Tecnologías de la información y la comunicación como apoyo a la salud mental para mujeres en etapa perinatal / Information and communication technology as a support for mental health in perinatal women / Tecnologias de informação e comunicação como apoio à saúde mental de mulheres na fase perinatal

Durante el embarazo la mujer experimenta muchos cambios, no solo físicos, también mentales, por eso la salud mental perinatal es de gran importancia en esta etapa. La mayoría de las mujeres en embarazo que desarrollan alguna enfermedad mental durante la gestación, como depresión o ansiedad, no son diagnosticadas, lo que puede generar efectos adversos para la madre y el bebé. En ese sentido, es de gran importancia el tamizaje, diagnóstico, manejo y seguimiento de este grupo. Gracias a los avances tecnológicos podemos contar con las tecnologías de la Información y la comunicación (TIC) para buscar maneras cómo aproximarse a las mujeres en etapa perinatal para el tamizaje y hacer el seguimiento de su salud mental. Así que este artículo de revisión se enfoca en ver su aceptabilidad, la percepción, las barreras al acceso y nuevos desarrollos enfocados en mejorar la salud mental en las mujeres en etapa perinatal.

During pregnancy, a woman experiences many changes, not only physical, but also mental, which is why perinatal mental health is of great importance at this stage. The majority of pregnant women who develop a mental illness during pregnancy, such as depression or anxiety, are not diagnosed, which can cause adverse effects for the mother and baby. In this sense, the screening, diagnosis, management and follow-up of this group is of great importance. Thanks to technological advances, we can count on the Information and Communication Technologies (ICT) to find ways to approach women in the perinatal stage for screening and monitoring their mental health. So this review article focuses on seeing its acceptability, perception, barriers to access and new developments focused on improving mental health in perinatal women.

Durante el embarazo la mujer experimenta muchos cambios, no solo físicos, también mentales, por eso la salud mental perinatal es de gran importancia en esta etapa. La mayoría de las mujeres en embarazo que desarrollan alguna enfermedad mental durante la gestación, como depresión o ansiedad, no son diagnosticadas, lo que puede generar efectos adversos para la madre y el bebé. En ese sentido, es de gran importancia el tamizaje, diagnóstico, manejo y seguimiento de este grupo. Gracias a los avances tecnológicos podemos contar con las tecnologías de la Información y la comunicación (TIC) para buscar maneras cómo aproximarse a las mujeres en etapa perinatal para el tamizaje y hacer el seguimiento de su salud mental. Así que este artículo de revisión se enfoca en ver su aceptabilidad, la percepción, las barreras al acceso y nuevos desarrollos enfocados en mejorar la salud mental en las mujeres en etapa perinatal.

Aplicación móvil para el seguimiento del crecimiento y cuidado nutricional del bebé en hogares colombianos

Introducción: El predominio y asequibilidad actual de los teléfonos móviles inteligentes han permitido una amplia difusión de variedad de aplicaciones a nivel mundial para el monitoreo del crecimiento y del estado nutricional de los lactantes. No obstante, la mayoría de estos recursos no son lo suficientemente completos para proveer una interfaz amigable de seguimiento del crecimiento, combinada con una adecuada educación parental en materia de nutrición y alimentación complementaria. Objetivos: Este trabajo pretende presentar el desarrollo y evaluación de la aplicación propuesta "Baby Home", con el fin de estudiar su potencial como herramienta digital de apoyo a padres y cuidadores en el cuidado nutricional de sus niños desde el hogar. Materiales y métodos: Baby Home integra una interfaz de seguimiento interactivo del crecimiento del bebé con una serie de contenidos educativos alimentarios, posibilitando al usuario consultar las prácticas recomendadas según el estado nutricional estimado de su bebé. Un conjunto de 7 jueces expertos fue reunido para evaluar la validez de estos contenidos consignados en la aplicación. Posteriormente, se llevó a cabo un estudio de prueba piloto con 8 madres participantes, las cuales aportaron en las fortalezas y debilidades de las funcionalidades propuestas. Resultados: la aplicación desarrollada muestra una aprobación positiva por los especialistas consultados y una aceptación satisfactoria entre las madres participantes gracias a su diseño amigable y funcionalidades de fácil uso. Los recursos visuales implementados prueban ser adecuados para la apropiación de los contenidos alimentarios y el empoderamiento del usuario en torno a los cuidados nutricionales que requieren sus niños. Conclusiones: Baby Home se ubica como un soporte práctico y accesible para el cuidado nutricional del lactante, otorgando seguridad y confianza al usuario en la alimentación de su niño y disponiendo la posibilidad de detectar oportunamente problemas de crecimiento.

Introduction: The current prevalence and affordability of smartphones have enabled a broad diffusion of a variety of mobile applications worldwide for monitoring infant's growth and nutritional status. However, most of these resources are not comprehensive enough to provide a user-friendly interface for growth tracking combined with proper parental education on nutrition and complementary feeding. Objectives: This work aims to present the development and evaluation of the proposed application "Baby Home", in order to study its potential as a digital tool for supporting parents and caregivers in the nutritional care of their children from home. Materials and methods: Baby Home integrates an interactive baby growth monitoring interface with a collection of educational content on infant feeding, allowing the user to check the recommended practices based on the estimated nutritional status of their baby. A panel of seven expert judges was assembled to evaluate the validity of these contents included in the application. Subsequently, a pilot study was carried out with eight participating mothers who contributed to the strengths and weaknesses of the proposed functionalities. Results: The developed application received positive feedback by the consulted specialists and a satisfactory acceptance within the participating mothers thanks to its friendly design and easy-to-use functionalities. The implemented visual resources proved to be well suited for the user's appropriation of feeding contents and their empowerment regarding the nutritional care required by their children. Conclusions: Baby Home is positioned as a practical and accessible support for the nutritional care of infants, providing safeness and confidence to the user in their child's feeding and the possibility of timely detection of growth problems.

The long-term user experience of an m-Health application / A experiência do usuário a longo prazo de um aplicativo m-Health / La experiencia a largo plazo del usuario de una aplicación m-Health

Low user engagement in m-Health applications has been driving the use of retention techniques that aim to ensure a satisfactory long-term user experience. The aim was to understand the experience of hypertensive patients interacting with a mobile health application for 12 months. A qualitative/exploratory study was conducted after 12 months, with the same experimental group of participants as the non-randomized con-trolled clinical trial conducted in 2019. The mean age of the 16 participants was 57 years (SD=8), of which11 were female. All had low socioeconomic and educational levels. Content analysis showed no engagement with the m-health app over time. The main factors contributing to the lack of engagement were; inability of the user to use the app, lack of support and technical problems. When designing m-Health interventions, it is important to understand users' behavioral characteristics, motivations for treatment, level of involve-ment in health care, and ability to use technology

O baixo envolvimento dos usuários em aplicativos m-Health vem impulsionando o uso de técnicas de retenção que visam garantir uma experiência do usuário (UX) satisfatória a longo prazo. Objetivou-se compreender a experiência de pacientes hipertensos interagindo com um aplicativo de saúde móvel (m-Health) durante 12 meses. Realizou-se estudo qualitativo/exploratório após 12 meses, com o mesmo grupo experimental de participantes do ensaio-clínico controlado e não-randomizado realizado em 2019. A idade média dos 16 participantes foi de 57 anos (DP=8); 11 eram do sexo feminino, com baixos níveis socioeconômicos e educacionais. A análise de conteúdo não mostrou nenhum envolvimento ao longo do tempo usando o aplicativo m-Health. Os principais fatores que contribuíram para a falta de envolvimento foram: incapacidade do usuário de usar o aplicativo, falta de suporte e problemas técnicos. Ao propor intervenções que utilizem m-Health, é essencial conhecer características comportamentais dos usuários, motivações para o tratamento, nível de envolvimento nos cuidados com a saúde e sua capacidade de usar tecnologias

La baja participación de los usuarios en las aplicaciones de m-Health ha impulsado el uso de técnicas de retención que tienen como objetivo garantizar una experiencia de usuario satisfactoria a largo plazo. Se pretendió comprender la experiencia de pacientes hipertensos interactuando con una aplicación de salud móvil durante 12 meses. Se realizó un estudio cualitativo/exploratorio después de 12 meses, utilizando los participantes del ensayo clínico controlado no aleatorizado que se llevó a cabo en 2019. La edad media de los 16 participantes fue 57 años (SD=8); 11 mujeres, con niveles socioeconómicos y educativos bajos. El análisis de contenido no mostró compromiso a lo largo del tiempo utilizando la aplicación m-Health. Los principales factores contribuyentes fueron: incapacidad del usuario para utilizar la aplicación, falta de apoyo y problemas técnicos. Cuando se proponen intervenciones con m-Health, es esencial conocer las características de comportamiento de los usuarios, sus motivaciones para el tratamiento, nivel de implicación en el cuidado de la salud y capacidad para utilizar tecnologías

Usabilidade da Plataforma Zelo Saúde por cuidadores de pessoas idosas dependentes / Usability of the Zelo Saúde Platform by caregivers of dependent elderly people / Usabilidad de la Plataforma Zelo Saúde por cuidadores de personas mayores dependientes

A Plataforma Zelo Saúde (PZS) é uma tecnologia mSaúde de apoio ao cuidado de pessoas idosas. Este artigo apresenta um estudo de usabilidade que analisou a utilização da PZS por 68 cuidadores/familiares de pessoas idosas dependentes por 10 semanas. Foram preenchidos um formulário pré- e outro pós-uso do aplicativo, e foi feita uma série de perguntas visando ao monitoramento semanal. Para análise dos dados, utilizou-se o software SPSS® v.25. Os resultados indicaram que a plataforma foi simples de usar e de fácil compreensão. A PZS alcançou uma nota média, na avaliação de usabilidade, de 8,9 ± 1,6 na escala de 0 a 10 da System Usability Scale, e possibilitou não só o acesso dos cuidadores/familiares às informações clínico-funcionais, à rotina de cuidados, aos medicamentos em uso, como também a comunicação entre eles e os profissionais de saúde por meio de chat. A plataforma conta também com vídeos educativos, no contexto da atenção básica à saúde e dos serviços de atenção domiciliar, mostrando-se uma ferramenta de apoio ao cuidado de pessoas idosas em seus domicílios

The Zelo Saúde Platform (PZS) is an mHealth technology to support the care of the elderly. This article presents a usability study that analyzed the use of the PZS by 68 caregivers/relatives of dependent elderly people for 10 weeks. Pre- and post-use forms were illed by participants and a set of questions aiming weekly monitoring was answered. For data analysis, SPSS® v.25 software was used. The results indicated that the platform was simple to use and easy to understand. The PZS achieved an average usability score of 8.9 ± 1.6 on a scale of 0 to 10 of the System Usability Scale, and enabled caregivers/family members to access to functional status information, routine care, medications in use, and permitted the communication between them and health professionals through chat. The platform also includes educational videos, in the context of primary health care and home care services, proving to be a tool to support the home care of elderly people

La Plataforma Zelo Saúde (PZS) es una tecnología mHealth (salud móvil) para apoyar el cuidado de las personas mayores. Este artículo presenta un estudio de usabilidad que analizó el uso de la PZS por parte de 68 cuidadores/familiares de personas mayores dependientes durante 10 semanas. Fueron llenados un formulario previo y otro posterior a la utilización de la aplicación, y se formularon diversas preguntas con vistas al seguimiento semanal. Para el análisis de los datos se utilizó el software SPSS® v.25. Los resultados indicaron que la plataforma era sencilla de usar y fácil de entender. La PZS alcanzó una calificación media de usabilidad de 8,9 ± 1,6 en una escala de 0 a 10 de la System Usability Scale, y permitió a los cuidadores/familiares acceder a la información clínico funcional, a los cuidados de rutina, a los medicamentos en uso y permitó también la comunicación entre ellos y los profesionales de la salud a través de chat. La plataforma cuenta aun con videos educativos, en el contexto de la atención primaria de salud y de los servicios de atención domiciliaria, demostrando ser una herramienta de apoyo al cuidado en el domicilio de personas mayores

THE POTENTIAL OF TELECOMMUNICATIONS IN CANCER CLINICAL TRIALS: AN OVERVIEW

This review article explores the potential bene?ts and challenges of using telecommunications technology, including telemedicine and mobile health apps, in cancer clinical trials. The author conducted a search of four electronic databases for studies published in English between 2010 and 2021 that evaluated the use of telecommunications technology in adult cancer patients and reported patient outcomes. The studies were grouped based on the type of telecommunications technology used, and the outcomes were synthesized to provide an overview of the potential impact of telecommunications technology on cancer clinical trials. Telecommunications technologies were found to improve patient access and recruitment, data collection, management, and analysis, and enable real-time monitoring of patients' health and adherence to treatment. Telecommunications technologies can also reduce trial costs by minimizing the need for in- person visits and other expenses. However, the implementation of telecommunications technologies in clinical trials is not without challenges, including technical issues, patient acceptance and adherence, regulatory and legal approvals, and variability in healthcare systems. The author suggests that addressing these challenges could lead to improved patient outcomes and better overall health outcomes for cancer patients

Effectiveness of mobile applications as intervention tools in suicidal ideation: a systematic review and meta-analysis / Eficácia dos aplicativos móveis como ferramentas de intervenção na ideação suicida: uma revisão sistemática e meta-análise

Objective Evaluate the effectiveness of mobile applications developed for intervention in suicide risk in adults. Method Searches for articles were carried out in four databases (PubMed, Web of Science, Scopus and PsychINFO). For the meta-analyses, we used fixed effect modelling to assess the primary outcome. The PROSPERO register is CRD42020163876. Results After applying inclusion and exclusion criteria, six studies remained in the systematic review, of which four were eligible to the meta-analysis. There was no difference, or a little tendency in favor of control condition (usual treatment) comparing with applications. Conclusion Applications can be as effective as standard treatments in reducing suicide ideation. The results should be interpreted with caution once all studies presented at least one bias in their study design.

Objetivo Avaliar a eficácia dos aplicativos desenvolvidos para intervenção no risco de suicídio em adultos. Método As buscas por artigos foram realizadas em quatro bancos de dados (PubMed, Web of Science, Scopus e PsychINFO). Para a meta-análise, utilizamos modelagem de efeito fixo para avaliar o desfecho primário. O registro no PROSPERO é CRD42020163876. Resultados Após aplicação dos critérios de inclusão e exclusão, seis estudos permaneceram na revisão sistemática, dos quais quatro foram elegíveis para a meta-análise. Não houve diferença, ou uma pequena tendência a favor da condição de controle (tratamento usual) em comparação com aplicativos. Conclusão Os aplicativos parecem ser tão eficazes quanto os tratamentos padrões na redução de ideação suicida. Os resultados devem ser interpretados com cautela, pois todos os estudos apresentaram viés em seu desenho.

Effects of a Workplace mHealth Intervention for Smoking Behaviour: A Quasi Experimental Study Protocol

@#Introduction: Tobacco smoking causes various chronic diseases and adds costs to healthcare systems. The current smoking cessation interventions mostly target smokers who are ready to quit and are reactive in recruitment. Recently, mobile phones have become a new tool for promoting smoking cessation. The aim of this paper is to present a study protocol on a quasi-experimental study investigating the effects of a workplace mHealth intervention for smoking behaviour. Methods: A quasi-experimental study will be conducted among employees in an academic institution in Malaysia. The intervention group will receive a theory based WhaSTOP module via WhatsApp and will be compared with the control group (receive usual care). The primary outcomes are stage movement and the number of cigarettes per day. The secondary outcomes include knowledge of smoking, quit attempt, nicotine dependence, 7-day point prevalence of smoking abstinence, and the Transtheoretical Model constructs. A generalised estimating equation analysis will be performed to determine the effects of the intervention. Discussion: This protocol will provide a novel method to proactively approach smokers regardless of readiness to quit and to guide them through the stages of change so that they will be ready to take action to quit. This research will also provide insight into whether the intervention can be utilised as an additional tool for smokers at the workplace to quit smoking. Trial Registration: The trial was registered with the Iranian Registry of Clinical Trials (Registry Number IRCT20220415054539N1).

Current situation and effect evaluation of mobile applications for physical activity management in China / 中华健康管理学杂志

Objective:To analyze the current situation and effect of mobile applications for physical activity management in China.Methods:In this systematic review, search terms such as “exercise”, “sports”, “exercise”, “physical activity” and “mobile health” were used to retrieve the applications for physical activity management in the IOS Application Store developed in mainland of China. Then the Mobile Application Rating Scale (MARS) and the Behavior Change Technology (BCT) were used to evaluate the quality of the applications and analyze the behavior change technologies that applications adopted. Moreover, a systematic review of relevant experimental studies was applied to summarize the effectiveness of the applications in promoting physical activity.Results:Total of 141 applications were included in this analysis, and 58 behavior change techniques in 16 categories were applied. The most frequently used 4 categories of BCT were behavior comparison (67.4%), repetition and substitution (67.4%), knowledge construction (67.4%), feedback and monitoring (58.2%). The overall objective quality score of MARS was 3.17±0.42, of which, the score of engagements, functionality, aesthetic design and information quality was 2.67±0.73, 3.75±0.54, 3.44±0.59 and 2.83±0.55, respectively. The number of BCT adopted in each application had a linear relationship with the application′s objective quality score in MARS ( B=0.023, 95% CI: 0.018-0.029) and user rating ( B=0.040, 95% CI: 0.019-0.060) (both P<0.001). A total of 4 articles were included to test the effects of techniques (i.e., physical activity behavior monitoring, physical activity planning and physical activity guidance) in 4 applications. The overall quality of the literatures was good. The main outcomes were physical activity duration (3 articles) and step count (1 article). Compared with those who did not use the application or only used the accelerometer to monitor physical activity, subjects who used the application to monitor physical activity had significant longer physical activity durations and step count (both P<0.05). Conclusions:The number, function and technology of physical activity management applications in China are abundant, but the quality of the applications is moderate. The number of BCT is an important factor in evaluating application′s quality, but its effect on behavior change is still not clear.

Validity and reliability of mobile applications in physical therapy: protocol for a systematic review

BACKGROUND@#Due to technological advancements, mobile applications have aided in the enhancement of assessment, treatment, and exercise programs for the major stakeholders in healthcare. However, there is a lack of preponderance of the evidence of reliability and validity of these mobile applications among traditional tools/methods used in rehabilitation. Thus, this systematic review aims to identify and synthesize existing studies on evidence of the validity and reliability of mobile applications used in physical therapy. @*METHODS@#Included in this systematic review are studies written in English that tested the PT mobile application in healthy individuals, compared it with gold standard equipment, and tested the app's validity and/or reliability. A literature search will be conducted on nine databases, and two electronic software will be used - (1) Mendeley and (2) Rayyan. The Brink and Louw (2012) Critical Appraisal Tool will be used to assess the validity and reliability of the eligible articles. A qualitative review and meta-analyses will be conducted for data synthesis.@*EXPECTED RESULTS@#This study will contribute to current knowledge and healthcare practices by providing information on valid and reliable PT applications, synthesizing evidence on mobile applications that will improve PT assessments and interventions, and which applications can be further studied and developed. Overall, the results of this study will give information on how PT mobile applications can complement standard test measures or procedures in physical therapy such as assessments, interventions, and home exercise programs.

EFETIVIDADE DO APLICATIVO IPELVIS® NA REABILITAÇÃO DE PACIENTES COM INCONTINÊNCIA URINÁRIA: UM ENSAIO-CLÍNICO ALEATORIZADO / EFFECTIVENESS OF THE IPELVIS® APPLICATION IN THE REHABILITATION OF PATIENTS WITH URINARY INCONTINENCE: A RANDOMIZED CLINICAL TRIAL

Objetivo: Verificar a efetividade do aplicativo Ipelvis® na reabilitação de pacientes com incontinência urinária comparada com a fisioterapia pélvica convencional e domiciliar. Metodologia: Trata-se de um ensaio-clínico aleatorizado realizado 20 mulheres que apresentavam sintomas de incontinência urinária. Foram utilizados os instrumentos para avaliar antes e após a intervenção: The 3 Incontinence Questions, International Consultation on Incontinence Questionnaire ­ Short Form e Qualidade de vida medida pelo King's Health Questionnaire. As participantes foram divididas aleatoriamente em grupos e receberam orientações de tratamento domiciliar por três meses, com o Grupo 1 utilizando o aplicativo como tratamento domiciliar e o Grupo 2, utilizou uma folha convencional com exercícios terapêuticos. Os dados foram analisados por meio da estatística descritiva. Resultados: Após intervenção, 85% das pacientes não apresentaram nenhum sintoma de incontinência, 10% apresentaram Incontinência urinária de esforço, 5% de Incontinência urinária de urgência e nenhuma paciente apresentou Incontinência urinária de mista, evidenciando a melhora do quadro das pacientes com incontinência urinária posteriormente à realização dos exercícios terapêuticos de assoalho pélvico em ambos os grupos. Conclusão: Os exercícios terapêuticos de assoalho pélvico foram eficazes para pacientes com incontinência urinária em ambos os grupos, mas os resultados foram mais eficazes no método de tratamento digital, por meio do aplicativo Ipelvis® quando comparado com o método tradicional por meio da folha.

Objective: To verify the effectiveness of the Ipelvis® application in the rehabilitation of patients with urinary incontinence compared to conventional and home pelvic physiotherapy. Methodology: This is a randomized clinical trial carried out with 20 women who had symptoms of urinary incontinence. The following instruments were used to assess before and after the intervention: The 3 Incontinence Questions, International Consultation on Incontinence Questionnaire ­ Short Form and Quality of life measured by the King's Health Questionnaire. Participants were randomly divided into groups and received home treatment guidelines for three months, with Group 1 using the app as home treatment and Group 2 using a conventional sheet with therapeutic exercises. Data were analyzed using descriptive statistics. Results: After the intervention, 85% of the patients had no symptoms of incontinence, 10% had stress urinary incontinence, 5% had urge urinary incontinence and no patient had mixed urinary incontinence, showing the improvement in the condition of patients with urinary incontinence. after performing therapeutic pelvic floor exercises in both groups. Conclusion: Therapeutic pelvic floor exercises were effective for patients with urinary incontinence in both groups, but the results were more effective in the digital treatment method, through the Ipelvis® application, when compared to the traditional method through the sheet.

Optimizing Internet Use during Adolescence: eHealth Solutions

Internet offers an immense opportunity as a resource for education, training, and health promotion. This narrative review summarizes the opportunities for health promotion among adolescents through use of the Internet and technology (defined as eHealth). The details of technology and use of Internet for adolescent-health related topics such as nutrition, fitness, sexual health, adventure, and violence were searched through PubMed. The review reports few digital solutions to address key challenges during adolescence like promotion of nutrition and sexual reproductive health, prevention of noncommunicable diseases, substance abuse, and mental health issues. eHealth was concluded as a potential solution for preventive and promotional health practices during adolescence. However, concerns of Internet addiction, safety, privacy, mental health disorders, and misinformation need to be addressed and monitored during adolescence.

Acompañando la lactancia materna con eHealth: revisión integrativa

Resumen: Introducción: La Organización Mundial de la Salud recomienda la lactancia materna exclusiva durante los primeros 6 meses de vida, así como continuar complementada con alimentos apropiados hasta los 2 años y más. Es por esto, que se observa la necesidad del apoyo profesional en torno a esta, para las madres durante el embarazo y una vez iniciado el amamantamiento. La Asamblea Mundial de la Salud, reconoció el potencial de las tecnologías digitales para la mejora de la salud pública, destacando que el uso de eHealth ha transformado la salud, permitiendo la entrega de cuidados en los hogares de las personas de manera remota. Objetivo: Determinar si el apoyo profesional por medio de eHealth es una estrategia que favorece el acompañamiento a las madres que viven el proceso de amamantamiento y mejora sus resultados en la lactancia materna. Metodología: Se realizó una revisión integrativa buscando la comprensión del fenómeno o tema de interés desde diversas perspectivas. Para llevarla a cabo en junio de 2020 se consultaron las bases de datos Pubmed, Scopus, CINAHL, ProQuest, ClinicalKey y Science Direct. Resultados: Se organizaron en dos grupos: estrategias de acompañamiento profesional a través de eHealth a las madres en proceso de amamantamiento y resultados de eHealth como herramienta para el acompañamiento profesional a las madres en proceso de amamantamiento. Conclusión: La eHealth es una herramienta efectiva para brindar apoyo a mujeres embarazadas o en proceso de amamantamiento.

Resumo: Introdução: A A Organização Mundial da Saúde recomenda o aleitamento materno exclusivo durante os primeiros 6 meses de vida, e também que seja complementado com alimentos apropriados até os 2 anos ou mais. É por isso que se faz necessário o apoio profissional às mães neste processo, desde a gestação até o início da amamentação. A Assembléia Mundial da Saúde reconheceu os benefícios das tecnologias digitais para o aprimoramento da saúde pública, destacando a ferramenta eHealth, cuja utilização transformou a saúde e permitiu um atendimento especializado nos lares das pessoas, de maneira remota. Objetivo: Determinar se o apoio profissional por meio da eHealth é uma estratégia que favorece o acompanhamento às mães que estão atravessando o processo de amamentação e melhora seus resultados do aleitamento. Metodologia: Foi realizada uma revisão integrativa, procurando compreender o fenômeno ou tópico de interesse a partir de diferentes perspectivas. Para implementá-la em junho de 2020 foram consultadas as bases de dados Pubmed Scopus, CINAHL, ProQuest, ClinicalKey e Science Direct. Resultados: Eles foram organizados em dois grupos: estratégias de apoio profissional por meio da eHealth para mães em processo de amamentação e resultados da eHealth como ferramenta de apoio profissional para mães em processo de amamentação. Conclusão: A eHealth é uma ferramenta efetiva oferecem um suporte significativo às gestantes e às mães durante o aleitamento.

Abstract: Introduction: The World Health Organization recommends exclusive breastfeeding during the first 6 months of life, as well as continuing it supplemented with appropriate foods up, to 2 years and more. Therefore, the need of professional support around it is observed for mothers during pregnancy and once breastfeeding has begun. The World Health Assembly recognized the potential of digital technologies to improve public health, highlighting that the use of eHealth has transformed health, allowing the delivery of care in people's homes remotely. Objective: To determine if professional support through eHealth is a strategy that favors the support to mothers who are going through the breastfeeding process and improves their breastfeeding results. Methodology: A integrative review was carried out seeking to understand the phenomenon or topic of interest from different perspectives. To carry it out in June 2020, the databases Pubmed, Scopus, CINAHL, ProQuest, ClinicalKey and Science Direct were consulted. Results: They were organized into two groups: professional support strategies through eHealth to mothers in breastfeeding process and results of eHealth as a tool for professional support to mothers in breastfeeding process. Conclusion: eHealth is an effective tool to provide meaningful support to pregnant or breastfeeding women.

Knowledge, Perceptions, Needs and Challenges of Dominican Adolescents with Type 1 Diabetes Mellitus / Conocimientos, percepciones, necesidades y desafíos de los adolescentes dominicanos con diabetes mellitus tipo 1

Introduction: The lack of metabolic control in patients with Type 1 Diabetes Mellitus (T1DM) can cause severe complications and reduce their life expectancy. Transition into adolescence among children with T1DM effects important changes that could negatively influence their metabolic control. Purpose: To determine knowledge, perceptions, needs and challenges of Dominican adolescents with T1DM. Methodology: Phone interviews to adolescents with T1DM between 14 and 18 years. Analysis included coding using the Health Belief Model, and using Nvivo, with a deductive and inductive approach. Results: Participants reported a high level of perceived susceptibility to complications, and severity associated to an incurable disease that causes severe complications. Within modifying factors, the family socioeconomic level was identified as relevant, and the role of support networks in managing their disease was mentioned as an external variable. Conclusions: Culturally, relevant interventions are needed to improve metabolic control and psychosocial aspects among Dominican adolescents with T1DM, including the use of a self-management mobile application; in addition, incorporating perspectives, context realities and knowledge of adolescents in developing therapeutical education strategies about T1DM could improve the impact of these strategies

Introducción: el descontrol metabólico en pacientes con diabetes tipo 1 (DMT1) puede provocar complicaciones severas y reducir la esperanza de vida. La transición a la adolescencia en jóvenes con DMT1 determina cambios importantes que pueden influenciar negativamente el control metabólico. Propósito: determinar el nivel de conocimiento, las percepciones, las necesidades y los desafíos de los adolescentes dominicanos con DMT1. Metodología: entrevistas telefónicas a adolescentes con DMT1, entre 14 y 18 años. El análisis incluyó la codificación con base al Modelo de Creencias de Salud, utilizando NVivo, a través de un abordaje deductivo e inductivo. Resultados: participantes reportaron un alto nivel de susceptibilidad percibida de sufrir complicaciones y una percepción de severidad asociada a una enfermedad incurable que causa complicaciones severas. En los factores modificadores se destacan determinantes sociales como el nivel socioeconómico de la familia y, en las variables externas, el rol de las redes de apoyo en el manejo de la enfermedad. Conclusiones: se requieren intervenciones culturalmente relevantes para mejorar el control metabólico y los aspectos psicosociales en los adolescentes dominicanos con DMT1, como sería una aplicación móvil para el automanejo; además, incorporar las perspectivas, las realidades contextuales y los conocimientos de los adolescentes en las estrategias de educación terapéutica sobre la DMT1 favorecería su impacto

Mobile Phone-based intervention to promote un-interrupted HIV treatment during the COVID-19 pandemic

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

Rural community health workers’ readiness for mobile-phone based telemedicine uptake in India / Journal of Rural Medicine

Objective: Healthcare services using mobile-phone based telemedicine provide simple technology that does not require sophisticated equipment. This study assessed community health workers’ knowledge, attitude, and practice (i.e., their readiness) at the village level for uptake of mobile-phone based telemedicine.Materials and Methods: This cross-sectional study was conducted among 80 community health workers, including Auxiliary Nurse Midwives, Multipurpose Health Workers and Accredited Social Health Activists working in a rural health block of India. A pre-tested, semi-structured, interviewer-assisted, self-administered questionnaire was used to assess their mobile-phone based telemedicine readiness.Results: Sixty (75.0%) health workers owned mobile phones. The median readiness score for mobile-phone based telemedicine was 109.0. The Accredited Social Health Activists showed a better attitude toward mobile-phone based telemedicine than others. There was a significant moderate positive correlation (r=0.67) between knowledge and practice domains. Community health workers who had smartphones showed a significantly better attitude than those who did not.Conclusion: Training programs on telemedicine service delivery, focused on Auxiliary Nurse Midwives/ Multipurpose Health Workers, can improve their attitudes towards telemedicine. A better attitude of the Accredited Social Health Activists must be leveraged to initiate mobile-phone based telemedicine services on a pilot basis initially and later scaled up in other settings.

Teste de dígitos no ruído no Português Brasileiro: influência das variáveis demográficas e socioeconômicas em normo-ouvintes / Digits-in-noise test in Brazilian Portuguese: how demographic and socioeconomic variables influence normal-hearing subjects

RESUMO Objetivo Verificar a influência das variáveis demográficas e socioeconômicas no limiar de reconhecimento de fala no ruído (LRF) obtidos no teste de dígitos no ruído (TDR) no Português Brasileiro em normo-ouvintes. Método Estudo transversal e prospectivo. A amostra de conveniência foi composta por 151 sujeitos normo-ouvintes com idade entre 12 e 79 anos (média =34,66) que realizaram audiometria tonal liminar e teste de dígitos no ruído branco com sequência de trios numéricos em estímulo diótico (inphase) no mesmo dia. O TDR foi realizado com um smartphone Motorola Z3 play com acesso à internet com fones de ouvido intra-auriculares. Os limiares de reconhecimento dos dígitos no ruído (LRF) foram analisados em função do sexo, idade, escolaridade e nível socioeconômico. Foi utilizado para comparar as amostras independentes, o teste não-paramétrico Kruskal-Wallis e Mann-Whitney, adotando-se o nível de significância de 5%. Resultados A média do LRF foi de -8,47 dBNA (dp -3,89), com mediana de -9,6 dBNA. O LRF foi proporcionalmente inverso à escolaridade e nível socioeconômico e mais negativo (isto é, melhor) com menor faixa-etária. Não houve evidência de influência do sexo no LRF do TDR. Conclusão Idade, escolaridade e nível socioeconômico mostraram influenciar o limiar no TDR; essas variáveis devem ser consideradas na análise de desempenho do TDR no Português Brasileiro em sujeitos normo-ouvintes.

ABSTRACT Purpose Verify how demographic and socioeconomic variables on the in-noise speech recognition threshold (SRT) from the digits-in-noise test (DIN) in Brazilian Portuguese influence normal-hearing subjects. Methods Cross-sectional, prospective study. The convenience sample had 151 normal-hearing subjects between 12 and 79 years (mean=34.66) who underwent pure tone audiometry and digits-in-noise test with white noise using a sequence of three numbers in diotic stimulus (in-phase) on the same day. The DIN was performed using a Motorola Z3 Play smartphone with internet access and in-ear headphones. In-noise digit speech recognition threshold (SRT) was analyzed for gender, age, educational levels, and socioeconomic status. We used the non-parametric version of the Kruskal-Wallis and Mann-Whitney U tests to compare independent samples adopting a significance level of 5%. Results The mean SRT was -8.47 dBNA (SD -3.89) with a median of -9.6 dBNA. The SRT was proportionally inverse to educational levels and socioeconomic status and more negative (better) with lower age groups. Gender did not influence the DIN SRT. Conclusion Age, educational levels, and socioeconomic status influenced the DIN threshold. These variables must be considered when analyzing DIN performance in Brazilian Portuguese in normal-hearing subjects.

CHECKEATE, aplicación tecnológica en la prevención y tratamiento de las enfermedades crónicas no transmisibles / CHECKEATE, a technological application for the prevention and treatment of chronic non-communicable diseases

La falta de cultura preventiva y un diagnóstico precoz oportuno representan dos de los factores más importantes a considerar en la prevención y tratamiento de las enfermedades crónicas no transmisibles a nivel mundial, por lo que la tecnología móvil constituye una alternativa que bien puede ser utilizada en la medicina preventiva. En este sentido, el presente artículo tuvo como objetivo validar una aplicación tecnológica que permita realizar el diagnóstico de enfermedades crónicas no transmisibles, utilizando el dispositivo móvil. Se realizó un estudio descriptivo, que utilizó la encuesta como técnica y el cuestionario como instrumento para la recolección de la información en una muestra de 60 personas mayores de 18 años, todos usuarios de la red social Facebook, quienes seguían la página https://es-la.facebook.com/DrLuisPacoraCamargo/. Los resultados obtenidos permitieron demostrar que el 57,1 por ciento de los encuestados presentaba edades comprendidas entre los 21 y 40 años de edad, de los cuales el 88,3 por ciento reportó que utilizaba internet diariamente; el 53,3 por ciento respondió que utilizaba sus dispositivos frecuentemente para comunicarse a través de las redes sociales; el 53,4 por ciento de los encuestados había descargado un aplicativo relacionado con la salud y, finalmente, el 82,8 por ciento de las personas respondió tener conocimiento del término de medicina preventiva y, que de tener información en sus dispositivos móviles, la utilizaría con frecuencia. En conclusión, el diseño e implementación de un servicio de salud a través de los dispositivos móviles, como el CHECKEATE, es viable en un mercado joven, potencialmente interesado en temas de salud preventiva(AU)

Lack of a preventive culture and of timely early diagnosis are two of the most important factors to be considered in the prevention and treatment of chronic non-communicable diseases worldwide. Mobile technology is therefore an alternative which could very well be used in preventive medicine. The purpose of the study was to validate a technological application for the diagnosis of chronic non-communicable diseases using a mobile device. A descriptive study was conducted based on the survey as technique and the questionnaire as data collection tool. The sample was 60 people aged over 18 years, all of them users of the social network Facebook, who follow the webpage https://es-la.facebook.com/DrLuisPacoraCamargo/. Results show that 57.1 percent of the respondents were aged 21-40 years; 88.3 percent reported using the Internet daily; 53.3 percent that they used their devices frequently for communication through social networks; 53.4 percent had downloaded a health-related application, and 82.8 percent were familiar with the term "preventive medicine" and would used it more frequently if they had more information on their mobile devices. In conclusion, design and implementation of a health service through mobile devices, as is the case with CHECKEATE, would be viable in a young market potentially interested in preventive health topics(AU)

Instrumentos de vigilância e rastreio do desenvolvimento infantil e tecnologia móvel: revisão / Child development monitoring and screening instruments and mobile technology: review / Instrumentos de vigilancia y detección del desarrollo infantil y tecnología móvil: revisión

Este estudo é uma revisão de literatura desenvolvida para investigar o uso de instrumentos de vigilância e rastreio para atraso do desenvolvimento infantil por meio de tecnologia móvel. Além disso, objetivou-se caracterizar as metodologias utilizadas, amostras de participantes, se clínicas ou não, contexto de pesquisa, bem como a finalidade do uso instrumento. Foi realizada a busca de artigos, por três juízes, nas bases de dados indexadas na BVS, PUBMED/MEDLINE e APA PsyNET. Utilizaram-se as recomendações do PRISMA para essa revisão. A partir de critérios de inclusão/exclusão, foram recuperados e analisados cinco artigos. As duas modalidades de instrumentos: vigilância e rastreio, apresentaram-se em três categorias de estudo: 1) descritivo 2) viabilidade/usabilidade 3) validade. Conclui-se que mais estudos sejam necessários, especialmente para avaliar o impacto e eficácia do uso de instrumentos de vigilância e rastreio para atraso no desenvolvimento infantil em formato de tecnologia móvel. (AU)

This study is a literature review designed to investigate the use of monitoring and screening instruments for child developmental delay using mobile technology. In addition, the aim was to characterize the methodologies used, samples of participants, whether clinical or not, the research context and the purpose of the instrument use. Articles were searched by three judges in the databases indexed in the BVS, PUBMED/MEDLINE and APA PsyNET. The PRISMA recommendations were used for this review. After applying the inclusion/exclusion criteria, five articles were retrieved and analyzed. The two types of instruments: monitoring and screening, were presented in three study categories: 1) descriptive 2) viability/usability 3) validity. Further studies are needed to assess the impact and effectiveness of the use of mobile format instruments for the monitoring and screening for childhood developmental delays. (AU)

Este estudio es una revisión de la literatura desarrollada para investigar el uso de instrumentos de vigilancia y rastreo del retraso del desarrollo infantil a través de la tecnología móvil. Asimismo, el objetivo fue caracterizar las metodologías utilizadas, muestras de participantes, ya sean clínicas o no; además del contexto de investigación y la finalidad del uso del instrumento. Tres jueces realizaron una búsqueda de artículos en las bases de datos indexadas en la BVS, PUBMED/MEDLINE y APA PsyNET. Las recomendaciones de PRISMA se utilizaron para esta revisión. Según los criterios de inclusión/exclusión, cinco artículos fueron recuperados y analizados. Los dos tipos de instrumentos fueron: vigilancia y detección, se presentaron en tres categorías de estudio: 1) descriptivo 2) viabilidad/usabilidad 3) validez. Se concluyó que son necesarios más estudios, especialmente para evaluar el impacto y la efectividad del uso de instrumentos de vigilancia y rastreo del retraso en el desarrollo infantil en formato de tecnología móvil. (AU)

eHealth and mHealth: Adherence to treatment in chronic diseases / Cibersalud y salud móvil: adherencia al tratamiento en enfermedades crónicas

Abstract Poor adherence to treatment is a common problem in patients with chronic diseases since, given their nature, they involve long-term therapeutic regimens, hence the importance of permanent follow-up. In general, it is known that adherence to treatment is necessary to achieve better health outcomes, improve quality of life, and reduce health care-related costs. The growth of eHealth, particularly telemedicine and mobile health (mHealth), has resulted in a real benefit of technological platforms in the therapeutic adherence of these patients. With this in mind, the aim of this reflection paper is to briefly describe the current state of eHealth strategies and the impact they may have on adherence to treatment in patients with chronic diseases.

Resumen La poca adherencia a los tratamientos es un problema frecuente en pacientes con enfermedades crónicas, ya que, dada su naturaleza, implican esquemas terapéuticos que se perpetúan a largo plazo, de ahí la importancia de un seguimiento continuo. En general, se sabe que una mejor adherencia al tratamiento es de gran importancia para lograr mejores resultados en salud, mejorar la calidad de vida y reducir los costos asociados con la atención en salud. Actualmente, con el crecimiento de la cibersalud (ehealth), en particular la telemedicina y la salud móvil (mhealth), se ha comenzado a describir un beneficio real de las plataformas tecnológicas en la adherencia terapéutica de estos pacientes. Teniendo en cuenta lo anterior, el objetivo de esta reflexión es describir brevemente el estado actual de las estrategias de cibersalud y el impacto que podrían generar en la adherencia al tratamiento en pacientes con enfermedades crónicas.

Cardiología digital (e-Cardiología): herramientas de utilidad para el diagnóstico y el manejo del paciente con fibrilación auricular / Digital Cardiology (e-Cardiology): useful tools for diagnosis and management of atrial fibrillation / Cardiologia digital (e-Cardiologia): ferramentas úteis para o diagnóstico e tratamiento de pacientes com fibrilação atrial

La tecnología digital móvil (mSalud), recurso aún subutilizado, tiene el potencial para transformarse en un auxiliar imprescindible en la práctica clínica, en particular en Cardiología. La fibrilación auricular es la arritmia más frecuente, cuya prevalencia aumenta con la edad y tiene como complicación más temida el accidente cerebrovascular. Su prevención depende de un diagnóstico oportuno, una adecuada estratificación de riesgo y el uso de anticoagulantes orales. Sin embargo, es con frecuencia paroxística y asintomática, lo que dificulta su diagnóstico. El aporte de la tecnología mediante el desarrollo de aplicaciones para celulares, relojes, dispositivos portátiles o implantables que registran el ritmo cardíaco y permiten el monitoreo prolongado, ambulatorio y a distancia facilitan su detección. Se repasan las principales evidencias que justifican la aplicación de estas estrategias de tamizaje, cuando está indicado realizarlo, cómo y a quiénes hacerlo. Por último, se plantea también la utilidad de estas estrategias de monitoreo prolongado en el manejo y la prevención de la fibrilación auricular.

The mobile digital technology (mHealth), a tool still underutilized, has the potential to become an essential aid in clinical practice, particularly in Cardiology. Atrial fibrillation is the most frequent arrhythmia whose prevalence increases with age and its most feared complication is cerebrovascular accident. Its prevention depends on a timely diagnosis, an adequate risk stratification and the use of oral anticoagulants. However, it is frequently paroxysmal and asymptomatic, which makes its diagnosis difficult. The contribution of technology through the development of applications for cell phones, watches, portable or implantable devices that record the heart rhythm and allow prolonged, outpatient and remote monitoring, facilitate its detection. The main evidences that justify the application of these screening strategies are reviewed, when it is indicated to perform it, how and to whom to do it. Finally, the usefulness of these prolonged monitoring strategies in the management and prevention of atrial fibrillation is also considered.

A utilização da tecnologia digital móvel (m-Saúde), ainda pouco utilizada, tem potencial para se tornar um auxílio essencial na prática clínica, principalmente na Cardiologia. A fibrilação atrial é a arritmia mais frequente, cuja prevalência aumenta com a idade e sua complicação mais temida é o acidente vascular cerebral. Sua prevenção depende de um diagnóstico oportuno, de uma estratificação de risco adequada e do uso de anticoagulantes orais. Porém, freqüentemente é paroxística e assintomática, o que dificulta seu diagnóstico. A contribuição da tecnologia por meio do desenvolvimento de aplicativos para telefones celulares, relógios, dispositivos portáteis ou implantáveis ​​que registram o ritmo cardíaco e permitem monitoramento prolongado, ambulatorial e remoto, facilitam sua detecção. São revisadas as principais evidências que justificam a aplicação dessas estratégias de rastreamento, quando é indicado fazê-lo, como e para quem fazê-lo. Finalmente, a utilidade dessas estratégias de monitoramento prolongado no manejo e prevenção da fibrilação atrial também é considerada.