RESUMEN

The rapid growth of mHealth applications for Type 2 Diabetes Mellitus (T2DM) patients' self-management has motivated the evaluation of these applications from both the usability and user point of view. The objective of this study was to identify mHealth applications that focus on T2DM from the Android store and rate them from the usability perspective using the MARS tool. Additionally, a classification of these mHealth applications was conducted using the ID3 algorithm to identify the most preferred application. The usability of the applications was assessed by two experts using MARS. A total of 11 mHealth applications were identified from the initial search, which fulfilled our inclusion criteria. The usability of the applications was rated using the MARS scale, from 1 (inadequate) to 5 (excellent). The Functionality (3.23) and Aesthetics (3.22) attributes had the highest score, whereas Information (3.1) had the lowest score. Among the 11 applications, "mySugr" had the highest average MARS score for both Application Quality (4.1/5) as well as Application Subjective Quality (4.5/5). Moreover, from the classification conducted using the ID3 algorithm, it was observed that 6 out of 11 mHealth applications were preferred for the self-management of T2DM.

Asunto(s)

RESUMEN

The recent developments in the IT world have brought several changes in the medical industry. This research work focuses on few mHealth applications that work on the management of type 2 diabetes mellitus (T2DM) by the patients on their own. Looking into the present doctor-to-patient ratio in our country (1:1700 as per a Times of India report in 2021), it is very essential to develop self-management mHealth applications. Thus, there is a need to ensure simple and user-friendly mHealth applications to improve customer satisfaction. The goal of this study is to assess and appraise the usability and effectiveness of existing T2DM-focused mHealth applications. TOPSIS, VIKOR, and PROMETHEE II are three multi-criteria decision-making (MCDM) approaches considered in the proposed work for the evaluation of the usability of five existing T2DM mHealth applications, which include Glucose Buddy, mySugr, Diabetes: M, Blood Glucose Tracker, and OneTouch Reveal. The methodology used in the research work is a questionnaire-based evaluation that focuses on certain attributes and sub-attributes, identified based on the features of mHealth applications. CRITIC methodology is used for obtaining the attribute weights, which give the priority of the attributes. The resulting analysis signifies our proposed research by ranking the mHealth applications based on usability and customer satisfaction.

RESUMEN

Suicide is among the 10 leading causes of death in the US and has the potential to suddenly change many lives. It often occurs when people are disproportionately affected by societal conditions, including inequities, discrimination, oppression, and historical trauma. We posit that a social justice framework can improve suicide prevention efforts when incorporated into existing strategies because it mandates that inequities be addressed. It does so through education, engagement, advocacy, and action, and can be especially effective in states and nations with high suicide rates and entrenched societal inequities.

Asunto(s)

RESUMEN

BACKGROUND: Intradetrusor onabotulinumtoxinA (BoNT-ONA) injections have become a well-established therapy for refractory neurogenic detrusor overactivity (NDO). However, little is known about long-term outcome and patients' adherence to this treatment. OBJECTIVE: To assess long-term outcomes of intradetrusor BoNT-ONA injections and patients' adherence to treatment. DESIGN, SETTING, AND PARTICIPANTS: A consecutive series of 52 patients who underwent first intradetrusor BoNT-ONA injections for refractory NDO >10 yr ago were evaluated retrospectively and prospectively at a single university spinal cord injury (SCI) centre. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Primary outcome was current neuro-urologic treatment. Secondary outcomes were urodynamic parameters. For data comparison, the paired/unpaired t test, chi-square test, and McNemar test were used. RESULTS AND LIMITATIONS: Mean duration since first intradetrusor BoNT-ONA injections was 12±2 yr. Most patients (61% [32 of 52]) suffered from SCI, 15% (8 of 52) from spina bifida, 14% (7 of 52) from multiple sclerosis (MS), and the remaining (10% [5 of 52]) from other neurologic disorders. Almost 60% (31 of 52) of all patients are continuing with intradetrusor BoNT-ONA injections but only 14% (1 of 7) of the patients with MS. Lack of clinical and/or urodynamic response (21% [11 of 52]) and switching to another treatment (antimuscarinics and/or neuromodulation) despite appropriate BoNT-ONA efficacy (19% [10 of 52]) were the reasons for discontinuation. In patients continuing BoNT-ONA treatment, the positive effect was sustained after repeat injections (p<0.05). CONCLUSIONS: Although intradetrusor BoNT-ONA injections are a highly effective therapy for refractory NDO, approximately 40% of the patients discontinue treatment over time. All prospective neurologic patients should be given this information, and it needs to be considered in the treatment decision-making process. PATIENT SUMMARY: Approximately 60% of the patients treated with intradetrusor onabotulinumtoxinA injections for refractory neurogenic detrusor overactivity continue this therapy long term with good therapeutic effects. STUDY REGISTRATION NUMBER: NCT01293110.

Asunto(s)