Desenvolvimento de um aplicativo para ensino de ultrassonografia pulmonar em emergência / Development of an application for teaching pulmonary ultrasound in an emergency

Resumo: Introdução: A utilização de protocolos de ultrassonografia revolucionou o atendimento na medicina de emergência e pode auxiliar no diagnóstico de insuficiência respiratória no pronto atendimento. Assim, torna-se importante o treinamento médico para a utilização desses protocolos. Já foi demonstrado também que os aplicativos de smartphone médico têm resultados positivos na prática diária, além de serem uma ferramenta educacional potencialmente valiosa. Objetivo: Dessa forma, o objetivo deste estudo foi desenvolver um aplicativo em ultrassonografia pulmonar de emergência. O BLUE SIM é um aplicativo de celular que simula atendimentos de casos clínicos utilizando o protocolo Bedside Lung Ultrasound in Emergency, o qual pode auxiliar alunos e profissionais da área da saúde a usar a ultrassonografia pulmonar no atendimento da insuficiência respiratória aguda. A hipótese é que o BLUE SIM será um aplicativo usável e aceitável entre os usuários. Método: Após desenvolvido, avaliou-se o aplicativo com 36 voluntários: 18 fisioterapeutas, um médico, sete enfermeiros e dez acadêmicos de Medicina. Analisaram-se a usabilidade e a utilidade de uma aplicação móvel para o sistema iOS, utilizando como referências a escala de usabilidade System Utility Score (SUS) e o modelo de aceitação Technology Acceptance Model (TAM). Os dados obtidos foram tabulados e analisados pelo teste exato de Fisher ou Mann-Whitney. Resultado: Pela aplicação do questionário SUS (usabilidade), o aplicativo obteve um escore de 76,8%. Exclusivamente entre os fisioterapeutas, obteve-se um escore de 75%, não havendo diferença estatística entre o grupo geral de todos os profissionais emergencistas e o grupo somente de fisioterapeutas (p = 0,239). Segundo a análise de percepção de utilidade, 93,9% dos profissionais emergencistas responderam positivamente, enquanto, entre os fisioterapeutas, obteve-se um escore de 88,9% (p = 0,04). Conclusão: O aplicativo desenvolvido foi classificado de utilidade na aprendizagem do diagnóstico de insuficiência respiratória entre os profissionais, contudo eles consideraram que é necessário um treinamento para o uso da ferramenta.

Abstract: Introduction: The use of ultrasound protocols has revolutionized care in emergency medicine and can help in the diagnosis of respiratory failure in emergency care; therefore, medical training for the use of these protocols has become important. It has also been demonstrated that medical smartphone apps have positive results in daily practice, in addition to being a potentially valuable educational tool. Objective: Thus, the objective was to develop an emergency pulmonary ultrasound application. The "BLUE SIM" is a cell phone application that simulates clinical cases using the "Bedside Lung Ultrasound in Emergency" protocol, which can help students and health professionals regarding the use of pulmonary ultrasound in the care of acute respiratory failure. The hypothesis is that the "BLUE SIM" will be a usable and acceptable application among users. Method: After the development, the application was evaluated with a group of 36 volunteers, which included 18 physical therapists and 18 other professionals consisting of physicians, nurses and medical students. The usability and usefulness of a mobile application for the iOS system was analyzed, using the System Utility Score (SUS) usability scale and the Technology Acceptance Model (TAM) as references. The obtained data were tabulated and analyzed using Fisher's exact test or Mann-Whitney test. Result: When applying the SUS questionnaire (usability), the application obtained a score of 76.8%. A score of 75% was obtained exclusively among physical therapists, with no statistical difference between the general group of all emergency professionals and the group of physical therapists only (p=0.239). According to the usefulness perception analysis, 93.9% of the emergency professionals had a positive response, while a score of 88.9% was obtained among physical therapists (p=0.04). Conclusion: It was concluded that the developed application was classified as useful in learning the diagnosis of respiratory failure among health professionals; however, they considered that training is necessary for its use.

Nomophobia and smartphone addiction: do the variables age and sex explain this relationship? / Nomofobia e dependência de smartphone: as variáveis idade e sexo explicam essa relação? / Nomofobia y dependencia de los smartphones: ¿las variables edad y sexo explican esta relación?

This study aimed to identify the extent nomophobia explains smartphone addiction, controlling for age and gender effects. Participants were 316 people from the 22 Brazilian states (Mage = 28.1 years), most from Paraíba (38.9%) and Piauí (16.5%), equally distributed between genders. They answered the Nomophobia Questionnaire, the Smartphone Addition Scale and demographic questions. The results demonstrate that the factors of the nomophobia measure explained smartphone addiction, indicating that more nomophobic behavior equates to increased smartphone addiction, especially in the younger participants, there was no difference regarding gender. These findings are discussed according to the literature on adherence to new technologies, revealing the current problem of smartphone addiction in young people. (AU)

O objetivo deste estudo foi conhecer em que medida a nomofobia explica a dependência de smartphone, controlando os efeitos de idade e sexo. Participaram 316 pessoas de 22 estados brasileiros (Midade = 28,1), a maioria da Paraíba (38,9%) e do Piauí (16,5%), distribuídas equitativamente entre os sexos. Estas responderam o Questionário de Nomofobia, a Escala de Adição ao Smartphone e perguntas demográficas. Os resultados foram de que os fatores da medida de nomofobia explicaram a dependência de smartphone, indicando que quanto mais as pessoas são nomofóbicas, mais elas dependem de smartphone, principalmente aquelas mais jovens, não havendo diferença quanto ao sexo. Esses achados foram discutidos de acordo com a literatura acerca da adesão a novas tecnologias, revelando o problema da dependência de smartphones para os jovens nos dias de hoje. (AU)

El objetivo de este estudio ha sido conocer en qué medida la nomofobia explica la dependencia de smartphones, controlando los efectos de la edad y el sexo. Participaron 316 personas de 22 estados brasileños (Medad = 28.1), en su mayoría de Paraíba (38.9%) y Piauí (16.5%), distribuidos equitativamente entre los sexos. Estos respondieron al Nomophobia Questionnaire, a la Smartphone Addition Scale y a preguntas demográficas. Los resultados demuestran que los factores de la medida de nomofobia explican la adición a los smartphones, indicando que un comportamiento más nomofóbico equivale a una mayor adicción a los smartphones, especialmente en los más jóvenes, no existiendo diferencias en cuanto al género. Estos hallazgos han sido discutidos de acuerdo con la literatura sobre la adhesión a las nuevas tecnologías, revelando el problema actual de la adicción a los smartphones en los jóvenes. (AU)

Mobile phone usage among nigerians: risk factors for musculoskeletal injuries and preventive strategies

Aims: The increase in the usage of hand-held devices (HHDs) and smartphones (SPs), especially in Nigeria has resulted in an upsurge of musculoskeletal complaints. The aim of this study was to determine the incidence and risk factors for musculoskeletal injuries due to mobile phone usage among Nigerians and the preventive strategies. Materials and Methods: This study involved 630 male and female participants above 18 years old who were purposively recruited across designated study centres in public places. The instrument used was a questionnaire specifically designed to suit the Nigerian culture and environment and developed from previously validated questionnaires. Data were exported to Statistical Computing Programming R version 4.0.5 for analysis and Chi-square was used to compare the characteristics of those who experienced injury using SPs/HHDS and those who did not. Independent variables with a 95% confidence level and P < 0.05 in the multivariate model were considered statistically significant. Results: The most common daily use of SPs/HHDS by the participants was phone calls (98.4%) followed closely by social networking (96.0%) while the occupation and educational level of the participants had statistically significant (P < 0.05) impact on musculoskeletal injuries. The type of mobile device and the time spent using these devices were also significant (P < 0.05) risk factors for injuries. Some self­treatment strategies adopted by the participants were all significantly (P < 0.05) associated with reduction of musculoskeletal discomfort. Conclusion: The occupation, educational level, the types of mobile devices and time spent using the devices were risk factors for musculoskeletal injuries

Accuracy of smartphone-based hearing screening tests: a systematic review / Acurácia de testes de triagem auditiva baseados em smartphone: uma revisão sistemática

ABSTRACT Purpose To verify the accuracy of smartphone apps to identify hearing loss. Research strategies A systematic review followed the PRISMA-DATA checklist. The search strategies were applied across four databases (Lilacs, PubMed, Scopus and Web of Science) and grey literature (Google Scholar, OpenGrey, and ProQuest Dissertations and Thesis). Selection criteria The acronym PIRD was used in review. This included populations of any gender and all age groups. The Index test is the smartphone-based hearing screening test; the Reference test is the pure-tone audiometry, which is considered the gold reference for hearing diagnostics; the diagnosis was performed via validity data (sensitivity and specificity) to identify hearing loss and diagnostic studies. Data analysis Two reviewers selected the studies in a two-step process. The risk of bias was assessed according to the criteria of the QUADAS-2. Results Of 1395 articles, 104 articles were eligible for full-text reading and 17 were included. Only four met all criteria for methodological quality. All of the included studies were published in English between 2015 and 2020. The applications Digits-in noise Test (5 articles), uHear (4 articles), HearScreen (2 articles), hearTest (2 articles) and Hearing Test (2 articles) were the most studied. All this application showed sensitivity and specificity values between 75 and 100%. The other applications were EarScale, uHearing Test, Free field hearing (FFH) and Free Hearing Test. Conclusion uHear, Digit-in-Noise Test, HearTest and HearScreen have shown significant values of sensitivity and specificity and can be considered as the most accurate methods for screening of hearing impairment.

RESUMO Objetivo Verificar a acurácia dos aplicativos de smartphone para identificar a perda auditiva. Estratégias de pesquisa Uma revisão sistemática seguiu o checklist PRISMA-DATA. As estratégias de busca foram aplicadas nos bancos de dados Lilacs, PubMed, Scopus e Web of Science e na literatura cinzenta (Google Scholar, OpenGrey e ProQuest Dissertations and Thesis). Critérios de seleção O anacrônimo PIRD foi usado na revisão. Incluiu populações de qualquer gênero e todas as faixas etárias. O teste Index foi o de triagem auditiva baseado em smartphone; o teste de referência foi a audiometria tonal; o diagnóstico foi realizado por meio de dados de validade (sensibilidade e especificidade) para identificação da perda auditiva e estudos diagnósticos. Análise de dados Dois revisores selecionaram os estudos em um processo de duas etapas. O risco de viés foi avaliado de acordo com os critérios do QUADAS-2. Resultados De 1395 artigos, 104 artigos foram elegíveis para leitura de texto completo e 17 foram incluídos. Apenas quatro preencheram todos os critérios de qualidade metodológica. Todos os estudos incluídos foram publicados em inglês entre 2015 e 2020. Os aplicativos mais estudados foram: Digits-in-noise (5 artigos), uHear (4 artigos), HearScreen (2 artigos), hearTest (2 artigos) e Hearing Test (2 artigos). Todos apresentaram valores de sensibilidade e especificidade entre 75 e 100%. Os outros aplicativos foram EarScale, uHearing, Free Field Hearing e teste Free Hearing. Conclusão uHear, Digit-in-Noise Test, HearTest e HearScreen apresentaram valores significativos de sensibilidade e especificidade e podem ser considerados os métodos mais precisos para rastreamento de deficiência auditiva.

Increasing physical activity by Gamification among Brazilian high school students: a pilot study / Aumento da atividade física por gamificação em estudantes brasileiros do ensino médio: um estudo piloto

This pilot study aimed to evaluate the effectiveness of a Gamification-based intervention on physical activity levels of High School students. This quasi-experimental study was conducted in two federal high schools in Southern Brazil. One class from each school was selected to be either intervention (INT) or control (CON) group. Experiment duration was two weeks, and both groups downloaded My Active Life app. INT group (n = 69) participants received daily app alerts with messages of en-couragement to practice physical activity. They also received a score based on the percentage of goal achieved. CON group (n = 35) only had access to total number of steps per day. INT group showed a lower decrease in physical activity at school compared to CON group (p = 0.024). No effect of inter-vention was observed in physical activity out of school (p = 0.911). Gamification-based intervention prevented a decrease in physical activity at school among male (F = 10.680; p = 0.004), students at first half of high school (F = 12.668; p = 0.002), and adequate body mass index (F = 4.640; p = 0.037), and with lower perception of barriers to physical activity (F = 5.437; p = 0.024). Although we did not observe an increase in physical activity at school, gamification-based intervention may mitigate its decrease among adolescents

Este estudo piloto teve como objetivo avaliar a eficácia de uma intervenção baseada em gamificação nos níveis de atividade física de alunos do ensino médio. Este estudo quase-experimental foi realizado em duas escolas federais de ensino médio no sul do Brasil. Uma turma de cada escola foi selecionada para ser um grupo de intervenção (INT) ou controle (CON). A duração do experimento foi de duas semanas, e ambos os grupos baixaram o aplicativo My Active Life. Os participantes do grupo INT (n = 69) receberam alertas diários no app com mensagens de incentivo à prática de atividade física. Eles também receberam uma pontuação com base no percentual de meta alcançada. O grupo CON (n = 35) só teve acesso ao número total de passos por dia. O grupo INT apresentou menor diminuição da atividade física na escola em comparação ao grupo CON (p = 0,024). Nenhum efeito da intervenção foi observado na atividade física fora da escola (p = 0,911). A intervenção baseada na gamificação evitou uma diminuição da atividade física na escola entre meninos (F = 10,680; p = 0,004), alunos na primeira metade do ensino médio (F = 12,668; p = 0,002) e índice de massa corporal adequado (F = 4,640; p = 0,037), e com menor percepção de barreiras à atividade física (F = 5,437; p = 0,024). Embora não tenhamos observado aumento da atividade física na escola, a intervenção baseada na gamificação pode atenuar sua diminuição entre os adolescentes

Information technology by mobile communication for the notification of canine visceral leishmaniasis / Tecnologia da informação por comunicação móvel para notificação de leishmaniose visceral canina

Visceral leishmaniasis is the most severe form of a human and animal disease complex entitled leishmaniasis, which is endemic to 70 countries. It is imperative to develop and offer technologies capable of increasing the resolution ability of control programs of this zoonosis. In the search for technological innovations in health, especially in environmental surveillance, the objective is to develop a mobile application (App) for smartphones in order to facilitate and systematize the notification of positive cases of canine visceral leishmaniasis (CVL) by veterinarians working in clinics for assisting the municipal health surveillance in the management of this zoonosis. Thus, we developed an App, C7 LVC - Canine Visceral Leishmaniasis Notification System, with formatting based on the CR Campeiro 7® software. The technology created enables the filling of important gaps in information systems, facilitating the transmission of data and the use of this data by public management bodies to take CVL prevention and control actions.(AU)

A leishmaniose visceral é a forma mais grave de um complexo de doenças humanas e animais, denominado leishmaniose, endêmica em 70 países. É imprescindível desenvolver e oferecer tecnologias capazes de aumentar a capacidade de resolução dos programas de controle desta zoonose. Na busca por inovações tecnológicas em saúde, principalmente na vigilância ambiental, o objetivo é desenvolver um aplicativo móvel (App) para smartphones a fim de facilitar e sistematizar a notificação de casos positivos de leishmaniose visceral canina (LVC) por médicos veterinários que atuam em clínicas auxiliando a vigilância sanitária municipal, na gestão desta zoonose. Para tanto, foi desenvolvido um App, C7 LVC - Sistema de Notificação da Leishmaniose Visceral Canina, com formatação baseada no software CR Campeiro 7®. A tecnologia criada possibilita o preenchimento de lacunas importantes nos sistemas de informação, facilitando a transmissão de dados e a utilização desses dados pelos órgãos da gestão pública para a tomada de ações de prevenção e controle da LVC.(AU)

Information technology by mobile communication for the notification of canine visceral leishmaniasis

ABSTRACT: Visceral leishmaniasis is the most severe form of a human and animal disease complex entitled leishmaniasis, which is endemic to 70 countries. It is imperative to develop and offer technologies capable of increasing the resolution ability of control programs of this zoonosis. In the search for technological innovations in health, especially in environmental surveillance, the objective is to develop a mobile application (App) for smartphones in order to facilitate and systematize the notification of positive cases of canine visceral leishmaniasis (CVL) by veterinarians working in clinics for assisting the municipal health surveillance in the management of this zoonosis. Thus, we developed an App, C7 LVC - Canine Visceral Leishmaniasis Notification System, with formatting based on the CR Campeiro 7® software. The technology created enables the filling of important gaps in information systems, facilitating the transmission of data and the use of this data by public management bodies to take CVL prevention and control actions.

RESUMO: A leishmaniose visceral é a forma mais grave de um complexo de doenças humanas e animais, denominado leishmaniose, endêmica em 70 países. É imprescindível desenvolver e oferecer tecnologias capazes de aumentar a capacidade de resolução dos programas de controle desta zoonose. Na busca por inovações tecnológicas em saúde, principalmente na vigilância ambiental, o objetivo é desenvolver um aplicativo móvel (App) para smartphones a fim de facilitar e sistematizar a notificação de casos positivos de leishmaniose visceral canina (LVC) por médicos veterinários que atuam em clínicas auxiliando a vigilância sanitária municipal, na gestão desta zoonose. Para tanto, foi desenvolvido um App, C7 LVC - Sistema de Notificação da Leishmaniose Visceral Canina, com formatação baseada no software CR Campeiro 7®. A tecnologia criada possibilita o preenchimento de lacunas importantes nos sistemas de informação, facilitando a transmissão de dados e a utilização desses dados pelos órgãos da gestão pública para a tomada de ações de prevenção e controle da LVC.

The use of smartphones in ophthalmology: technological development and application / O uso de smartphones na oftalmologia: desenvolvimento tecnológico e aplicação

Objective: Technological development has promoted several advances in society, including the creation of smartphones, which have been increasingly used in medicine, especially in ophthalmology. This study aimed to review the use of smartphones in ophthalmology. Methods: In January of 2020, the MEDLINE and LILACS databases were selected to provide articles containing the terms "Ophthalmology" and "Smartphone", filtering the results between the years of 2015 and 2019. The evaluated outcomes were finally included into the following categories in the discussion: "Visual acuity", "Amblyopia and strabismus", "Anterior segment", "Posterior segment", "Glaucoma", "Community patient education and assistance" and "Neurophthalmology". Results: Smartphones can be useful in several different areas of ophthalmology and can provide the patients better understating and adhesion to their treatment. Conclusion: Applications can be used as tools to facilitate the work of several professionals and improve the understanding of patients about their clinical conditions.

Objetivo: O desenvolvimento tecnológico tem promovido diversos avanços na sociedade, incluindo a criação de smartphones, que têm sido cada vez mais utilizados na medicina, principalmente na oftalmologia. O objetivo deste estudo foi revisar o uso de smartphones na oftalmologia. Métodos: Durante o mês de janeiro de 2020, as bases de dados MEDLINE e LILACS foram selecionadas para buscar artigos contendo os termos "Oftalmologia" e "Smartphone", filtrando os resultados entre os anos de 2015 e 2019. Os dados avaliados foram, finalmente, incluídos nas seguintes categorias na discussão: "Acuidade visual", "Ambliopia e estrabismo", "Segmento anterior", "Segmento posterior", "Glaucoma", "Assistência e educação ao paciente da comunidade" e "Neuroftalmologia". Resultados: Os smartphones podem ser úteis em diversas áreas da oftalmologia e fornecem melhor compreensão e adesão dos pacientes ao tratamento. Conclusão: O uso de aplicativos pode ser utilizado como ferramenta para facilitar o trabalho de diversos profissionais e melhorar o entendimento dos pacientes sobre suas condições clínicas.

Aplicativos para smartphones que possibilitam o lazer em tempos de lockdown: entre a socialização, o entretenimento e as práticas corporais / Apps for smartphones that enable leisure in lockdown times: between socialization, entertainment and body practices

Este artigo objetivou identificar e caracterizar os aplicativos para smartphones que possibilitam o lazer em tempos de isolamento social. Os dados analisados foram os 100 aplicativos mais baixados nos sistemas IOS e Android que possibilitam o lazer. A pesquisa se caracterizou como qualitativa com o uso da técnica de Análise Categorial. Identificou-se uma diversificação das possibilidades de lazer por meio dos smartphones, possibilitando socialização, entretenimento e práticas corporais. Todos esses aplicativos, no contexto pandêmico e permeado por lockdowns, auxiliam no isolamento social dos indivíduos e oferecem possibilidades de lazer.

This article aimed to identify and characterize the apps for smartphones that enable leisure in times of social isolation. The data analyzed were the 100 most downloaded apps on IOS and Android systems that enable leisure. The research was characterized as qualitative with the use of the Categorical Analysis technique. A diversification of leisure possibilities was identified through smartphones, enabling socialization, entertainment and body practices. All of these applications, in a pandemic context and permeated by lockdowns, assist in the social isolation of individuals and offer possibilities for leisure.

Smartphones- Help or Hindrance in Advancing Medical/Dental Education.

BACKGROUND Smartphone - a hand-held minicomputer housing in itself innumerable applications (Apps) from as simple as a clock to more complex apps like mobile banking etc. has completely revolutionized the very existence of human beings. There are myriads of apps available to the medical fraternity, which aids in not only practicing medicine but learning it too. The major advantage is the convenience it provides in accessing and organizing the data at a speed which is manually inconceivable. But as every coin has two sides, this tool like any other has disadvantages too. Distraction, dependence and reliability of information are some to name a few. The present survey was undertaken as a preliminary step to discern the stance of medical and dental students towards smartphone and its integration as an aid to promote teaching and learning.METHODSA questionnaire based cross sectional study was conducted in SGT University and Manav Rachna Dental College. A total of 750 MBBS and BDS students participated in the study.RESULTSThe study revealed that smartphones have permeated the medical education system, but their use is still limited to sharing timetables, assignment and staying connected with teachers and fellow students. Portability, ease of accessing data, time management, cost effectiveness and respite from carrying heavy books everywhere have endeared the device to students. But a majority of them (83%) still feel more comfortable in learning texts from conventional textbooks.CONCLUSIONSThough the merits of incorporating smartphones in our education system definitely outnumber the demerits, one cannot ignore the challenges facing us today. Addressing the limitations, especially devising a method to keep the smartphones in the campus but out of our lectures is of utmost importance.

Knowledge and attitude toward use of internet in smartphones for dental education

Introduction: Internet has become ubiquitous with the advent of smartphones. The dental fraternity keeps themselves updated and share knowledge through webinars, video conferences, research publications, etc. Hence, the internet serves as an imperative tool for dissemination of information. The usage of internet in dental education can be exploited to the fullest, especially due to the increased ownership rates of smartphones. Materials and Methods: A total of 490 students from four dental colleges in Tamil Nadu were asked to fill a close-ended questionnaire to assess the knowledge and attitude of dental students toward internet usage in smartphones. This study was conducted from November 2016 to January 2017. Results: The response rate was 100%. Almost all the students (98%) had knowledge on browsing. The percentage of internet use in smartphones were the highest (55.2%) followed by computers or laptops at home (26.5%). About 34.6% of students used internet in smartphones daily. More than half of the students (52.2%) used internet in smartphone at least 2–3 h a day. About one quarter (23.4%) of students used internet on a daily basis while 29.59% of students accessed the internet thrice a week for searching content related to dentistry. The preferred source for collecting dental-related information was through the internet (28.9%) and textbooks (28.5%). Conclusion: Dental students have considerable knowledge in using the internet for dental education and some of them utilize internet more frequently because of the possession of smartphones.

Evaluation of safety, effectiveness and reproducibility of telemedicine for neurosurgical screening / Avaliação da segurança, da efetividade e da reprodutibilidade na utilização de telemedicina para triagem neurocirúrgica

ABSTRACT Objective: To ascertain the safety, effectiveness and reproducibility of screening potential neurosurgical patients by means of smartphones. Methods: This is a retrospective and multicentric study. Data were collected from the medical records of patients subjected to real emergency neurosurgical evaluations and compared with assessments by neurosurgeons using smartphones to determine the feasibility of identifying changes in cranial computed tomography scans, potentially serious conditions of patients, and the need for transfer to reference centers. Results: We analyzed 232 cases. The main diagnosis was traumatic brain injury, with 119 cases (51.3%). Of this, 105 (45.3%) patients were discharged immediately after the assessment. The telemedicine evaluators presented 95.69% accuracy in the identification of changes in computed tomography scans, with 0.858 concordance. Accuracy in the identification of severity was 95.26%, with 0.858 concordance. As for procedure, the concordance among evaluators was 0.672, increasing to 100% in cases that required surgical treatment. Conclusion: Our study indicated that the use of telemedicine for screening patients with acute neurological disorders was safe, effective and reproducible. Implementation of the method shows a promising potential to improve the patient's outcome by reducing unnecessary transfers and decreasing the time elapsed until a specialist can be consulted.

RESUMO Objetivo: Verificar a segurança, a efetividade e a reprodutibilidade da triagem de pacientes potencialmente neurocirúrgicos feita por smartphones. Métodos: Estudo retrospectivo e multicêntrico. Dados de prontuários dos pacientes submetidos à avaliação neurocirúrgica de urgência foram coletados e comparados com a avaliação realizada por neurocirurgiões por meio de smartphones, determinando a capacidade de identificar alterações na tomografia computadorizada de crânio, pacientes potencialmente graves e necessidade de transferência. Resultados: Foram analisados 232 casos. O principal diagnóstico foi traumatismo crânio encefálico, com 119 casos (51,3%). Destes, 105 (45,3%) tiveram alta após a avaliação. Os avaliadores por telemedicina apresentaram acurácia de 95,69% para identificação de alteração na tomografia computadorizada, com concordância de 0,858. Com relação à identificação de gravidade, a acurácia foi de 95,26%, com concordância de 0,858. Com relação à conduta, os avaliadores apresentaram concordância de 0,672, aumentando para 100% nos casos de tratamento cirúrgico. Conclusão: O uso da telemedicina em nosso estudo foi seguro, efetivo e reprodutível para triagem dos pacientes com afecções neurológicas agudas. A implementação do método tem potencial de impacto na melhora do resultado para o paciente devido à redução das transferências desnecessárias e do tempo até o atendimento.

La consulta médica por WhatsApp: un deterioro en la relación médico-paciente / The medical consultation for WhatsApp: A deterioration in the doctor-patient relationship

Resumen En la actualidad la aplicación de mensajería WhatsApp® se ha convertido en una de las principales formas de comunicación virtual porque permite establecer relaciones interpersonales y grupales; incluso, ha generado un lenguaje basado en emoticones que permite transmitir ideas y sentimientos. La consulta médica no ha quedado fuera de esta nueva modalidad de comunicación; cada vez es más frecuente que los pacientes consulten a los médicos mediante el uso de esta aplicación para teléfonos inteligentes. Sin embargo, debido a la importancia que entraña la relación médico-paciente, no es el medio ideal para dar la atención adecuada a los pacientes en relación con la consulta de algún padecimiento.

Abstract Currently, the WhatsApp® messaging application has become one of the main forms of virtual communication since it allows to establish interpersonal and group relationships, and has even generated a language based on emoticons that allows transmitting ideas and feelings. The medical consultation has not been left out of this new mode of communication as it is increasingly common for patients to consult doctors through the use of this application for smartphones. However, due to the importance of the doctor-patient relationship, it is not the ideal means to provide adequate care to patients in relation to the consultation of a condition.

Efectos de la utilización de la aplicación móvil VILLAHEALTH en el comportamiento y desempeño del personal de enfermería / Effects of the use of the mobile application VILLAHEALTH on the behavior and performance of the nursing staff

RESUMEN Introducción: La salud móvil es una forma económica de mejorar el control y seguimiento de los pacientes, y puede ayudar a optimizar la atención de un centro médico. Sin embargo, su potencial aún no ha sido completamente estudiado. Objetivo: Exponer los efectos de la utilización de la aplicación móvil VILLAHEALTH en el comportamiento y desempeño del personal de enfermería. Métodos: Observación sistemática de personal de salud en sus labores diarias. Se escogieron a ocho enfermeras que poseían un dispositivo móvil, y que estaban familiarizadas con la aplicación del sistema Android; la misma que logra almacenar estados, tratamientos e información básica del paciente, y también programa tareas con notificaciones que se muestran en el calendario del celular. Se midió y comparó los tiempos de respuesta con y sin la ayuda de la aplicación. Resultados: Con las notificaciones de la aplicación, el 77,08 por ciento de las veces, las tareas eran comenzadas antes de 5 minutos de su programación, frente al 25,00 por ciento sin su ayuda. La media de tiempo de respuesta con la aplicación fue de 105,18 (± 86,08) segundos, mientras que sin la aplicación fue de 616,72 (± 223,30) segundos. Conclusión: Con la aplicación VILLAHEALTH, los usuarios empezaron sus actividades en los cinco primeros minutos a partir del inicio establecido en comparación a los 10 minutos sin ella. Además, la aplicación ayudó al personal de enfermería a reducir sus tiempos de respuesta para tratar a los pacientes(AU)

ABSTRACT Introduction: Mobile health is an inexpensive way to improve the control and monitoring of patients, and may help improve the service a medical center has. However, Its full potential still hasn't been studied. Objective: To show the results of the infirmary personnel's behaviour when using the mobile application VILLAHEALTH in their professional performance. Methods: Systematic observation of health personnel in their daily work. Eight nurses were selected who owned a smartphone with Internet access and were familiarized with the Android application, which stores the states, treatments and basic patient information, and programs tasks with notifications which are displayed on the calendar. The response times with and without the help of the application were measured and compared. Results: With the application notifications, 77,08 percent of the time the tasks were started within 5 minutes of programming, compared to 25,00 percent without its help. The average response time with the application was 105,18 (± 86,08) seconds, while without it was 616,72 (± 223,30) seconds. Conclusion: Using the VILLAHEALTH app, users started their activities within the first five minutes, compared to the 10 minutes without using it. In addition, the app helped nurses reduce response times when treating patients(AU)

Craving en adicciones conductuales: propuesta de un modelo teórico explicativo en la adicción a facebook y mensajería instantánea / Craving in behavioral addictions: proposal of an explicative theoretical model in addiction to facebook and Instant messaging

El craving se define como el deseo o ansias por introducir una sustancia en el cuerpo. La American Psychiatric Association ha propuesto que para adicciones conductuales, que implican el realizar algún tipo de acción, se consideren los mismos criterios que para una adicción a sustancias. Las naturalezas de los objetos son diferentes por lo que surge el desafío de analizar si el abordaje de las adicciones conductuales debe realizarse bajo los criterios de una adicción a sustancias. Se seleccionaron 23 artículos sobre la materia los que permitieron elaborar un modelo teórico explicativo de craving hacia Facebook y Mensajería instantánea. El modelo consta de tres dimensiones: intensidad del deseo, grado de control y expectativas de calma. Se propone estudiar la forma en que estas dimensiones se presentan en adicciones conductuales para reconstruir el concepto en este campo, y generar un instrumento que permita su evaluación.

Craving is defined as the desire to introduce a substance in the body. The American Psychiatric Association proposed to research if behavioral addictions can be assessed with the substance addictions criteria. Nature of both objects are different so the challenge of analyze if assessment of behavioral addictions can be done with the same criteria of substance addictions. 23 articles about substance addictions were selected to elaborate a theoretical explicative model of craving to start research craving to Facebook and Instant Messaging. The model consists of three dimensions: desire intensity, degree of control and calm expectations. It is proposed to study how these dimensions are in behavioral addictions to rebuild the concept in this area, and generate an instrument to asses it.

Analysis of health habit and hair mineral nutrition status of media addicted adolescent / 한국영양학회지

PURPOSE: Koreans' internet and smartphone usage hours are steadily increasing and the dependence of young people on smartphones is causing social problems. Therefore, this study was conducted to examine health and dietary habits, as well as hair mineral contents according to the level of dependence of smartphone use among adolescents to clarify the interrelation of smartphone dependence, lifestyle, dietary behavior, and mineral nutrition status. METHODS: A total of 80 smartphone-addicted adolescents participated in this study and were divided into three groups (general, potential and danger group) according to smartphone dependence. The subjects' lifestyles and dietary behaviors were then surveyed, and hair mineral contents were analyzed. RESULTS: Higher smartphone dependence was associated with lower average weekly sleeping time and later first smoking age. In the danger group, the rate of eating fast and the rate of snacking twice a day was also relatively high. Parents (45.0%) and mobile (30.0%) were the factors having the greatest influence on an individual's dietary behavior. In the hair mineral analysis, all subjects had lower selenium concentrations and higher lead concentrations than normal. In addition, the levels of aluminum in the danger group were higher than in the normal range and the highest among the three groups. CONCLUSIONS: It is necessary to guide adolescents to use smartphones correctly and manage dietary habits. In addition, careful attention is needed the mineral nutritional status of smartphone-addicted adolescents.

¿Cómo afectan los medios sociales a la confidencialidad de los pacientes? Revisión de los potenciales problemas y recomendaciones / How social media affects the confidentiality of patients? A review of potential problems and recommendations / Como mídias sociais afetam a confidencialidade dos pacientes? Revisão dos potenciais problemas e recomendações

Resumen: Los datos personales relativos a la salud de un individuo se consideran como datos sensibles, por lo que necesitan una "especial protección". Nos encontramos en una sociedad en la que las tecnologías de información y comunicación (TIC), especialmente en lo referente a las redes sociales, ofrecen amplias posibilidades de intercambio de información médica, sirviendo de apoyo, consejo o ayuda a los compañeros que se encuentran en el mismo ámbito o en cualquier lugar de la geografía mundial. Los avances tecnológicos en comunicación desafían el concepto de "público" y de "privado", de tal forma que la información que se comparte es casi imposible de eliminar, pudiendo llegar a propagarse rápidamente por las redes. En base a nuestra propia experiencia y a los diferentes trabajos revisados, creemos que resulta necesario capacitar a los profesionales de la salud y especialmente a los estudiantes de medicina durante su formación, para que utilicen de forma adecuada dichas herramientas, especialmente a la hora de publicar contenido sensible en lugares cuyo acceso sea público, ya que puede tener consecuencias importantes para la intimidad de las personas, tanto para los pacientes como para su propia vida personal.

Abstract: Personal health data are considered as sensitive information, so they need a "special protection". We are in a society where Information and Communications Technology (ICT), especially in relation to social networks, offer many opportunities for the exchange of medical information, serving as support, advice or assistance to colleagues who work in the same field or in any other place around the world. Technological advances in communication challenge the concept of "public" and "private," in a way that the shared information is almost impossible to remove, and could spread rapidly through social networks. Based on our own experience and the different papers reviewed, we believe it is necessary to train health professionals and especially medical students during their academic education to use these tools properly, especially when posting sensitive data in places of public access, as it may have important consequences for the privacy of individuals, both for patients and for their own life.

Resumo: Os dados pessoais relativos à saúde do indivíduo são considerados dados sensíveis, por esse motivo eles necessitam de uma "proteção especial". Nos encontramos em uma sociedade em que as tecnologias de informação e comunicação (TIC), especialmente em relação às redes sociais, oferecem amplas oportunidades para a troca de informações médicas, servindo como apoio, conselho ou assistência aos colegas que estão na mesma área ou em qualquer lugar na geografia mundial. Os avanços tecnológicos em comunicação desafiam os conceitos de "público" e de "privado", de tal maneira que a informação compartilhada é quase impossível de ser eliminada, podendo se propagar rapidamente através das redes. Com base em nossa própria experiência e em diferentes trabalhos revisados, acreditamos que é necessário capacitar profissionais de saúde e especialmente os estudantes de medicina durante sua formação, para que utilizem de forma adequada estas ferramentas, especialmente quando se trata de publicar conteúdo sensível em locais cujo acesso será público, uma vez que pode ter implicações importantes para a privacidade das pessoas, tanto para pacientes como para sua própria vida pessoal.

Usages of Computers and Smartphones to Develop Dementia Care Education Program for Asian American Family Caregivers / 대한의료정보학회지

OBJECTIVES: Families of ethnic minority persons with dementia often seek help at later stages of the disease. Little is known about the effectiveness of various methods in supporting ethnic minority dementia patients' caregivers. The objective of the study was to identify smartphone and computer usage among family caregivers of dementia patients (i.e., Korean and Vietnamese Americans) to develop dementia-care education programs for them. METHODS: Participants were asked various questions related to their computer or smartphone usage in conjunction with needs-assessment interviews. Flyers were distributed at two ethnic minority community centers in Southern California. Snowball recruitment was also utilized to reach out to the families of dementia patients dwelling in the community. RESULTS: Thirty-five family caregivers, including 20 Vietnamese and 15 Korean individuals, participated in this survey. Thirty participants (30 of 35, 85.7%) were computer users. Among those, 76.7% (23 of 30) reported daily usage and 53% (16 of 30) claimed to use social media. A majority of the participants (31 of 35, 88.6%) reported that they owned smartphones. More than half of smartphone users (18 of 29, 62%) claimed to use social media applications. Many participants claimed that they could not attend in-class education due to caregiving and/or transportation issues. CONCLUSIONS: Most family caregivers of dementia patients use smartphones more often than computers, and more than half of those caregivers communicate with others through social media apps. A smartphone-app-based caregiver intervention may serve as a more effective approach compared to the conventional in-class method. Multiple modalities for the development of caregiver interventions should be considered.

Utilización de Internet y dependencia a teléfonos móviles en adolescentes / Using Internet and dependence on mobile phones in adolescents / A utilização da Internet e a dependência de celulares dos adolescentes

El objetivo principal del presente trabajo ha sido analizar el uso que los adolescentes realizan de Internet y los teléfonos móviles. Se utilizó un diseño descriptivo, para la muestra se seleccionaron aleatoriamente 10 centros educativos, registrando 874 encuestas. Los adolescentes utilizan masivamente la Red, accediendo a la misma cada vez más a través del teléfono móvil, no aparecen casos llamativos de dependencia en el empleo del teléfono móvil. Otro de los problemas detectados ha sido el del tiempo de conexión a Internet, que aumenta de manera significativa al igual que destacan otros estudios similares. Es fundamental potenciar el papel de familias y centros educativos para dotar a los jóvenes de estrategias que les permitan realizar unos usos adecuados.

The main objective of this study was to analyze the use made of the teenagers Internet and mobile phones. A descriptive design was used, for the sample were randomly selected 10 schools, registering 874 surveys. Teens use Internet massively, increasingly accessed via mobile phone, although do not show a lot of cases of dependency on the use of mobile phone. Another of the problems identified was the Internet connection time, which increases significantly as others similar studies indicates. It is essential to enhance the role of families and schools to equip young people with strategies to do adequate use.

O principal objetivo deste estudo foi analisar o uso da Internet e de celulares pelos adolescentes. Utilizou-se um modelo descritivo. Para a amostra, a seleção ocorreu de forma aleatória em 10 centros educativos, registrando 874 respostas. Os adolescentes utilizam massivamente a Internet e a acessam cada vez mais por meio dos smartphones. Não constam, nesta pesquisa, casos marcantes de dependência no emprego do smartphone. Outro dos problemas detectados tem sido o do tempo de conexão à Internet, que aumenta de maneira significativa, conforme destacam outros estudos similares. É fundamental reforçar o papel das famílias e das escolas na hora de adotar estratégias que permitam aos jovens utilizar a internet de modo adequado, visando a potencialização de suas capacidades cognitivas.