The effectiveness of M-health technologies for improving health and health services: a systematic review protocol

BACKGROUND: The application of mobile computing and communication technology is rapidly expanding in the fields of health care and public health. This systematic review will summarise the evidence for the effectiveness of mobile technology interventions for improving health and health service outcomes (M-health) around the world. FINDINGS: To be included in the review interventions must aim to improve or promote health or health service use and quality, employing any mobile computing and communication technology. This includes: (1) interventions designed to improve diagnosis, investigation, treatment, monitoring and management of disease; (2) interventions to deliver treatment or disease management programmes to patients, health promotion interventions, and interventions designed to improve treatment compliance; and (3) interventions to improve health care processes e.g. appointment attendance, result notification, vaccination reminders.A comprehensive, electronic search strategy will be used to identify controlled studies, published since 1990, and indexed in MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, the Cochrane Library, or the UK NHS Health Technology Assessment database. The search strategy will include terms (and synonyms) for the following mobile electronic devices (MEDs) and a range of compatible media: mobile phone; personal digital assistant (PDA); handheld computer (e.g. tablet PC); PDA phone (e.g. BlackBerry, Palm Pilot); Smartphone; enterprise digital assistant; portable media player (i.e. MP3 or MP4 player); handheld video game console. No terms for health or health service outcomes will be included, to ensure that all applications of mobile technology in public health and health services are identified. Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies. Data on objective and self-reported outcomes and study quality will be independently extracted by two review authors. Where there are sufficient numbers of similar interventions, we will calculate and report pooled risk ratios or standardised mean differences using meta-analysis. DISCUSSION: This systematic review will provide recommendations on the use of mobile computing and communication technology in health care and public health and will guide future work on intervention development and primary research in this field

Using marketing theory to inform strategies for recruitment : a recruitment optimisation model and the txt2stop experience

Background: Recruitment is a major challenge for many trials; just over half reach their targets and almost a third resort to grant extensions. The economic and societal implications of this shortcoming are significant. Yet, we have a limited understanding of the processes that increase the probability that recruitment targets will be achieved. Accordingly, there is an urgent need to bring analytical rigour to the task of improving recruitment, thereby increasing the likelihood that trials reach their recruitment targets. This paper presents a conceptual framework that can be used to improve recruitment to clinical trials. Methods: Using a case-study approach, we reviewed the range of initiatives that had been undertaken to improve recruitment in the txt2stop trial using qualitative (semi-structured interviews with the principal investigator) and quantitative (recruitment) data analysis. Later, the txt2stop recruitment practices were compared to a previous model of marketing a trial and to key constructs in social marketing theory. Results: Post hoc, we developed a recruitment optimisation model to serve as a conceptual framework to improve recruitment to clinical trials. A core premise of the model is that improving recruitment needs to be an iterative, learning process. The model describes three essential activities: i) recruitment phase monitoring, ii) marketing research, and iii) the evaluation of current performance. We describe the initiatives undertaken by the txt2stop trial and the results achieved, as an example of the use of the model. Conclusions: Further research should explore the impact of adopting the recruitment optimisation model when applied to other trials

Audio recordings dataset of grazing jaw movements in dairy cattle.

This dataset is composed of correlated audio recordings and labels of ingestive jaw movements performed during grazing by dairy cattle. Using a wireless microphone, we recorded sounds of three Holstein dairy cows grazing short and tall alfalfa and short and tall fescue. Two experts in grazing behavior identified and labeled the start, end, and type of each jaw movement: bite, chew, and chew-bite (compound movement). For each segment of raw audio corresponding to a jaw movement we computed four well-known features: amplitude, duration, zero crossings, and envelope symmetry. These features are in the dataset and can be used as inputs to build automated methods for classification of ingestive jaw movements. Cow's grazing behavior can be monitored and characterized by identifying and analyzing these masticatory events

A RELEVÂNCIA DE MÚLTIPLOS GRUPOS ZOOPLANCTÔNICOS PARA O MONITORAMENTO AMBIENTAL NO CERRADO: ESTUDO DA ESTAÇÃO ECOLÓGICA ÁGUAS EMENDADAS

Because of the growing and intense impact of human population on natural resources, environmental monitoring programs become increasingly necessary to continually evaluate such impacts and propose mitigation measures in a timely manner. However, effective monitoring programs are limited by the lack of time, fi nancial resources and qualifi ed professionals. Thus, this study aims to evaluate the most effective strategies to monitor the zooplankton community in the Lagoa Bonita, located in the Águas Emendadas Ecological Station, Planaltina (DF). The following issues were raised: (i) which is the zooplankton diversity at the study area? (ii) do the zooplankton groups show concordant patterns of spatial distribution? (iii) is there a signifi cant loss of information when using higher taxonomic levels (genera data instead of species data) and different numerical resolutions (species occurrence data instead of organisms density data?). The results of this study indicates that cladocerans, copepods and rotifers could be well evaluated in a environmental monitoring program at genus level, once the loss of species data information is low. On the other hand, all zooplankton groups and the information generated from density data must be considered.Devido ao crescente e intenso impacto da população humana sobre os recursos naturais, programas de monitoramento ambiental tornam-se cada vez mais necessários para avaliar continuamente tais impactos e propor medidas mitigadoras em tempo hábil. Entretanto, efi cientes programas de monitoramento são limitados pela falta de tempo, recursos fi nanceiros e profi ssionais qualifi cados. Desta forma, este estudo pretende avaliar estratégias mais efetivas de monitorar a comunidade zooplanctônica em um pequeno lago tropical (Lagoa Bonita, localizada na Estação Ecológica de Águas Emendadas, Brasília - DF). As seguintes questões foram levantadas: (i) qual a diversidade zooplanctônica da área de estudo? (ii) os grupos zooplanctônicos apresentam padrões de distribuição espacial concordantes? (iii) existe uma perda de informação signifi cativa ao utilizar níveis taxonômicos superiores (dados de gêneros ao invés de espécies) e resoluções numéricas diferentes (dados de ocorrência de espécies ao invés de densidades de organismos)? Os resultados desse estudo indicam que programas de monitoramento ambiental na Lagoa Bonita poderiam avaliar cladóceros, copépodes e rotíferos utilizando informações em nível de gênero, pois a perda de informação relativa aos dados de espécies é pequena. Por outro lado, todos os grupos zooplanctônicos e as informações geradas a partir de dados de densidade devem ser considerados

Dupilumab in the treatment of severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP): A multicentric observational Phase IV real-life study (DUPIREAL)

Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with significant morbidity and reduced health-related quality of life. Findings from clinical trials have demonstrated the effectiveness of dupilumab in CRSwNP, although real-world evidence is still limited. Methods This Phase IV real-life, observational, multicenter study assessed the effectiveness and safety of dupilumab in patients with severe uncontrolled CRSwNP (n = 648) over the first year of treatment. We collected data at baseline and after 1, 3, 6, 9, and 12 months of follow-up. We focused on nasal polyps score (NPS), symptoms, and olfactory function. We stratified outcomes by comorbidities, previous surgery, and adherence to intranasal corticosteroids, and examined the success rates based on current guidelines, as well as potential predictors of response at each timepoint. Results We observed a significant decrease in NPS from a median value of 6 (IQR 5–6) at baseline to 1.0 (IQR 0.0–2.0) at 12 months (p < .001), and a significant decrease in Sino-Nasal Outcomes Test-22 (SNOT-22) from a median score of 58 (IQR 49–70) at baseline to 11 (IQR 6–21; p < .001) at 12 months. Sniffin' Sticks scores showed a significant increase over 12 months (p < .001) compared to baseline. The results were unaffected by concomitant diseases, number of previous surgeries, and adherence to topical steroids, except for minor differences in rapidity of action. An excellent-moderate response was observed in 96.9% of patients at 12 months based on EPOS 2020 criteria. Conclusions Our findings from this large-scale real-life study support the effectiveness of dupilumab as an add-on therapy in patients with severe uncontrolled CRSwNP in reducing polyp size and improving the quality of life, severity of symptoms, nasal congestion, and smell

La renovación de la palabra en el bicentenario de la Argentina : los colores de la mirada lingüística

El libro reúne trabajos en los que se exponen resultados de investigaciones presentadas por investigadores de Argentina, Chile, Brasil, España, Italia y Alemania en el XII Congreso de la Sociedad Argentina de Lingüística (SAL), Bicentenario: la renovación de la palabra, realizado en Mendoza, Argentina, entre el 6 y el 9 de abril de 2010. Las temáticas abordadas en los 167 capítulos muestran las grandes líneas de investigación que se desarrollan fundamentalmente en nuestro país, pero también en los otros países mencionados arriba, y señalan además las áreas que recién se inician, con poca tradición en nuestro país y que deberían fomentarse. Los trabajos aquí publicados se enmarcan dentro de las siguientes disciplinas y/o campos de investigación: Fonología, Sintaxis, Semántica y Pragmática, Lingüística Cognitiva, Análisis del Discurso, Psicolingüística, Adquisición de la Lengua, Sociolingüística y Dialectología, Didáctica de la lengua, Lingüística Aplicada, Lingüística Computacional, Historia de la Lengua y la Lingüística, Lenguas Aborígenes, Filosofía del Lenguaje, Lexicología y Terminología

Economic consequences of investing in anti-HCV antiviral treatment from the Italian NHS perspective : a real-world-based analysis of PITER data

OBJECTIVE: We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy. METHODS: A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered. RESULTS: The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal €25 million, €15 million, and €9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were €50.13 and €55.50 million for 1000 patients treated in 2016 and 2017, respectively. CONCLUSIONS: This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV

A study of CP violation in B-+/- -> DK +/- and B-+/- -> D pi(+/-) decays with D -> (KSK +/-)-K-0 pi(-/+) final states

A first study of CP violation in the decay modes $B^\pm\to [K^0_{\rm S} K^\pm \pi^\mp]_D h^\pm$ and $B^\pm\to [K^0_{\rm S} K^\mp \pi^\pm]_D h^\pm$, where $h$ labels a $K$ or $\pi$ meson and $D$ labels a $D^0$ or $\overline{D}^0$ meson, is performed. The analysis uses the LHCb data set collected in $pp$ collisions, corresponding to an integrated luminosity of 3 fb$^{-1}$. The analysis is sensitive to the CP-violating CKM phase $\gamma$ through seven observables: one charge asymmetry in each of the four modes and three ratios of the charge-integrated yields. The results are consistent with measurements of $\gamma$ using other decay modes