name, game description, game features, game mechanics, game themes, and operating systems were recorded.Results: A total of eight gamified applications related to type 1 diabetes were identified. Seven of these applications were in English language and only one application was in Arabic language. The applications were categorized into three main categories based on the theme of the application. The categories were taking care of a character, quizzes, and the storytelling theme. Moreover, there was no application that included the social networking feature.Conclusion: This study highlighted the most important features of the free mobile health applications “apps” for diabetes type 1 available in Google Play and App stores that can contribute to enhance the self-management of the diabetes condition by patients in Saudi Arabia. The identified applications have important characteristics that can be used in the future for the care and self-control of type 1 diabetic patients in Saudi Arabia.Keywords: gamification, diabetes type 1, applications, Google Play store, App store, mobile health, m-Health, mobile health applications, digital health

Purpose The objective of this study was to review most of the existing free m-Health applications (Apps) that use the gamification approach to manage diabetes type 1 in both App and Google Play stores. Methods Free mobile health applications “apps” that were related to diabetes mellitus have been identified in both App and Google Play stores. In order to cover all the mentioned applications, the following keywords, “game for type 1 diabetes” and “gamification for type 1 diabetes” were used in English and Arabic languages. All applications that were collected in the inclusion process were carefully analyzed, and the game name, game description, game features, game mechanics, game themes, and operating systems were recorded. Results A total of eight gamified applications related to type 1 diabetes were identified. Seven of these applications were in English language and only one application was in Arabic language. The applications were categorized into three main categories based on the theme of the application. The categories were taking care of a character, quizzes, and the storytelling theme. Moreover, there was no application that included the social networking feature. Conclusion This study highlighted the most important features of the free mobile health applications “apps” for diabetes type 1 available in Google Play and App stores that can contribute to enhance the self-management of the diabetes condition by patients in Saudi Arabia. The identified applications have important characteristics that can be used in the future for the care and self-control of type 1 diabetic patients in Saudi Arabia.

Introduction: Strong evidence has shown the benefits of engagement in recommended amount of physical activity. However, it is estimated that nearly half of university students do not participate in sufficient amount of physical activity. While entering university life is a transitional stage important for adopting a particular lifestyle, it is crucial to develop and implement novel strategies to promote physical activity among this population. A smartphone application is a potential media for delivering physical activity intervention. However, recent reviews in this area have demonstrated high levels of heterogeneity, potentially due to population diversity. To date there has been no attempt to synthesize the literature assessing the effectiveness of this particular intervention in university students.Aim: The primary aim of this review is to investigate the effectiveness of smartphone application intervention on physical activity level among university students. The secondary aim is examining the behavior change technique elements of smartphone applications used in available studies.Methods: Sixteen electronic databases will be searched for randomized controlled trials and quasi-experimental studies reporting the effect of smartphone application intervention on physical activity outcomes among university students. Two reviewers will independently screen the potential studies and extract data from included studies. Active elements of smartphone applications used in included studies will be coded using the Behavior Change Technique taxonomy v1. Risk of bias and quality of evidence of individual studies will be assessed. The overall evidence will be presented in a narrative synthesis and quantitative synthesis.

Background and Aim: The incidence of osteoporotic fractures, which leads to morbidity and mortality in the elderly, is increasing worldwide. Mobile health application could empower patients to engage in managing their own health. This has a significant impact on improving health outcomes in chronic diseases. For this reason, this study was conducted to develop a mobile-based self-management application for patients with Osteoporotic fractures. Materials and Methods: In this descriptive-developmental study, initially, the data required in this research were collected through searching in library resources, clinical guidelines and application review. Then, a questionnaire was applied by physician to validate and determine the significance of these elements and the rational design of application was provided with the obtained elements. Finally, the application was developed in Android Studio environment and then evaluated. Results: The main application parts include: Disease prevention information, fracture risk assessment tool and information for self-management in osteoporotic fractures care which was divided into two parts: Hip fracture and other fractures. Moreover, provides functions like exercise program adjustments, reminders and patient records. The application functions were evaluated and was able to meet the expectations. Conclusion: This is a mobile application with validated content and can be used to help patients with osteoporotic fractures to manage their disease and to obtain self-management skills.

Background Patients with metastatic breast cancer (MBC) are treated with a palliative approach with focus on controlling for disease symptoms and maintaining high quality of life. Information on individual needs of patients and their relatives as well as on treatment patterns in clinical routine care for this specific patient group are lacking or are not routinely documented in established Cancer Registries. Thus, we developed a registry concept specifically adapted for these incurable patients comprising primary and secondary data as well as mobile-health (m-health) data. Methods The concept for patient-centered “Breast cancer care for patients with metastatic disease” (BRE-4-MED) registry was developed and piloted exemplarily in the region of Main-Franconia, a mainly rural region in Germany comprising about 1.3 M inhabitants. The registry concept includes data on diagnosis, therapy, progression, patient-reported outcome measures (PROMs), and needs of family members from several sources of information including routine data from established Cancer Registries in different federal states, treating physicians in hospital as well as in outpatient settings, patients with metastatic breast cancer and their family members. Linkage with routine cancer registry data was performed to collect secondary data on diagnosis, therapy, and progression. Paper and online-based questionnaires were used to assess PROMs. A dedicated mobile application software (APP) was developed to monitor needs, progression, and therapy change of individual patients. Patient’s acceptance and feasibility of data collection in clinical routine was assessed within a proof-of-concept study. Results The concept for the BRE-4-MED registry was developed and piloted between September 2017 and May 2018. In total n = 31 patients were included in the pilot study, n = 22 patients were followed up after 1 month. Record linkage with the Cancer Registries of Bavaria and Baden-Württemberg demonstrated to be feasible. The voluntary APP/online questionnaire was used by n = 7 participants. The feasibility of the registry concept in clinical routine was positively evaluated by the participating hospitals. Conclusion The concept of the BRE-4-MED registry provides evidence that combinatorial evaluation of PROMs, needs of family members, and raising clinical parameters from primary and secondary data sources as well as m-health applications are feasible and accepted in an incurable cancer collective.