A reusable application framework for context-aware mobile patient monitoring systems

The development of Context-aware Mobile Patient Monitoring Systems (CaMPaMS) using wireless sensors is very complex. To overcome this problem, the Context-aware Mobile Patient Monitoring Framework (CaMPaMF) was introduced as an ideal reuse technique to enhance the overall development quality and overcome the development complexity of CaMPaMS. While a few studies have designed reusable CaMPaMFs, there has not been enough study looking at how to design and evaluate application frameworks based on multiple reusability aspects and multiple reusability evaluation approaches. Furthermore, there also has not been enough study that integrates the identified domain requirements of CaMPaMS. Therefore, the aim of this research is to design a reusable CaMPaMF for CaMPaMS. To achieve this aim, twelve methods were used: literature search, content analysis, concept matrix, feature modelling, use case assortment, domain expert review, model-driven architecture approach, static code analysis, reusability model approach, prototyping, amount of reuse calculation, and software expert review. The primary outcome of this research is a reusable CaMPaMF designed and evaluated to capture reusability from different aspects. CaMPaMF includes a domain model validated by consultant physicians as domain experts, an architectural model, a platform-independent model, a platform-specific model validated by software expert review, and three CaMPaMS prototypes for monitoring patients with hypertension, epilepsy, or diabetes, and multiple reusability evaluation approaches. This research contributes to the body of software engineering knowledge, particularly in the area of design and evaluation of reusable application frameworks. Researchers can use the domain model to enhance the understanding of CaMPaMS domain requirements, thus extend it with new requirements. Developers can also reuse and extend CaMPaMF to develop various CaMPaMS for different diseases. Software industries can also reuse CaMPaMF to reduce the need to consult domain experts and the time required to build CaMPaMS from scratch, thus reducing the development cost and time

Assessing The Role of Anti-Filarial Antibody As A Community Infection Indicator In Areas Treated With Double- or Triple- Mass Drug Administration In Quartier Morin Haiti

In the global effort to eliminate lymphatic filariasis (LF) additional treatment regimens like triple drug therapy and diagnostic tools like Wb123 anti-filarial antibody have become increasingly available. This study aimed to look at two components, time and treatment regimen, in order to assess prevalence of anti-filarial antibody and its programmatic potential in the evolving Global Programme to Eliminate Lymphatic Filariasis (GPELF) setting. At year 0, 2,394 (47.4%) samples were collected from participants before mass drug administration (MDA) was administered and 2,656 (52.6%) were collected 12 months later (year 1). Blood samples from 4,939 (97.8%) participants 5 years of age and older were tested for antigen status by filariasis test strip (FTS) and dried blood spots (DBS) from 4,740 (93.9%) participants were tested for Wb123 antibodies. Our results show older individuals were more likely to be both antigen and antibody positive than younger children. Overall and across most age groups antibody prevalence was higher than antigen prevalence for both drug arms. Individuals living in localities treated with the double drug regimen had 66% greater chance of demonstrating declining antibody prevalence than those living in localities treated with the triple drug regimen. The results of this investigation support treatment with both MDA regimens and the addition of antibody testing as a surveillance tool. Our results have contributed to the evidence base surrounding population-level antibody data and help to inform programmatic decision making around treatment strategies

Conceptual Drivers for an Exploration Medical System

Interplanetary spaceflight, such as NASA's proposed three-year mission to Mars, provides unique and novel challenges when compared with human spaceflight to date. Extended distance and multi-year missions introduce new elements of operational complexity and additional risk. These elements include: inability to resupply medications and consumables, inability to evacuate injured or ill crew, uncharted psychosocial conditions, and communication delays that create a requirement for some level of autonomous medical capability. Because of these unique challenges, the approaches used in prior programs have limited application to a Mars mission. On a Mars mission, resource limitations will significantly constrain available medical capabilities, and require a paradigm shift in the approach to medical system design and risk mitigation for crew health. To respond to this need for a new paradigm, the Exploration Medical Capability (ExMC) Element is assessing each Mars mission phase-transit, surface stay, rendezvous, extravehicular activity, and return-to identify and prioritize medical needs for the journey beyond low Earth orbit (LEO). ExMC is addressing both planned medical operations, and unplanned contingency medical operations that meld clinical needs and research needs into a single system. This assessment is being used to derive a gap analysis and studies to support meaningful medical capabilities trades. These trades, in turn, allow the exploration medical system design to proceed from both a mission centric and ethics-based approach, and to manage the risks associated with the medical limitations inherent in an exploration class mission. This paper outlines the conceptual drivers used to derive medical system and vehicle needs from an integrated vision of how medical care will be provided within this paradigm. Keywords: (Max 6 keywords: exploration, medicine, spaceflight, Mars, research, NASA

FARMAPRICE: A Pharmacogenetic Clinical decision support system for precise and Cost-Effective Therapy

Pharmacogenetic (PGx) guidelines for the precise dosing and selection of drugs remain poorly implemented in current clinical practice. Among the barriers to the implementation process is the lack of clinical decision support system (CDSS) tools to aid health providers in managing PGx information in the clinical context. The present study aimed to describe the first Italian endeavor to develop a PGx CDSS, called FARMAPRICE. FARMAPRICE prototype was conceived for integration of patient molecular data into the clinical prescription process in the Italian Centro di Riferimento Oncologico (CRO)-Aviano Hospital. It was developed through a coordinated partnership between two high-tech companies active in the computerization of the Italian healthcare system. Introducing FARMAPRICE into the clinical setting can aid physicians in prescribing the most efficacious and cost-effective pharmacological therapy available

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Enhancing diabetes self-management through mobile phone application

Mary Adu adopted a systematic health behavioural framework and user engagement process to develop and explore the efficacy of a novel mobile-phone app for diabetes self-management. Reported benefits of the app provide empirical evidence of support for its multi-feature functionality and comprehensive interventional role in diabetes self-management education and support

Enabling Sophisticated Lifecycle Support for Mobile Healthcare Data Collection Applications

The widespread dissemination of smart mobile devices enables new ways of collecting longitudinal data sets in a multitude of healthcare scenarios. On the one hand, mobile data collection can be accomplished more effectively and quicker compared with validated paper-based instruments. On the other hand, it can increase the data quality significantly and enable data collection in scenarios not covered by existing approaches so far. Previous attempts to utilize smart mobile devices for collecting data in these scenarios, however, often struggle with high costs for developing and maintaining mobile applications, which need to run on a multitude of mobile operating systems. Therefore, in the QuestionSys project, we are developing a generic (i.e., platform-independent) framework for enabling mobile data collection and sensor data integration in healthcare scenarios. The latter, in turn, is addressed by a model-driven approach, which is shown this paper along with the core components of the QuestionSys framework. In particular, it is shown how healthcare experts are empowered to create mobile data collection and sensing applications on their own and with reasonable efforts

Development and Initial Validation of a Questionnaire to Measure Health-Related Quality of Life of Adults with Common Variable Immune Deficiency: The CVID_QoL Questionnaire.

BACKGROUND: Generic health status quality of life (QoL) instruments have been used in patients with common variable immune deficiency (CVID). However, by their nature, these tools may over- or underestimate the impact of diseases on an individual's QoL. OBJECTIVE: The objective of this study was to develop and validate a questionnaire to measure specific-health-related QoL for adults with CVID (CVID_QoL). METHODS: The 32-item content of the CVID_QoL questionnaire was developed using focus groups and individual patient interviews. Validation studies included 118 adults with CVID who completed Short Form-36, Saint George Respiratory Questionnaire, General Health Questionnaire-12, and EuroQol-5D questionnaire in a single session. Principal component and factor analysis solutions identified 3 scores to be similar in number and content for each solution. Validation of 3 factor scores was performed by construct validity. Reproducibility, reliability, convergent validity, and discriminant validity were evaluated. Matrices consisting of correlations between the 32 items in the CVID_QOL were calculated. RESULTS: Factor analysis identified 3 dimensions: emotional functioning (EF), relational functioning (RF), and gastrointestinal and skin symptoms (GSS). The instrument had good internal consistency (Cronbach's alpha, min. 0.74 for GSS, max. 0.84 for RF, n = 118) and high reproducibility (intraclass correlation coefficient, min. 0.79 for RF, max 0.90 for EF, n = 27). EF and RF scores showed good convergent validity correlating with conceptually similar dimensions of other study scales. Acute and relapsing infections had a significant impact on EF and RF. CONCLUSIONS: This study provides evidence of the reliability and construct validity of the CVID_QoL to identify QoL issues in patients with CVID that may not be addressed by generic instruments

Mobile device acceptance in nursing education

Mobile devices such as smartphones and tablets are being used in healthcare settings for better patient outcomes. By laying the foundation for mobile device use in the educational setting, students can be better prepared for nursing practice in this technology-rich environment (National League for Nursing [NLN], 2008). The purpose of this cross-sectional study was to investigate the mobile device acceptance (MDA) model that guides nursing students’ decision to use mobile devices as educational tools. The MDA model also guides the measurement development and psychometrics testing for the MDA constructs in order to understand mobile device use and to examine correlates in the nursing student population. The study included variables that measure diversity including students who are first generation college students (FGCS), English as a second language (ESL), Pell grant eligible, recipient of welfare/public housing, and ethnic minority. The study also tested moderating effects between demographic variables and MDA constructs. The study sample included 327 nursing students from two BSN programs who completed the study instrument. The results showed that the MDA instrument had strong reliability and promising construct validity. Diverse students (i.e., FGCS, ESL, Pell grant eligible, recipient of welfare, ethnic minority) had significantly higher MDA scores than non-diverse students. Age was considered a main variable in the MDA model. The preferred size and function of device had significant MDA results. Based on the regression analysis, three predictor variables (i.e., diversity, social persuasion, and affective state) explained a small percentage of variance in the standardized test scores (i.e., ATI). Nursing educators can support diverse nursing students through the continued use of mobile devices in the nursing curriculum. Further examination is needed to see if diverse students are affected more than non-diverse students by not gaining admission into nursing programs. As mobile devices continue to be embedded into health care, nurse educators and students can use them in educational settings