The effect of mHealth on vaccine uptake, coverage, and acceptance among children, adolescents and adults: A meta-analysis

Background@#This meta-analysis was conducted to synthesize the evidence on the effectiveness of mhealth for vaccination uptake, coverage, and acceptance among children, adolescents, and adults.@*Methods@#Database search was conducted in PubMed, Medline, and Cochrane Library. Studies were included if the following were met: 1) RCTs or CCTs, and 2) with comparison of mHealth on usual care. Studies were excluded if mHealth was not assessed and the data were insufficient to calculate pooled results. The effectiveness was evaluated using Odds ratio with 95% confidence interval in RevMan 5.3.@*Results@#A total of 17 studies were included in the analysis. The pooled analysis showed that mHealth can improve vaccine uptake (OR 1.83, p=0.0005), coverage (OR 1.49, p=0.03), up-to-date vaccination (OR 2.37, p=0.0007), and completion of full vaccine series (OR 1.81, p=0.0002). Subgroup analyses showed that vaccine uptake is significantly improved when text messaging is used as a reminder system (OR 1.73, p<0.001) and when mHealth is employed for children’s vaccines (OR of 2.77, p=0.007). Majority of the pooled studies showed significant heterogeneity. Statistical synthesis on vaccine acceptance was not feasible, but existing studies report positive effects of mHealth on this outcome.@*Conclusion@#mHealth can improve vaccine uptake, coverage, up-to-date vaccination, and completion of the full vaccine series. Additional unpublished and rigorous studies may be considered in a future research to fully assess its effectiveness.

El derecho a la muerte / The right to written death

Este artículo fue publicado originalmente en el número 42 de la revista Conjetural, e incluido luego, con modificaciones, como Postfacio del libro Epitafios : el derecho a la muerte escrita (Grupo Edit. Norma, Buenos Aires, 2005). Se lo reproduce aquí en una versión completa cedida por el autor para este número de la revista de la UBA. Se consignan a continuación sus apartados : Duelo y transmisión / Lo siniestro perdura : un funeral sin resolver / La política de los huesos : No entregar los cadáveres / La estetización de la muerte / El espejismo de restos.

This article was originally published in issue 42 of Conjetural magazine, and then included, with modifications, such as Postface of the book Epitafios : the right to written death (Grupo Edit, Norma, Buenos Aires, 2005). It is reproduced here in a complete version provided by the author for this issue of the UBA magazine. Its sections are consigned below : Grief and transmission / The sinister endures : an unresolved funeral / The policy of the bones : Do not deliver the corpses / The aestheticization of death / The mirage of remains.

Assessment of efficacy of home available reminders to aid in the adherence and effectiveness of home-based pelvic floor muscle training in the management of stress urinary incontinence

Background: Strengthening exercises for pelvic floor muscles (SEPFM) are considered the first approach in the treatment of stress urinary incontinence (SUI). UI has a devastating effect on women's quality of life in the physical, social, sexual and psychological spheres. Women restrict or diminish their activity and social participation, with serious implications. In SUI, there is an association between physical exertion and urinary loss. Increased intra-abdominal pressure triggered by physical exertion leads to increased intra-vesical pressure and, if it exceeds intraurethral pressure, in the absence of contraction of the detrusor muscle, the resulting urinary leakage is referred to as SUI. Aim of the study: To identify the protocol and/or most effective training parameters in the treatment of female SUI. Materials and methods: 100 patients with stress urinary incontinence attending the out-patient department were thoroughly evaluated and randomized into 2 groups of 50 patients each, both groups were taught Kegels exercises and instructions to perform them at home. The experimental group (A) received additional strategies to enhance the efficacy of PFME in the form of reminder bindis to be placed in areas of the home frequented by the patient like the kitchen and its appliances. Patients in the control group (B) did not receive any additional reminders. Both groups were asked to maintain an T. Srikala Prasad, Jessima Subahani, B. Amirtha. Assessment of efficacy of home available reminders to aid in the adherence and effectiveness of home-based pelvic floor muscle training in the management of stress urinary incontinence. IAIM, 2019; 6(9): 7-12. Page 8 exercise diary and allowed to continue their routine medications for comorbidities if any. They were reviewed on Day 15, Day 30 and physiotherapy sessions are given. Later on Day 90 the patients of both groups were reviewed and evaluated with a questionnaire for improvement in symptoms and adherence to PFME. Results: Among the total 100 patients who were trained to do PFME, 23 (14 from group A and 9 from group B) were completely dry by 90 days, 51 (29 from group A and 22 from group B) patients had reduction in the leak and 26 (7 from group A and 19 from group B) patients showed no improvement. Assessment from the exercise diary showed good adherence and symptom relief in most patients in the trial group. Conclusions: Adherence to PFME was better in the trial group in whom indigenous reminders were used which in turn translated into clinical improvement. In this time and era as PFMT is the first management modality in patients with stress and mixed incontinence implementation of such strategies to improve adherence to treatment is suggested especially in tertiary care setups.