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BACKGROUND: Poor anticoagulation management of warfarin may lead to patient admission, prolonged hospital stays, and even death due to anticoagulation-related adverse events. Traditional non-web-based outpatient clinics struggle to provide ideal anticoagulation management services for patients, and there is a need to explore a safer, more effective, and more convenient mode of warfarin management. OBJECTIVE: This study aimed to compare differences in the quality of anticoagulation management and clinical adverse events between a web-based management model (via a smartphone app) and the conventional non-web-based outpatient management model. METHODS: This study is a prospective cohort research that includes multiple national centers. Patients meeting the nadir criteria were split into a web-based management group using the Alfalfa app or a non-web-based management group with traditional outpatient management, and they were then monitored for a 6-month follow-up period to collect coagulation test results and clinical events. The effectiveness and safety of the 2 management models were assessed by the following indicators: time in therapeutic range (TTR), bleeding events, thromboembolic events, all-cause mortality events, cumulative event rates, and the distribution of the international normalized ratio (INR). RESULTS: This national multicenter cohort study enrolled 522 patients between June 2019 and May 2021, with 519 (99%) patients reaching the follow-up end point, including 260 (50%) in the non-web-based management group and 259 (50%) in the web-based management group. There were no observable differences in baseline characteristics between the 2 patient groups. The web-based management group had a significantly higher TTR than the non-web-based management group (82.4% vs 71.6%, P<.001), and a higher proportion of patients received effective anticoagulation management (81.2% vs 63.5%, P<.001). The incidence of minor bleeding events in the non-web-based management group was significantly higher than that in the web-based management group (12.1% vs 6.6%, P=.048). Between the 2 groups, there was no statistically significant difference in the incidence of severe bleeding and thromboembolic and all-cause death events. In addition, compared with the non-web-based management group, the web-based management group had a lower proportion of INR in the extreme subtreatment range (17.6% vs 21.3%) and severe supertreatment range (0% vs 0.8%) and a higher proportion in the treatment range (50.4% vs 43.1%), with statistical significance. CONCLUSIONS: Compared with traditional non-web-based outpatient management, web-based management via the Alfalfa app may be more beneficial because it can enhance patient anticoagulation management quality, lower the frequency of small bleeding events, and improve INR distribution.
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Anticoagulantes , Relación Normalizada Internacional , Internet , Warfarina , Humanos , Warfarina/uso terapéutico , Warfarina/efectos adversos , Estudios Prospectivos , Anticoagulantes/uso terapéutico , Anticoagulantes/efectos adversos , Femenino , Masculino , Anciano , Persona de Mediana Edad , Hemorragia , Aplicaciones Móviles , Estudios de CohortesRESUMEN
Objective: We aimed to explore the relationship between remote resistance exercise programs delivered via a smartphone application and skeletal muscle mass among elderly patients with type 2 diabetes, utilizing real-world data. Methods: The resistance exercises were provided through Joymotion®, a web-based telerehabilitation smartphone application (Shanghai Medmotion Medical Management Co., Ltd). The primary outcome was the changes in skeletal muscle index (SMI) before and after the remote resistance exercises programs. The secondary outcomes were changes in skeletal muscle cross-sectional area (SMA), skeletal muscle radiodensity (SMD) and intermuscular adipose tissue (IMAT). Results: A total of 101 elderly patients with type 2 diabetes were analyzed. The participants had an average age of 72.9 ± 6.11 years for males and 74.4 ± 4.39 years for females. The pre- and post-intervention SMI mean (± SE) was 31.64 ± 4.14 vs. 33.25 ± 4.22 cm2/m2 in male, and 22.72 ± 3.24 vs. 24.28 ± 3.60 cm2/m2 in female respectively (all P < 0.001). Similarly, a statistically significant improvement in SMA, IMAT, and SMD for both male and female groups were also observed respectively (P < 0.001). Multiple linear regression models showed potential confounding factors of baseline hemoglobin A1c and duration of diabetes with changes in SMI in male, while hemoglobin A1c and high density lipoprotein cholesterol with changes in SMI in female. Conclusion: Remote resistance exercises programs delivered by a smartphone application were feasible and effective in helping elderly patients with type 2 diabetes to improve their skeletal muscle mass.
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Diabetes Mellitus Tipo 2 , Aplicaciones Móviles , Músculo Esquelético , Entrenamiento de Fuerza , Teléfono Inteligente , Humanos , Diabetes Mellitus Tipo 2/terapia , Masculino , Femenino , Entrenamiento de Fuerza/métodos , Anciano , Estudios RetrospectivosRESUMEN
Background: Static balance is often impaired in patients after ankle sprains. The ability to identify static balance impairments is dependent on an effective balance assessment tool. The Sway Balance Mobile Application (SWAY App) (Sway Medical, Tulsa, OK) uses a smart phone or tablet to assess postural sway during a modified Balance Error Scoring System (mBESS) assessment and shows promise as an accessible method to quantify changes in static balance after injury. Purpose: The primary purposes of this study were to determine the ability to differentiate between those with ankle sprain versus controls (construct validity) and ability to detect change over time (responsiveness) of a mBESS assessment using a mobile device application to evaluate static balance after an acute ankle sprain. Study Design: Case-control study. Methods: Twenty-two military academy Cadets with an acute ankle sprain and 20 healthy Cadets were enrolled in the study. All participants completed an assessment measuring self-reported function, ankle dorsiflexion range of motion (via the weightbearing lunge), dynamic balance, and static balance. Static balance measured with the mBESS using the SWAY App was validated against laboratory-based measures. Cadets with ankle sprains completed their assessment twice: once within two weeks of injury (baseline) and again after four weeks of rehabilitation that included balance training. Independent and paired t-tests were utilized to analyze differences over time and between groups. Effect sizes were calculated and relationships explored using Pearson's correlation coefficients. Results: The mBESS scores measured by the SWAY App were lower in participants with acute ankle sprains than healthy Cadets (t = 3.15, p = 0.004). Injured participants improved their mBESS score measured by SWAY at four weeks following their initial assessments (t = 3.31, p = 0.004; Baseline: 74.2 +/- 16.1, 4-weeks: 82.7 +/- 9.5). The mBESS measured by the SWAY App demonstrated moderate to good correlation with a laboratory measure of static balance (r = -0.59, p \< 0.001). Conclusion: The mBESS assessed with a mobile device application is a valid and responsive clinical tool for evaluating static balance. The tool demonstrated construct (known groups) validity detecting balance differences between a healthy and injured group, concurrent validity demonstrating moderate to good correlation with established laboratory measures, and responsiveness to changes in static balance in military Cadets during recovery from an acute ankle sprain. Level of Evidence: Level 3.
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INTRODUCTION: Patients admitted to intensive care units (ICUs) have high rates of mortality and morbidity. Improved communication between providers within ICUs may reduce morbidity. The goal of this study is to leverage a natural experiment of the temporally staggered implementation of a smart phone application for interprofessional communication to quantify the association with postoperative mortality and morbidity among critically ill surgical patients. METHODS: We conducted an observational case-control study and utilized a difference-in-difference model to determine the impact of temporally staggered implementation of an interprofessional communication smart phone application on mortality, postoperative hyperglycemia, malnutrition, venous thromboembolism (VTE), and surgical site infections. Our study included patients who underwent surgical procedures and were admitted to the ICU at one of three hospitals (one academic medical center, hospital A, and two community hospitals, hospitals B and C) in a single health system between March 2018 and April 2021. RESULTS: Our cohort consisted of 1457 patients, of which 1174 were hospitalized at hospital A and 283 at hospitals B and C. In the full cohort, 80 (5.6%) patients died during ICU admission. Difference-in-difference analysis demonstrated a relative difference in mortality of 4.8% [1.1%-8.5%] (P = 0.04) at hospitals B and C compared to hospital A after the implementation of the application. Our model demonstrated a 2.5% difference in VTEs [1.1%-3.8%], P = 0.03. There were no significant reductions in hyperglycemia, malnutrition, or surgical site infection. CONCLUSIONS: The implementation of an interprofessional communication smart phone application is associated with reduced mortality and VTE incidence among critically ill surgical patients across three diverse hospitals.
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Hiperglucemia , Desnutrición , Tromboembolia Venosa , Humanos , Enfermedad Crítica , Estudios de Casos y Controles , Teléfono Inteligente , Unidades de Cuidados Intensivos , Hospitales Comunitarios , Comunicación , Mortalidad HospitalariaRESUMEN
This paper mainly studies the smartphone application for health vigilance in elderly adults, based on geographic information system (GIS) for village health volunteers (OSOMO in Thai) to monitor elderly's health. Eight areas from 4 provinces of 7th health territory (Roi Et, Khon Kaen, Maha Sarakham, and Kalasin) were employed for research. The smartphone application called "OSOMO Prompt" was created for both iPhone (iOS) and Android devices for 1,246 OSOMOs. The comparison results of the difference of mean scores of knowledge of before and after using the "OSOMO Prompt" smartphone application, showed that the trial group, 240 elderly participants had the mean scores after smartphone application use of 1.69, higher than before use smartphone application. The results also indicated a statistically significant difference (p-value < .001) at 95%, confidence interval between 2.15-1.22. In conclusion, the "OSOMO Prompt" smartphone application was proved as a tool for village health volunteers to make health decision for the elderly persons. Moreover, the system was easy to use and could improve the quality of the elderly's healthcare.
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Aplicaciones Móviles , Teléfono Inteligente , Anciano , Sistemas de Información Geográfica , Voluntarios Sanos , Humanos , TailandiaRESUMEN
OBJECTIVE: Cognitive decline is an important and well-documented health problem. The Mini-Cog, a simple cognitive function test, is recommended as a potential early cognitive screening tool. Kanagawa Prefecture, one of the largest prefectures in Japan, developed this self-testing application on a smartphone to enable a large number of residents to assess their cognitive function. This study aimed to verify the validity and reliability of the Mini-Cog. RESULTS: Twenty men and 20 women aged 65-85 years were enrolled. Criterion-related validity of the method tested by professional staff was found to have an acceptable positive association. The test-retest reliability was lower than the clinically expected intraclass correlation coefficient value because of the inclusion of learning and order effects. If the Mini-Cog score of this application is low, the system is equipped with a function that advises the users on preventing cognitive decline, directing them to the appropriate services, and recommending visits to a medical institution. Therefore, the system can be used continuously as a tool for health behaviors and promotions.
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Teléfono Inteligente , Femenino , Humanos , Japón , Masculino , Pruebas de Estado Mental y Demencia , Pruebas Neuropsicológicas , Reproducibilidad de los ResultadosRESUMEN
We developed a smartphone application to measure wrist motion using the mobile device's built-in motion sensors or connecting it via Bluetooth to a wearable sensor. Measurement of wrist motion with this method was assessed in 33 participants on two occasions and compared with those obtained with a standard goniometer. The test-retest reproducibility in healthy individuals ranged from good to excellent (intraclass correlation (ICC) 0.76-0.95) for all motions, both with and without the wearable sensor. These results improved to excellent (ICC 0.90-0.96) on the second test day, suggesting a learning effect. The day-to-day reproducibility was overall better with the wearable sensor (mean ICC 0.87) compared with the application without using sensor or goniometer (mean ICC 0.82 and 0.60, respectively). This study suggests that smartphone-based measurements of wrist range of motion are feasible and highly accurate, making it a powerful tool for outcome studies after wrist surgery.
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Aplicaciones Móviles , Dispositivos Electrónicos Vestibles , Humanos , Rango del Movimiento Articular , Reproducibilidad de los Resultados , Teléfono Inteligente , Muñeca , Articulación de la MuñecaRESUMEN
BACKGROUND: Continuing education aims at assisting physicians to maintain competency and expose them to emerging issues in their field. Over the last decade, approaches to the delivery of educational content have changed dramatically as medical education at all levels is now benefitting from the use of web-based content and applications for mobile devices. The aim of the present study is to investigate through a randomized trial the effectiveness of a smart phone application to increase public health service physicians' (PHS physicians) knowledge regarding pediatric oral health care. METHOD: Five of all seven DHCs (District Health Center) in Tehran, which were under the supervision of Tehran University of Medical Sciences and Iran University of Medical Sciences, were selected for our study. Physicians of one DHC had participated in a pilot study. All PHS physicians in the other four centers were invited to the current study on a voluntary basis (n = 107). They completed a self-administered questionnaire regarding their knowledge, attitudes, practice in pediatric dentistry, and background. PHS physicians were assigned randomly to intervention and control groups; those in the intervention group, received a newly designed evidence-based smartphone application, and those in the control group received a booklet, a CME seminar, and a pamphlet. A post-intervention survey was administered 4 months later and t-test and repeated measures ANCOVA (Analysis of Covariance) were performed to measure the difference in the PHS physicians' knowledge, attitude and practice. RESULTS: In both groups, the mean knowledge scores were significantly higher (p-Value < 0.001) in post-intervention data compared to those at baseline. Similar results existed in attitude and practice scores. Although the scores in knowledge in the intervention group indicating potentially greater improvement when compared to those of the control group, the differences between the two groups were not statistically significant (dif: 0.84, 95% CI - 0.35 to 2.02). CONCLUSION: In the light of the limitations of the present study, smart phone applications could improve knowledge, attitude and practice in physicians although this method was not superior to the conventional method of CME. TRIAL REGISTRATION: Our clinical trial had been registered in Iranian Registry of Clinical Trials (registration code: IRCT2016091029765N1).
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Educación Médica Continua/métodos , Salud Bucal/educación , Pediatría , Teléfono Inteligente , Adulto , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Irán , Masculino , Persona de Mediana Edad , Proyectos Piloto , Evaluación de Programas y Proyectos de SaludRESUMEN
This article is aimed at investigating the use of smart phone software Sina in the localization of supratentorial lesions, finding the error between Sina method and neuronavigation, and identifying the reliability of the new method. Neuronavigation and Sina measurement were used to locate the lesion in the patients whose lesion lengths are between 2â¯cm and 6â¯cm. The reference point was the center of the lesion. We found the error of Sina method is 13.6⯱â¯0.55â¯mm comparing with neuronavigation, so the Sina method still cannot replace the localization method of the neuronavigation system. However, in practical clinical work, with the help of the new method, the lesion can be located more precisely and easily.
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Aplicaciones Móviles , Neuronavegación , Teléfono Inteligente , Neoplasias Supratentoriales/cirugía , Cirugía Asistida por Computador , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neuronavegación/instrumentación , Neuronavegación/métodos , Reproducibilidad de los Resultados , Estudios Retrospectivos , Cirugía Asistida por Computador/instrumentación , Cirugía Asistida por Computador/métodos , Adulto JovenRESUMEN
A novel luminescent hydrazone ligand was synthesized via 1:1 condensation reaction of 9-anthracene aldehyde and 2-hydrazinobenzoic acid followed by its characterization with the help of absorption, emission, FTIR, NMR and mass studies. It was investigated as a reversible, ratiometric and turn-on luminescent chemosensor for Cu2+ in aqueous environment. The receptor shows a prominent color change in presence of Cu2+ from yellow to reddish brown in DMSO-H2O (2:1) medium. Upon addition of Cu2+, a remarkable increment in emission intensity (Φ = 0.091, 11 fold) was observed probably due to intra-ligand charge transfer transition (ILCT). Interestingly, this sensor is capable to extract Cu2+ selectively from aqueous mixture of metal ions using dichloromethane solvent with the increased extraction efficiency from 85% (L:Cu2+, 1:1) to 95% (L:Cu2+, 2:1) in the pH range of 6.5-10.0. The extraction behavior of Cu2+ was monitored with the help of UV-Vis spectroscopy and a readily-usable smartphone to capture the RGB data which may be helpful as a field based analysis tool. In presence of Cu2+ (1.0 × 10-5 M), no significant interference was observed after addition of 5-fold excess of other metal ions (Zn2+, Cd2+, Co2+, Fe2+, Fe3+, Ni2+, Hg2+, Sn2+, Al3+, Cr3+, Mn2+) in DMSO-H2O (2:1) medium. Moreover, the ligand was regenerated (> 98%) by adjusting the pH upto 4 cycles and showed a good recyclability and reusability which might be helpful to extract Cu2+ efficiently from aqueous medium.
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Introduction: Variable airflow obstruction that can be confirmed by diurnal variability of peak expiratory flow (PEF) >13% is an important characteristic of asthma. Home monitoring of PEF may be helpful to diagnose and monitor asthma. In this feasibility study, we aimed to study if asthmatic children can measure PEF at home twice daily during a 4-week period using a device designed as a "whistle" and a smart phone software application.Materials and Methods: Twice daily during 4 weeks, children aged 5-12 years with current asthma rated their asthma condition electronically on the smart phone application Blowfish before inhaling deeply then exhaling into the device to produce a high-pitched sound recorded by the application. Through mathematical algorithms, the sound was transferred to PEF, which was uploaded to a server. At inclusion, the Pediatric Asthma Quality of Life Questionnaire and the Childhood Asthma Control Test were answered. At the end, the parents graded the device and application.Results: One child did not manage to upload PEF. For the remaining 21 children, the median (quartiles) days with at least one measurement during the period were 27 (21-29.5), and on median 18 (9-24) days PEF was recorded twice daily. The median parental score (potential score 0-20) of the application was 18 (15-20).Discussion/Conclusion: The study shows promising results for home monitoring of PEF by an electronic device with automatic teletransmission. The high rate of successful recordings and parental satisfaction suggests that the clinical utility of the solution should be further studied.
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Asma/patología , Aplicaciones Móviles , Monitoreo Ambulatorio/métodos , Ápice del Flujo Espiratorio , Niño , Preescolar , Femenino , Humanos , Masculino , Monitoreo Ambulatorio/instrumentación , Satisfacción del Paciente , Calidad de Vida , Teléfono InteligenteRESUMEN
BACKGROUND: Low physical activity level is associated with poor prognosis in patients with colorectal cancer (CRC). To increase physical activity, technology-based platforms are emerging and provide intriguing opportunities to prescribe and monitor active lifestyle interventions. The "Interval Walking in Colorectal Cancer"(I-WALK-CRC) study explores the feasibility and efficacy a home-based interval-walking intervention delivered by a smart-phone application in order to improve cardio-metabolic health profile among CRC survivors. The aim of the present report is to describe the design, methods and recruitment results of the I-WALK-CRC study.Methods/Results: The I-WALK-CRC study is a randomized controlled trial designed to evaluate the feasibility and efficacy of a home-based interval walking intervention compared to a waiting-list control group for physiological and patient-reported outcomes. Patients who had completed surgery for local stage disease and patients who had completed surgery and any adjuvant chemotherapy for locally advanced stage disease were eligible for inclusion. Between October 1st, 2015, and February 1st, 2017, 136 inquiries were recorded; 83 patients were eligible for enrollment, and 42 patients accepted participation. Age and employment status were associated with participation, as participants were significantly younger (60.5 vs 70.8 years, Pâ¯<â¯0.001) and more likely to be working (OR 5.04; 95%CI 1.96-12.98, Pâ¯<â¯0.001) than non-participants. CONCLUSION: In the present study, recruitment of CRC survivors was feasible but we aim to better the recruitment rate in future studies. Further, the study clearly favored younger participants. The I-WALK-CRC study will provide important information regarding feasibility and efficacy of a home-based walking exercise program in CRC survivors.
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BACKGROUND: Genital Chlamydia trachomatis infection is a major public health problem worldwide affecting mostly youth. Sweden introduced an opportunistic screening approach in 1982 accompanied by treatment, partner notification and case reporting. After an initial decline in infection rate till the mid-90s, the number of reported cases has increased over the last two decades and has now stabilized at a high level of 37,000 reported cases in Sweden per year (85% of cases in youth). Sexual risk-taking among youth is also reported to have significantly increased over the last 20 years. Mobile health (mHealth) interventions could be particularly suitable for youth and sexual health promotion as the intervention is delivered in a familiar and discrete way to a tech savvy at-risk population. This paper presents a protocol for a randomized trial to study the effect of an interactive mHealth application (app) on condom use among the youth of Stockholm. METHODS: 446 youth resident in Stockholm, will be recruited in this two arm parallel group individually randomized trial. Recruitment will be from Youth Health Clinics or via the trial website. Participants will be randomized to receive either the intervention (which comprises an interactive app on safe sexual health that will be installed on their smart phones) or a control group (standard of care). Youth will be followed up for 6 months, with questionnaire responses submitted periodically via the app. Self-reported condom use over 6 months will be the primary outcome. Secondary outcomes will include presence of an infection, Chlamydia tests during the study period and proxy markers of safe sex. Analysis is by intention to treat. DISCUSSION: This trial exploits the high mobile phone usage among youth to provide a phone app intervention in the area of sexual health. If successful, the results will have implications for health service delivery and health promotion among the youth. From a methodological perspective, this trial is expected to provide information on the strength and challenges of implementing a partially app (internet) based trial in this context. TRIAL REGISTRATION: ISRCTN 13212899, date of registration June 22, 2017.
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Condones/estadística & datos numéricos , Promoción de la Salud/métodos , Aplicaciones Móviles , Sexo Seguro , Conducta Sexual/psicología , Salud Sexual , Telemedicina , Adolescente , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/prevención & control , Protocolos Clínicos , Femenino , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Asunción de Riesgos , Teléfono Inteligente , Suecia/epidemiología , Adulto JovenRESUMEN
AIM: Patients with progressive chronic kidney disease (CKD) develop positive phosphate balance that is associated with increased cardiovascular risk and mortality. Modification of dietary phosphate is a commonly used strategy to improve outcomes but is complicated by the need for adequate dietary protein. Surprisingly, the evidence for patient-level benefits from phosphate restriction is tenuous, and the justification for using any phosphate binder for pre-dialysis patients is questionable. METHODS: The evidence for dietary phosphate modification was reviewed, along with the possible role of a smart phone application (app) that provides information on phosphate, sodium, potassium and nutrients in over 50 000 Australian foods. A pilot study of healthy participants assigned to dietetic advice and standard diet sheets, or dietetic advice, diet sheets and use of the smart phone app was performed. RESULTS: Following baseline studies, 25 participants commenced the sodium and phosphate restricted diet. After 2 weeks, both groups showed non-significant trends to reduction in urinary phosphate and sodium. App users referred to information on the app more frequently than the control group participants referred to written instructions, found referring to the app more convenient, felt they learned more new information, were more motivated to maintain the diet and were more likely to recommend their information source to family or friends (all P < 0.05). CONCLUSIONS: Maintaining phosphate balance remains an important goal of CKD management, although diets incorporating very low phosphate and protein contents may worsen patient outcomes. For selected patients, a smart phone app may improve dietary acceptance and compliance.
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Riñón/fisiopatología , Aplicaciones Móviles , Fósforo Dietético/administración & dosificación , Insuficiencia Renal Crónica/dietoterapia , Telemedicina/instrumentación , Adulto , Dieta Hiposódica , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Riñón/metabolismo , Masculino , Nueva Gales del Sur , Estado Nutricional , Educación del Paciente como Asunto , Fósforo Dietético/efectos adversos , Fósforo Dietético/orina , Proyectos Piloto , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/fisiopatología , Insuficiencia Renal Crónica/orina , Teléfono Inteligente , Factores de Tiempo , Resultado del Tratamiento , Equilibrio Hidroelectrolítico , Adulto JovenRESUMEN
Smartphones are increasingly used in healthcare, yet little is known about their utility in medical research as a means of data collection in low- and middle-income countries (LMIC). In this letter, we discuss results from our experiences with data collection on smartphones in an LMIC setting. Our experience found smartphones a secure and reliable data collection tool for medical research that can empower researchers in countries to participate in surgical studies.
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Investigación Biomédica/métodos , Recolección de Datos/métodos , Países en Desarrollo , Teléfono Inteligente , Exactitud de los Datos , Humanos , Pakistán , Estudios ProspectivosRESUMEN
Objective:To investigate the interventional effect of smart-phone application on development of complications of chemoradiotherapy in patients with nasopharyngeal carcinoma (NPC) after discharge.Method:Sixty-five NPC patients receving first chemoradiotherapy were randomly divided into two groups. Control group including 33 patients, use traditional oral Health education. Intervention group including 32 patients, use a smart-phone application after discharge. The smart-phone application with text and graphics was established to conduct health education and dynamically manage discharged patients for promoting themselves health management. Poisonous side reactions and quality of life of two groups were investigated at discharge and 6 months after discharge.Result:There were not significant difference between two groups on complications of chemoradiotherapy and quality of life at discharge. After discharge 6 months, the incidence of oral mucositis, dry mouth, nasal obstruction and difficulty in opening mouth of intervention group were lower than control group significantly, while the quality of life of intervention group higher than control group significantly (P< 0.05). Conclusion:Smart-phone application can reduce complications of chemoradiotherapy, and improve the quality of life in patients with NPC after discharge.
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Carcinoma/terapia , Quimioradioterapia/efectos adversos , Neoplasias Nasofaríngeas/psicología , Calidad de Vida/psicología , Teléfono Inteligente , Carcinoma/psicología , China/epidemiología , Humanos , Incidencia , Obstrucción Nasal/epidemiología , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas/terapia , Estomatitis/epidemiología , Resultado del TratamientoRESUMEN
INTRODUCTION: Infants born extremely preterm (EP; <28â weeks' gestation) and/or with extremely low birth weight (ELBW; <1000â g birth weight) are at increased risk for adverse neurodevelopmental outcomes. However, it is challenging to predict those EP/ELBW infants destined to have long-term neurodevelopmental impairments in order to target early intervention to those in most need. The General Movements Assessment (GMA) in early infancy has high predictive validity for neurodevelopmental outcomes in preterm infants. However, access to a GMA may be limited by geographical constraints and a lack of GMA-trained health professionals. Baby Moves is a smartphone application (app) developed for caregivers to video and upload their infant's general movements to be scored remotely by a certified GMA assessor. The aim of this study is to determine the predictive ability of using the GMA via the Baby Moves app for neurodevelopmental impairment in infants born EP/ELBW. METHODS AND ANALYSIS: This prospective cohort study will recruit infants born EP/ELBW across the state of Victoria, Australia in 2016 and 2017. A control group of normal birth weight (>2500â g birth weight), term-born (≥37â weeks' gestation) infants will also be recruited as a local reference group. Parents will video their infant's general movements at two time points between 3 and 4â months' corrected age using the Baby Moves app. Videos will be scored by certified GMA assessors and classified as normal or abnormal. Parental satisfaction using the Baby Moves app will be assessed via survey. Neurodevelopmental outcome at 2â years' corrected age includes developmental delay according to the Bayley Scales of Infant and Toddler Development-III and cerebral palsy diagnosis. ETHICS AND DISSEMINATION: This study was approved by the Human Research and Ethics Committees at the Royal Children's Hospital, The Royal Women's Hospital, Monash Health and Mercy Health in Melbourne, Australia. Study findings will be disseminated via peer-reviewed publications and conference presentations.
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Parálisis Cerebral/diagnóstico , Discapacidades del Desarrollo/diagnóstico , Recien Nacido con Peso al Nacer Extremadamente Bajo , Recien Nacido Extremadamente Prematuro , Aplicaciones Móviles , Movimiento , Telemedicina/métodos , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Estudios Prospectivos , Proyectos de Investigación , Teléfono Inteligente , Encuestas y Cuestionarios , Victoria , Grabación en VideoRESUMEN
AIMS: The primary objective was to evaluate the impact of the smart phone-based diabetes management application, Welltang, on glycated hemoglobin (HbA1c). The second objective was to measure whether Welltang improves blood glucose, low-density lipoprotein cholesterol, weight, blood pressure, hypoglycemic events, satisfaction of patients to use Welltang, diabetes knowledge of patients, and self-care behaviors. METHODS: One hundred evenly randomized subjects with diabetes, aged 18-74years, were recruited from the outpatient Department of Endocrinology for a 3-month study. The Welltang intervention group received training for the use of Welltang, while the control group received their usual standard of care. HbA1c, blood glucose, low-density lipoprotein cholesterol, weight, blood pressure, hypoglycemic events, satisfaction of patients to use Welltang, diabetes knowledge of patients, and self-care behaviors were measured. Patient data were analyzed using independent t test and paired sample test using SPSS version 12. RESULTS: The average decrease in HbA1c was 1.95% (21mmol/mol) in the intervention group and 0.79% (8mmol/mol) in the control group (P<0.001). Measures of self-monitored blood glucose, diabetes knowledge, and self-care behaviors improved in patients in the intervention group. Eighty four percent of patients in the intervention group were satisfied with the use of Welltang. Differences in hypoglycemic events, low-density lipoprotein cholesterol, weight, and blood pressure were not statistically significant. CONCLUSION: Diabetes patients using the Welltang application achieved statistically significant improvements in HbA1c, blood glucose, satisfaction of patients to use of Welltang, diabetes knowledge, and self-care behaviors.