mHealth and eHealth

Se evaluó el acceso, uso y preferencias de las tecnologías de información y comunicación (TIC) de los médicos que laboran en el Hospital Nacional Cayetano Heredia, el cuestionario exploró la disponibilidad y dominio de las TIC, el tiempo, las actividades educativas, el uso de buscadores y aplicaciones tecnológicas más usadas así como las preferencias de TIC en educación. Se encuestaron 211 médicos; el uso de laptop fue 93%, tablet y smartphone en un 66 y 88%. El 68% tiene Internet móvil. Se evidenció diferencias en la frecuencia de uso de TIC en el grupo de edad de 25 a 34 años, así como un mayor nivel de dominio (p<0,05); el 86% usa PubMed, Facebook y WhatsApp como medio de intercambio de imágenes y datos relacionados con salud, el 50% participó en blogs médicos, cursos en línea o videoconferencias. El uso y acceso de TIC es frecuente en los médicos de este hospital y existe interés positivo por su uso en educación.

Penelitian ini bertujuan untuk mengetahui dan menganalisis analisis strategi optimalisasi pelayanan medis dalam upaya meningkatkan jumlah kunjungan pasien. Hasil penelitian yang dilakukan diharapkan dapat mampu meningkatkan utility pelayanan di Rumah sakit, sehingga hasil penelitian ini dapat menjadi masukan bagi Rumah Sakit Hermina Pasteur untuk membuat rencana strategi palayanan. Metode penelitian yang digunakan adalah analisis deskriptif kualitatif. Pengumpulan data yang digunakan adalah wawancara dengan menggunakan wawancara disertai dengan teknik observasi dan kepustakaan. Teknik analisis data menggunakan analisis model interaktif terdiri dari pengumpulan data, reduksi data, penyajian data dan penarikan kesimpulan. Hasil penelitian dapat diketahui bahwa Strategi optimalisasi pelayanan saat ini pada masa Pandemi Covid di Rumah Sakit yaitu untuk mempersingkat masa tunggu pasien dalam mendapat layanan kesehatan serta mempermudah bagi Rumah Sakit dalam mengatur penjadwalan kunjunga...

Use your device to scan and read the article online Objectives With the growth in the aged population and the increase in the health needs of older people, new challenges have been raised for the health care systems. Therefore, advanced methods for management of the health needs of older adults is needed. Artificial intelligence (AI) can play an effective role in this field. The present study aims to investigate the different applications of AI in geriatric care management. Methods & Materials The is a qualitative review study using the meta-synthesis approach. The related articles were searched in national and international databases. The identified data were coded and analyzed in MAXQDA software, version 2020. Results A total of 25 articles were selected for the review. From 122 initial codes, 8 main themes, 21 subthemes or concepts, and 42 indicators were extracted. The main themes included prediction and prevention of diseases, management of chronic diseases, organization and sorting of medications, smart home monitoring, online communication with doctors, car assistance systems, health service management, and psychological support. Conclusion The AI technology can be used to manage the health needs of older adults. Its different applications should be taken into consideration in geriatric care management.

The rising prevalence of chronic diseases has led to a growing health burden necessitating novel management strategies. Mobile health (mHealth)-defined as the use of mobile communication and information technology for the delivery of health services and clinical information-holds promise in addressing this issue. Example mHealth interventions such as text message medication reminders, glucose-monitoring telephone calls, and phone apps propose solutions for common challenges faced by patients with chronic diseases. Drawing on broad considerations in the selection, design, and implementation of mHealth interventions, the perspective of patient engagement is introduced as a critical factor. As the quality of engagement is a prerequisite for securing measurable health outcomes, focus is placed on its components, determinants, and metrics. The discussion is illustrated with scenarios representative of mHealth application in asthma, chronic obstructive pulmonary disease, and diabetes. Engaging patients has been a major challenge for many existing mHealth interventions and influences the reliability and validity of treatment effect assessments. There is thus a need to equip future-generation mHealth interventions with tools capable of quantifying and enhancing patient participation.

Η ψηφιακή τεχνολογία έχει μετασχηματίσει ριζικά τον τομέα της υγείας, από τους ηλεκτρονικούς φακέλους και την τηλεϊατρική έως τη χρήση τεχνητής νοημοσύνης στη διάγνωση και τη θεραπεία. Παρά τα σημαντικά οφέλη, οι καινοτομίες αυτές εγείρουν κρίσιμα ζητήματα βιοηθικής, βιοεξουσίας και κοινωνικής δικαιοσύνης. Η εργασία εξετάζει τις προκλήσεις που προκύπτουν για το κράτος δικαίου, τη δημοκρατία και τα θεμελιώδη δικαιώματα των πολιτών, αναλύοντας μοντέλα διαχείρισης δεδομένων υγείας και τις συνέπειες της αλγοριθμικής λήψης αποφάσεων στην ιατρική πράξη. Μέσα από παραδείγματα καλών και κακών πρακτικών, αναδεικνύεται η ανάγκη για θεσμικές εγγυήσεις, διαφάνεια και ενεργή συμμετοχή των πολιτών, ώστε η τεχνολογία να υπηρετεί την υγεία χωρίς να υπονομεύει την ελευθερία και την αξιοπρέπεια του ανθρώπου.
Digital technology has radically transformed the field of healthcare, from electronic health records and telemedicine to the use of artificial intelligence in diagnosis and treatment. Despite its significant benefits, these innovations raise critical issues of bioethics, biopower, and social justice. This paper examines the challenges posed to the rule of law, democracy, and fundamental rights, analyzing models of health data governance and the implications of algorithmic decision-making in medical practice. Through examples of best and worst practices, it highlights the need for institutional safeguards, transparency, and active citizen participation, so that technology can serve health without undermining human freedom and dignity.
Digital Health, Artificial Intelligence, Bioethics, Biopower, Health Data, Rule of Law, Democracy

The Internet of Things (IoT) is already transforming industries, cities, and homes. The economic value of this transformation across all industries is estimated to be trillions of dollars and the societal impact on energy efficiency, health, and productivity are enormous. Alongside potential benefits of interconnected smart devices comes increased risk and potential for abuse when embedding sensing and intelligence into every device. One of the core problems with the increasing number of IoT devices is the increased complexity that is required to operate them safely and securely. This increased complexity creates new safety, security, privacy, and usability challenges far beyond the difficult challenges individuals face just securing a single device. We highlight some of the negative trends that smart devices and collections of devices cause and we argue that issues related to security, physical safety, privacy, and usability are tightly interconnected and solutions that address all...

Telemedicine in the pandemic of coronavirus disease 2019 (COVID-19) has responded to societal distancing in medical treatments by protecting health workers while also managing available resources. To attain best practices in telemedicine, a platform must be functional, and both patients and clinicians must be satisfied with the technology. To ensure the benefits of telehealth systems, usability refers to how easy the user interfaces of telehealth systems are to use. In this study, the usability of telemedicine systems has been investigated. Material and Methods: The authors of this study review the study from 2015 to 2021 using a combination of the keywords "health", "telemedicine", "telemedicine", "mobile health", "usability" "Software", "System" and "Program", which led to the extraction of 119 articles in this field. Results: Articles in the field of remote health software and evaluation of the usability of remote health applications in the form of applications based on mobile health technologies, web-based applications or a combination of both types with sample devices Primary are wearable electronics, sensors or robots. Conclusion: In this study, most of the remote health software are mobile based and their usability has been evaluated by a questionnaire. Satisfaction is the most important usability attributes to consider when designing Health mobile apps.

A identificação do sedentarismo como fator de risco para doenças crônico-degenerativas influenciou significativamente nas recomendações de saúde pública em defesa de estilos de vida fisicamente ativos. O artigo estuda o processo de patologização do sedentarismo e seus desdobramentos para o campo da saúde pública. Num primeiro momento, discutimos de que maneira o modelo biomédico serve de base para a transposição de aspectos da conduta humana como "fator de risco" e, a seguir, como patologia, tal qual no caso específico da "Síndrome da Morte Sedentária", assim classificada por alguns autores. Em seguida, analisamos como essa visão vem sendo difundida no campo da saúde, tomando por base um programa institucional que, ao mesmo tempo em que transforma o sedentarismo em doença, apresenta a atividade física como um remédio cujos resultados podem se estender a todas as esferas da vida. Nessa linha de raciocínio, em que os mal-estares de nossa civilização são medicalizados e tornados mercadoria ao serem transformados em riscos e patologias, a atividade física torna-se vacina para o corpo social. Palavras-chave: Estilo de vida sedentário; Risco; Atividade motora; Exercício; Política de saúde.

The widespread adoption of smartphones and mobile apps has revolutionized many industries, including the wellness sector. Wellness apps, which provide users with tools and resources to improve their physical and mental well-being, have gained significant popularity in recent years. However, to ensure long-term success and customer loyalty, these apps must prioritize customer satisfaction. This study explores the role of mobile app intelligence in enhancing customer satisfaction within the context of wellness apps. Through a comprehensive literature review and empirical research involving surveys and user data analysis, we investigate the key factors contributing to customer satisfaction in wellness apps and propose a framework for leveraging mobile app intelligence to optimize the user experience. Our findings highlight the importance of personalization, user engagement, and data-driven insights in driving customer satisfaction. We also discuss the implications of our research for mobile app developers, marketers, and wellness service providers, offering practical recommendations for improving customer satisfaction through mobile app intelligence. This study contributes to the growing body of literature on mobile app marketing and customer satisfaction, providing valuable insights for both academics and practitioners in the wellness industry.

Men who were used to an active sex life they found it difficult to remain celibate.  They also wanted to confirm it still worked.  The major constraint that they felt was avoiding pain. In one case this was covered by the use of additional pain tablets.  That weekend, we went out. You know when we go out it will happen that they meet with girls ..… I thought about that fact that I have never experienced any pain. I fear pain

Background: The global prevalence of dementia presents profound challenges for health care systems, societies, and legal structures worldwide. While the ethical dimensions of dementia care have been extensively discussed in the literature, limited research addresses how ethical principles are effectively operationalized within legal frameworks governing dementia care. Objective: We aim to explore how national, European, and international legal instruments integrate and translate ethical principles such as autonomy, dignity, beneficence, and justice into dementia care legal documents, including case law and legislation. Methods: This study will be conducted by a team of 24 researchers from 15 European countries, within a European Union (EU)-funded European Cooperation in Science and Technology Action on dementia care. The project applies a combined methodological approach, using qualitative thematic synthesis and a legal document review framework. Legal documents published between 2010 and 2025 will be searched and qualitatively analyzed at 3 levels: national, EU, and international, including legislation, case law, and authoritative legal literature explicitly addressing dementia care. Researchers from each country will conduct searches in national legal databases using predefined search terms. At the EU and international levels, databases such as Westlaw, Lexis+, the European Court of Human Rights, and the European Ombudsman will be consulted. Key information from each document will be collected using a standardized data extraction tool, focusing on ethical principles and frameworks. Data analysis will combine deductive and inductive approaches, allowing the identification of ethical principles and the emergence of new concepts discussed in the documents. Thematic analysis will follow a 3-stage process: line-by-line coding, grouping codes into descriptive themes, and developing analytical themes to address the research questions. Results: This study will identify and categorize ethical principles embedded in legal documents, analyzing their expression, interpretation, and variability across jurisdictions. The project is scheduled to be implemented throughout 2025.

Este artigo tem como objetivo apresentar um sistema de apoio à educação em saúde voltado ao tratamento e prevenção da obesidade em adultos, denominado Emagreça@Saudável. Três teorias principais embasam o sistema: a) o Modelo Transteórico de Mudança; b) as tecnologias persuasivas para mudança de comportamento visando a adoção de hábitos saudáveis; c) os princípios de design para dispositivos móveis. O sistema visa suprir funcionalidades e indicar mecanismos inovadores para apoio à reeducação alimentar e motivação da prática de atividades físicas, com a intenção de servir de apoio a ações de saúde pública na prevenção e controle da epidemia da obesidade.This article aims to present a system of assistance to health education aimed at the treatment and prevention of obesity in adults, called Slim&Healthy. Three main theories support the system: a) the Transtheoretical Model of Change; b) persuasive technologies for behavior change aiming at the adoption of healthy habits; C) the design ...

Este artigo apresenta uma solução m-Health para apoio à educação em saúde constituída por um aplicativo para Android no dispositivo móvel cliente e uma aplicação em máquina servidora. Diferentes conceitos e teorias estão integrados visando aumentar a motivação do usuário, com foco na mudança de comportamento para hábitos mais saudáveis e melhoria da qualidade de vida. Uma avaliação da interface da aplicação foi realizada através de questionário baseado na ISO 9241-11 e ABNT ISO/IEC 25062:2011 junto a oito especialistas. Além disto, o questionário WHOQOLbref foi disponibilizado aos usuários via app, e feedbacks sobre conteúdos também são analisados e trazidos para discussão.

Latar Belakang: Pelaksanaan Rekam Medis Elektronik (RME) pada fasilitas pelayanan kesehatan terdapat ketimpangan dengan Permenkes No. 24 Tahun 2022 tentang Rekam Medis (RM). Salah satunya adalah ketimpangan adalah perbaikan atau penambahan catatan RM yang berujung pada pengaktifan kembali RME lebih dari 2x24 jam. Tujuan: Penelitian ini bertujuan untuk mengetahui pengaturan dan hak akses pengaktifan kembali RME. Metode: Desain penelitian ini menggunakan pendekatan kualitatif dengan metode postpositivistik. Sampel penelitian dari Instalasi RM periode April 2023 berjumlah 43 RM yang telah mengalami perbaikan. Pengumpulan data dilakukan dengan wawancara serta teknik triangulasi berupa studi dokumentasi dan observasi. Hasil: Proses pengaktifan kembali meliputi memperbaiki SOAP dan asesmen, penambahan diagnosis dan melengkapi resume. Dua orang diberikan akses untuk memastikan kelengkapan pengisian RME sesuai peraturan direktur. Kesalahan atau ketidaklengkapan dalam diagnosis dan tindakan, mengakibatkan pemberian kode penyakit dan tindakan tidak tepat sehingga hasil pengumpulan data dan pelaporan tidak akurat. Kesimpulan: Pengaturan pengaktifan kembali dan hak akses RME di RS X Kota Denpasar tidak sesuai Standar Prosedur Operasional dan Permenkes No. 24 Tahun 2022 tentang RM karena pengaktifan kembali melebihi 2 x 24 jam setelah pasien selesai dirawat. Evaluasi kebijakan dengan pelatihan, sosialisasi, kontrol akses serta pelaporan pelaksanaan RME dilakukan untuk menjaga kerahasiaan serta integritas data pasien.

The current study outlines the creation of an online community designed to connect patients to providers of Complementary and Alternative Medicine (CAM) and western biomedicine. The purpose of the site was to create a forum for patients and healthcare providers to share information and social support regarding eight popular CAM treatments. First, we created a prototype and pilot tested it through a usability analysis. Second, we conducted semistructured interviews with 12 key stakeholders from the CAM, biomedicine, and patient populations. Third, we conducted a content analysis of the discussion forums to examine common posting behaviour. We found that CAM providers were the most active contributors to the forums. This project provides proof of concept for using an online community platform to connect patients and CAM providers. Future work should attempt to engage Western medicine providers while studying techniques and features that best engage users.

Background Collecting NHS patient experience data is critical to ensure the delivery of high-quality services. Data are obtained from multiple sources, including service-specific surveys and widely used generic surveys. There are concerns about the timeliness of feedback, that some groups of patients and carers do not give feedback and that free-text feedback may be useful but is difficult to analyse. Objective To understand how to improve the collection and usefulness of patient experience data in services for people with long-term conditions using digital data capture and improved analysis of comments. Design The DEPEND study is a mixed-methods study with four parts: qualitative research to explore the perspectives of patients, carers and staff; use of computer science text-analytics methods to analyse comments; co-design of new tools to improve data collection and usefulness; and implementation and process evaluation to assess use of the tools and any impacts. Setting Services fo...

Introduction: The global health policy&#39;s main goal is to reduce the under-five mortality rate (U5MR), especially in low- and middle-income countries (LMICs), where children still die of various ailments. Mobile-Based Health (mHealth) methods may help improve health information and access to maternity and childcare services. This systematic review was aimed to evaluate the efficacy of m-Health in enhancing the health of children under five in LIMICs. Methodology: A search strategy was carried out in the databases like PubMed, CINAHL, SCOPUS, Science Direct, PsycINFO including some grey literature with a focus on the studies published in English 2013 to 2024 were only included. From a total of 518 studies identified, twenty-two satisfied the criteria for inclusion after a selection process. Results: The results emphasized the impact of m-Health in improving immunization rates, supporting breastfeeding, child growth monitoring, and health-seeking behaviours of the mothers. Text mes...

In the paper we apply a theoretical concept of technologies of the self developed by Michel Foucault to the field of lifelogging practices. Lifelogging is a global social phenomenon, a part of contemporary experience of everyday, especially in the developed societies of the West. Our hypothesis is that, despite different ways of quantifying self, lifelogging practices have some characteristics in common: they all belong to the field of biopolitics. This is demonstrated on the levels of the body, identity and subjectivity, since they are influenced and changed by lifelogging. At the same time, lifelogging practices blur the relationship between coercion and consent, power and resistance. The theoretical framework for addressing lifelogging is the concept of biopolitics, also developed by, since it refers to the mechanisms, techniques and technologies, as well as the forms of rationality that regulate life and its various manifestations. In conclusion, we claim that it is still not po...

Background: Three recent reviews evaluated 19 studies testing the hemoglobin A1c (HbA1c) benefit of 16 diabetes apps, including 5 publicly available apps. Most studies relied on small samples and did not link app engagement with outcomes. Objective: This study assessed both HbA1c change in a large sample of people using the One Drop | Mobile app and associations between app engagement and changes in HbA1c. The One Drop | Mobile app for iOS and Android is designed to manually and passively (via Apple HealthKit, Google Fit, and the One Drop | Chrome blood glucose meter) store, track, and share data. Users can schedule medication reminders, view statistics, set goals, track health outcomes, and get data-driven insights. In June 2017, we queried data on people with diabetes using the app who had entered at least 2 HbA1c values in the app >60 and ≤365 days apart. Multiple imputation corrected for missing data. Unadjusted and adjusted mixed effects repeated measures models tested mean HbA1c change by time, diabetes type, and their interaction. Multiple regression models assessed relationships between using the app to track food, activity, blood glucose, and medications and HbA1c change. The sample (N=1288) included people with type 1 diabetes (T1D) (n=367) or type 2 diabetes (T2D) (n=921) who were 35% female, diagnosed with diabetes for a mean 9.4 (SD 9.9) years, and tracked an average 1646.1 (SD 3621.9) self-care activities in One Drop | Mobile between their first (mean 8.14% [SD 2.06%]) and second HbA1c entry (mean 6.98% [SD 1.1%]). HbA1c values were significantly associated with user-entered average blood glucose 90 days before the second HbA1c entry (rho=.73 to .75, P<.001). HbA1c decreased by an absolute 1.07% (unadjusted and adjusted F=292.03, P<.001) from first to second HbA1c entry. There was a significant interaction between diabetes type and HbA1c. Both groups significantly improved, but users with T2D had a greater HbA1c decrease over time than users with T1D (F=10.54, P<.001). For users with T2D (n=921), HbA1c decreased by an absolute 1.27% (F=364.50, P<.001) from first to second HbA1c entry. Finally, using One Drop | Mobile to record food was associated with greater HbA1c reductions even after adjusting for covariates and after also adjusting for insulin use for users with T2D (all P<.05). People with T1D and T2D reported a 1.07% to 1.27% absolute reduction in HbA1c during a median 4 months of using the One Drop | Mobile app. Using the app to track self-care was associated with improved HbA1c. More research is needed on the health benefits of publicly available diabetes apps, particularly studies associating app engagement with short-and long-term effects.

Background Artificial Intelligence (AI) is increasingly applied in healthcare to boost productivity, reduce administrative workloads, and improve patient outcomes. In nursing, AI offers both opportunities and challenges. This study explores nurses' perspectives on implementing AI in nursing practice within the context of Jordan, focusing on the perceived benefits and concerns related to its integration. Method A qualitative research approach was employed, involving semi-structured interviews with 25 nurses and 3 focus group discussions, each consisting of 7-8 participants. The data collected was coded and analyzed using thematic analysis to identify recurring patterns and key themes in the nurses' views on AI. Results Three major themes emerged from the analysis: (1) AI as an efficiency tool-Nurses recognized AI's ability to reduce administrative burdens and improve patient monitoring in real-time. (2) Ethical and practical concerns-Nurses raised issues regarding patient privacy, data security, and the fear that AI might replace human decisionmaking in care. (3) Lack of preparedness and training-There was a consensus on nurses' inadequate training in AI tools, limiting their ability to integrate AI into their practice fully. Conclusion While AI is seen as a valuable tool to enhance nursing productivity, several challenges still need to be addressed, particularly regarding ethical concerns and insufficient training. To ensure AI complements nursing without compromising the human element, healthcare institutions must address these issues by implementing comprehensive training programs and establishing clear ethical guidelines.

This paper examines 'mobile health' or 'mHealth' programs that are using mobile phones to improve maternal health in the developing world. Whereas its implementers present mobile health as a neutral, universal, accessible and 'smart' empowering technology for women, we will question this empowering effect and analyze how the device transforms gender inequalities on the ground. To this end, we will use empirical data collected on a global mHealth program deployed in Ghana and India. Informed by gender, postcolonial, science and technology studies, we offer a critical analysis of these new devices using mobile phones to 'empower' women in the Global South. This multisite analysis highlights the gender gap and male domination in accessing mobile phones in rural India and Ghana. It also reveals how mHealth devices can negate the multifactorial dimension of gender and health inequalities, how these global assemblages are renegotiating local power relations and enhancing gender imbalance and health disparities for women in these villages.

Information and communication technologies are increasingly used for development in the Global South, and mHealth (health assisted by mobile technologies) plays key role. This paper analyzes the particular relationship to science that characterizes a global maternal mHealth program deployed in Ghana and India. Using science and technology studies (STS), this research relies on qualitative interviews conducted between 2014 and 2016 with funders, implementers, and beneficiaries of this mHealth program. This story begins with a randomized controlled trial, a biomedical experiment with a strong positioning regarding science and the production of evidence. But rapidly the scientific stance disappears to give way to the testing and marketing of a product for the digital economy. From science to market, this paper offers to revisit a classical STS topic through the lens of mHealth. It shows how the various experimental forms taken by this project fundamentally diverge from scientific metho...

Éditeur CREIS-Terminal Ce document vous est offert par École des hautes études en sciences sociales (EHESS) Référence électronique Marine Al Dahdah, « Les mobiles du développement : le téléphone portable comme outil d'empowerment des femmes des Suds ? »,

Kemajuan teknologi media saat ini ikut memengaruhi cara masyarakat memahami dan menjaga kesehatannya. Penelitian ini membahas bagaimana media teknologi dimanfaatkan untuk mendukung edukasi serta pemantauan kondisi kesehatan sehari-hari. Metode yang digunakan adalah studi kasus dengan pendekatan deskriptif kualitatif, yang berfokus pada pengguna perangkat teknologi dengan fitur pelacak kesehatan otomatis. Hasil yang diperoleh menunjukkan bahwa keberadaan teknologi ini mempermudah individu dalam memantau kesehatannya secara langsung, serta meningkatkan kesadaran terhadap pola hidup sehat. Selain itu, teknologi ini juga memberikan informasi kesehatan secara praktis dan mudah dipahami, sehingga membantu pengguna dalam mengambil keputusan yang berkaitan dengan kesehatannya. Temuan ini menunjukkan bahwa media teknologi tidak hanya sebagai alat bantu, tetapi juga berperan aktif dalam membangun komunikasi kesehatan yang lebih efektif dalam kehidupan seharihari.

eHealth and mHealth systems are getting more popular today; yet, vulnerabilities are much higher when the sensitive medical data being transferred through public networks. Therefore, it is essential to have a digital identification and authentication mechanism to authenticate peers in a digital world. Especially, it will help to avoid attacks such as man-in-the-middle attack. Although the digital certificates can solve this issue, it has not been used by the general public yet to protect their digital data. This is mainly due to their limited knowledge in IT and the complexity of the process. Thus, it is required to have a simple security tool to support encryption, digital signature, digital authentication, and integrity verification. However, we have developed a digital certificate management system to facilitate all these features including creating asymmetric key pairs, generating, signing, chaining and revoking certificates, and signing and verifying digital contents. Because i...

with dementia but also to the 'jeopardy' , people with dementia may face. Multiple jeopardies including, ethnicity, gender, class, sexual orientation and physical disability lead to various forms of discrimination and the marginalisation of people with dementia. The label dementia carries with it a stigma, referred to by Goffman (1963: 3) as an "attribute that is deeply discrediting" and that reduces the bearer "from a whole and usual person to a tainted, discounted one." Research has shown that people with dementia are stigmatised and discriminated against (Benbow and Jolley 2012; Milne 2010). This stigma weakens people's sense of self-worth and self-esteem whilst increasing their sense of being burdensome (Sabat 2010). This may create barriers to accessing services which are designed to support their healthy ageing or enable them to play an active role in wider society. discuss the concept of 'social citizenship' to illustrate how society can impede people with dementia from upholding their basic rights as a citizen bestowed upon them by the state, including accessing health and social services and being socially active and connected to others. This often impacts detrimentally on their well-being and healthy ageing by further adding to their social exclusion and marginalisation (Innes et al 2004, Gilmour and. It is vital that people with dementia are supported to successfully achieve healthy ageing; this requires promoting public awareness and understanding to challenge on-going misconceptions and stigma of dementia reported globally (ADI 2012). National Institute for Health and Clinical Excellence (NICE) and Social Care Institute for Excellence (SCIE) (2006) guidelines argue for the reduction of pharmacological interventions in dementia care. Psychosocial interventions offer an alternative way to support people with dementia to live independently for longer and are now acknowledged as a core element of dementia care research (Moniz-Cook et al, 2008; Moniz-Cook et al 2011; Orrell 2012).

► This will be the first trial to evaluate the effectiveness of protocolled practice nurse-led care for children with asthma in primary care. ► Asthma in children is a clinical diagnosis for which no 'gold standard' diagnostic criteria are available.'Physician-diagnosed asthma' will be used as an inclusion criterium in this trial. ► Primary outcome will be asthma control during the 18 month follow-up measured by the Childhood Asthma Control Test. This questionnaire shows good agreement as compared with the Global Initiative for Asthma criteria.

There is increasing recognition of the potential to use mobile health (mHealth) technologies such as smartphone apps to support clinical care. Mobile apps are progressively being implemented to manage chronic diseases like cancer to improve patient care. The app deployed at the Brazilian National Cancer Institute enables patients to access the appointments/exam booking, medication prescription, and cancer-prevent educational resources, improving self-management, autonomy, and cancer treatment outcomes in resource-limited environments. Despite acknowledging the importance of mHealth, research is still scarce regarding patients’ views on using these innovations in cancer care management.

Background: Smartphones are popular technologies that combine telephone communications and informatics in portable devices. Limited evidence exists regarding their effectiveness in improving academic performance among medical students. This study aims to assess whether a smartphone application could improve academic performance in multiple-choice tests. Methods: A double-masked randomised trial was held among interns at the School of Medicine of the Universidad de Valparaiso. Participants were randomised to receive an application designed to review key concepts in Internal Medicine and its subspecialties using clinical vignettes. Contents were selected and provided in a format akin to a mandatory national examination required for practising medicine in Chile. Analyses were undertaken under the intention to treat principle and missing data were handled using multiple imputation techniques. Results: Eighty interns volunteered to participate in this trial, most were female (48 students, 60%) and had a mean age of 25.3 ± 2.2 years. Participants showed significant experience with smartphones, with a median use of 4 years (IQR 3-6 years) and 67 (83.7%) reporting routine use in clinical practice. Intention-to-treat analyses showed significant improvements in performance amongst students allocated to the smartphone application (mean increase of 14.5 ± 8.9 vs 9.4 ± 11.6points, p = 0.03). A reduction in total time and mean time per question was also found, which was significant in complete-case analyses (p = 0.04). Discussion: Smartphones were popular among medical trainees. Academic performance was significantly improved by the use of our application, although the overall effect was smaller than expected from previous trials. This study provides evidence that smartphone-based interventions can assist in teaching internal medicine. Trial registration: ClinicalTrials NCT02723136.

Background: The use of mobile services for health promotion is rapidly increasing. The purpose of this paper is to review studies on using cell phone applications as an intervention to improve mental health in breast cancer patients and to provide an overview of their effectiveness. Methods: A systematic search in PubMed, Scopus, Web of Science and PsycINFO was performed to retrieve relevant studies published from 2010 to 2020. The criteria for inclusion were any study conducted on breast cancer, written in English and on mental health. The meta-synthesis of the articles was conducted based on a predefined classification. Then from the selected studies, the following information was extracted: authors, publication date, study objectives, study population, study design, interventions, and results. Results: Overall, 81 papers were retrieved from databases, 46 articles were reviewed, and finally 7 articles were selected for analysis. We identified 7 RCT studies that utilized a mental health application as a mental health intervention in breast cancer patients. The results showed the effectiveness of mobile apps on stress, depression, anxiety, self-efficacy, social support, resiliency and coping with breast cancer in all the studies which were analyzed. This study demonstrated the important role of mobile apps in promoting mental wellness of breast cancer patients. Mobile app interventions can be implemented to decrease depression through positive impacts on stress management, self-efficacy, resilience and breast cancer adaptation. We recommend that the role of mobile apps for the prevention and rehabilitation of mental health aspects in breast cancer patients should be examined through a blended delivery management approach in future studies.

Background: Mobile health (mHealth) is showing increasing potential to address health outcomes in underresourced settings as smartphone coverage increases. The NeoTree is an mHealth app codeveloped in Malawi to improve the quality of newborn care at the point of admission to neonatal units. When collecting vital demographic and clinical data, this interactive platform provides clinical decision support and training for the end users (health care professionals [HCPs]), according to evidence-based national and international guidelines. Objective: This study aims to examine 1 month's data collected using NeoTree in an outcome audit of babies admitted to a district-level neonatal nursery in Malawi and to demonstrate proof of concept of digital outcome audit data in this setting. Methods: Using a phased approach over 1 month (November 21-December 19, 2016), frontline HCPs were trained and supported to use NeoTree to admit newborns. Discharge data were collected by the research team using a discharge form within NeoTree, called NeoDischarge. We conducted a descriptive analysis of the exported pseudoanonymized data and presented it to the newborn care department as a digital outcome audit. Results: Of 191 total admissions, 134 (70.2%) admissions were completed using NeoTree, and 129 (67.5%) were exported and analyzed. Of 121 patients for whom outcome data were available, 102 (84.3%) were discharged alive. The overall case fatality rate was 93 per 1000 admitted babies. Prematurity with respiratory distress syndrome, birth asphyxia, and neonatal sepsis contributed to 25% (3/12), 58% (7/12), and 8% (1/12) of deaths, respectively. Data were more than 90% complete for all fields. Deaths may have been underreported because of phased implementation and some families of babies with imminent deaths self-discharging home. Detailed characterization of the data enabled departmental discussion of modifiable factors for quality improvement, for example, improved thermoregulation of infants. This digital outcome audit demonstrates that data can be captured digitally at the bedside by HCPs in underresourced newborn facilities, and these data can contribute to a meaningful review of the quality of care, outcomes, and potential modifiable factors. Coverage may be improved during future implementation by streamlining the admission process to be solely via digital format. Our results present a new methodology for newborn audits in low-resource settings and are a proof of concept for a novel newborn data system in these settings.

Background. Vulnerability factors for obsessive-compulsive (OC) features in immigrant youth are under-studied. The migration process can have a highly stressful impact on the psychological wellbeing of the individual and it may represent a precipitating factor for different forms of psychopathology. Little is known about the occurrence of OC traits. Unlike other European countries, immigration to Italy is a recent phenomenon. In community children/early adolescents, this study compared OC general symptoms/subtypes and vulnerability cognitive factors amongst Italian natives, first- and second-generation immigrants, and examined whether such vulnerability factors moderate the relation between immigrant status and OC symptoms/subtypes, beyond socio-demographic/clinical variables. Methods. Two hundred sixty-eight children/early adolescents (99 natives, 82 and 87 first- and second-generation immigrants respectively) completed the Obsessive Belief Questionnaire-Child Version, Obsessive Co...

Objective Cognitive models of Obsessive-Compulsive Disorder (OCD) identified four types of beliefs, which would develop during childhood and play a role in the aetiology and maintenance of OCD: Inflated Responsibility, Threat Overestimation, Importance/Control of Thoughts, Perfectionism/Intolerance of Uncertainty. Whereas research produced consistent evidence in adults that these beliefs constitute vulnerability factors for OCD, no study examined whether the obsessive beliefs prospectively predict OCD symptoms over time in youth. The current study investigated the role of the obsessive beliefs as predictors of OCD symptoms after one year in a large cohort sample of community children and early adolescents prospectively followed-up. Method Seven hundred and fifty-four children and early adolescents recruited from the community (mean age= 10.87 years, 51.46% females) completed the Obsessive Belief Questionnaire-Child Version (OBQ-CV) as a measure of obsessive beliefs, the Obsessive-Co...

eHealth is an opportunity cost, competing for limited available funds with other health priorities such as clinics, vaccinations, medicines and even salaries. As such, it should be appraised for probable impact prior to allocation of funds. This is especially pertinent as recognition grows for the role of eHealth in attaining Universal Health Coverage. Despite optimism about eHealth’s potential role, in Africa there remain insufficient data and skills for adequate economic appraisals to select optimal investments from numerous competing initiatives. The aim of this review is to identify eHealth investment appraisal approaches and tools that have been used in African countries, describe their characteristics and make recommendations regarding African eHealth investment appraisal in the face of limited data and expertise. Methods: Literature on eHealth investment appraisals conducted in African countries and published between January 1, 2010 and June 30, 2020 was reviewed. Selected pa...

Significant investment in eHealth solutions is being made in nearly every country of the world. How do we know that these investments and the foregone opportunity costs are the correct ones? Absent, poor, or vague eHealth strategy is a significant barrier to effective investment in, and implementation of, sustainable eHealth solutions and establishment of an eHealth favorable policy environment. Strategy is the driving force, the first essential ingredient, that can place countries in charge of their own eHealth destiny and inform them of the policy necessary to achieve it. In the last 2 years, there has been renewed interest in eHealth strategy from the World Health Organization (WHO), International Telecommunications Union (ITU), Pan American Health Organization (PAHO), the African Union, and the Commonwealth; yet overall, the literature lacks clear guidance to inform countries why and how to develop their own complementary but locally specific eHealth strategy. To address this gap, this paper further develops an eHealth Strategy Development Framework, basing it upon a conceptual framework and relevant theories of strategy and complex system analysis available from the literature. We present here the rationale, theories, and final eHealth strategy development framework by which a systematic and methodical approach can be applied by institutions, subnational regions, and countries to create holistic, needs-and evidence-based, and defensible eHealth strategy and to ensure wise investment in eHealth.

With the advancement of information technology, hospitals around the world are increasingly adopting technology-based application systems to enhance efficiency and service quality. One of the essential applications in hospital management is the product application system, which manages and distributes medical products, equipment, and medicines. This system is designed to simplify the management of inventory, ordering, and distribution of medical products across hospital departments. This study aims to analyze the implementation of the product application system in hospitals, focusing on its effectiveness, efficiency, and impact on healthcare services. The research method used is a case study of hospitals that have implemented the product application system. The results of the study show that this system can improve the accuracy of inventory management, reduce operational costs, and accelerate the distribution process of medical products. However, there are challenges in terms of human resource training and system integration with other hospital devices. The study concludes that despite some obstacles, the implementation of the product application system in hospitals has a positive impact on operational performance and the quality of patient care services.

Background: Despite progress to expand access to HIV testing and treatment during pregnancy in Kenya, gaps still remain in prevention of mother-to-child transmission of HIV (PMTCT) services. This study addresses the need for effective and scalable interventions to support women throughout the continuum of care for PMTCT services in low-resource settings. Our research team has successfully implemented the HIV Infant Tracking System (HITSystem), a Web-based, system-level intervention to improve early infant diagnosis (EID) outcomes. Objective: This study will expand the scope of the HITSystem to address PMTCT services to bridge the gap between maternal and pediatric HIV services and improve outcomes. This paper describes the intervention development protocol to adapt and pilot an HITSystem version 2.0 to assess acceptability, feasibility, and preliminary PMTCT outcomes in Kenya. Methods: This is a 3-year intervention development study to adapt the current HITSystem intervention to support a range of PMTCT outcomes including appointment attendance, antiretroviral therapy (ART) adherence, hospital deliveries, and integration of maternal and pediatric HIV services in low-resource settings. The study will be conducted in 3 phases. Phase 1 will elicit feedback from intervention users (patients and providers) to guide development and refinement of the new PMTCT components and inform optimal implementation. In Phase 2, we will design and develop the HITSystem 2.0 features to support key PMTCT outcomes guided by clinical content experts and findings from Phase 1. Phase 3 will assess complete PMTCT retention (before, during, and after delivery) using a matched randomized pilot study design in 2 hospitals over 18 months. A total of N=108 HIV-positive pregnant women (n=54 per site) will be enrolled and followed from their first PMTCT appointment until infant HIV DNA Polymerase Chain Reaction testing at the target age of 6 weeks (<7 weeks) postnatal.

Interoperability plays a key role in the future of digital health. It allows seamless workflows by connecting patients, technologies and stakeholders into a unified healthcare ecosystem. Standardized data transactions allow millions of interconnected devices, applications, machines, people and stakeholders to reliably exchange and interpret health data, while preserving data privacy and uniqueness. Interoperability connects devices, applications, stakeholders and services to the healthcare ecosystem. It also refers to the seamless and reliable exchange of data between devices, applications, back-end integrations and big data infrastructures, while providing and preserving the unique data privacy of individual patients. A unique digital health ecosystem enables a unified data flow around the patient, where points of care, stakeholders and devices come together and securely connect, allowing data to flow to and from individual patients and their physical and digital health. Seamless workflows of connected devices allow stakeholders to increase healthcare system performance and transparency, while reducing costs, effort, errors, fraud and delays. Digital and data-driven patient engagement solutions connected to point of care, patient generated health data, social determinants and back-end infrastructure drive seamless and meaningful patient participation into a digital health ecosystem. From a digital health ecosystem perspective, relevant focus areas of medical device interoperability include remote and point-of-care diagnostic solutions, sensor-based and digital treatments delivered from wearables, implanted devices, connected pharmaceuticals, bio-responsive digital therapies, advanced telehealth solutions and patient-centered care connectivity during the perioperative period. A unique digital health ecosystem enables a unified data flow around the patient through connected point-of-care diagnostic devices, sensors, data analytics infrastructure and digital health solutions, while allowing secure access to Deep Science Publishing

Background: Primary care health professionals, especially family physicians, see a variety of wounds, and yet-despite the frequency of providing wound care-many family physicians do not feel confident in wound care management. This is partly due to a lack of formal wound education in Family Medicine programs. While there are numerous electronic wound care resources available in the UK and North America, none were identified that address the specific need in supporting clinical decision-making in wound dressing selection. At the same time, healthcare providers are increasingly using technology in personal and professional contexts, and a logical extension is to use technology for knowledge translation strategies. Objective: This work developed a prototype mobile health software application named WounDS, designed to support clinical decision-making in selecting wound dressings. This article presents the development and evaluation plan for the WounDS app. Methods: WounDS has been developed on the iOS platform. The primary specification included ease of use, in that one of the primary influences in user adoption would be the ability to receive a wound dressing recommendation in under 30 seconds and under 5 taps on the screen. The WounDS app guides users through a series of binary decisions for assessing the wound and provides a wound dressing recommendation. The selection algorithm is based in best practices using the Wound Bed Preparation Paradigm. Results: Current work is underway to examine the implementation needs for WounDS to be most effectively utilized and to pilot test its feasibility and use in clinical care. Data will be collected through user trials, focus groups, and user metadata will be collected within the app. Optimizing these preconditions will enable a subsequent phase of study to determine effects on clinical decision-making and clinical outcomes. WounDS is designed for knowledge translation, use of technology in clinical decision-making, and continuity of care. The benefits of WounDS include the potential to improve healthcare providers' competency in wound management and to improve wound healing through better alignment with evidence-based best practices in wound dressing selection, consistency in care from primary to community care, and subsequent downstream impacts in quality of life for patients.

This report provides a comprehensive literature overview of Digital Health and Artificial Intelligence (AI) in healthcare within Bulgaria, aligning with the "Digital Health: Implementation, Governance, Deliberation" project (BG-RRP-2.2018-0004). The Bulgarian government views digital transformation in healthcare as a key national priority, aiming to improve quality of life and service delivery, notably through the National Health Strategy 2030.

The methodology involved a profound literature review using both manual and AI-assisted searches across academic repositories and national/European reports. The objective is to map the evolution of digital health implementation in Bulgaria, identify strengths and weaknesses, and propose a Framework for Implementation, Governance, and Democratic Deliberation of digital health (FIGDD). This will inform future empirical research, including questionnaires and interviews with medical personnel, to ensure alignment with national, European, and WHO standards.

While Bulgaria has made significant strides, particularly with the post-2020 acceleration in digitalization and the successful implementation of the National Health Information System (NHIS), challenges persist. These include a fragmented legal framework, issues with data interoperability, and existing digital literacy gaps among professionals and patients. Although an AI strategy is in place, Bulgaria's scientific output in this field remains modest. The report highlights governmental strategies, university involvement, emerging HealthTech startups, and discussions on ethical and philosophical considerations surrounding AI in medicine. The findings underscore the need for continued investment, regulatory clarity, and enhanced digital education to foster a truly integrated and patient-centered digital healthcare ecosystem in Bulgaria.

We conducted a systematic review of studies on mHealth and health care services delivery that were carried out within Africa. Our search process was through MEDLINE, and then on PubMed, we searched key terms based on various keywords: “Whatsapp, health, Africa, Text messages, health impact, Africa, mHealth tools, Africa”. This was done in December of 2018. Only English written articles from journals indexed in Science Citation Index Expanded and Social Science Citation Index were incorporated in this review. In line with our inclusion criteria, only a total of 19 out of 155 studies were relevant. Inferences from these studies showed that mHealth tools are speedy and quality means for health care delivery in Africa. We also found out that there is less usage of internet devices in Africa as suspected. There is a serious need for improvement in the use of other online based mHealth tools as it was found that the use of Short Messaging Service (SMS) has been the nearly the sole mHealth...

El presente trabajo desarrolla el aporte de la Red de Oficinas de Comunicación a Distancia (OCD) Telesalud en la concreción del derecho de acceso a la salud en Niños, Niñas y Adolescentes (NNyA) en diálogo con la legislación internacional y argentina. Para ello realiza un análisis documental y retoma experiencias de la red a partir de crónicas y observaciones participantes de reuniones interinstitucionales. Describe el desarrollo de la red, desde su nacimiento en 1997, fortalecido por un entramado de personas e instituciones que resuelven consultas local o regionalmente, al consultar instituciones más cercanas, y así evitar el traslado de NNyA hasta las capitales de provincia o incluso a la Ciudad de Buenos Aires, en un país de 2.780.000 km2. Las conclusiones también identifican las fortalezas y las oportunidades de mejora de la red OCD Telesalud, que mediante el trabajo interinstitucional e interdisciplinario favorece la concreción del derecho a la salud de NNyA facilitando el acce...

UNSTRUCTURED Health communication campaigns often suffer from the shortcomings of a limited budget and limited reach, resulting in a limited impact. This paper suggests a shift to audience-centered communication platforms – particularly apps on mobile phones. By using a common platform, multiple interventions and campaigns can combine resources and increase user engagement, resulting in a larger impact on health behavior. Given the widespread use of mobile phones, mobile apps can be an effective and efficient tool to provide health interventions. One such platform is Father’s Playbook, a mobile app designed for men to be more involved during their partner’s pregnancy. Health campaigns and interventions looking to reach expectant fathers can use Father’s Playbook as a vehicle for their messages.

Hospital Information System (HIS) membantu digitalisasi layanan rumah sakit di Indonesia. Meski bermanfaat, implementasinya menghadapi tantangan seperti keamanan data, keterbatasan SDM, dan fragmentasi sistem. Dengan strategi tepat, HIS berpotensi meningkatkan efisiensi, mutu pelayanan, dan integrasi sistem kesehatan nasional secara berkelanjutan.

Pemerintah daerah di Kabupaten Pandeglang menghadapi tantangan dalam meningkatkan kualitas pelayanan publik dan efisiensi administrasi melalui sistem informasi yang ada. Seiring dengan perkembangan teknologi, kecerdasan buatan (Artificial Intelligence/AI) menawarkan potensi besar untuk menyempurnakan sistem informasi pemerintah daerah. Penelitian ini bertujuan untuk mengeksplorasi pemanfaatan kecerdasan buatan dalam penyempurnaan sistem informasi di Kabupaten Pandeglang, dengan fokus pada peningkatan efisiensi operasional, kualitas pengambilan keputusan, dan pelayanan publik. Metode yang digunakan dalam penelitian ini adalah pendekatan kualitatif dengan studi kasus, yang melibatkan analisis data primer dari wawancara dengan stakeholder terkait, serta studi literatur mengenai aplikasi AI dalam pemerintahan daerah. Hasil penelitian menunjukkan bahwa penerapan AI dalam sistem informasi pemerintah daerah dapat meningkatkan akurasi data, mempercepat proses administrasi, serta mempermudah pengawasan dan evaluasi kebijakan. Selain itu, AI juga dapat berperan dalam analisis prediktif untuk perencanaan pembangunan yang lebih tepat sasaran. Meskipun demikian, tantangan dalam implementasi AI seperti keterbatasan sumber daya manusia yang terampil dan masalah infrastruktur teknologi perlu mendapatkan perhatian lebih. Penelitian ini memberikan rekomendasi untuk pengembangan kapasitas sumber daya manusia dan pemanfaatan teknologi yang lebih optimal guna mendukung keberhasilan penerapan AI dalam pemerintahan daerah di Kabupaten

The Eye and Cataract Clinic Tambun Bungai Palangka Raya has embraced digital transformation through the implementation of the Kanza Management Information System (MIS) since 2020. This shift was primarily driven by the clinic's collaboration with BPJS, requiring integrated and real-time patient data management. This study adopts a descriptive approach to explore how the digital system enhances healthcare service delivery, particularly in managing patient registration, medical records, diagnostic coding, and medication logistics. The Kanza MIS offers specific features such as detailed diagnosis codes and a comprehensive list of medications tailored to ophthalmic care. Despite these advancements, online registration is still conducted manually through messaging services like WhatsApp or SMS and remains unintegrated with the system. Data security is maintained through cloud-based storage, while backup power systems are in place to mitigate data loss during outages. Overall, the MIS has significantly improved the clinic's efficiency and reliability in delivering eye care services, though further system integration is recommended to optimize performance.