scholarly journals Identifying and addressing digital health risks associated with emergency pandemic response: Problem identification, scoping review, and directions toward evidence-based evaluation

Author(s):  
Zoie Shui-Yee Wong ◽  
Michael Rigby
2019 ◽  
Vol 15 (2) ◽  
pp. 130-139
Author(s):  
Ehsan T. Moghaddam ◽  
Ali Tafazoli

Background: Excessive consumption of cola beverages is accompanied by numerous public health risks. But besides these well-known adverse effects, recently, several medical articles have been published that show some indications for cola beverages in clinical practice like resolution of gastrointestinal or feeding tube obstructions, increasing bioavailability and palatability of other medications, rehydration and other uses in healthcare settings. These approaches are not without shortcomings and complications. Methods: In this systematic review we tried to explore these new uses for practitioners and also reemphasize on the most evidence-based complications of cola consumption like bone loss and metabolic and cardiovascular adverse effects in cases of misuse and overuse from both clinical and nutritional points of view via searching the PubMed database. Results: We chose 145 journal articles from the most relevant ones plus 30 extra references and categorized their topics in two classes of medical uses and adverse effects. Conclusion: It could be stated that cola beverages have demonstrated interesting uses and benefits in medicine but their use should be regulated as strict as possible.


Obesity Facts ◽  
2021 ◽  
pp. 1-14
Author(s):  
R. James Stubbs ◽  
Cristiana Duarte ◽  
António L. Palmeira ◽  
Falko F. Sniehotta ◽  
Graham Horgan ◽  
...  

<b><i>Background:</i></b> Effective interventions and commercial programmes for weight loss (WL) are widely available, but most people regain weight. Few effective WL maintenance (WLM) solutions exist. The most promising evidence-based behaviour change techniques for WLM are self-monitoring, goal setting, action planning and control, building self-efficacy, and techniques that promote autonomous motivation (e.g., provide choice). Stress management and emotion regulation techniques show potential for prevention of relapse and weight regain. Digital technologies (including networked-wireless tracking technologies, online tools and smartphone apps, multimedia resources, and internet-based support) offer attractive tools for teaching and supporting long-term behaviour change techniques. However, many digital offerings for weight management tend not to include evidence-based content and the evidence base is still limited. <b><i>The Project:</i></b> First, the project examined why, when, and how many European citizens make WL and WLM attempts and how successful they are. Second, the project employed the most up-to-date behavioural science research to develop a digital toolkit for WLM based on 2 key conditions, i.e., self-management (self-regulation and motivation) of behaviour and self-management of emotional responses for WLM. Then, the NoHoW trial tested the efficacy of this digital toolkit in adults who achieved clinically significant (≥5%) WL in the previous 12 months (initial BMI ≥25). The primary outcome was change in weight (kg) at 12 months from baseline. Secondary outcomes included biological, psychological, and behavioural moderators and mediators of long-term energy balance (EB) behaviours, and user experience, acceptability, and cost-effectiveness. <b><i>Impact:</i></b> The project will directly feed results from studies on European consumer behaviour, design and evaluation of digital toolkits self-management of EB behaviours into development of new products and services for WLM and digital health. The project has developed a framework and digital architecture for interventions in the context of EB tracking and will generate results that will help inform the next generation of personalised interventions for effective self-management of weight and health.


2021 ◽  
Vol 2 ◽  
pp. 263348952098825
Author(s):  
Cheri J Shapiro ◽  
Kathleen Watson MacDonell ◽  
Mariah Moran

Background: Among the many variables that affect implementation of evidence-based interventions in real-world settings, self-efficacy is one of the most important factors at the provider level of the social ecology. Yet, research on the construct of provider self-efficacy remains limited. Objectives: This scoping review was conducted to enhance understanding of the construct of provider self-efficacy and to examine how the construct is defined and measured in the context of implementation of evidence-based mental health interventions. Design: Online databases were used to identify 190 papers published from 1999 to June of 2018 that included search terms for providers, evidence-based, and self-efficacy. To be eligible for the scoping review, papers needed to focus on the self-efficacy of mental health providers to deliver evidence-based psychosocial interventions. A total of 15 publications were included in the review. Results: The construct of provider self-efficacy is not clearly defined but is typically described as confidence to deliver a specific intervention or practice. A range of measures are used to assess provider self-efficacy across both provider and intervention types. Conclusions: Standardized definition and measurement of provider self-efficacy is needed to advance practice and implementation research. Plain language abstract: Provider self-efficacy is known to influence implementation of evidence-based mental health interventions. However, the ways in which provider self-efficacy is defined and measured in implementation research literature is not well understood; furthermore, it is not clear what types of providers and interventions are represented in this literature. This scoping review adds to current research by revealing that there is no agreed upon definition or measure of provider self-efficacy in the context of implementation of evidence-based interventions, and that the research includes multiple types of providers (e.g., social workers, counselors, psychologists) and interventions. Self-efficacy appears to change as a function of training and support. To further research in this area, a common definition and agreed upon measures of this construct are needed.


Author(s):  
Simon Thompson ◽  
Mary Kathryn Bohn ◽  
Nicasio Mancini ◽  
Tze Ping Loh ◽  
Cheng-Bin Wang ◽  
...  

AbstractRoutine biochemical and hematological tests have been reported to be useful in the stratification and prognostication of pediatric and adult patients with diagnosed coronavirus disease (COVID-19), correlating with poor outcomes such as the need for mechanical ventilation or intensive care, progression to multisystem organ failure, and/or death. While these tests are already well established in most clinical laboratories, there is still debate regarding their clinical value in the management of COVID-19, particularly in pediatrics, as well as the value of composite clinical risk scores in COVID-19 prognostication. This document by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on COVID-19 provides interim guidance on: (A) clinical indications for testing, (B) recommendations for test selection and interpretation, (C) considerations in test interpretation, and (D) current limitations of biochemical/hematological monitoring of COVID-19 patients. These evidence-based recommendations will provide practical guidance to clinical laboratories worldwide, underscoring the contribution of biochemical and hematological testing to our collective pandemic response.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 732-733
Author(s):  
Shannon Jarrott ◽  
Rachel Scrivano ◽  
Nancy Mendoza ◽  
Cherrie Park

Abstract Intergenerational programs facilitate mutually beneficial interactions between youth and older adults, achieving an array of outcomes. With few exceptions, implementation factors rarely figure into outcome analyses, though researchers frequently gather data on factors influencing outcomes. The resulting practice-evidence gap may deter wide-spread adoption of intergenerational programming. We conducted a scoping review of 35 peer-reviewed articles (2000-2019) to map key concepts and evidence sources of empirically-supported practices impacting intergenerational program outcomes. A scoping review is appropriate when an area is complex, like intergenerational programs that incorporate diverse participants, content, and goals. Primarily qualitative studies involved programs equally likely to involve young, school-age, or post-secondary age youth and independent or frail older adults. Half had sample sizes under 50, frequently measuring both age groups. Implementation practices included co-learning and sharing personal stories. Program content (e.g., technology) and greater exposure amplified outcomes. Rigorous implementation research is needed to advance evidence-based intergenerational practice.


2020 ◽  
Vol 8 (1) ◽  
Author(s):  
A. Hambleton ◽  
D. Le Grange ◽  
J. Miskovic-Wheatley ◽  
S. Touyz ◽  
M. Cunich ◽  
...  

Abstract Background Family-based treatment (FBT) is an efficacious outpatient intervention for young people diagnosed with Anorexia Nervosa (AN). To date, treatment to protocol has relied on standard face-to-face delivery. Face-to-face therapy is subject to geographic, temporal and human factors, rendering it particularly susceptible to inequities and disruption. This has resulted in poorer service provision for rural and regional families, and recently a significant challenge to providing face-to-face services during the COVID-19 global pandemic. The present study examines whether FBT for AN can be successfully translated to a digital delivery platform to address these access issues. Method Forty young people aged 12 to 18 years who meet DSM-5 diagnostic criteria for AN, and live in a rural or regional setting, will along with their family be recruited to the study. Trained therapists will provide 18 sessions of FBT over 9 months via telemedicine to the home of the young person and their family. The analysis will examine treatment effectiveness, feasibility, acceptability, and cost-effectiveness. Discussion The study addresses the treatment needs of families not able to attend face-to-face clinical services for evidence-based treatment for eating disorders. This might be due to several barriers, including a lack of local services or long travel distances to services. There has been a recent and unprecedented demand for telemedicine to facilitate the continuity of care during COVID-19 despite geographical circumstances. If delivering treatment in this modality is clinically and economically effective and feasible, it will facilitate access to potentially lifesaving, evidence-based treatments for families formerly unable to access such care and provide evidence for the continuity of services when and where face-to-face treatment is not feasible.


10.2196/20158 ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. e20158
Author(s):  
Dylan Gilbey ◽  
Helen Morgan ◽  
Ashleigh Lin ◽  
Yael Perry

Background Young people (aged 12-25 years) with diverse sexuality, gender, or bodily characteristics, such as those who identify as lesbian, gay, bisexual, transgender, intersex, or queer (LGBTIQ+), are at substantially greater risk of a range of mental, physical, and sexual health difficulties compared with their peers. Digital health interventions have been identified as a potential way to reduce these health disparities. Objective This review aims to summarize the characteristics of existing evidence-based digital health interventions for LGBTIQ+ young people and to describe the evidence for their effectiveness, acceptability, and feasibility. Methods A systematic literature search was conducted using internet databases and gray literature sources, and the results were screened for inclusion. The included studies were synthesized qualitatively. Results The search identified 38 studies of 24 unique interventions seeking to address mental, physical, or sexual health–related concerns in LGBTIQ+ young people. Substantially more evidence-based interventions existed for gay and bisexual men than for any other population group, and there were more interventions related to risk reduction of sexually transmitted infections than to any other health concern. There was some evidence for the effectiveness, feasibility, and acceptability of these interventions overall; however, the quality of evidence is often lacking. Conclusions There is sufficient evidence to suggest that targeted digital health interventions are an important focus for future research aimed at addressing health difficulties in LGBTIQ+ young people. Additional digital health interventions are needed for a wider range of health difficulties, particularly in terms of mental and physical health concerns, as well as more targeted interventions for same gender–attracted women, trans and gender-diverse people, and people with intersex variations. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020128164; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=128164


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C E Chronaki ◽  
A Miglietta

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and reliable data is typically lacking. The process of including data for preparedness and training for evidence-based decision making in public health emergencies is not systematic and is complicated by many barriers as the absence of common digital tools and approaches for resource planning and update of response plans. Health Technology Assessment (HTA) is used with the aim to improve the quality and efficiency of public health interventions and to make healthcare systems more sustainable. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability to share data and to plan coordinated response. Digital health tools have an important role to play in this setting, facilitating use of knowledge about the population that can potentially affected by the crisis within and across regional and national borders. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define and align mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. Activities and policy development in the HTA network could inform this process. The objective of this presentation is to identify barriers for evidence-based decision making during public health emergencies and discuss how standardization in digital health and HTA processes may help overcome these barriers leading to more effective coordinated and evidence-based public health emergency response.


10.2196/15727 ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. e15727 ◽  
Author(s):  
Yejin Lee ◽  
Mario C Raviglione ◽  
Antoine Flahault

Background Tuberculosis (TB) is the leading cause of death from a single infectious agent, with around 1.5 million deaths reported in 2018, and is a major contributor to suffering worldwide, with an estimated 10 million new cases every year. In the context of the World Health Organization’s End TB strategy and the quest for digital innovations, there is a need to understand what is happening around the world regarding research into the use of digital technology for better TB care and control. Objective The purpose of this scoping review was to summarize the state of research on the use of digital technology to enhance TB care and control. This study provides an overview of publications covering this subject and answers 3 main questions: (1) to what extent has the issue been addressed in the scientific literature between January 2016 and March 2019, (2) which countries have been investing in research in this field, and (3) what digital technologies were used? Methods A Web-based search was conducted on PubMed and Web of Science. Studies that describe the use of digital technology with specific reference to keywords such as TB, digital health, eHealth, and mHealth were included. Data from selected studies were synthesized into 4 functions using narrative and graphical methods. Such digital health interventions were categorized based on 2 classifications, one by function and the other by targeted user. Results A total of 145 relevant studies were identified out of the 1005 published between January 2016 and March 2019. Overall, 72.4% (105/145) of the research focused on patient care and 20.7% (30/145) on surveillance and monitoring. Other programmatic functions 4.8% (7/145) and electronic learning 2.1% (3/145) were less frequently studied. Most digital health technologies used for patient care included primarily diagnostic 59.4% (63/106) and treatment adherence tools 40.6% (43/106). On the basis of the second type of classification, 107 studies targeted health care providers (107/145, 73.8%), 20 studies targeted clients (20/145, 13.8%), 17 dealt with data services (17/145, 11.7%), and 1 study was on the health system or resource management. The first authors’ affiliations were mainly from 3 countries: the United States (30/145 studies, 20.7%), China (20/145 studies, 13.8%), and India (17/145 studies, 11.7%). The researchers from the United States conducted their research both domestically and abroad, whereas researchers from China and India conducted all studies domestically. Conclusions The majority of research conducted between January 2016 and March 2019 on digital interventions for TB focused on diagnostic tools and treatment adherence technologies, such as video-observed therapy and SMS. Only a few studies addressed interventions for data services and health system or resource management.


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