Renal Health: Providing Information and Technological Tools to Empower Patients to Live Better with Kidney Disease.

Chronic kidney disease (CKD) is a growing Public Health problem. Recent evidence points that low education and poor socio-economic conditions are associated with higher risk of developing CKD and progressing to dialysis or transplantation need. Hence patient empowerment through health education and qualification with technological tools that allows better treatment adherence may play an important role in the achievement of optimal clinical outcomes. The Renal Health is a multidisciplinary project created at the University of Fortaleza, northeast Brazil, in 2015, aiming to create novel educational material and technological tools for people with CKD, in different treatment modalities, including dialysis and transplant. The products developed so far in the project include an application for smartphones aiming to help patients in dialysis and transplant in their treatments, including schedule for medications, with alarms, water ingestion control, laboratory tests results, and medical appointments' agenda, besides all information regarding CKD. The other tools include a medication box, an insole for weight control (both are in the prototype phase), connection with smartbands (for vital signs monitoring) and multimedia educational tools, including a profile in the Instagram and a channel in YouTube. Since the first release of the application in the virtual stores, there were more than 1,000 downloads, predominantly in Brazil, although the app is also available in English and Spanish. All these tools represent innovative ways of patient empowerment and may be increasingly present in daily life. Further studies are required to assess the impact of these tools in patients' outcomes, including CKD progression and mortality.

The Renal Health Instagram: An Analysis of Comments.

Chronic kidney disease (CKD) is a Public Health problem affecting a considerable number of patients worldwide. CKD treatment is complex and requires patients' education. Based on this we have created technological tools, including an application for smartphones and a profile on Instagram (Renal Health) aiming to educate patients to self-monitor and cope with their disease, to increase adherence to treatment. In this study, we have analyzed the spontaneous feedbacks patients, and other people have posted on the Renal Health Instagram (comments) to investigate which information was needed the most by which types of patients. During the first 15 months since the release of this profile, there were 3380 followers, a total of 449 posts, with 36,079 "likes". Most of the followers were patients and parents, they gave spontaneous testimonials of their experiences with having kidney disease, and were thankful for the information provided and for the response we gave to their questions. From the analysis of the comments, we found that information on nutrition, physical activities and kidney transplant were the most discussed and valued. Our results also showed that the main use of this medium for dialysis and transplant patients was to share their experience. The Renal Health Instagram was considered a good digital platform of trusted information for both patients and the general population and also a space for sharing experiences in the context of kidney disease epidemics.

Exergaming as a strategic tool in the fight against childhood obesity: a systematic review.

Improper use of electronic media is considered a major contributing factor to childhood obesity. However, exergames, a new generation of active games, have made it possible to combine electronic entertainment with physical exercise. The purpose of this systematic review was to analyze the use of exergaming as a strategic tool in the fight against childhood obesity. Information was retrieved from the databases SciELO, LILACS, Pubmed, Ebsco, and Science Direct, using the search words "egames," "exergames," "exergaming," "new generation of video games," "active video games," "energy expenditure," "body composition," and "physical activity" in English and Portuguese, covering the period January 2008 to April 2012. Nine articles met the inclusion criteria. Exergaming was found to increase physical activity levels, energy expenditure, maximal oxygen uptake, heart rate, and percentage of physical activity engaged in and to reduce waist circumference and sedentary screen time. Thus, exergaming may be considered a highly relevant strategic tool for the adoption of an active and healthy lifestyle and may be useful in the fight against childhood obesity.