Stakeholders' views and opinions on existing guidelines on “How to Choose Mental Health Apps”

BackgroundMental health Applications (Mhealth Apps) can change how healthcare is delivered. However, very little is known about the efficacy of Mhealth Apps. Currently, only minimum guidance is available in Assessment and Evaluation Tools (AETs). Therefore, this project aims to understand AET developers' perspectives and end users' experiences and opinions on “how to choose a Mhealth App”.ObjectiveThe primary objectives were: (1) obtaining stakeholder's opinions and experiences of development and use of AETs for Mhealth Apps, their weaknesses and strengths, and barriers in their implementation of Mhealth Apps; (2) the experiences of App users, their analyzation and, obstacles in the use of apps; and (3) to quantify themes related to choosing a Mhealth App.MethodsThis qualitative study, used a sampling method to recruit six stakeholders (one App developer, two AET developers, an individual with lived experience of mental health illness, and two physicians) who were interviewed using a topic guide. These were examined by researchers (CT, WK, & FN) using thematic content analysis. Additionally, an anonymous online survey of 107 individuals was conducted.FindingsOur analyses revealed six main themes: (a) needs and opportunities; (b) views on Mhealth apps; (c) views & opinions on AETs; (d) implementation barriers; (e) system of evaluation and; (f) future directions. The first key concept was, all stakeholders agreed that Apps could significantly impact mental health and that end-users were unaware of mental health AETs and Apps. Secondly, due to commercial interests, end-users reliability of App evaluations requires clear conflict-free guidelines. Thirdly, AETs should be evaluated and developed through a rigorous methodology. Finally, stakeholders shared insights into future developments for AETs and Mhealth Apps. Additionally, online survey respondents chose a “health professional” as their preferred source of guidance in selecting a Mhealth app (84%) and best suited to develop guidelines (70%).ConclusionThe interviews and survey highlight the need for Mhealth Apps to be regulated and the importance of health professionals' engagement in the implementation process. Similarly, without well-defined roles for App evaluations within the health care system, it is unlikely that AETs will have wider spread use and impact without risk

Health related quality of life in children with autism spectrum disorder in Bangladesh

Background and objective: Autism spectrum disorder (ASD) is considered as an emerging problem in our socioeconomic context. The objectives of this study were to compare the health related quality of life of children with autism spectrum disorder to that of typically developing peers. Methods: A cross sectional comparative study was conducted on autistic children and normal children in six centers of Dhaka city to see the health related quality of life from parent’s perspective by using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL scale). Total of 115 children within the age group of 8-12 years were selected, among them 57 were autistic and 58 were normal peers. Results: Children with autism spectrum disorder had poor physical (mean score 6.04), emotional (mean score 9.77) and social (mean score 14.51) functions as well as learning ability (mean score 8.12) whereas normal children’s functioning mean scores were 0.10, 1.79, 0.0 and 0.45 in respective domains and the differences were significant (p<.0001) in each aspect of quality of life. Conclusion: This study revealed that, children with autism spectrum disorder experienced poorer health-related quality of life than normal children and thus the findings would contribute in implementing different strategies for improving the health status of autistic children. IMC J Med Sci 2017; 11(2): 40-4

Immediate psychological responses during the initial period of the COVID-19 pandemic among Bangladeshi medical students

Background: The most recent global pandemic of COVID-19 has been creating multidimensional damages, including a detrimental impact on the mental health status of individuals. Medical students, a vulnerable cross-section of the population, may have perceived a myriad of psychological stressors during this crisis in the background of their prevailing stressful academic pressure and preexisting higher psychological and mental health issue. Objective: To determine the prevalence of anxiety and depressive symptoms and to elucidate the psychological impact of COVID-19 pandemic on Bangladeshi medical students. Method: A cross-sectional study design was utilized to conduct this survey. The online survey including demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS; higher scores on the subscales indicate higher levels of depressive and anxiety symptoms), was completed by 425 Bangladeshi medical students. Collected data were statistically analyzed by using SPSS (version 25.0) software. Result: The HADS anxiety subscale revealed that 65.9% of the medical students had different levels of anxiety, ranging from mild (27.3%), moderate (26.8%), and severe (11.8%). As per HADS depression subscale, 49.9% of the medical students had varying degrees of depressive symptoms, with 3.3% of the participants had suffered from severely severe depressive symptoms. Female students had a relatively more anxiety and depressive symptoms, when compared with males. The students, who were severely tensed of getting infected by the virus, were at higher risk of suffering from anxiety (3.5-fold) and depressive (2.7-fold) symptoms, when compared with no/minimally stressed students. Besides, fear of getting assaulted or humiliated on the way to hospital or home, not to be able to give maximum concentration on study after COVID-19 pandemic, students’ present emotional status (agitation), had statistically significant higher risk of anxiety. Conclusion: A substantial proportion of Bangladeshi medical students are experiencing pandemic-related adverse psychological impact. The poor mental health conditions of these vulnerable medical students pose important threat to their potential contribution in future health care. Thus, medical colleges and health authorities should focus on addressing their psychological needs and formulate effective strategies to ameliorate medical students’ mental health status, particularly during any infectious disease outbreak

Ecofitting circular economy: An alternative approach to market, consumption, and design towards zero emissions

Ecofitting Circular Economy -An alternative approach to market, consumption, and design towards zero emissions is a peer reviewed paper presented at the 2020 EVER Monaco Conference on Electric Vehicles and Renewable Energies, which reports on the initial findings of the research leaded by Artur Mausbach. Mausbach’s research is concerned with the investigation on the aesthetics of sustainability to support the transitions of the automobile. In this project he proposes a new circular economy strategy to contribute towards zero-emissions in a sustainable manner by retrofitting the existing fleet of internal Combustion Engine (ICE) cars. The research addresses the destiny of 15 million non-compliant ICE cars in the UK alone which are currently expected to be exported, recycled, or disposed of, following the requirements for Ultra Low Emission vehicles and targets for zero-emissions. In response, the project creates the concept of Ecofitting to promote behavioural change, and long-term ownership. Initial research looked at legislation and data from the department of transport to conclude that cars made after 1980 until the implementation of the current emission standards are worthy candidates for Ecofitting. The research also identified trends in automotive design represented by past leanings, the car culture around restoring and customization, the search for meaningful lifestyle, and the behaviour favouring disruptive attitudes, as a possible support to alternative approaches to automotive design. Research on the struggles of automotive industry and retrofitting companies indicates how to create an industry focused on local production and social cohesion. By encouraging the act of reusing, recycling, and updating products in usability, technology and aesthetics, the project promotes whole-life design and provides opportunities to engage a wide network of stakeholders as part of a circular economy. Ecofitting project was awarded by EPSRC CENTS to develop a feasibility study

Effects of incorporation of whey protein concentrate on physicochemical, texture, and microbial evaluation of developed cookies

Whey Protein concentrate (WPC) was incorporated into cookies at different levels (0, 2, 4, and 6%). Cookies were analyzed for physicochemical, color, textural, microbial, and sensory attributes. Physicochemical analysis revealed that 6% WPC supplemented cookies shows maximum protein content (13.22%), moisture content (11.33%), fat content (23.08%), and ash content (2.02%) as compared to control. However, control sample shows significantly different (p ≤ 0.05) value for crude fiber and carbohydrate content. Maximum thickness (9.63 mm), diameter (44.06 mm), and weight (9.10 g) were found for control and these decreased significantly (p ≤ 0.05) with increase in WPC supplementation level in cookies. Cookie supplemented with 4% WPC showed maximum overall acceptability (4.76). Texture analysis revealed that 6% WPC supplemented cookie shows maximum cutting force (55.3 N). Lightness (L*) value of cookies decreased from 67.32 to 57.94. Where as a* and b* value increased from 0.37 to 3.57 and 25.35 to 27.54, respectively. The total plate count of cookie samples was under acceptable limits

Ecofitting: Design directions upgrading cars to zero emissions

This paper presents the design directions for Ecofitting, a sustainable solution for the large UK fleet of internal combustion engine cars that will soon be rendered noncompliant with fast approaching initiatives for Ultra Low Emission Vehicles. Ecofitting circular economy strategy goes beyond just electrification, opening an opportunity for new approaches to automotive design, and to cater for generational shifts in desirability. State-of-the-art, taxonomic and trend mapping research have identified opportunities for retrofitting leading to four proposed design directions inspired and influenced by sustainable practices across other industries, that directly involve the consumer, and provide an alternative approach to the longstanding aesthetic of perfection historically seen in vehicle design

A quadruple bottom line of sustainability analysis of ecofitting design concept

This paper presents a Quadruple Bottom Line Analysis of Sustainable Design Directions for Ecofitting, a sustainable solution for the large UK fleet of internal combustion engine cars that will soon be rendered non-compliant with fast approaching initiatives for Ultra Low Emission Vehicles. Ecofitting circular economy strategy goes beyond just electrification, opening an opportunity for new approaches to automotive design, and to cater for generational shifts in desirability. The need to understand subjective aspects related to aesthetic experience, aesthetic properties, values, worldviews, and tastes, initiated the development of an extended view on sustainability include these issues. The paper presents the analysis made with an expanded and revised Sustainable Design-Orienting tool. The analysis pointed out that Ecofitting can have a significant impact in the automotive industry. At the same time, this study reveals the importance of the quadruple bottom line to develop tangible and intangible aspects of design

Culturally Adapted Cognitive Behaviour Therapy (CaCBT) to Improve Community Mental Health Services for Canadians of South Asian Origin: A Qualitative Study

Background: South Asian (SA) Canadians are disproportionately affected by higher rates of mood and anxiety disorders. SA Canadians with depression report significant barriers to accessing mental health care and the highest proportion of unmet mental health needs. The Mental Health Commission of Canada (MHCC) advocates for culturally and linguistically relevant services for SA Canadians. Culturally adapted cognitive behavior therapy (CaCBT) has shown to be more effective than standard cognitive behavior therapy (CBT). Adapting CBT for the growing SA population in Canada will ensure equitable access to effective, culturally-appropriate mental health interventions. Method: The study used a qualitative design to elicit stakeholder consultation via in-depth interviews. This study is reported using the criteria included in Consolidated Criteria for Reporting Qualitative Studies (COREQ). The analysis follows an ethnographic approach and was informed by the principles of emergent design. Results: Five themes were identified from the analysis, (i) Awareness and preparation: factors that impact the individual's understanding of therapy and mental illness. (ii) Access and provision: SA Canadians' perception of barriers, facilitators, and access to treatment. (iii) Assessment and engagement: experiences of receiving helpful treatment. (iv) Adjustments to therapy: modifications and suggestions to standard CBT. (v) Ideology and ambiguity: racism, immigration, discrimination, and other socio-political factors. Conclusions: Mainstream mental health services need to be culturally appropriate to better serve SA Canadians experiencing depression and anxiety. Services must understand the family dynamics, cultural values and socio-political factors that impact SA Canadians to reduce attrition rates in therapy

Anxiety and depressive symptoms among physicians during the COVID-19 pandemic in Bangladesh: a cross-sectional study

Objectives In addition to risking their physical well-being, frontline physicians are enduring significant emotional burden both at work and home during the coronavirus disease 2019 (COVID-19) pandemic. This study aims to investigate the levels of anxiety and depressive symptoms and to identify associated factors among Bangladeshi physicians during the COVID-19 outbreak. Methods and design A cross-sectional study using an online survey following a convenience sampling technique was conducted between April 21 and May 10, 2020. Outcomes assessed included demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS). Results The survey was completed by 412 Bangladeshi physicians. The findings revealed that, in terms of standardized HADS cut-off points, the prevalence of anxiety and depressive symptoms among physicians was 67.72% and 48.5% respectively. Risk factors for higher rates of anxiety or depressive symptoms were: being female, physicians who had experienced COVID-19 like symptoms during the pandemic, those who had not received incentives, those who used self-funded personal protective equipment (PPE), not received adequate training, lacking perceived self-efficacy to manage COVID-19 positive patients, greater perceived stress of being infected, fear of getting assaulted/humiliated, being more connected with social media, having lower income levels to support the family, feeling more agitated, less than 2 h of leisure activity per day and short sleep duration. All these factors were found to be positively associated with anxiety and depression in unadjusted and adjusted statistical models. Conclusions This study identifies a real concern about the prevalence of anxiety and depressive symptoms among Bangladeshi physicians and identifies several associated factors during the COVID-19 pandemic. Given the vulnerability of the physicians in this extraordinary period whilst they are putting their own lives at risk to help people infected by COVID-19, health authorities should address the psychological needs of medical staff and formulate effective strategies to support vital frontline health workers