The effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries: A systematic review

Background: Promoting physical activity and healthy eating is important to combat the unprecedented rise in NCDs in many developing countries. Using modern information-and communication technologies to deliver physical activity and diet interventions is particularly promising considering the increased proliferation of such technologies in many developing countries. The objective of this systematic review is to investigate the effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries. Methods: Major databases and grey literature sources were searched to retrieve studies that quantitatively examined the effectiveness of e-& mHealth interventions on physical activity and diet outcomes in developing countries. Additional studies were retrieved through citation alerts and scientific social media allowing study inclusion until August 2016. The CONSORT checklist was used to assess the risk of bias of the included studies. Results: A total of 15 studies conducted in 13 developing countries in Europe, Africa, Latin-and South America and Asia were included in the review. The majority of studies enrolled adults who were healthy or at risk of diabetes or hypertension. The average intervention length was 6.4 months, and text messages and the Internet were the most frequently used intervention delivery channels. Risk of bias across the studies was moderate (55.7 % of the criteria fulfilled). Eleven studies reported significant positive effects of an e-& mHealth intervention on physical activity and/or diet behaviour. Respectively, 50 % and 70 % of the interventions were effective in promoting physical activity and healthy diets. Conclusions: The majority of studies demonstrated that e-& mHealth interventions were effective in promoting physical activity and healthy diets in developing countries. Future interventions should use more rigorous study designs, investigate the cost-effectiveness and reach of interventions, and focus on emerging technologies, such as smart phone apps and wearable activity trackers

Therapy satisfaction and health literacy are key factors to improve medication adherence in systemic sclerosis

Although medication adherence (MA) contributes to therapeutic outcome in systemic sclerosis (SSc), research data are scarce. Factors influencing MA in SSc are hardly known. We conducted a monocentric, cross-sectional study on 85 patients with SSc at the University of Lübeck, Germany, using the Compliance Questionnaire of Rheumatology as the main measurement tool of MA. We also used the Scleroderma Health Assessment Questionnaire, Illness Perception Questionnaire – Revised, Health Literacy Questionnaire, Lübeck Medication Satisfaction Questionnaire (a novel instrument created for this study), and patients’ demographic and clinical data, to find factors contributing to MA. Good MA was seen in 51.8% of patients. MA was positively associated with therapy satisfaction (p Although most SSc patients display good MA, non-adherence remains a major problem. Patients should be assessed for non-adherence. The factors affecting MA identified herein could help to improve therapeutic outcomes.</p

Results of the analysis of excited primary-ion-beam admixtures possibly present in the experiment

<p><b>Table 1.</b> Results of the analysis of excited primary-ion-beam admixtures possibly present in the experiment. The calculations were performed using the Cowan code [<a href="http://iopscience.iop.org/0953-4075/46/17/175201/article#jpb473129bib27" target="_blank">27</a>]. The estimated fractions are the coefficients <em>k^E</em> obtained from fitting equation (<a href="http://iopscience.iop.org/0953-4075/46/17/175201/article#jpb473129eqn03" target="_blank">3</a>) to the experimental data. Calculated excitation energies are given in column 4. The experimentally obtained ionization threshold energies (T.E.), T.E. taken from NIST Atomic Spectra Database [<a href="http://iopscience.iop.org/0953-4075/46/17/175201/article#jpb473129bib28" target="_blank">28</a>] and T.E. calculated within the configuration-averaged approximation are provided in columns 5, 6 and 7, respectively. The estimated excited-levels' lifetimes and flight times of ions between the source and the interaction region are provided in the last two columns, respectively. The numbers in square brackets are powers of 10 to be multiplied with the preceding numbers, respectively.</p> <p><strong>Abstract</strong></p> <p>Electron-impact single-ionization cross sections of Sn^{<em>q</em> +} ions in charge states <em>q</em> = 4–13 with 4d^{[10 − (<em>q</em> − 4)]} outer-shell configurations have been studied in the energy range from the corresponding thresholds up to 1000 eV. Absolute cross sections and fine-step energy-scan data have been measured employing the crossed-beams technique. Contributions of different ionization mechanisms have been analysed by comparing the experimental data with calculations employing the configuration-averaged distorted wave approximation. Ionization plasma rate coefficients inferred from the experimental data are also presented.</p

Overview of the inner-subshell excitations <em>n</em>₀<em>l</em>₀ → <em>nl</em> included in the present calculations

<p><b>Table 2.</b> Overview of the inner-subshell excitations <em>n</em>₀<em>l</em>₀ → <em>nl</em> included in the present calculations. All subshells with quantum numbers <em>nl</em>, where <em>n</em> ≤ <em>n</em>_max and <em>l</em> ≤ <em>l</em>_max, providing at least one vacancy to which the <em>n</em>₀<em>l</em>₀ electron can be excited were considered. The orbital quantum numbers <em>l</em>₀, <em>l</em>_max = 0, 1, 2, ... are expressed by their spectroscopic symbols s, p, d,..., respectively. For ions in the ground-state configuration, <em>m</em> is the number of electrons in the 4d subshell. It is equal to 10 for Sn^{4 +} and 1 for Sn^{13 +}. As far as long-lived excited ions are concerned, we only had to consider 4d-subshell-excited configurations for the charge states up to <em>q</em> = 12. In the configurations of interest, the 4d subshell is initially populated with <em>m</em> − 1 electrons and the excited electron is initially in subshell <em>n</em>₁<em>l</em>₁. The subshells <em>n</em>₁<em>l</em>₁ taken into account in the present analysis are listed in table <a href="http://iopscience.iop.org/0953-4075/46/17/175201/article#jpb473129t1" target="_blank">1</a>. For the case of Sn^{13 +}, the only excited configuration of relevance to the present measurements is the 4p⁵4d² configuration.</p> <p><strong>Abstract</strong></p> <p>Electron-impact single-ionization cross sections of Sn^{<em>q</em> +} ions in charge states <em>q</em> = 4–13 with 4d^{[10 − (<em>q</em> − 4)]} outer-shell configurations have been studied in the energy range from the corresponding thresholds up to 1000 eV. Absolute cross sections and fine-step energy-scan data have been measured employing the crossed-beams technique. Contributions of different ionization mechanisms have been analysed by comparing the experimental data with calculations employing the configuration-averaged distorted wave approximation. Ionization plasma rate coefficients inferred from the experimental data are also presented.</p

The present single-ionization cross section of Sn^{12 +} compared to the results of the present CADW calculations

<p><strong>Figure 11.</strong> The present single-ionization cross section of Sn^{12 +} compared to the results of the present CADW calculations. Same notation as in figure <a href="http://iopscience.iop.org/0953-4075/46/17/175201/article#jpb473129f2" target="_blank">2</a>. The brackets with arrows denote energy ranges, where REDA processes involving 3d- and 3p-subshell excitations are to be expected. The dark-shaded area at the bottom of the graph represents the total ionization contribution of the 4d4f excited-ion beam component with an estimated fraction of 5%.</p> <p><strong>Abstract</strong></p> <p>Electron-impact single-ionization cross sections of Sn^{<em>q</em> +} ions in charge states <em>q</em> = 4–13 with 4d^{[10 − (<em>q</em> − 4)]} outer-shell configurations have been studied in the energy range from the corresponding thresholds up to 1000 eV. Absolute cross sections and fine-step energy-scan data have been measured employing the crossed-beams technique. Contributions of different ionization mechanisms have been analysed by comparing the experimental data with calculations employing the configuration-averaged distorted wave approximation. Ionization plasma rate coefficients inferred from the experimental data are also presented.</p

Ionization PRC derived from the present experimental data for Sn^{4 +} (the very top curve) through Sn^{13 +} (the very bottom curve)

<p><strong>Figure 14.</strong> Ionization PRC derived from the present experimental data for Sn^{4 +} (the very top curve) through Sn^{13 +} (the very bottom curve).</p> <p><strong>Abstract</strong></p> <p>Electron-impact single-ionization cross sections of Sn^{<em>q</em> +} ions in charge states <em>q</em> = 4–13 with 4d^{[10 − (<em>q</em> − 4)]} outer-shell configurations have been studied in the energy range from the corresponding thresholds up to 1000 eV. Absolute cross sections and fine-step energy-scan data have been measured employing the crossed-beams technique. Contributions of different ionization mechanisms have been analysed by comparing the experimental data with calculations employing the configuration-averaged distorted wave approximation. Ionization plasma rate coefficients inferred from the experimental data are also presented.</p

Overview over the present single-ionization cross sections of Sn^{4 +} through Sn^{13 +} ions

<p><strong>Figure 1.</strong> Overview over the present single-ionization cross sections of Sn^{4 +} through Sn^{13 +} ions. The cross-section scale is in units of 10⁻¹⁷ cm² and the cross section for each next ion stage is shifted downwards by 1 <b>×</b> 10⁻¹⁷ cm² and multiplied by a certain coefficient provided on the graph. The thin kinked polygon connects the ground-state ionization thresholds marked by short vertical bars.</p> <p><strong>Abstract</strong></p> <p>Electron-impact single-ionization cross sections of Sn^{<em>q</em> +} ions in charge states <em>q</em> = 4–13 with 4d^{[10 − (<em>q</em> − 4)]} outer-shell configurations have been studied in the energy range from the corresponding thresholds up to 1000 eV. Absolute cross sections and fine-step energy-scan data have been measured employing the crossed-beams technique. Contributions of different ionization mechanisms have been analysed by comparing the experimental data with calculations employing the configuration-averaged distorted wave approximation. Ionization plasma rate coefficients inferred from the experimental data are also presented.</p

The present single-ionization cross section of Sn^{8 +} compared to the results of the present CADW calculations

<p><strong>Figure 7.</strong> The present single-ionization cross section of Sn^{8 +} compared to the results of the present CADW calculations. Same notation as in figure <a href="http://iopscience.iop.org/0953-4075/46/17/175201/article#jpb473129f2" target="_blank">2</a>. The brackets with arrows denote energy ranges, where REDA processes involving 3d-subshell excitations are to be expected. The brackets with arrows denote energy ranges, where REDA processes involving 3d- and 3p-subshell excitations are to be expected. The dark-shaded area at the bottom of the graph represents the total ionization contribution of the 4d⁵4f excited-ion-beam component with an estimated fraction of 0.6%.</p> <p><strong>Abstract</strong></p> <p>Electron-impact single-ionization cross sections of Sn^{<em>q</em> +} ions in charge states <em>q</em> = 4–13 with 4d^{[10 − (<em>q</em> − 4)]} outer-shell configurations have been studied in the energy range from the corresponding thresholds up to 1000 eV. Absolute cross sections and fine-step energy-scan data have been measured employing the crossed-beams technique. Contributions of different ionization mechanisms have been analysed by comparing the experimental data with calculations employing the configuration-averaged distorted wave approximation. Ionization plasma rate coefficients inferred from the experimental data are also presented.</p

The present single-ionization cross section of Sn^{11 +} compared to the results of the present CADW calculations

<p><strong>Figure 10.</strong> The present single-ionization cross section of Sn^{11 +} compared to the results of the present CADW calculations. Same notation as in figure <a href="http://iopscience.iop.org/0953-4075/46/17/175201/article#jpb473129f2" target="_blank">2</a>. The brackets with arrows denote energy ranges, where REDA processes involving 3d- and 3p-subshell excitations are to be expected. The dark-shaded area at the bottom of the graph represents the total ionization contribution of the 4d²4f excited-ion beam component with an estimated fraction of 1%.</p> <p><strong>Abstract</strong></p> <p>Electron-impact single-ionization cross sections of Sn^{<em>q</em> +} ions in charge states <em>q</em> = 4–13 with 4d^{[10 − (<em>q</em> − 4)]} outer-shell configurations have been studied in the energy range from the corresponding thresholds up to 1000 eV. Absolute cross sections and fine-step energy-scan data have been measured employing the crossed-beams technique. Contributions of different ionization mechanisms have been analysed by comparing the experimental data with calculations employing the configuration-averaged distorted wave approximation. Ionization plasma rate coefficients inferred from the experimental data are also presented.</p

The magnified threshold energy range of the cross section of Sn^{6 +}

<p><strong>Figure 4.</strong> The magnified threshold energy range of the cross section of Sn^{6 +}. Same notation as in figure <a href="http://iopscience.iop.org/0953-4075/46/17/175201/article#jpb473129f2" target="_blank">2</a>. The vertical arrows indicate the energies of the predicted ground-state ionization threshold (arrow <em>a</em>), of the experimental threshold of the ground-state electron configuration (arrow <em>b</em>) and of an onset for calculated EA contributions (arrow <em>c</em>).</p> <p><strong>Abstract</strong></p> <p>Electron-impact single-ionization cross sections of Sn^{<em>q</em> +} ions in charge states <em>q</em> = 4–13 with 4d^{[10 − (<em>q</em> − 4)]} outer-shell configurations have been studied in the energy range from the corresponding thresholds up to 1000 eV. Absolute cross sections and fine-step energy-scan data have been measured employing the crossed-beams technique. Contributions of different ionization mechanisms have been analysed by comparing the experimental data with calculations employing the configuration-averaged distorted wave approximation. Ionization plasma rate coefficients inferred from the experimental data are also presented.</p