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Behavior change interventions that incentivize desired behavior are highly effective for improving personal health, but difficult to maintain long term. Relapse is common and examining the mechanisms that contribute to relapse in experimental settings can identify processes relevant to substance abuse treatment. We developed a laboratory task that parallels a recent operant model of relapse after incentivized choice reported in the rodent laboratory. In two experiments, undergraduate participants first learned to make an operant response (keyboard button; R1) to earn a reinforcer consisting of an image of a preferred snack food (O1). In a second phase (Phase 2), R1 was still reinforced, but a new response (R2) was introduced and reinforced with a different reinforcer (a coin; O2). In a test phase, contingent incentives for R2 were removed (extinction) and relapse of R1 was assessed. Experiment 1 found that the O2 contingency suppressed R1 during Phase 2, and R1 relapsed rapidly in the test. Neither effect was consistently related to O2 value. Experiment 2 examined whether noncontingent presentations of O1 or O2 during the test could weaken relapse. Here, we found that noncontingent reinforcers did little to reduce or slow the increase in R1 responding. The present experiments highlight a laboratory approach to studying variables that may influence relapse after incentivized treatment. We identify and discuss areas for development to address differences between the present results and prior observations from animal and clinical studies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Purpose of Review A gap exists between PrEP interest and PrEP uptake in key populations (KP) for HIV prevention that may be ascribed to PrEP delivery services not being acceptable. This review summarizes novel platforms for HIV prevention outside of the traditional health facilities environment. Recent Findings Mobile health clinics provide highly acceptable integrated, KP-focused services at convenient locations with the potential of high PrEP uptake. Telemedicine and health apps decongest health systems and allow for personal agency and informed decision-making on personal health. Pharmacy-led PrEP delivery provides de-medicalized, confidential PrEP services at extended hours in community locations, from trusted medical professionals. Peer-supported delivery encourages continued PrEP use. Summary Community-based, differentiated and de-medicalized PrEP delivery can address uptake and continued use barriers in key populations. Future research should assess scalability, cost-effectiveness and sustainability of these PrEP delivery platforms, as well as focus on ways to simplify PrEP provision.

Objective Preconception and prenatal carrier screening is designed to provide reproductive risk information, but carriers for some autosomal recessive or X-linked conditions also have personal health risks. This study investigated the prevalence of and inclusion of personal health implications in pre- and post-test counseling. Methods Twelve genetic conditions with personal health risks for carriers included on carrier screening panels but not otherwise screened routinely were identified (e.g., Gaucher disease with Parkinson's disease risk). A retrospective review was performed of patients with a positive carrier screen for one of these conditions at our center from 2012-2019. Results Of 6,147 individuals that had carrier screening for one of the twelve conditions, 96 (1.56%) did not report a known family history and screened positive for one of the conditions. Testing was ordered largely by reproductive endocrinologists (51.0%) and genetic counselors (35.4%). Most individuals did not receive pre- (96.8%) or post-test (64.6%) counseling about personal health risks. Post-test counseling was performed principally by genetic counselors (97.1%). For carriers of conditions with guidelines for specialist referral, most individuals (75.9%) were referred. Conclusion Expanded genetic carrier screening increasingly identifies individuals with personal health implications, but patients are frequently not counseled before or after testing. These findings stress the importance of developing guidelines for practitioners about expanded carrier screening counseling and follow-up. This article is protected by copyright. All rights reserved.

Fibers and textiles play key roles in the development and day-to-day activities of human society. Innovations related to flexible electronics-smart fibers and textiles with sensing, thermal regulation, and energy management capabilities-have drawn great interest from both academic and industrial communities. Smart fibers and textiles are anticipated to revolutionize personal health management due to their manifold features and capabilities, providing the foundation for many intelligent wearables. In this Perspective, we provide a brief overview of recent advances in the design and fabrication of smart fibers and textiles for health management applications, focusing primarily on those with sensing, thermal regulation, and energy management functions. We describe the existing challenges and opportunities and propose future development directions.

Introduction The early COVID‐19 pandemic rapidly transformed healthcare and medical education. We sought to evaluate the professional and personal impact of the pandemic on 2019–2020 Breast Surgical Oncology (BSO) fellows in Society of Surgical Oncology approved programs to capture the experience and direct future changes. Methods From July 15, 2020 to August 4, 2020 a survey was administered to the American Society of Breast Surgeons' fellow members. The survey assessed the impact of the pandemic on clinical experience, education/research opportunities, personal health/well‐being, and future career. Responses were collected and aggregated to quantify the collective experience of respondents. Results Twenty‐eight of fifty‐seven (54%) eligible fellows responded. Twenty‐one (75%) indicated the clinical experience changed. Twenty‐seven (96%) reported less time spent caring for ambulatory breast patients and sixteen (57%) reported the same/more time spent in the operating room. Fourteen (50%) stated their future job was impacted and eight (29%) delayed general surgery board examinations. Stress was increased in 26 (93%). Personal health was unaffected in 20 (71%), and 3 (10%) quarantined for COVID‐19 exposure/infection. Conclusion The COVID‐19 pandemic altered the clinical experience of BSO fellows; however, the operative experience was generally unaffected. The creation of frameworks and support mechanisms to mitigate potential challenges for fellows and fellowship programs in the ongoing pandemic and other times of national crisis should be considered.

Background The COVID19 pandemic is one of the greatest modern global healthcare crises. The resultant morbidity and mortality of public and healthcare professionals has led to psychological impacts and economic repercussions. We set out to assess the concerns of doctors in training during this crisis. Methods A questionnaire was developed and delivered via Survey Monkey to doctors in training from 27 March to 6 April 2020, 2 weeks prior to the expected surge in Ireland and UK. The Perceived Stress Scale (PSS) was incorporated to gauge respondent stress as they prepared for the COVID19 impact. Results A total of 285 participants engaged with 197 (69%) completing all questions. Almost 86% of respondents had been trained in donning and doffing personal protective equipment (PPE), and nearly 85% felt confident in the process. Overall, most respondents felt somewhat prepared (60%) or well prepared (20%) to treat COVID19 patients. However, 42% worried that their hospital would struggle, or not cope at all; in particular, 91% highlighted the risk of running out of PPE. Family health (86%), personal health (72%), and social life (47%) topped the list of junior doctor concerns. According to the PSS, the majority of respondents (62%) had moderate stress. Conclusions This survey is the first to measure the concerns of doctors in training in Ireland as regards the COVID19 pandemic. Worries included PPE exhaustion and personal and family health. A significant majority had moderate stress. Additional supports for doctors in training are essential to aid stress and manage concerns better.

Vaccination is a key protective factor against COVID-19. Some vaccines have already received emergency authorization from Health Agencies, but growing skepticism and vaccine hesitancy will probably affect COVID-19 vaccination campaigns. In the attempt to shed light on this issue, we conducted an online survey in a population of parents referring to 4 pediatric practices in Naples, Italy in whom we evaluated potential vaccine acceptability in relation to socio-demographic characteristics, perception of personal health and of the impact of COVID-19, and attitudes toward general vaccination practices. Vaccination rates were analyzed also in the corresponding pediatric population. Almost 27% of participants declared they were in favor of vaccinations, and in fact real life vaccination rates in children exceeded the national mean. Only 26.5% of respondents declared they would receive COVID-19 vaccine. Vaccine refusal was attributed to safety concerns in 76% of parents. Specific vaccine attributes further reduced the acceptance rate. Female gender, younger age and lower education level were associated with non-adherence to vaccination. Among extrinsic factors of COVID-19 vaccination, only information from National Health Authorities was significantly associated to vaccine acceptance. The rate of potential COVID-19 vaccine acceptability was very poor in our population of parents. Vaccine hesitancy was mainly due to safety concerns. Demographic and educational factors were correlated to vaccine acceptability. Health education and communication strategies are needed to achieve large-scale vaccine acceptability and finally herd immunity.

BACKGROUND: Traditionally, during crises the number of new blood donors increases. However, the current coronavirus disease 2019 (COVID-19) pandemic created additional barriers to donate due to governmental prevention measures and increased personal health risks. In this report, we examined how the pandemic affected new donor registrations in the Netherlands, especially among groups with higher risk profiles for severe COVID-19. Additionally, we explored the role of media for blood donation and new donor registrations.STUDY DESIGN AND METHODS: We analyzed new donor registrations and attention for blood donation in newspapers and on social media from January until May 2020, in comparison to the same period in 2017 to 2019.RESULTS: After the introduction of nationwide prevention measures, several peaks in new donor registrations occurred, which coincided with peaks in media attention. Interestingly, people with a higher risk profile for COVID-19 (e.g., due to age or region of residence) were overrepresented among new registrants.DISCUSSION: In sum, the first peak of the current pandemic has led to increased new blood donor registrations, despite the associated increased health risks. Time and future studies will have to tell whether these new donors are one-off 'pandemic' donors or if they will become regular, loyal donors.

Clinical decision-making regarding treatments based on personal characteristics leads to effective health improvements. Machine learning (ML) has been the primary concern of diagnosis support according to comprehensive patient information. A prominent issue is the development of objective treatment processes in clinical situations. This study proposes a framework to plan treatment processes in a data-driven manner. A key point of the framework is the evaluation of the actionability for personal health improvements by using a surrogate Bayesian model in addition to a high-performance nonlinear ML model. We first evaluate the framework from the viewpoint of its methodology using a synthetic dataset. Subsequently, the framework is applied to an actual health checkup dataset comprising data from 3132 participants, to lower systolic blood pressure and risk of chronic kidney disease at the individual level. We confirm that the computed treatment processes are actionable and consistent with clinical knowledge for improving these values. We also show that the improvement processes presented by the framework can be clinically informative. These results demonstrate that our framework can contribute toward decision-making in the medical field, providing clinicians with deeper insights., 効果的な健康改善プランを提案するAIを開発 --個別化医療における健康介入への活用に期待--. 京都大学プレスリリース. 2021-05-28.

Background Paid employment has been shown to benefit childless women’s health, while employed mothers experience poorer health, and more pronounced fatigue. This study measures the association between job characteristics and the health and well-being of employed mothers and the differential susceptibility to job characteristics between coupled and single-parent mothers. Methods We used data from the 5th Portuguese National Health Survey from 1649 employed women (aged 25–54) living with a child under 16. We modelled depression (assessed by the Personal Health Questionnaire-8) and self-reported health as a function of job characteristics, adding interaction terms to compare coupled and single-parent mothers, using logistic regressions. Results Working part-time was associated with depression (odds ratio (OR) = 3.39, 95% confidence interval (CI) = 3.31–3.48) and less-than-good health (OR = 1.28, 95%CI = 1.26–1.31), compared to working full time. Compared to high-skill jobs, the likelihood for depression among low-skill occupations was lower among coupled mothers (OR = 0.25, 95%CI = 0.24–0.26), and higher among single-parent mothers (OR = 1.75, 95%CI = 1.54–1.99). Unstable jobs were associated with depression among coupled mothers. Conclusions Part-time jobs are detrimental for mothers’ mental health, but high-skilled jobs are protective for single-parent mothers. Part-time and unstable jobs are linked to poorer self-reported health among coupled mothers. Results question the gendered arrangements that may face employed coupled mothers.

BackgroundThe proportion of elderly is on the rise both in Europe and in Hungary. The challenge is to increase the number of years spent in good health as well as to improve quality of life of those 60 years and above. This study focuses on the impact of physical activity on this age group.MethodsA nationally representative sample of 2000 respondents were surveyed in an age range of 15–74. Our data concerns those being 60–74 years of age. The focus of our investigation was level and impact of physical activity in the group above. First, we used Chi-squared tests and correspondence analysis to identify the deviation in the answers of different groups in our sample. After we built a hierarchical linear regression model to get a deeper understanding of the impact of physical activity for elderly.ResultsThose reporting no physical/sports activity at all have to do with the negative culture of exercising. Only 9.3% reported being engaged with any sports; 72% reported no regular exercising throughout their lives. The relationship between sport activity and self-reported health was significant (p = 0.009, Cramer’s V = 0.2). Elderly were characterized by walking, hiking and less intense sports.ConclusionsThose who actively exercised in this research reported better health outcomes than those who stopped or had never been engaged in any sports. We conclude that of all variables tested, physical activity was most effective to improve personal health of the elderly in this sample. Compared to European data on physical activity of elderly populations, Hungary seems to fall behind and needs to consider concentrated efforts to improve the future health of its senior populace.

Background Immense volumes of personal health information (PHI) are required to realize the anticipated benefits of artificial intelligence in clinical medicine. To maintain public trust in medical research, consent policies must evolve to reflect contemporary patient preferences. Methods Patients were invited to complete a 27-item survey focusing on: (a) broad versus specific consent; (b) opt-in versus opt-out approaches; (c) comfort level sharing with different recipients; (d) attitudes towards commercialization; and (e) options to track PHI use and study results. Results 222 participants were included in the analysis; 83% were comfortable sharing PHI with researchers at their own hospital, although younger patients (≤ 49 years) were more uncomfortable than older patients (50 + years; 13% versus 2% uncomfortable, p Conclusions While most patients were willing to share their PHI with researchers within their own institution, many preferred a transparent and reciprocal consent process. These data also suggest a generational shift, wherein younger patients preferred more specific consent options. Modernizing consent policies to reflect increased autonomy is crucial in fostering sustained public engagement with medical research.

Single walled carbon nanotubes have special chemical and physical properties, at the same time, they have the advantage of macro maneuverability in maneuverability, so they have the potential of multi-functional applications. At present, composite materials, super capacitors and corresponding personal care products based on carbon nanotubes are widely used in all aspects of people’s lives, and these products have obvious functional advantages. In this paper, based on the application of single-walled carbon nanotubes technology in personal care products, the separation and purification of ginsenoside pods, the raw material of high-end washing and care products, was studied. In order to enhance the conductivity and tensile strength of SWNTs, this paper innovatively introduces the purification method of current acid treatment to enhance the performance of SWNTs. Based on the improved single-walled carbon nanotubes technology, the extraction efficiency of the optimized single-walled carbon nanotubes was analyzed. In the end of this paper, the optimized extraction method of ginsenoside pods from SWNTs is compared with the traditional extraction method. The experimental results show that SWNTs has obvious time efficiency advantage.

PURPOSE: Patients are frequently asked to share their personal health information. The objective of this study was to compare the effects on patient experiences of 3 electronic consent (e-consent) versions asking patients to share their health records for research. METHODS: A multi-arm randomized controlled trial was conducted from November 2017 through November 2018. Adult patients (n = 734) were recruited from 4 family medicine clinics in Florida. Using a tablet computer, participants were randomized to (1) a standard e-consent (standard), (2) an e-consent containing standard information plus hyperlinks to additional interactive details (interactive), or (3) an e-consent containing standard information, interactive hyperlinks, and factual messages about data protections and researcher training (trust-enhanced). Satisfaction (1 to 5), subjective understanding (0 to 100), and other outcomes were measured immediately, at 1 week, and at 6 months. RESULTS: A majority of participants (94%) consented to future uses of their health record information for research. No differences in study outcomes between versions were observed at immediate or 1-week follow-up. At 6-month follow-up, compared with the standard e-consent, participants who used the interactive e-consent reported greater satisfaction (B = 0.43; SE = 0.09; P

Hydrogels are natural or synthetic polymeric networks, insoluble in water, or sometimes found as colloidal gel where the dispersion medium is water. Hydrogels can absorb approximately 90% water and are regarded as superabsorbent materials; hence these resemble the natural living tissues more than any other biological- based materials. Because of their ability to absorb water, they are used to investigate the properties of swollen polymer networks and have wide applications in different fields such as contact lenses, drug delivery systems for proteins, and many others. To make them biodegradable, labile chemical bonds are introduced in the main backbone through crosslinking. These unstable bonds can then be broken down by various agents chemically, physically, or enzymatically, generally by hydrolysis or through some controlled parameters. Hydrogels are frequently used in the medical field. For instance, pH and temperature-sensitive hydrogels may be used in the targeted drug delivery which have been explained in detail in the current review. The other applications of hydrogels are also explained with regard to personal health care products, biomedical, bio-separation, wound healing, tissue engineering, and drug delivery, etc., which make them promising materials in pharmaceutics. They are also used in agriculture and environmental remediation. The purpose of this review is to expose their salient features and biomedical applications.

The COVID-19 pandemic has had a major impact on global healthcare systems, has drastically affected patient care, and has had widespread effects upon medical education. As plans are being devised to reinstate elective surgical services, it is important to consider the impact that the pandemic has had and will continue to have on surgical training. We describe the effect COVID-19 has had at all levels of training in the UK within trauma and orthopaedics and evaluate how training might change in the future. We found that the COVID-19 pandemic has significantly impacted trainees within trauma and orthopaedics at all levels of training. It had led to reduced operative exposure, cancellations of examinations and courses, and modifications to speciality recruitment and annual appraisals. This cohort of trainees is witnessing novel methods of delivering orthopaedic services, which will continue to develop and become part of routine practice even once the pandemic has resolved. It will be important to observe the extent to which the rapid changes currently being introduced will impact the personal health, safety, and career progression of current trainees.

BACKGROUND: Sleep disturbances are common during pregnancy and are associated with the development of adverse pregnancy outcomes. Personal health monitors (PHM) can facilitate change in health behaviors, though few studies have examined their use in improving sleep during pregnancy. This pilot study aimed to characterize sleep changes during pregnancy in women participating in a self-management intervention using a PHM. PARTICIPANTS/METHODS: Participants with low risk, singleton pregnancies from Western Massachusetts were randomized at 24 weeks gestation to receive sleep education only (n=12) or sleep education, and PHM intervention (n=12). The single-session sleep education was given at baseline by a registered nurse. Sleep quality, duration, efficiency, disturbances, daytime sleepiness, and fatigue were assessed at baseline and 12 weeks follow-up using questionnaires. We described mean ± standard deviation within and between-group changes in each sleep outcome from baseline to 12 weeks follow-up. RESULTS: The PHM arm experienced larger sleep quality improvements and daytime sleepiness than the sleep-education only arm, but the differences were not statistically significant. In the PHM arm, the Pittsburgh Sleep Quality Index (PSQI) score decreased (i.e., sleep quality increased) 1.22 ±2.39 (p=0.16), and the Epworth Sleepiness Scale (ESS) score decreased (i.e., daytime sleepiness decreased) 1.11 ±2.08 (p=0.15). In the sleep-education arm PSQI decreased 0.57±2.37 (p=0.55) and ESS decreased 1.29±2.93 (p=0.29). Neither group experienced statistically significant changes in sleep duration, efficiency, disturbances, or fatigue. CONCLUSION: Sleep education with PHM may improve or prevent decreases in sleep outcomes during pregnancy. Further investigation in larger trials is warranted.

BACKGROUND: Multiple sclerosis (MS) is an intrusive disease that significantly affects labor force participation. OBJECTIVE: This study examined the extent to which factors at the personal, health and function, and environmental/career maintenance levels contribute to the predictability power for quality of life among employed people with MS. METHOD: Participants consisted of 523 members of nine National Multiple Sclerosis Society chapters representing 21 states and Washington, DC. These individuals were employed at the time of the survey, and they were primarily middle age (average age of 48 years) and Caucasian (74%). RESULTS: The final hierarchical multiple regression model explained 54 percent of the variability in participants’ quality of life scores, although none of the hypothesized personal/demographic predictors were significant. Participants who perceived better overall health and lower levels of stress, who experienced less severe cognitive and mobility-related MS symptoms, and who expressed stronger job-person matches and higher levels of job satisfaction reported higher quality of life scores than did other participants. CONCLUSIONS: The findings underscore the complexity involved in predicting perceived quality of life among employed people with MS. Implications of these findings for future research and clinical practice are discussed.

Caregivers may receive information at a rate far higher than their individual abilities to process. Hence, caregivers can cause less desirable health outcomes for their care recipients. This study sought to identify caregiver information overload in comparison to noncaregivers. Relating factors such as caregiving contexts, health status, and personal health literacy were also compared between caregivers and noncaregivers. Using a nationally representative survey, the Health Information National Trends Survey, the differences between caregivers and noncaregivers regarding information overload were compared. A total of 2,918 noncaregivers and 484 caregivers were identified. More than two-thirds of the study sample demonstrated information overload regardless of caregiving status. Male, less educated, lower income, married, and employed caregivers are likely overloaded with information. Caregivers with information overload show less healthy conditions and expressed more information seeking burden. Effective countermeasures of heavy information overload should be devised based on specific causes and their accompanying consequences.

College students often struggle with the decision to disclose personal health information to their instructors. Students have to weigh the benefits and risks of disclosing personal health information to their instructors. Guided by Communication Privacy Management Theory, this study examined the motivating factors that contribute to students' disclosure of personal health information to their instructors. Undergraduate students (

BACKGROUND Absence from work due to illness is one of the important problems in organizations in Serbia. The subjective experience of stress contributes to the degree of absenteeism for several reasons: the demands of the organization in relation to its employees, the low standard of living and care for existence, poor health prevention, and many others. According to European standards, subjective stress contributes to high absenteeism in organizations and to relatively significant health problems. The lack of preventive health care measures, and unclear organizational requirements that do not correspond to the capacities of employees are among the causes of this phenomenon. OBJECTIVE The objective of the research is to determine and identify the existence of stress indicators manifested through self-evaluation of the respondents, as well as to establish the nature of the relationship between stress symptoms and general demographic indicators, personal health assessment and the existence of stressful events of the respondents. This paper presents an analysis of the results of stress indicators, as well as psychosomatic difficulties whose existence could indicate the occurrence or increase of absenteeism of employees in organizations. RESULTS Significant differences between stress symptoms with respect to age, years of service, the self-evaluation of health, and recorded unpleasant events were apparent. CONCLUSIONS In Serbia, the problem of absenteeism, primarily sickness-related, is quite pronounced and significantly higher than in other European countries. Researching the causes of stress and the possibilities for decreasing and preventing it would help reduce adverse effects on the health, economic and psychological state of both employees and organizations.

Wearable sensor industry is on the rise, because it can achieve real-time monitoring, intervention and prediction functions in the field of personal health management. To date, although remarkable progress has been made and laboratory-based theoretical researches have also been confirmed, there are still only a handful of sensors that have been commercialized or clinically available due to the immaturity of technologies. Here, we make an up-to-date Review of wearable and biodegradable sensors. First, we introduce the basic concepts and transduction mechanisms of four physical sensors based on piezoresistive, capacitive, piezoelectric and triboelectric effects. Then, we survey the latest research advances in terms of wearable and biodegradable sensors, focusing our attention on material option, structure design and application exploration. In particular, the implantable sensors made from biocompatible and biodegradable materials are emphasized, which may become the mainstream research direction of green electronic products. Finally, we debate the current challenges and future trends of wearable and biodegradable sensors.

OBJECTIVE: Behavioral health homes, which provide primary medical care onsite in mental health clinics, face challenges in integrating information across multiple health records. This study tested whether a mobile personal health record improves quality of medical care for individuals treated in these settings. METHODS: This randomized study enrolled 311 participants with a serious mental illness and one or more cardiometabolic risk factor across two behavioral health homes to receive a mobile personal health record app (n=156) or usual care (n=155). For the intervention group, a secure mobile personal health record app (mPHR) provided participants with key information about diagnoses, medications, and lab values, and allowed them to track health goals. The primary study outcome was a chart-derived composite measure of quality of cardiometabolic and preventive services. RESULTS: At 12-month follow up, participants in the mPHR group maintained high quality of care (70% of indicated services at baseline and 12-month follow-up), in contrast to a decline in quality for the usual care group (71% at baseline and 67% at follow up) resulting in a statistically significant but clinically modest differential impact between the intervention and usual care group. No differences between the study groups were found in secondary self-reported outcomes including delivery of chronic illness care, patient activation, or mental or physical health related quality of life. CONCLUSIONS: A mobile personal health record was associated with a statistically significant but clinically modest differential benefit for quality of medical care in individuals with serious mental illness and cardiovascular comorbidity. Clinicaltrials.gov registry number: NCT01890226. The study was approved by the EmoryUniversity Institutional Review Board

Late life is a period frequently marked by decline in personal health and heightened need for social support. Consequently, the social networks in which individuals are embedded assume an increasingly central role in the health and wellbeing of older adults. In the present article, I review the state of the literature on social networks and health in later life. By drawing on insights from the sociology of ageing and the life course, I address new developments and current challenges within the field. Chief among these developments and challenges is the recognition that the ageing process does not occur in a vacuum. Rather, individuals are consistently exposed to numerous changes to their social lives which have strong implications for current and future health outcomes. Upon highlighting the latest innovations within the field of networks and health, I conclude with useful directions for future research.

White blood cells, which are also called leukocytes, are found in the immune system that are involved in protecting the body against infections and foreign invaders. Conventional methods of leukocyte analysis provide valuable and accurate information to medical specialists. Analyzing and diagnosing of a disease requires a combination of multiple biomarkers, in some cases, however, such as personal health care, this will occupy some medical resources and causes unnecessary consumption. Traditional method (such as flow cytometer) for WBC counting is time and labor consuming. Compared to gold standard (flow-based fraction/micropore filtration) or improved filtration methods for WBC counting, this is still a lengthy and time consuming process and can lead to membrane fouling due to the rapid accumulation of biological materials. Therefore, the analysis of WBC counts requires more compact and efficient equipment. The microfluidic technologies, powered by different field (force, thermal, acoustic, optical, magnetic) and other methods for leukocyte counting and analysis, are much cost-efficient and can be used in in-home or in resource-limited areas to achieve Point-of-Care (POC). In this review, we highlight the mainstream devices that have been commercialized and extensively employed for patients for WBC counting, Next, we present some recent development with regards to leucocyte counting (mainly microfluidic technologies) and comment on their relative merits. We aim to focus and discuss the possibility of achieving POC and help researchers to tackle individual challenges accordingly. Finally, we offer some technologies in addition to previous detection devices, such as image recognition technology and cloud computing, which we believe have great potential to further promote real-time detection and improve medical diagnosis.

Purpose Electronic health records (EHRs) have led to more transparency and improvements in patient safety, yet electronic access to personal health information can pose significant threats to maintaining confidentiality for adolescents. To date, no studies have explored clinicians' perspectives on EHR functionality and institutional policies related to confidentiality and health information sharing for adolescents aged Methods A Web-based survey was sent out via the national listserv of the Society for Adolescent Health and Medicine. All English-speaking members practicing in the U.S. were eligible to participate. The survey included questions about demographics, EHR functionality, information sharing, and attitudes about confidentiality within the EHR. Results Participants included 212 clinicians who consented to the survey and used an EHR to document clinical visits with minors. Most participants were physicians and nurse practitioners (96.5%), and 60.0% had been on their institution's EHR for >5 years. Positive findings included high levels of experience and comfort using the EHR and awareness of confidential features within their EHR. However, providers reported lack of training related to confidentiality within the EHR, low confidence in their EHR's ability to maintain confidentiality, and variation in approaches to portal access for adolescents and their adult proxies. Conclusions Despite high comfort levels and robust EHR functionality at many institutions, significant concerns about adolescent confidentiality remain. Varying institutional approaches to protecting confidentiality underscores the need for a standardized and comprehensive framework to enable providers and institutions to take better care of adolescents in the age of EHRs.

Recently, we have witnessed a shift in the nature of genetic testing. What was once solely in the hands of the scientific community is now easily accessible to anyone. Commercial companies such as Veritas Genetics, Ancestry, and 23andMe offer cheap direct-to-consumer home DNA kits that are branded as a “health and ancestry service.” These tests are gaining in popularity, and it is estimated that since their marketing, over 30 million people worldwide have provided their DNA samples. The implications of this new genetic era are diverse, ranging from the individuals personal health assessment, to family genealogy and ancestry, and the complexity of establishing an enormous population-based genetic database. Unique implications of commercial DNA tests on fertility patients and heath care providers, such as in the case of gamete donation, are important to acknowledge and have implications for reproductive care.

Maintenance in HIV care is important to achieve optimal personal health and HIV viral load suppression for young people living with HIV (PLWH). Prior studies have identified incarceration as a risk factor for poor long-term HIV outcomes. We assessed the relationship between incarceration and missed visits among young PLWH in the US. Longitudinal data were collected on a cohort of PLWH (n=910), ages 12–24, from 14 adolescent trial network sites across the US. Incarceration histories were self-reported, missed HIV care appointments and viral load measurements were ascertained by records review. The time from study entry to missed visits was modeled using Cox proportional hazards models. The cohort was mostly male (78%) and African American (75%) with a median age of 22. Prior incarceration (i.e., being put in jail, prison, or juvenile detention, or held overnight after an arrest) had been experienced by 39% of the cohort, with a median number of times incarcerated of 2 (IQR: 1–3). The hazard ratio for missed HIV care visits comparing those with incarceration histories to those without was 1.27 (95% CI: 1.06, 1.54). After adjustment for study site, age, gender, and race the hazard ratio was 1.53 (95% CI: 1.26, 1.86). While time to re-connection to care after a missed visit did not differ between the two groups, HIV viral loads upon returning to care were more likely to be unsuppressed among those with incarceration history compared to those without (RR: 1.28, 95% CI: 0.95, 1.74). This association was attenuated to the null after adjustment for suppression of viral load at the visit prior to the missed visit. Young PLWH with incarceration histories are at higher risk of missing HIV care visits.

BACKGROUND Unhealthy diets account for 20% of all deaths globally. Most medical schools do not sufficiently teach their students the clinical application of nutrition science. Evaluating the efficacy of nutrition education interventions is therefore important for their widespread implementation. METHODS A rapid review of the literature published between 2015 and 2020 was conducted to identify nutrition education interventions delivered to undergraduate medical students. The modified Kirkpatrick hierarchy score was used to evaluate the outcome measures. Study characteristics and outcomes were charted and discussed using narrative synthesis. Included studies were appraised using the MERSQI criteria. RESULTS Fifteen nutrition education interventions met the inclusion criteria. Twelve were from the USA and most were optional rather than compulsory. Interventions involved a mixture of methods including cooking sessions, lectures, and student-led programs. The content covered was variable and the median duration was 11 h (range 90 min to 75 h). The modified Kirkpatrick scores varied and the median MERSQI score was 12.8/18. No studies reported the use of national or standardised guidance to inform the learning objectives of the interventions. CONCLUSIONS The interventions reviewed are heterogenous in their nature and outcomes. This review highlights the advantages of utilising interprofessional learning, focusing on student's personal health behaviours and harnessing novel teaching methods such as hands-on cooking. Using national guidance to develop learning outcomes will help to standardise the content taught. Future studies may aim to use validated assessment tools and investigate the long-term impacts on delivery of care and patient outcomes.

Medicare readmissions from the 5% national sample of Medicare Fee For Service claims were assessed to identify the contribution of various demographic or personal health history risk factors to the liklihood of readmission within 30 days of discharge. The Medicare population was evaluated as 2 cohorts based on their eligibility status: age (71.9%) or disability (18.1%). Roughly 12% of admissions for the aged population resulted in a readmission within 30 days, whereas ∼18% was true of the disabled population. Patients with a history of frequent emergency department visits or an urgent index admission had an increased risk for a readmission in both groups of beneficiaries. An important indicator for readmission risk was discharge status from the index hospital stay. In both categories of beneficiaries, individuals who were discharged against medical advice were 1.6 times more likely to experience a readmission. Most importantly, personal and social determinants of health (SDOH) documented preadmission and postdischarge were more evident for the disabled population than the aged. Furthermore, when pre- and postadmission spans for SDOH conditions were examined, (6 months before initial admission to 30 days postadmission), both the aged and disabled populations were statistically significantly more likely to experience readmissions if they had an SDOH diagnosis.

As part of its Patient and Public Partnership Strategy, The BMJ is shining a spotlight on the barriers and challenges to enabling better access to personal health records. The BMJ ’s patient editors start to unpick why progress has been so slow, and how to speed it up. Accessing data about ourselves, for the most part, has never been easier. Personal data on our finances, our Twitter account, Facebook page, phone network, stocks and shares, browsing habits, broadband consumption... even the number of steps we take and the minutes’ sleep we get, can now be logged and accessed. There is barely a corner of our lives left untouched by the data revolution. The move to more data has also been seen in healthcare. This is particularly true in long term conditions like type 1 diabetes (T1D), where the amount of data available to patients has increased dramatically over the past 10 years. This has altered …

Various digital healthcare devices and apps, such as blood glucose meters, blood pressure monitors, and step-trackers are commonly used by patients; however, digital healthcare devices have not been widely accepted in the medical market as of yet. Despite the various legal and privacy issues involved in their use, the main reason for its poor acceptance is that users do not use such devices voluntarily and continuously. Digital healthcare devices generally do not provide valuable information to users except for tracking self-checked glucose or walking. To increase the use of these devices, users must first understand the health data produced in the context of their personal health, and the devices must be easy to use and integrated into everyday life. Thus, users need to know how to manage their own data. Medical staff must teach and encourage users to analyze and manage their patient-generated healthcare data, and users should be able to find medical values from these digital devices. Eventually, a single customized service that can comprehensively analyze various medical data to provide valuable customized services to users, and which can be linked to various heterogeneous digital healthcare devices based on the integration of various health data should be developed. Digital healthcare professionals should have detailed knowledge about a variety of digital healthcare devices and fully understand the advantages and disadvantages of digital healthcare to help patients understand and embrace the use of such devices., Graphical Abstract

Rationale Health digitalization raises important challenges for personal health-data management. Particularly, the advantages underlying the implementation of Electronic Health Record (EHR) remain limited in many countries due to patients’ privacy concerns. Objective Drawing on the privacy calculus theory, the objective of this research is to introduce personal health concerns and trust in healthcare providers as new predictors, beyond the constituent variables of the privacy calculus model - the perceived benefits and risk. We propose and test a conceptual model that investigates simultaneously the effects of these four variables on patients' privacy concerns and intention to share personal health-data on EHR. Method A cross-sectional study using an on online survey was administered from December 2019 to February 2020 in France to both users and non-users of EHR. A structural equation modelling was used to assess the reliability and validity of the measurement as well as to test the research hypotheses. Results The results confirm the positive effects of personal health concerns and trust in healthcare providers on (a) the intention to create an EHR and (b) to share personal health-data. In the same vein, we do not find any significant effect of patients' privacy concerns on the intention to create an EHR and intention to share personal health-data. Furthermore, the patients’ perceived benefits outweigh the perceived risks for EHR using. Conclusions This research provides a more holistic understanding of patients’ privacy concerns. Particularly, we highlight the key role of personal health concerns and trust in healthcare providers with the intention to create an EHR and to share personal health data. Empirical evidence underlines the importance to involve all the stakeholders in the implementation process. Findings are discussed according to existing literature and practical guidelines are suggested to the health policymakers and healthcare providers.

The rapid development of COVID-19 vaccines is a tremendous scientific response to the current global pandemic. However, vaccines per se do not save lives and restart economies. Their success depends on the number of people getting vaccinated. We used a survey experiment to examine the impact on vaccine intentions of a variety of public health messages identified as particularly promising: three messages that emphasize different benefits from the vaccines (personal health, the health of others, and the recovery of local and national economies) and one message that emphasizes vaccine safety. Because people will likely be exposed to multiple messages in the real world, we also examined the effect of these messages in combination. Based on a nationally quota representative sample of 3,048 adults in the United States, our findings suggest that several forms of public messages can increase vaccine intentions, but messaging that emphasizes personal health benefits had the largest impact.

This article presents a personal reflection using theoretical frameworks as the basis of understanding multifaceted influences on the personal health of the primary author since beginning undergraduate university degree studies in nursing. It also explores theoretical and lay definitions of health and wellbeing, before analysing influences on health from a personal perspective. This illustrates how understanding, developed through the use of theoretical frameworks, can enable individuals to enhance their own health and wellbeing.

OBJECTIVES: To describe, using mixed-methods, perceptions of access to sexually transmitted infection test results via electronic personal health record (PHR) and correlates of willingness to adopt its use. PARTICIPANTS: Students at a mid-Atlantic historically Black college. METHODS: Focus-groups and interviews were conducted to explore themes on sexual health-related PHR-use (n=35). Codes were operationalized into survey measures assessing beliefs in a cross-sectional sample (n=354). Exploratory factor analysis identified latent factors among survey items. Multiple logistic regression models measured correlates of adoption willingness. RESULTS: Three qualitative themes emerged on relative advantages, barriers, and functionality of PHRs. 57.6% of survey participants were willing to use PHRs for sexual health services. Reliable latent factors, centering on PHR convenience and functionality, were positively associated with adoption willingness. CONCLUSIONS: Data highlights interest among Black college-age youth in adopting PHRs for comprehensive sexual health-related services. Adoption may be boosted with tailored designs responsive to expressed service needs.

The objective of the systematic review is to explore adult patients' experiences using electronic personal health records (e-PHRs) for chronic non-communicable disease self-management.Self-management is a key component of chronic disease management. One of the strategies to support self-management in patients with chronic disease is the use of e-PHRs. Electronic personal health records offer patients the opportunity to actively engage with their own health information, promote continuity of care and collaboration through disease tracking, and provide patients and providers with an ongoing connection. To adopt e-PHRs and maximize any benefits for chronic disease management, they should align with patients' values and preferences.The review will include qualitative studies that explore the experiences of adult patients (aged 18 years and over) with a chronic non-communicable disease who have used e-PHR for the self-management of their condition. This review will consider studies conducted in any setting or country.The systematic review will be conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence, with meta-aggregation as the method of synthesis. Published studies will be searched in CINAHL, PubMed, PsycINFO, Embase and Scopus. Gray literature will also be considered. Critical appraisal and data extraction will be conducted using the appropriate JBI tools. Extracted data will be aggregated and analyzed to produce a set of synthesized findings that can be used to develop evidence-informed recommendations for the use of e-PHRs in chronic disease self-management.PROSPERO CRD42019133301.

Dietary choices affect personal health and environmental impacts, but little is known about the relation between these outcomes. Here we examine the intake-related health impacts and the food-production related impacts to ecosystems and human health by applying life cycle impact assessment methods to habitual diet data of 1457 European adults. We measured food production impacts for each individual in terms of Disability Adjusted Life Years (DALYs) as calculated by the Recipe 2016 life cycle impact assessment method using secondary production data, which were then compared with their personal health DALYs predicted from the known relationships between dietary choices and disease risk. Across this population cohort, each individual was estimated to lose on average 2.5 ± 0.9 DALYs per lifetime due to sub-optimal dietary intake (with seed and vegetable under-consumption the greatest contributors) and their food choices caused environmental human health impacts of 2.4 ± 1.3 DALYs (particularly due to the damage associated with production of meats, milk, and vegetables). Overall, there was no relationship between a healthier dietary pattern and the environmental human health impacts associated with production of its constituent foods (i.e. healthier diets did not have lower or higher production impacts). This was due to a combination of decreased meat consumption correlating with increased consumption of other foods, as well as the fact that under-consumption of some low impact foods yielded high personal health consequences. However, for specific food items synergies and tradeoffs could be identified. For example, reduced processed meat consumption benefits both personal and environmental health. Every DALY caused by higher whole grain and vegetable production and consumption would be offset by reduced disease risk that equated to an average of 7.7 (5.7 to 10.4) and 1.4 (0.9 to 2.5) lower personal health DALYs, respectively.

Prediction modelling with radiomics is a rapidly developing research topic that requires access to vast amounts of imaging data. Methods that work on decentralized data are urgently needed, because of concerns about patient privacy. Previously published computed tomography medical image sets with gross tumour volume (GTV) outlines for non-small cell lung cancer have been updated with extended follow-up. In a previous study, these were referred to as Lung1 (n = 421) and Lung2 (n = 221). The Lung1 dataset is made publicly accessible via The Cancer Imaging Archive (TCIA; https://www.cancerimagingarchive.net). We performed a decentralized multi-centre study to develop a radiomic signature (hereafter “ZS2019”) in one institution and validated the performance in an independent institution, without the need for data exchange and compared this to an analysis where all data was centralized. The performance of ZS2019 for 2-year overall survival validated in distributed radiomics was not statistically different from the centralized validation (AUC 0.61 vs 0.61; p = 0.52). Although slightly different in terms of data and methods, no statistically significant difference in performance was observed between the new signature and previous work (c-index 0.58 vs 0.65; p = 0.37). Our objective was not the development of a new signature with the best performance, but to suggest an approach for distributed radiomics. Therefore, we used a similar method as an earlier study. We foresee that the Lung1 dataset can be further re-used for testing radiomic models and investigating feature reproducibility.

Children with intellectual disabilities (IDs) can have complex health conditions that require intense and ongoing care management by multiple healthcare professionals (HCPs). Families often experience frustrations and challenges sharing necessary information about their children’s unique emotional and communicative needs with HCPs. In turn, these needs are often poorly documented and shared with other HCPs. This contributes to compromised care and frustrations for families and HCPs. We conducted a qualitative study using focus groups to examine how 10 parents and 3 HCPs experienced provision of care for children with ID, as well as their suggestions for developing a one-page personal health profile (PHP) to improve communication. Parents suggested including behavioural descriptors rather than diagnoses. All participants believed a one-page PHP that was child and parent led would be very helpful and would improve communication between HCPs, parents and children leading to effective and supportive care.

This study examines how posters on an online forum discussed their own current and past decision-making in response to a celebrity health announcement. We examined messages in response to a celebrity narrative, and extracted those explicitly related to decision-making around genetic testing and preventative surgery. Using deductive coding we identified different types of decision-making narratives, and with inductive coding we examined how users discussed decision-making activities. Guided by the literature on narrative content types in decision-making, and on celebrity health narratives, we found that the celebrity decision announcement facilitated social sharing in relation to two key decision-making activities. First, identifying with the celebrity allowed people to reflect and compare their own personal health circumstances. This empowered readers to appraise and select options about their current decision-making regarding preventative surgery. Second, the announcement allowed an extension of the discussion beyond the celebrity, and acted as a catalyst encouraging other people to share their own previous decision-making experiences. These experiences contained a mix of narratives content types, and provided an opportunity for posters to evaluate their decisions, and to contribute to a repository of decision-making examples for others. Health narratives act as communication devices in decision-making, and we discuss the findings in relation to the extension of the educational and persuasive function of celebrity health narratives.

Miniaturization of electronic components and advances in flexible and stretchable materials have stimulated the development of wearable health care systems that can reflect and monitor personal health status by health care professionals. New skin-mountable devices that offer seamless contact onto the human skin, even under large deformations by natural motions of the wearer, provide a route for both high-fidelity monitoring and patient-controlled therapy. This article provides an overview of several important aspects of skin-mountable devices and their applications in many medical settings and clinical practices. We comprehensively describe various transdermal sensors and therapeutic systems that are capable of detecting physical, electrophysiological, and electrochemical responses and/or providing electrical and thermal therapies and drug delivery services, and we discuss the current challenges, opportunities, and future perspectives in the field. Finally, we present ways to protect the embedded electronic components of skin-mountable devices from the environment by use of mechanically soft packaging materials.

Background:The number of people living with dementia (PWD) is increasing worldwide, corresponding with an increasing number of caregivers for PWD. This study aims to identify and describe the literature surrounding the needs of caregivers of PWD and the solutions identified to meet these needs.Method:A literature search was performed in: PsycInfo, Medline, CINAHL, SCIELO and LILACS, January 2007–January 2018. Two independent reviewers evaluated 1,661 abstracts, and full-text screening was subsequently performed for 55 articles. The scoping review consisted of 31 studies, which were evaluated according to sociodemographic characteristics, methodological approach, and caregiver’s experiences, realities, and needs. To help extract and organize reported caregiver needs, we used the C.A.R.E. Tool as a guiding framework.Results:Thirty-one studies were identified. The most common needs were related to personal health (58% emotional health; 32% physical health) and receiving help from others (55%). Solutions from the articles reviewed primarily concerned information gaps (55%) and the education/learning needs of caregivers (52%).Conclusion:This review identified the needs of caregivers of PWD. Caregivers’ personal health emerged as a key area of need, while provision of information was identified as a key area of support. Future studies should explore the changes that occur in needs over the caregiving trajectory and consider comparing caregivers’ needs across different countries.

Biospecimen donation is essential for studies of cancer prevention, early detection, and treatment. Donations from minority groups, for whom the cancer burden is high, are infrequent and inadequate for research purposes. The obstacles to donation of biospecimens by African Americans and other minority groups must be identified. Patients aged 18-85 years were surveyed based on the clinic visited (group A: GI/primary care and group B: oncology with confirmed cancer diagnosis) and analyzed as separate groups. The validated biobanking attitudes and knowledge survey (BANKS) as well as pancreatic cancer questions were used. In group A, 278/292 surveys were completed (5/6 patients participated). In group B, 54/59 surveys were completed (4/5 patients participated). There were low mean scores on the BANKS knowledge sections, specifically in regard to specimen ownership and the separation of research and medical records. Also, two major concerns limited donation: (1) fear that personal, medical, and family medical information may be stolen from the biobank; and (2) mistrust that biospecimens could be used for unintended purposes. Low knowledge about biospecimen acquisition, added to mistrust, warrant community-based, and patient education in an effort to improve attitudes, increase participation, and regain healthy therapeutic alliances.

People's privacy concerns about electronic health records (EHRs) have been widely discussed. Given that in principle, patients have the right to control their information in EHRs, the system will not reach its full potential without their support. Although human beings are generally inclined toward privacy, contextual differences play a role in individual decisions to disclose personal information. Likewise, patients exhibit different responses in terms of sharing their health information in diverse scenarios. Empirical work on patients' attitudes towards the secondary use of their health information is scarce. This study aims to investigate individuals' willingness to share their health information based on anonymity, information type (partial vs. whole), and the type of information user (health professionals, health researchers, health-related governmental agencies, and other governmental agencies). Furthermore, this study attempts to examine the effects of interaction between the three factors. A survey was conducted in South Korea, and the data obtained were analyzed by ANOVA. Despite the recent rapid diffusion of EHRs in South Korea, there is little discussion of patients' privacy in society. The results show that, although anonymity and the user type have a significant effect on willingness to share health information, the information type has no significant effect. The results also indicate that the willingness to share was higher for health-related governmental agencies and health professionals than for other governmental agencies. The findings reveal that, although willingness to share anonymous information does not vary significantly, the willingness differs for identified information. The study contributes to research on patients' privacy behavior by analyzing their comprehensive responses to health information-sharing investigations.

Background This statewide survey sought to understand the adoption level of new health information and medical technologies, and whether these patterns differed between urban and rural populations. Methods A random sample of 7,979 people aged 18-75 years, stratified by rural status and race, who lived in 1 of 34 Indiana counties with high cancer mortality rates and were seen at least once in the past year in a statewide health system were surveyed. Results Completed surveys were returned by 970 participants. Rural patients were less likely than urban to use electronic health record messaging systems (28.3% vs 34.5%, P = .045) or any communication technology (43.0% vs 50.8%, P = .017). Rural patients were less likely to look for personal health information for someone else's medical record (11.0% vs 16.3%, P = .022), look-up test results (29.5% vs 38.3%, P = .005), or use any form of electronic medical record (EMR) access (57.5% vs 67.1%, P = .003). Rural differences in any use of communication technology or EMRs were no longer significant in adjusted models, while education and income were significantly associated. There was a trend in the higher use of low-dose computed tomography (CT) scan among rural patients (19.1% vs 14.4%, P = .057). No significant difference was present between rural and urban patients in the use of the human papilloma virus test (27.1% vs 26.6%, P = .880). Conclusions Differences in health information technology use between rural and urban populations may be moderated by social determinants. Lower adoption of new health information technologies (HITs) than medical technologies among rural, compared to urban, individuals may be due to lower levels of evidence supporting HITs.

The advent of personalized medicine has brought an increased interest in personal health among general consumers. As a result, there is a great need for user-centric point-of-care (POC) health devices. Such devices are equally pertinent in developing countries or resource-limited settings for performing diagnostic tests. However, current POC tests for diseases such as human immunodeficiency virus (HIV) or leukocytosis do not provide adequate levels of sensitivity or do not exist at all. Here, we extend our mobile magneto-nanosensor platform to point-of-care HIV and leukocytosis detection. The platform can be multiplexed, and the circuitry enables portability and sensitivity in the POC setting. A smartphone application simplifies operation and provides guidance to facilitate self-testing. Commercially available POC test kits typically provide only qualitative or semi-quantitative results of a single analyte. The magneto-nanosensor platform can provide users with pleasant user-experience while demonstrating robust sensitive and specific multiplexed quantification and detection of common diseases.

Risk adopts an ambiguous position between health and illness/disease and is culturally salient in various health-related everyday practices. Previous research on risk experience has mostly focused on the illness/disease side of this risk ambiguity. Persons at risk have typically been defined as patients (of some kind) and their condition as a form of proto-illness. To allow for the cultural proliferation of health risk and to account for the health side of risk ambiguity, I chose to focus on elevated cholesterol, a condition both intensely medicalised and connected to the everyday practice of eating, among participants (n = 14) recruited from a consumer panel and approached not as patients, but as individuals concerned about their cholesterol. Utilising the biographical disruption framework developed by Bury, I show how the risk experience of my participants differed from the chronic illness experience. Instead of patients-in-waiting suffering from a proto-illness, they presented themselves as 'chronically healthy individuals' (Varul 2010), actively trying to avoid becoming patients through a responsible regimen of personal health care. The results call for a more nuanced approach to the risk experience, which accounts for both sides of the risk ambiguity.