Aplicaciones móviles en salud: potencial, normativa de seguridad y regulación

The objective of the present study is to analyze the implications and the potential of the denominated mobile health or mHealth, as well as to revise the normative and regulations about security, developed by mobile applications in health. The use of mobile technologies to support the achievement of health goals has the potential to transform health care delivery worldwide. This includes rapid advances in technology and the exponential growth of mobile applications, leading to new opportunities for the integration of mobile health into health services. However, the quality of these applications is very variable, in terms of both their content and their functionality. Many of them are of doubtful reliability and most are not integrated into the health care system. This disorderly growth makes it necessary to establish regulatory mechanisms to ensure that these applications are used safely. The present paper discusses the steps taken on an international, regional and national level (Spain) to regulate the professional and patient use of mobile health applications and other applications aimed at disease prevention and the building of healthy habits. An analysis of the most outstanding health regulations in the field reveals that some of the applications considered to be safe by some regulatory agencies, do not pass some of the mobile security tests, such as the OWASP, established by the Open Web Application Security Project. It is therefore recommended that steps are taken to minimize the possible risks of using mobile health applications

¿Son útiles y seguras las aplicaciones móviles en salud?

[ES] La tecnología móvil ha cambiado la forma en que vivimos, trabajamos y nos comunicamos afectando a todas las esferas de nuestra vida. Oficialmente según GSMA ya hay más dispositivos móviles que personas en el mundo (Julio Alonso-Arévalo, 2017)3. El campo de la salud móvil se ha convertido en un sub-segmento de la eSalud, que tiene que ver con el uso de los avances tecnológicos, tales como teléfonos móviles, GPS, apps o monitores de pacientes en los servicios de Salud e información. Así, el uso de las tecnologías móviles para apoyar el logro de objetivos de salud se denomina Salud móvil o mHealth, y tiene un potencial importante para transformar la prestación de servicios de salud en todo el mundo, tal como se reconoce el Libro Verde sobre la Salud móvil publicado por la Comisión Europe

Mobile health applications: potential, regulation and security

[ES] El objetivo del presente trabajo es analizar las implicaciones y el potencial de lo que se ha denominado salud móvil o mHealth, así como revisar las normativas y regulaciones sobre seguridad desarrolladas por aplicaciones móviles en salud. Entendemos por seguridad móvil, la capacidad de hacer un uso confiable de una aplicación móvil, en términos de rendimiento, medición adecuada y privacidad de los datos. El uso de las tecnologías móviles para apoyar el logro de los objetivos de salud tiene el potencial de transformar la prestación de servicios de salud en todo el mundo. Esto incluye rápidos avances en el ámbito tecnológico y el crecimiento exponencial de las aplicaciones móviles, lo que conlleva nuevas oportunidades para la integración de la salud móvil en los servicios sanitarios. Sin embargo, la calidad de estas apps es muy variable, tanto en contenidos como en funcionalidades. Muchas de ellas son de dudosa fiabilidad y la mayoría no están integradas en el sistema sanitario. Este crecimiento desordenado hace necesario establecer mecanismos de regulación que garanticen que estas aplicaciones se utilicen con seguridad. En este documento se analizan los esfuerzos de regulación a nivel internacional, regional y nacional (España) de las aplicaciones móviles sobre salud, tanto para uso profesional como para el uso por parte de pacientes, y otras aplicaciones orientadas hacia la prevención y los hábitos saludables. Tras un análisis de las normativas de salud más destacadas en el ámbito, se observa que algunas de las aplicaciones que son consideradas como seguras por parte de algunos organismos reguladores, no superan algunos de los tests de seguridad móvil, tales como Open Web Application Security Project, por lo cual se recomienda la existencia de medidas que minimicen los posibles riesgos del uso de aplicaciones móviles en salud

Val247Leu beta2-glycoprotein-I allelic variant is associated with antiphospholipid syndrome: Systematic review and meta-analysis

[EN] Previous studies have suggested that the possession of the Val/Val genotype of the Val247Leu polymorphism of the β2-glycoproteinI (β2-GPI) gene may be associated with antiphospholipid syndrome (APS), and, among patients with APS, with the production of anti-β2-GPI antibodies or the development of thrombosis. Given the controversial results reported, the aim of this work is to combine previous findings by means of a systematic review and a meta-analysis. Methods: We retrieved studies analyzing the genotype of the above-mentioned polymorphism among patients with APS by means of electronic database search. A meta-analysis was conducted in a random effects model and calculations of odds ratio (OR) and confidence intervals (CI) were done. Sensitivity analysis and tests for heterogeneity of the results were performed. Results: Eight previous studies analyzed the association of APS, anti-β2-GPI antibodies and/or thrombosis with the Val247Leu polymorphism. After meta-analysis, patients with APS had a significantly higher prevalence of the Val/ Val genotype of this genetic variant when compared with controls (OR=2.04; 95% CI: 1.12, 3.73; P=0.02). Among patients with APS, those with anti-β2-GPI antibodies had a higher prevalence of this genotype (OR=1.73; 95% CI: 1.04, 2.87; P=0.03). No significant results were found for the presence of arterial or venous thrombosis. Conclusions: Val/Val genotype of β2-GPI gene is associated with a significant excess risk to suffer from APS and, among patients with APS, to have anti-β2-GPI antibodies. No definite conclusions can be made regarding the association of this polymorphism with thrombosis among APS patients. © 2

Self-direct Learning by E-book for the Control and Prevention of HCAI

[EN] A teaching experience related to the evaluation of self-learning in the control and prevention of Healthcare-Related Infections (HCAI) in healthcare settings is presented. For this purpose, we have considered the measurement of self-learning through the pedagogical E-book designed for this reason. The measurement procedure aims to determine the assessment made by nursing students, since they are the ones to whom this training support is addressed. The procedure initially poses to the students the completion of different tasks that are managed in the training support. Subsequently, an individual evaluation of its use is made by means of a structured questionnaire and another group evaluation by means of a focus group. The results show the functionality of the E-book to transfer the training contents on control and prevention of HCAI in health care settings in an autonomous way, as well as to acquire and develop key competencies in the professional practice of nursing

La lectura y su relación con la salud y el bienestar de las personas

The aim of this study was to try to identify the elements of reading that involve us most powerfully in this activity, in order to determine how reading habits affect health. To this end, a survey was designed and distributed among people who habitually read, from the Autonomous Communities of Castilla y León, Extremadura, Madrid, and Asturias. In this, the respondents had to assess those aspects that they considered most important for them regarding reading: tranquility, fun, information, and others. Collected and analyzed 255 responses, the results highlight that, above traditional functions related to training and information, the respondents valued most the healing aspects of reading, such as alleviating loneliness, avoiding negative thoughts and managing emotions better

La lectura y su relación con la salud y el bienestar de las personas

The aim of this study was to try to identify the elements of reading that involve us most powerfully in this activity, in order to determine how reading habits affect health. To this end, a survey was designed and distributed among people who habitually read, from the Autonomous Communities of Castilla y León, Extremadura, Madrid, and Asturias. In this, the respondents had to assess those aspects that they considered most important for them regarding reading: tranquility, fun, information, and others. Collected and analyzed 255 responses, the results highlight that, above traditional functions related to training and information, the respondents valued most the healing aspects of reading, such as alleviating loneliness, avoiding negative thoughts and managing emotions better

La lectura y su relación con la salud y el bienestar de las personas

[ES] El objetivo de este estudio fue identificar los elementos de la lectura que nos implican más poderosamente en esta actividad y su relación con la salud. Para esto se diseñó y distribuyó una encuesta entre personas que habitualmente leen, pertenecientes a las Comunidades autónomas de Castilla y León, Extremadura, Madrid y Asturias. En esta, los encuestados tenían que valorar aquellos aspectos que consideraban más importantes para ellos respecto a la lectura: tranquilidad, diversión, información y otros. Recogidas y analizadas 255 respuestas, los resultados pusieron de relieve que por encima de las funciones tradicionales relacionadas con las actividades formativas e informativas, lo que más valoran los encuestados son los aspectos protectores de la lectura, como paliar la soledad, evitar pensamientos negativos y gestionar mejor las emociones.[ENG} The aim of this study was to try to identify the elements of reading that involve us most powerfully in this activity, in order to determine how reading habits affect health. To this end, a survey was designed and distributed among people who habitually read, from the Autonomous Communities of Castilla y León, Extremadura, Madrid, and Asturias. In this, the respondents had to assess those aspects that they considered most important for them regarding reading: tranquility, fun, information, and others. Collected and analyzed 255 responses, the results highlight that, above traditional functions related to training and information, the respondents valued most the healing aspects of reading, such as alleviating loneliness, avoiding negative thoughts and managing emotions better.Infomed - Centro Nacional de Información de Ciencias Médica

Beneficios de la lectura sobre la salud y el bienestar de las personas. Estudio sobre aspectos preventivos de la lectura

The aim of this study is to identify and analyse the elements associated with reading in order to find out how reading habits affect health. For this purpose, a cross-sectional sample study was carried out by means of a survey among people who usually read and which was distributed online through distribution lists and social networks interested in the field of reading and health. In it, the respondents had to assess those aspects that they consider most important for them regarding reading such as: tranquility, fun, information and others. A total of 1,511 surveys were completed from various countries, especially from Spain and Latin American countries. The results observed show that, in addition to valuing the importance of reading in relation to traditional functions such as training and information activities, the respondents also use and value the capacity that reading has in relation to preventive and healthy aspects such as: alleviating loneliness, avoiding negative thoughts and better managing emotions

Health-related quality of life in Spanish women with osteoporosis

OBJETIVO: Analisar a qualidade de vida relacionada à saúde de pacientes com osteoporose e compará-la com a população geral. MÉTODOS: Foi realizado um estudo descritivo transversal com 60 pacientes do sexo feminino no serviço de reumatologia de um hospital universitário na Espanha, de abril a outubro de 2003. Foi aplicado o questionário Short Form-36, abordando dados demográficos, características clínicas e dados sobre estilos de vida relacionados à saúde. As pacientes foram classificadas em grupos etários. Foram utilizados os seguintes testes estatísticos: qui-quadrado, modelo linear geral, t de Student. RESULTADOS: As entrevistadas tinham idade média de 65,57 (DP: ±9,7 anos), e tempo de diagnóstico médio de 3,4±2,84 anos. As melhores pontuações foram obtidas nas dimensões aspectos sociais (89), aspectos emocionais (72,2) e saúde mental (63). As mais baixas foram em estado geral de saúde (45,1), capacidade funcional (47,7), dor (52,3) e aspectos físicos (59,9). As pontuações médias dos pacientes resultaram inferiores às pontuações conhecidas da população geral espanhola nas dimensões capacidade funcional, aspectos físicos, dor e estado geral de saúde. As máximas diferenças entre as pontuações médias do SF-36 dos pacientes e os valores populacionais espanhóis correspondem ao grupo de idade de 55 a 64 anos. Nas demais dimensões do SF-36, as pontuações foram inferiores ou similares aos valores populacionais espanhóis. Não se encontraram associações significativas entre as dimensões do SF-36 estudadas e os dados clínicos, demográficos e de estilos de vida analisados. CONCLUSÕES: Os pacientes apresentaram baixa qualidade de vida, sobretudo nas dimensões mais relevantes da enfermidade, quando comparada com valores da população espanhola em geral. As áreas físicas foram as mais afetadas.OBJECTIVE: To analyze the health-related quality of life in patients with osteoporosis and to compare it with the overall population. METHODS: A cross-sectional descriptive study was carried out with 60 female patients of the rheumatology service at a university hospital, in Spain, from April to October 2003. The Short Form-36 (SF-36) questionnaire was applied in order to obtain demographic data, clinical characteristics and data about lifestyles related to health. Patients were classified in age groups. The statistics tests performed were Chi-square, general linear model, Student\u27s t-test. RESULTS: The interviewees\u27 average age was 65.57 years old (SD: ±9.7 years), and average time interval for diagnosis was 3.4±2.84 years. The best scores were in social functioning (89), emotional aspects (72.2), mental health (63), and vitality (53.7). The lowest scores were in general health (45.1), physical capacity (47.7), pain (52.3) and physical aspects (59.9). The patients\u27 average scores were lower than the general Spanish population\u27s scores in the following dimensions: functional capacity, physical aspects, pain and overall health status. The greatest differences between the average SF-36 scores for patients and for the overall Spanish population were in the age group ranging from 55 to 64 years old. Scores were lower or similar to the general Spanish population in all other dimensions of the questionnaire. No significant associations were found between the dimensions of the SF-36 contemplated in this study and the clinical, demographic and lifestyle data. CONCLUSIONS: The patients presented bad quality of life, particularly with respect to those dimensions that are most relevant with respect to osteoporosis, when compared with the overall Spanish population. The physical dimensions were the ones most affected