Mobile apps for health behaviour change in physical activity, diet, drug and alcohol use, and mental health: a systematic review

Background: With a growing focus on patient interaction with health management, mobile apps are increasingly used to deliver behavioural health interventions. The large variation in these mobile health apps - their target patient group, health behaviour, and behavioural change strategies - has resulted in a large but incohesive body of literature. Objective: The purpose of this systematic review was to assess the effectiveness of mobile apps at improving health behaviours and outcomes, and to examine the inclusion and effectiveness of Behaviour Change Techniques in mobile health apps. Methods: Medline, EMBASE, CINAHL, and Web of Science were systematically searched for articles published between 2014 and 2019 that evaluated mobile apps for health behaviour change. Two authors independently screened and selected studies according to the eligibility criteria. Data was extracted and risk of bias assessed by one reviewer and validated by a second reviewer. Results: 52 randomized controlled trials met the inclusion criteria and were included in analysis - 37 studies focused on physical activity, diet, or a combination of both, 11 on drug and alcohol use, and 4 on mental health. Participant perceptions were generally positive - only one app was rated as less helpful and satisfactory than the control - and the studies that measured engagement and usability found relatively high study completion rates (mean = 83.3%, n = 18) and ease of use ratings (3 significantly better than control, 9/15 rated >70%) . However, there was little evidence of changed behaviour or health outcomes. Conclusions: There was not strong evidence found to support the effectiveness of mobile apps at improving health behaviours or outcomes because few studies found significant differences between the app and control groups. Further research is needed to identify the behaviour change techniques that are most effective at promoting behaviour change. Improved reporting is necessary to accurately evaluate the mobile health app effectiveness and risk of bias

Topical steroid therapy for the treatment of eosinophilic esophagitis (EoE): a systematic review and meta-analysis

OBJECTIVES: Current guidelines recommend topical steroids as first-line treatment for patients with eosinophilic esophagitis (EoE). However, the evidence for this approach has been inconsistent in earlier reports. This meta-analysis aimed to clarify the efficacy of topical steroid treatment in active EoE using updated evidence. METHODS: CENTRAL, MEDLINE and EMBASE databases were searched for randomized controlled trials (RCTs) published up to May 2014 that compared topical steroids with control treatments for active EoE. Study bias was assessed using the Cochrane Collaboration Tool, and outcomes were pooled using random effects models. The primary outcome was the mean change in eosinophil counts. Secondary outcomes were symptom responses and adverse events. RESULTS: In total, seven RCTs (226 patients) were included. Topical steroids were associated with a significant reduction in esophageal mucosal eosinophil counts compared with control therapy although substantial heterogeneity between studies was observed (weighted mean difference (WMD) −27.2, 95% confidence interval (CI) − 45.3 to −9.1, I2=56.2%). Subgroup analysis indicated the reduction in eosinophil counts was only present in studies where a proton pump inhibitor (PPI) trial was used to exclude other diagnoses (WMD −46.3, 95% CI − 61.3 to − 31.4, I2=0.0%). Subdivision of studies on the use of a PPI trial also accounted for the majority of heterogeneity among RCTs. No clear trends in symptom resolution were observed. Eleven out of 127 patients who received topical steroids developed asymptomatic esophageal candidiasis. CONCLUSIONS: These data provide updated high-quality evidence that support current guidelines for first-line EoE treatment with topical steroids after an initial PPI trial to exclude non-EoE pathologies (PROSPERO ID: CRD42014008828).Ming-yu (Anthony) Chuang, Mohamed A. Chinnaratha, David G. Hancock, Richard Woodman, Geoffrey R. Wong, Charles Cock, and Robert JL. Frase

Engineering requirements of a Herpes simplex virus patient registry: discovery phase of a real-world evidence platform to advance pharmacogenomics and personalized medicine

Comprehensive pharmacogenomic understanding requires both robust genomic and demographic data. Patient registries present an opportunity to collect large amounts of robust, patient-level data. Pharmacogenomic advancement in the treatment of infectious diseases is yet to be fully realised. Herpes simplex virus (HSV) is one disease for which pharmacogenomic understanding is wanting. This paper aims to understand the key factors that impact data collection quality for medical registries and suggest potential design features of an HSV medical registry to overcome current constraints and allow for this data to be used as a complement to genomic and clinical data to further the treatment of HSV. This paper outlines the discovery phase for the development of an HSV registry with the aim of learning about the users and their contexts, the technological constraints and the potential improvements that can be made. The design requirements and user stories for the HSV registry have been identified for further alpha phase development. The current landscape of HSV research and patient registry development were discussed. Through the analysis of the current state of the art and thematic user analysis, potential design features were elucidated to facilitate the collection of high-quality, robust patient-level data which could contribute to advances in pharmacogenomic understanding and personalised medicine in HSV. The user requirements specification for the development of an HSV registry has been summarised and implementation strategies for the alpha phase discussed

Prioritising prevention strategies for patients in antiretroviral treatment programmes in resource-limited settings

Expanded access to antiretroviral therapy (ART) offers opportunities to strengthen HIV prevention in resource-limited settings. We invited 27 ART programmes from urban settings in Africa, Asia and South America to participate in a survey, with the aim to examine what preventive services had been integrated in ART programmes. Twenty-two programmes participated; eight (36%) from South Africa, two from Brazil, two from Zambia and one each from Argentina, India, Thailand, Botswana, Ivory Coast, Malawi, Morocco, Uganda and Zimbabwe and one occupational programme of a brewery company included five countries (Nigeria, Republic of Congo, Democratic Republic of Congo, Rwanda and Burundi). Twenty-one sites (96%) provided health education and social support, and 18 (82%) provided HIV testing and counselling. All sites encouraged disclosure of HIV infection to spouses and partners, but only 11 (50%) had a protocol for partner notification. Twenty-one sites (96%) supplied male condoms, seven (32%) female condoms and 20 (91%) provided prophylactic ART for the prevention of mother-to child transmission. Seven sites (33%) regularly screened for sexually transmitted infections (STI). Twelve sites (55%) were involved in activities aimed at women or adolescents, and 10 sites (46%) in activities aimed at serodiscordant couples. Stigma and discrimination, gender roles and funding constraints were perceived as the main obstacles to effective prevention in ART programmes. We conclude that preventive services in ART programmes in lower income countries focus on health education and the provision of social support and male condoms. Strategies that might be equally or more important in this setting, including partner notification, prompt diagnosis and treatment of STI and reduction of stigma in the community, have not been implemented widely

The Body Dances: Carnival Dance and Organization

Building on the work of Pierre Bourdieu and Maurice Merleau-Ponty we seek to open up traditional categories of thought surrounding the relation `body-organization' and elicit a thought experiment: What happens if we move the body from the periphery to the centre? We pass the interlocking theoretical concepts of object-body/subject-body and habitus through the theoretically constructed empirical case of `carnival dance' in order to re-evaluate such key organizational concepts as knowledge and learning. In doing so, we connect with an emerging body of literature on `sensible knowledge'; knowledge that is produced and preserved within bodily practices. The investigation of habitual appropriation in carnival dance also allows us to make links between repetition and experimentation, and reflect on the mechanism through which the principles of social organization, whilst internalized and experienced as natural, are embodied so that humans are capable of spontaneously generating an infinite array of appropriate actions. This perspective on social and organizational life, where change and permanence are intricately interwoven, contrasts sharply with the dominant view in organization studies which juxtaposes change/ creativity and stability

The New ‘Hidden Abode’: Reflections on Value and Labour in the New Economy

In a pivotal section of Capital, volume 1, Marx (1976: 279) notes that, in order to understand the capitalist production of value, we must descend into the ‘hidden abode of production’: the site of the labour process conducted within an employment relationship. In this paper we argue that by remaining wedded to an analysis of labour that is confined to the employment relationship, Labour Process Theory (LPT) has missed a fundamental shift in the location of value production in contemporary capitalism. We examine this shift through the work of Autonomist Marxists like Hardt and Negri, Lazaratto and Arvidsson, who offer theoretical leverage to prize open a new ‘hidden abode’ outside employment, for example in the ‘production of organization’ and in consumption. Although they can open up this new ‘hidden abode’, without LPT's fine-grained analysis of control/resistance, indeterminacy and structured antagonism, these theorists risk succumbing to empirically naive claims about the ‘new economy’. Through developing an expanded conception of a ‘new hidden abode’ of production, the paper demarcates an analytical space in which both LPT and Autonomist Marxism can expand and develop their understanding of labour and value production in today's economy. </jats:p

Biopython: freely available Python tools for computational molecular biology and bioinformatics

Summary: The Biopython project is a mature open source international collaboration of volunteer developers, providing Python libraries for a wide range of bioinformatics problems. Biopython includes modules for reading and writing different sequence file formats and multiple sequence alignments, dealing with 3D macro molecular structures, interacting with common tools such as BLAST, ClustalW and EMBOSS, accessing key online databases, as well as providing numerical methods for statistical learning. Availability: Biopython is freely available, with documentation and source code at www.biopython.org under the Biopython license. Contact: All queries should be directed to the Biopython mailing lists, see www.biopython.org/wiki/[email protected]

Seed production from the mixed mating system of Chesapeake Bay (USA) eelgrass (Zostera marina; Zosteraceae)

In monoecious plants, gametes can be exchanged in three ways: among unrelated genets (outbreeding), with close relatives (inbreeding), or within individuals (geitonogamous selling). These different mating systems may have consequences for population demography and fitness. The experiment presented herein used artificial crosses to examine the mating system of Chesapeake Bay, Virginia, USA eelgrass (Zostera marina L; Zosteraceae), a bisexual submerged aquatic plant that can outbreed, inbreed, and self. Genetic data indicate severe heterozygosity deficiencies and patchy genotype distribution in these beds, suggesting that plants therein reproduce primarily by vegetative propagation, autogamy, or geitonogamy. To clarify eelgrass reproductive strategies, flowers from three genetically and geographically distinct beds were hand-pollinated in outbred, inbred, and selfed matings. Fertilization success and seed production, life history stages which contribute greatly to the numeric maintenance of populations, were monitored. We found no evidence that inbreeding had negative consequences for seed production. On the contrary, selfed matings produced seeds significantly more frequently than outcrossed matings and produced significantly larger numbers of seeds than either inbred or outbred matings. These results contrast with patterns for eelgrass in other regions but might be expected for similar populations in which pollen limitation or a short reproductive season renders selfing advantageous

Towards a Proof Theory of G\"odel Modal Logics

Analytic proof calculi are introduced for box and diamond fragments of basic modal fuzzy logics that combine the Kripke semantics of modal logic K with the many-valued semantics of G\"odel logic. The calculi are used to establish completeness and complexity results for these fragments