Development of mobile application for cervical cancer screening in women: Protocol of a multi-phase study.

BACKGROUND: Cervical cancer is one of the most common cancers in women. It is considered preventable due to the possibility of screening. The common barriers to cervical cancer screening include lack of knowledge, lack of time, and wrong beliefs. The use of e-Health technologies is one of the approaches for health promotion. The present study is aimed to the development of a mobile application for cervical cancer screening in women. MATERIALS AND METHOD: This is a multi-phase study. In the first step, a literature review will be conducted to examine factors related to cervical cancer screening and existing applications related to cervical cancer and its screening. Then, in the second step, a cross-sectional study will be conducted to investigate the factors related to cervical cancer screening in 246 women referred to comprehensive health centers and women's clinics in teaching hospitals in Isfahan, Iran. The comprehensive health centers and women's clinics in teaching hospitals will be randomly selected using a lottery method. Using convenience sampling, women who meet the inclusion criteria will be included in the study, provided they provide informed consent. The data will be collected using a questionnaire, and then the descriptive and inferential statistical tests and SPSS18 software will be used to analyze the data. In the third step, specialists (gynecologists, reproductive health specialists, and midwives) will prioritize the application content by filling out a questionnaire. Then, the research team will compile the application content draft, and this draft will be reviewed and approved by experts on the expert panel. The prototype of the application will be prepared, and experts will evaluate it in the fifth step. DISCUSSION: The results of this study will result in the development of applications for cervical cancer screening. The use of mobile applications can be useful in lifting some of the barriers to screening. Therefore, developing such applications may help improve cervical cancer screening.

The Utility of Predictive Modeling and a Systems Process Approach to Reduce Emergency Department Crowding: A Position Paper.

Emergency department (ED) crowding and its main causes, exit block and boarding, continue to threaten the quality and safety of ED care. Most interventions to reduce crowding have not been comprehensive or system solutions, only focusing on part of the care procession and not directly affecting boarding reduction. This position paper proposes that the ED crowding problem can be optimally addressed by applying a systems approach using predictive modeling to identify patients at risk of being admitted to the hospital and uses that information to initiate the time-consuming bed management process earlier in the care continuum, shortening the time during which patients wait in the ED for an inpatient bed assignment, thus removing the exit block that causes boarding and subsequently reducing crowding.

Multimedia de ejercicios profilácticos, terapéuticos y rehabilitadores en la superación de profesores de Educación Física / Multimedia of prophylactic, therapeutic and rehabilitative exercises in the upgrading of Physical Education teachers

Fundamento: la aplicación de las nuevas tecnologías de la información y las comunicaciones, como herramienta para la confección de diferentes medios de enseñanza y aprendizaje, ha demostrado su utilidad en el proceso de formación de los estudiantes y en el desarrollo metodológico de los profesionales. Objetivo: diseñar una multimedia con ejercicios terapéuticos, profilácticos y rehabilitadores, orientada a prevenir enfermedades y a enriquecer los conocimientos de los profesores de Educación Física. Métodos: se realizó una investigación de innovación tecnológica en la Facultad de Estomatología de la Universidad de Ciencias Médicas de Villa Clara entre enero 2017- diciembre 2018. Se utilizaron métodos teóricos: histórico-lógico, analítico-sintético e inductivo-deductivo; empíricos: grupo nominal a profesores, y criterio de especialistas y usuarios. Se utilizaron programas informáticos para el diseño de la multimedia: WebStorm, Photoshop y Windows Office. Resultados: a partir de las necesidades de preparación metodológica de los profesionales de Educación Física, y para disponer de un novedoso recurso de aprendizaje, se diseñó una multimedia con hipervínculos hacia los contenidos en correspondencia con los objetivos del programa, vídeos, bibliografías básica y complementaria, casos problemas y ejercicios físicos y terapéuticos. Conclusiones: la multimedia diseñada resultó valorada por criterios de especialistas y usuarios, quienes emitieron opiniones favorables sobre su diseño, utilidad, facilidad de interacción y aplicabilidad.

Background: the application of the new information and communication technologies, as a tool for the preparation of different teaching and learning aids, has demonstrated its usefulness in the process of training students and in the methodological development of professionals. Objective: to design a multimedia with therapeutic, prophylactic and rehabilitative exercises, aimed at preventing diseases and enriching the knowledge of Physical Education teachers. Methods: a technological innovation research was carried out at the Faculty of dentistry of Villa Clara University of Medical Sciences from January 2017 to December 2018. Theoretical methods were used: historical-logical, analytical-synthetic and inductive-deductive; Empirical ones: nominal group to teachers, and criteria of specialists and users. Computing programs were used for the design of the multimedia: WebStorm, Photoshop and Windows Office. Results: based on the methodological preparation needs of Physical Education professionals, and to have a new learning resource, a multimedia was designed with hyperlinks to the contents in correspondence with the objectives of the program, videos, basic and complementary bibliographies, cases problems and physical and therapeutic exercises. Conclusions: the designed multimedia was valued by the criteria of specialists and users, who issued favorable opinions about its design, usefulness, ease of interaction and applicability.

Inovação tecnológica: desenvolvimento de um aplicativo para profissionais que atuam na área de terapia intensiva ­ UTI AUX / Technological innovation: development of an application for professionals working in the area of intensive care ­ UTI AUX

INTRODUÇÃO: Profissionais atuantes na área de terapia intensiva (UTI) são constantemente desafiados a apresentarem um alto nível de desempenho e conhecimento. Neste cenário, destaca-se o fenômeno da utilização de aplicativos móveis (também conhecidos como APPS) entre a população mundial, visando assim ao acesso fácil e rápido a informação a fim de auxiliar na tomada de decisão. OBJETIVOS: Desenvolver um APP direcionado para profissionais intensivistas. MÉTODOS: O desenvolvimento do aplicativo (APP) foi feito a partir da plataforma Expo, elaborado em um computador e disponibilizado para as plataformas Android e IOS. As temáticas presentes no aplicativo foram definidas com base no conhecimento de dois fisioterapeutas especialistas em Fisioterapia em Terapia Intensiva Adulto com mais de 10 anos de experiência. RESULTADOS: O APP utiliza uma interface intuitiva, sensível ao toque e de rápido acesso às informações que o usuário solicitar. Há um menu apresentando os botões referentes a cada função do APP, tais como: índices e cálculos; escalas funcionais; exames laboratoriais; sinais vitais; desmame; ventilação mecânica (VM); ventilação não invasiva (VNI). Desta forma, o APP apresenta sete modalidades. O tempo de desenvolvimento do aplicativo foi de 12 meses. CONCLUSÃO: Desenvolvemos um APP com foco em profissionais que atuam em UTIs, com o objetivo de que estes obtenham informações à beira leito assim como facilidade de utilização de instrumentos avaliativos

INTRODUCTION: Professionals working in the area of intensive care (ICU) are constantly challenged to present a high level of performance and knowledge. In this scenario, the phenomenon of the use of mobile applications (also known as APPS) among the world population stands out. Thus aiming at easy and quick access to information in order to assist in decision making. OBJECTIVES: Develop an APP aimed at intensive care professionals. METHODS: The development of the application (APP) was made from the Expo platform, it was prepared on a computer and made available for the Android and IOS platforms. The themes present in the application were defined based on the knowledge of two Physiotherapists specializing in Physiotherapy in Adult Intensive Care with more than 10 years of experience. RESULTS: The APP uses an intuitive, touchsensitive interface with quick access to the information that the user requests. There is a menu showing the buttons representing each function of the APP, such as: indexes and calculations; functional scales; laboratory tests; vital signs; weaning; mechanical ventilation (MV); non-invasive ventilation (NIV). In this way, the APP presents seven modalities. Application development time was 12 months. CONCLUSION: We developed an APP focused on professionals who work in ICUs, with the objective that they obtain information at the bedside as well as ease of use of evaluative instruments.

Alternativa interactiva con la plataforma Moodle para la enseñanza-aprendizaje de la asignatura Pedagogía / Interactive alternative with the Moodle platform for the teaching-learning of the Pedagogy subject

RESUMEN Fundamento: el desarrollo de las Tecnologías de la Información y las Comunicaciones en la educación se convierte en una herramienta didáctica y pedagógica. Objetivo: diseñar una alternativa interactiva con el empleo de la plataforma Moodle para la enseñanza-aprendizaje de la asignatura Pedagogía de la carrera Licenciatura en Tecnología de la Salud. Métodos: se realizó un estudio de desarrollo con el empleo de una metodología cualitativa y cuantitativa en la Facultad de Ciencias Médicas de Sagua la Grande durante el curso 2018-2019. Se emplearon los métodos teóricos: analítico-sintético, inductivo-deductivo, lógico-práctico, el modelado; y empíricos: la revisión documental, entrevista, cuestionario y la observación a clase. Resultados: se diseñó la alternativa interactiva para la asignatura de Pedagogía con la aplicación de la metodología RUP (Proceso Unificado Racional) y el lenguaje UML (Lenguaje Unificado de Modelado) para el análisis, diseño, implementación y documentación de sistemas orientados a objetos y para visualizar, especificar, construir y documentar el sistema. Se montó en la plataforma Moodle con la estructura didáctica del diseño, componentes y elementos de manera que el estudiante pueda ejecutar tareas para arribar al conocimiento deseado. Conclusiones: el proceso enseñanza aprendizaje de la asignatura Pedagogía ha demostrado la necesidad del uso de la plataforma interactiva al usar métodos desarrolladores en los educandos, utilizados en formas organizativas presenciales y semipresenciales, los que posibilitan su generalización en el pregrado y posgrado.

ABSTRACT Background: the development of Information and Communication Technologies in education becomes a didactic and pedagogical tool. Objective: to design an interactive alternative with the use of the Moodle platform for the teaching-learning of the Pedagogy subject of the Bachelor's degree in Health Technology. Methods: a development study was carried out using a qualitative and quantitative methodology at the Faculty of Medical Sciences of Sagua la Grande during the 2018-2019 academic year. Theoretical methods were used: analytical-synthetic, inductive-deductive, logical-practical, modeling; and empirical ones: documentary review, interview, and questionnaire and class observation. Results: the interactive alternative for the Pedagogy subject was designed with the application of the RUP (Rational Unified Process) methodology and the UML (Unified Modeling Language) language for the analysis, design, implementation and documentation of object-oriented systems and for visualize, specify, build and document the system. It was assembled on the Moodle platform with the didactic structure of the design, components and elements so that the student can carry out tasks to arrive at the desired knowledge. Conclusions: the teaching-learning process of the Pedagogy subject has shown the need to use the interactive platform by using developeing methods in students, used in face-to-face and blended organizational forms, which allow its generalization in undergraduate and postgraduate courses.

Diseño de un software educativo para la asignatura de Rehabilitación II / Design of an educational software for the subject of Rehabilitation II

RESUMEN Introducción: según la Organización Mundial de la Salud, el software educativo ha revolucionado el modelo pedagógico tradicional hacia nuevos modelos didácticos, donde el espacio, el tiempo y los recursos para el aprendizaje no están limitados. Objetivo: diseñar un software educativo como soporte bibliográfico para la asignatura Rehabilitación II, de la carrera Estomatología. Métodos: se realizó una investigación de innovación tecnológica en la Facultad de Estomatología de la Universidad de Ciencias Médicas de Villa Clara, durante el curso 2018-2019. Se utilizaron métodos teóricos: histórico-lógico, analítico-sintético, e inductivo-deductivo; empíricos: revisión de documentos, entrevista no estructurada a estudiantes de otros años superiores y a directivos y otros docentes de la facultad, y cuestionario a estudiantes. Para la confección de la software educativo se utilizaron los programas: Notepad++, Paint, Photoshow, Microsoft Office Power Point y Wondershare Photo Story Platinum. Resultados: el análisis documental confirmó carencias de bibliografías y medios de enseñanza para el estudio e impartición de los contenidos de la asignatura, lo cual fue confirmado por los informantes clave. La mayoría de los estudiantes prefirieron como medio de obtención de la información un software educativo, el cual fue diseñado y valorado por criterios de especialistas. Conclusiones: por su información el software educativo es un recurso capaz de ser utilizado como medio de enseñanza en la impartición y estudio de la asignatura. Fue valorado por especialistas como un material funcional, de aplicabilidad, atractivo, factible y original.

ABSTRACT Background: according to the World Health Organization, educational software has revolutionized the traditional pedagogical model towards new didactic models, where space, time and resources for learning are not limited. Objective: to design an educational software as a bibliographic support for the Rehabilitation II subject, of the Dentistry degree. Methods: a technological innovation research was carried out at the Faculty of Dentistry of the Villa Clara University of Medical Sciences, during the 2018-2019 academic year. Theoretical methods were used: historical-logical, analytical-synthetic, and inductive-deductive; Empirical ones: review of documents, unstructured interview with students from other higher years and with directors and other teachers of the faculty, and questionnaire to students. For the preparation of the educational software, the following programs were used: Notepad++, Paint, Photoshop, Microsoft Office Power Point and Wondershare Photo Story Platinum. Results: the documentary analysis confirmed the lack of bibliographies and teaching aids for the study and teaching of the contents of the subject, which was confirmed by the key informants. Most of the students preferred an educational software as a means of obtaining information, which was designed and valued by specialist criteria. Conclusions: due to its information, educational software is a resource capable of being used as a teaching aid in the teaching and study of the subject. It was valued by specialists as a functional, applicable, attractive, feasible and original material.

Las nuevas tecnologías en la enseñanza de la reanimación cardiopulmonar para residentes en Anestesiología / New technologies in the teaching of cardiopulmonary resuscitation for residents in Anesthesiology

RESUMEN Fundamento: los residentes en Anestesiología y Reanimación deben demostrar competencias en la ejecución de las maniobras de reanimación cardiopulmonar y cerebral. Objetivo: determinar la percepción de los residentes de la especialidad en Anestesiología y Reanimación sobre el uso de las tecnologías de la información y las comunicaciones en la enseñanza de la reanimación cardiopulmonar. Métodos: se realizó un estudio descriptivo, transversal en el Hospital Gineco-Obstétrico Universitario Provincial "Mariana Grajales" en septiembre de 202. Se aplicaron métodos teóricos para la fundamentación de la investigación, y empírico: un cuestionario que consta de 6 ítems en formato tipo Likert, con cinco puntos de rango: dos en cada extremo y uno intermedio; se puntúan de 1 a 5. Resultados: la mayoría de los encuestados aceptó que la tecnología sí apoya en su formación y el proceso educativo en la especialidad: consideraron positivo el uso de las herramientas colaborativas, afirmaron que es indispensable emplear las tecnologías tanto dentro como fuera del aula y opinaron que los profesores no fomentan el uso de las tecnologías para reforzar el aprendizaje en esta materia. Todos estuvieron de acuerdo con el uso del video y software especializados para aprender sobre reanimación cardiopulmonar. Conclusiones: la percepción de los residentes en Anestesiología y Reanimación sobre el uso de las tecnologías de la información y las comunicaciones en el proceso de enseñanza aprendizaje de la reanimación cardiopulmonar es muy buena, al considerar la importancia de su uso para su formación en la especialidad.

ABSTRACT Background: residents in Anesthesiology and Resuscitation must demonstrate competencies in the execution of cardiopulmonary and cerebral resuscitation maneuvers. Objective: to determine the perception of residents of the Anesthesiology and Resuscitation specialty about the use of information and communication technologies in the teaching of cardiopulmonary resuscitation. Methods: a descriptive, cross-sectional study was carried out at the "Mariana Grajales" Provincial University Gyneco-Obstetric Hospital in September 202. Theoretical methods were applied to support the research, and empirical methods: a questionnaire consisting of 6 items in standard format Likert, with five range points: two at each end and one in between; are scored from 1 to 5. Results: the majority of the respondents accepted that technology does support their training and the educational process in the specialty: they considered the use of collaborative tools to be positive, they affirmed that it is essential to use technologies both inside and outside the classroom and they believed that the Teachers do not encourage the use of technologies to reinforce learning in this subject. All agreed with the use of video and specialized software to learn about cardiopulmonary resuscitation. Conclusions: the perception of residents in Anesthesiology and Resuscitation about the use of information and communication technologies in the teaching-learning process of cardiopulmonary resuscitation is very good, considering the importance of its use for their training in the specialty.

Metodología para integrar un software educativo en el proceso enseñanza aprendizaje de Rehabilitación Estomatológica / Methodology for the educational software integration in the teaching-learning process of dental Rehabilitation

Fundamento: la integración del software educativo en Rehabilitación Estomatológica requiere concretar una vía que conduzca a los profesores hacia el aprovechamiento de las potencialidades y recursos que contiene. Objetivo: explicar una metodología para la integración didáctica del software educativo en el proceso enseñanza aprendizaje de las asignaturas Rehabilitación I y II en Estomatología. Métodos: se realizó una investigación cualitativa en la Universidad de Ciencias Médicas de Holguín, de enero a junio de 2020. Se aplicaron métodos del nivel teórico: analítico-sintético, inductivo-deductivo, sistémico-estructural-funcional y la modelación, los que permitieron organizar y desarrollar la metodología. Resultados: a partir del diagnóstico previo de insuficiencias y potencialidades del estado actual de la integración del software educativo en el proceso enseñanza aprendizaje se elaboró una metodología que consta de objetivo general, fundamentación, aparato cognitivo y aparato instrumental; este último con tres etapas y sus procedimientos, así como orientaciones para su implementación. Conclusiones: la metodología constituye una herramienta teórico-metodológica para la integración didáctica del software educativo en el proceso de enseñanza aprendizaje. Su organización y estructuración aportan una visión nueva sobre cómo asumir la integración en Rehabilitación Estomatológica, con orientaciones que viabilizan la utilización de estos recursos en un ambiente de aprendizaje que promueve la actividad del estudiante.

Background: the integration of educational software in dental Rehabilitation requires specifying a path that leads teachers to take advantage of the potential and resources it contains. Objective: to explain a methodology for the didactic integration of educational software in the teaching-learning processes of the subjects Rehabilitation I and II in Dentistry. Methods: a qualitative research was carried out at the Holguín University of Medical Sciences, from January to June 2020. Theoretical level methods were applied: analytical-synthetic, inductive-deductive, systemic-structural-functional and modeling, which allowed organizing and developing the methodology. Results: from the previous diagnosis of insufficiencies and potentialities of the current state of the integration of educational software in the teaching-learning process, a methodology was elaborated that consists of a general objective, foundation, cognitive apparatus and instrumental apparatus; the latter with three stages and their procedures, as well as guidelines for their implementation. Conclusions: the methodology constitutes a theoretical-methodological tool for the didactic integration of educational software in the teaching-learning process. Its organization and structure provide a new vision on how to assume integration in dental Rehabilitation, with guidelines that make possible the use of these resources in a learning environment that promotes student activity.

A Deep Learning Model to Predict Knee Osteoarthritis Based on Nonimage Longitudinal Medical Record.

PURPOSE: To develop deep learning model (Deep-KOA) that can predict the risk of knee osteoarthritis (KOA) within the next year by using the previous three years nonimage-based electronic medical record (EMR) data. PATIENTS AND METHODS: We randomly selected information of two million patients from the Taiwan National Health Insurance Research Database (NHIRD) from January 1, 1999 to December 31, 2013. During the study period, 132,594 patients were diagnosed with KOA, while 1,068,464 patients without KOA were chosen randomly as control. We constructed a feature matrix by using the three-year history of sequential diagnoses, drug prescriptions, age, and sex. Deep learning methods of convolutional neural network (CNN) and artificial neural network (ANN) were used together to develop a risk prediction model. We used the area under the receiver operating characteristic (AUROC), sensitivity, specificity, and precision to evaluate the performance of Deep-KOA. Then, we explored the important features using stepwise feature selection. RESULTS: This study included 132,594 KOA patients, 83,111 females (62.68%), 49,483 males (37.32%), mean age 64.2 years, and 1,068,464 non-KOA patients, 545,902 females (51.09%), 522,562 males (48.91%), mean age 51.00 years. The Deep-KOA achieved an overall AUROC, sensitivity, specificity, and precision of 0.97, 0.89, 0.93, and 0.80 respectively. The discriminative analysis of Deep-KOA showed important features from several diseases such as disorders of the eye and adnexa, acute respiratory infection, other metabolic and immunity disorders, and diseases of the musculoskeletal and connective tissue. Age and sex were not found as the most discriminative features, with AUROC of 0.9593 (-0.76% loss) and 0.9644 (-0.25% loss) respectively. Whereas medications including antacid, cough suppressant, and expectorants were identified as discriminative features. CONCLUSION: Deep-KOA was developed to predict the risk of KOA within one year earlier, which may provide clues for clinical decision support systems to target patients with high risk of KOA to get precision prevention program.

Competencias informacionales en los profesionales del Hospital Ginecobstétrico Docente en Palma Soriano, Cuba / Informational competences in the professionals of the Teaching Gynecological-Obstetric Hospital in Palma Soriano, Cuba

RESUMEN Fundamento: la inserción de las competencias informacionales en la labor del profesional de ciencias médicas supone la gestión de nuevos roles que integren el consumo de información digital, la generación de nuevos conocimientos y su socialización. Objetivo: caracterizar el desarrollo de competencias informacionales en los profesionales de salud pertenecientes al Hospital Ginecobstétrico Docente del municipio Palma Soriano en la provincia Santiago de Cuba. Métodos: se realizó un estudio descriptivo en el Hospital Ginecobstétrico Docente "Nelia Irma Delfín Ripoll", durante el año 2020, en Palma Soriano. Se emplearon métodos teóricos: análisis-síntesis e inductivo-deductivo y enfoque sistémico; empíricos: análisis documental, el cuestionario y la observación. Resultados: se constató un predomino de la escolaridad universitaria, necesidad de información como algo objetivo, inadecuada utilización de estrategias de búsqueda, tipo de fuentes informativas utilizadas digitales para el autoestudio, inadecuado trabajo colaborativo y de grupos de discusión para la investigación. Conclusiones: se caracterizó el desarrollo de competencias informacionales en los profesionales de salud pertenecientes al Hospital Ginecobstétrico Docente en Palma Soriano, con vistas a lograr una amplia cobertura temática y calidad de los contenidos de la organización en los sistemas de gestión y el desarrollo de competencias informacionales que propicien la retroactividad en el enfrentamiento de los problemas de salud.

ABSTRACT Background: the insertion of informational competences in the work of the medical science professional implies the management of new roles that integrate the consumption of electronic information, the generation of new knowledge and its socialization. Objective: to characterize the development of informational competences in health professionals belonging to the Teaching Gynecological-obstetric Hospital of Palma Soriano municipality in Santiago de Cuba province. Methods: a descriptive study was carried out at "Nelia Irma Delfín Ripoll" Gynecological-obstetric Teaching Hospital, in Palma Soriano during 2020, Theoretical methods were used: analysis-synthesis and inductive-deductive and the systemic approach; empirical ones: documentary analysis, questionnaire and observation. Results: there was a predominance of university education, the need for information as something objective, inadequate use of search strategies, type of information sources used electronically for self-study, inadequate collaborative work and discussion groups for research. Conclusions: the development of informational competences in health professionals belonging to the Teaching Gynecological-Obstetric Hospital in Palma Soriano was characterized, with a view to achieving a wide thematic coverage and quality of the contents of the organization in the management systems and the development of informational competencies that promote retroactivity in the confrontation of health problems.

JointCalc: A web-based personalised patient decision support tool for joint replacement.

BACKGROUND AND PURPOSE: Health information systems (HIS) are expected to be effective and efficient in improving healthcare services, but empirical observation of HIS reveals that most perform poorly in terms of these metrics. Theoretical factors of HIS performance are widely studied, and solutions to mitigate poor performance have been proposed. In this paper we implement effective methods to eliminate some common drawbacks of HIS design and demonstrate the synergy between the methods. JointCalc, the first comprehensive patient-facing web-based decision support tool for joint replacement, is used as a case study for this purpose. METHODS AND RESULTS: User-centred design and thorough end-user involvement are employed throughout the design and development of JointCalc. This is supported by modern software production paradigms, including continuous integration/continuous development, agile and service-oriented architecture. The adopted methods result in a user-approved application delivered well within the scope of project. CONCLUSION: This work supports the claims of high potential efficiency of HIS. The methods identified are shown to be applicable in the production of an effective HIS whilst aiding development efficiency.

Quantification and visualisation methods of data-driven chronic care delivery pathways: protocol for a systematic review and content analysis.

INTRODUCTION: Chronic conditions require long periods of care and often involve repeated interactions with multiple healthcare providers. Faced with increasing illness burden and costs, healthcare systems are currently working towards integrated care to streamline these interactions and improve efficiency. To support this, one promising resource is the information on routine care delivery stored in various electronic healthcare databases (EHD). In chronic conditions, care delivery pathways (CDPs) can be constructed by linking multiple data sources and extracting time-stamped healthcare utilisation events and other medical data related to individual or groups of patients over specific time periods; CDPs may provide insights into current practice and ways of improving it. Several methods have been proposed in recent years to quantify and visualise CDPs. We present the protocol for a systematic review aiming to describe the content and development of CDP methods, to derive common recommendations for CDP construction. METHODS AND ANALYSIS: This protocol followed the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols. A literature search will be performed in PubMed (MEDLINE), Scopus, IEEE, CINAHL and EMBASE, without date restrictions, to review published papers reporting data-driven chronic CDPs quantification and visualisation methods. We will describe them using several characteristics relevant for EHD use in long-term care, grouped into three domains: (1) clinical (what clinical information does the method use and how was it considered relevant?), (2) data science (what are the method's development and implementation characteristics?) and (3) behavioural (which behaviours and interactions does the method aim to promote among users and how?). Data extraction will be performed via deductive content analysis using previously defined characteristics and accompanied by an inductive analysis to identify and code additional relevant features. Results will be presented in descriptive format and used to compare current CDPs and generate recommendations for future CDP development initiatives. ETHICS AND DISSEMINATION: Database searches will be initiated in May 2019. The review is expected to be completed by February 2020. Ethical approval is not required for this review. Results will be disseminated in peer-reviewed journals and conference presentations. PROSPERO REGISTRATION NUMBER: CRD42019140494.

Smartphone-based application vs paper-based record: female adolescents acceptance on fluid record tool

@#Introduction: Water is essential for normal functioning of the human body. Total fluid intake assessment using fluid record method is considered to be a burden for respondents, and the development of technology is expected to contribute favourably to this issue. My Fluid Diary is a smartphone-based application developed by the researcher as a fluid intake recording tool. This study aimed to evaluate the acceptance of manual, paper-based fluid intake recording compared to using My Fluid Diary as a trial among Indonesian vocational female students. Methods: A qualitative study was conducted to explore students’ acceptance of fluid intake recording using the smartphone-based application. An exploratory case study approach involving 38 female students as key informants was used via focus group discussion and in-depth interview as a method of triangulation. Results: Based on the data, female adolescents admitted that the application was more acceptable for fluid intake than recording manually using a book, in consideration of three aspects - the benefits, the easiness, and the application display or features. Based on its benefits, My Fluid Diary was mentioned as easy to learn and use. However, in order to improve the application, there is still a need for research development. Conclusion: My Fluid Diary was an application with respectable acceptance for fluid record compared to the manual, paper-based method among female adolescents.

Design and evaluation of a prototype of augmented reality applied to medical devices.

BACKGROUND: According to current legislation, medical devices have to incorporate all the necessary information to eliminate or greatly minimise any problem associated with their use. However, the physical capacity of the actual device's packaging may frequently not be enough to contain all this information. To address this limitation, this study aimed to design and evaluate a prototype app for mobile devices applying augmented reality technology. The main feature of this kind of technology is combining virtual images with images from the real world. METHODS: This work, carried out in Spain, was developed in three different phases. 1) Assessment of users' needs: Through a focus group and an online questionnaire, information was obtained about the following aspects: type of medical devices likely to be included in the app, relevant information that should be included and format in which this information should be presented. 2) Development of the prototype: Considering all the functional features identified in the previous phase, the software was developed by a team of professionals specialised in AR technology and applying a user-centred model. 3) Evaluation of the software: functionality and usability were assessed by means of the think-aloud method. RESULTS: 1) Assessment of users' needs: a total of 11 nurses participated in the focus group and 280 healthcare professionals answered the questionnaire. Their findings showed that users consider that information about the following aspects of medical devices should be included in the app: instructions for use, indications for use, brief description of the device, special precautions and biocompatibility, image of the content with its components and meaning of icons. 2) Description of the prototype: Once the app has been launched, when the user scans the medical device with the mobile device camera, access to the home screen is activated, where three sections can be found: name of the medical device, image of the device and four icons which provide access to: a brief description of the device, a detailed description of it, the packaging iconography and a video about use of the device. 3) Evaluation of the software: the app was defined by users as "very intuitive". They highlighted, as one of its main positive aspects, the chance to obtain information about the medical device just by scanning the object. Additionally, the evaluation performed through the think-aloud method identified potential improvements in the app. These improvements were subsequently implemented to make the prototype more functional. CONCLUSION: Working with potential prototype users made it possible to identify information considered relevant for these users and to delve into the format which they consider more appropriate to show this information in the prototype. Our results show that AR technology can be used as support for clinical practice.

The use of mobile educational tools to improve antimicrobial prescription for the treatment of acute pyelonephritis in pregnancy: A retrospective cross-sectional study / O uso de ferramentas educacionais móveis para o aperfeiçoamento da prescrição médica do tratamento de pielonefrite aguda na gestação: estudo transversal retrospectivo

Abstract Objective To analyze the prescription of antimicrobial agents for pregnant women admitted into the obstetrics service who presented with acute pyelonephritis. Methods Three cross-sectional studies were performed comparing the prescription of antimicrobials for pyelonephritis in pregnant women in the time periods evaluated (2010-2011: 99 patients evaluated; 2013: 116 patients evaluated; 2015: 107 patients evaluated), at the Hospital Fêmina, Porto Alegre, in the state of Rio Grande do Sul, Brazil. The analysis was performed before and after the promotion of an institutional protocol for the treatment of pyelonephritis during pregnancy, and on a third occasion after the introduction of a smartphone-based mobile educational tool. Results The evaluation of the prescribing physicians and the adequacy of the prescriptions between the different periods studied revealed a significant increase in appropriate conduct for the choice of antimicrobial (2010: 83.8%; 2013: 95.7%; and 2015: 100%), route of administration (2010: 97%; 2013: 100%; and 2015: 100%), and interval (2010: 91.9%; 2013: 95.7%; and 2015: 100%), following the introduction of the protocol, and again after the implementation of the softwareapplicationwithorientationsontheantimicrobial treatment. Conclusion The use of specific mobile applications should be encouraged to attain a better quality and accuracy in prescriptions and to include strategies that not only reduce the risk of negative outcomes, but also improve the quality of care and treatment for maintaining the health both of the mother and of the baby.

Resumo Objetivo Analisar a prescrição de antimicrobianos para gestantes admitidas no serviço de obstetrícia que apresentaram pielonefrite aguda. Métodos Foram realizados três estudos transversais comparando a prescrição de antimicrobianos para pielonefrite em gestantes nos períodos avaliados (2010-2011: 99 indivíduos avaliados; 2013: 116 indivíduos avaliados; 2015: 107 indivíduos avaliados), no Hospital Fêmina, Porto Alegre, RS, Brasil. A análise foi realizada antes e após a promoção de um protocolo institucional para o tratamento da pielonefrite durante a gravidez e, em uma terceira ocasião, após a introdução de uma ferramenta educacional móvel para uso por smartphone. Resultados A avaliação das prescrições médicas e a adequação das prescrições entre os diferentes períodos estudados revelaram um aumento significativo na conduta adequada para a escolha do antimicrobiano (2010: 83,8%; 2013: 95,7%; e 2015: 100%), via de administração (2010: 97%; 2013: 100%; e 2015: 100%) e intervalo (2010: 91,9%; 2013: 95,7%; e 2015: 100%), após a introdução do protocolo, e novamente após a implementação do aplicativo com orientações sobre tratamento antimicrobiano. Conclusão O uso de aplicativos móveis específicos deve ser incentivado para obter melhor qualidade e precisão nas prescrições e incluir estratégias que não apenas reduzam o risco de resultados negativos, mas que também melhorem a qualidade dos cuidados e do tratamento para manter a saúde conjunta da mãe e do bebê.

User-centered design of a mobile medication management.

BACKGROUND: The use of a nationwide medication plan has been promoted as an effective strategy to improve patient safety in Germany. However, the medication plan only exists as a paper-based version, which is related to several problems, that could be circumvented by an electronic alternative. OBJECTIVE: The main objective of this study was to report on the development of a mobile interface concept to support the management of medication information. METHODS: The human-centered design (UCD) process was chosen. First the context of use was analyzed, and personas and an interaction concept were designed. Next, a paper prototype was developed and evaluated by experts. Based on those results, a medium-fidelity prototype was created and assessed by seven end-users who performed a thinking-aloud test in combination with a questionnaire based on the System Usability Scale (SUS). RESULTS: Initially for one persona/user type, an interface design concept was developed, which received an average SUS-Score of 92.1 in the user test. Usability problems have been solved so that the design concept could be fixed for a future implementation. Contribution: The approach of the UCD process and the methods involved can be applied by other researchers as a framework for the development of similar applications.

Evaluation of an Interactive Visualization Tool for the Interpretation of Pediatric Laboratory Test Results.

The physiological age-related development of pediatric laboratory results interferes with pathological derangements, which can complicate the interpretation of test results. Recently proposed continuous reference intervals (RIs) promise to be beneficial, although their clinical use may depend on graphical presentations. To estimate the clinical utility of continuous RIs, we developed and evaluated an interactive visualization tool, and examined the differentiation of hemoglobinopathies that is attainable based on the underlying innovative RI model. The implemented web application allows users to easily enter laboratory test results, and displays various visualizations in conjunction with the corresponding RIs, such as charts and personalized Z-scores. To evaluate the usability of the visualization tool, we conducted concurrent think-aloud sessions with four physicians, who were prompted to solve a set of typical interpretation tasks, and acquired additional information through a questionnaire including the System Usability Scale (SUS). We used 85 de-identified clinical cases for an exemplified assessment of how well model-based interpretations of blood count parameters reproduced previously diagnosed hemoglobinopathies. Usability tests as well as questionnaire responses indicated that the developed tool was well received by the physicians. Results from the think-aloud evaluation revealed only minor problems and the tool reached an average SUS score of 86.9, suggesting good usability. Hemoglobinopathy discrimination depended on the considered subtype, although the overall performance of the novel method rivaled the one of the conventional approach. The interactive visualization of innovative continuous reference intervals demonstrated promising results, which justifies further testing on the path towards clinical routine.

Nationwide citizen access to their health data: analysing and comparing experiences in Denmark, Estonia and Australia.

BACKGROUND: Most countries face an ageing population, increasing chronic diseased, and constrictions on budget for providing health services. Involving patients in their own care by allowing them access to their patient data is a trend seen in many places. METHODS: Data on the type and level of access citizens have to their own health data in three countries was gathered from public sources. RESULTS: Data from each individual country is presented and the experiences of Denmark, Estonia and Australia are examined whilst similarities and differences explored. The discussion adopts a citizen-centred perspective to consider how the different e-portal systems support, protect and structure citizen interactions with their own health data in three key areas: Security, privacy and data protection; User support; and Citizen adoption and use. CONCLUSIONS: The paper highlights the impact of opt-in/opt-out approaches on citizen access and the lack of a structured approach to addressing differences in citizen health and e-health literacy. This research also confirms while current data provides detail on the availability and use of personal health data by citizens, questions still remain over the ultimate impact on patient outcomes of these initiatives. It is anticipated the insights generated from the three countries experiences, supporting citizen access to their health data will be useful to improve these initiatives and guide other countries aspiring to support similar initiatives.

Conversion of National Health Insurance Service-National Sample Cohort (NHIS-NSC) Database into Observational Medical Outcomes Partnership-Common Data Model (OMOP-CDM).

It is increasingly necessary to generate medical evidence applicable to Asian people compared to those in Western countries. Observational Health Data Sciences a Informatics (OHDSI) is an international collaborative which aims to facilitate generating high-quality evidence via creating and applying open-source data analytic solutions to a large network of health databases across countries. We aimed to incorporate Korean nationwide cohort data into the OHDSI network by converting the national sample cohort into Observational Medical Outcomes Partnership-Common Data Model (OMOP-CDM). The data of 1.13 million subjects was converted to OMOP-CDM, resulting in average 99.1% conversion rate. The ACHILLES, open-source OMOP-CDM-based data profiling tool, was conducted on the converted database to visualize data-driven characterization and access the quality of data. The OMOP-CDM version of National Health Insurance Service-National Sample Cohort (NHIS-NSC) can be a valuable tool for multiple aspects of medical research by incorporation into the OHDSI research network.

[Completeness assessment of the Breton registry of congenital abnormalities: A checking tool based on hospital discharge data]. / Contrôle automatisé de l'exhaustivité du registre breton des malformations congénitales à partir des données des bases médico-administratives des établissements de santé.

BACKGROUND: Exhaustiveness is required for registries. In the Breton registry of congenital abnormalities, cases are recorded at the source. We use hospital discharge data in order to verify the completeness of the registry. In this paper, we present a computerized tool for completeness assessment applied to the Breton registry. METHODS: All the medical information departments were solicited once a year, asking for infant medical stays for newborns alive at one year old and for mother's stays if not. Files were transmitted by secure messaging and data were processed on a secure server. An identity-matching algorithm was applied and a similarity score calculated. When the record was not linked automatically or manually, the medical record had to be consulted. The exhaustiveness rate was assessed using the capture recapture method and the proportion of cases matched manually was used to assess the identity matching algorithm. RESULTS: The computerized tool bas been used in common practice since June 2012 by the registry investigators. The results presented concerned the years 2011 and 2012. There were 470 potential cases identified from the hospital discharge data in 2011 and 538 in 2012, 35 new cases were detected in 2011 (32 children born alive and 3 stillborn), and 33 in 2012 (children born alive). There were respectively 85 and 137 false-positive cases. The theorical exhaustiveness rate reached 91% for both years. The rate of exact matching amounted to 68%; 6% of the potential cases were linked manually. CONCLUSION: Hospital discharge databases contribute to the quality of the registry even though reports are made at the source. The implemented tool facilitates the investigator's work. In the future, use of the national identifying number, when allowed, should facilitate linkage between registry data and hospital discharge data.