Mobile-Health (mHealth) Intervention on Chronic Kidney Diseases: A Critical Review and Its Implications (Preprint)

2020 ◽  
Author(s):  
Ira Suarilah ◽  
Chiu-Chu Lin ◽  
Chich-Hsiu Hung
Keyword(s):  
Mobile Health ◽  
Health Care Professionals ◽  
Kidney Diseases ◽  
Health Interventions ◽  
Evidence Based ◽  
Chronic Kidney Diseases ◽  
Mhealth Intervention ◽  
Center Care

BACKGROUND eElectronic health (eHealth) chronic kidney disease (CKD) information is readily available over the mobile devices and placed as mobile-health (mHealth) information resources. The field of mHealth on CKD is promising in that it can empower individuals and delay the progress of the disease. OBJECTIVE This study aims to critically review published papers on the eHealth and its implication on mHealth of CKD. METHODS The academic databases EBSCO (CINAHL and PROQUEST), MEDLINE, PubMed, and Cochrane were systematically searched. Eight studies investigated the specific role of mHealth on CKD, including the detailed contents related to the conceptual acceptance and usage of technology in daily life, user, health care professionals, and the system’s bonding, mobile eHealth, content and evaluation of mHealth on CKD. RESULTS The available evidence on mHealth of CKD is limited and the findings indicate a discrepancy of the wording concept of mHealth. Those evidences might be caused by the scarce evidence on the effectiveness of using mHealth on CKD. CONCLUSIONS The limitation on the availability of CKD’s mobile health interventions that focus on patient education, behavior change and prevention contributes to inconsistent usage. Inadequate evidence might interrupt the development of mHealth intervention for individuals with CKD. Our findings illustrate the need on the conceptualizing of mHealth on CKD, acceptance and accessed, content, and evaluation focused on evidence-based will advance the quality of mHealth services, facilitate the continuity of mHealth application, and proposed patient-center-care.

scholarly journals Kidney organoid systems for studies of immune-mediated kidney diseases: challenges and opportunities

2021 ◽  
Author(s):  
Melissa C. Stein ◽  
Fabian Braun ◽  
Christian F. Krebs ◽  
Madeleine J. Bunders
Keyword(s):  
Kidney Diseases ◽  
Three Dimensional ◽  
Renal Tissue ◽  
Chronic Kidney Diseases ◽  
Immune Mediated ◽  
Primary Epithelial Cell ◽  
Challenges And Opportunities ◽  
Underlying Mechanisms ◽  
Global Population

AbstractAcute and chronic kidney diseases are major contributors to morbidity and mortality in the global population. Many nephropathies are considered to be immune-mediated with dysregulated immune responses playing an important role in the pathogenesis. At present, targeted approaches for many kidney diseases are still lacking, as the underlying mechanisms remain insufficiently understood. With the recent development of organoids—a three-dimensional, multicellular culture system, which recapitulates important aspects of human tissues—new opportunities to investigate interactions between renal cells and immune cells in the pathogenesis of kidney diseases arise. To date, kidney organoid systems, which reflect the structure and closer resemble critical aspects of the organ, have been established. Here, we highlight the recent advances in the development of kidney organoid models, including pluripotent stem cell-derived kidney organoids and primary epithelial cell-based tubuloids. The employment and further required advances of current organoid models are discussed to investigate the role of the immune system in renal tissue development, regeneration, and inflammation to identify targets for the development of novel therapeutic approaches of immune-mediated kidney diseases.

scholarly journals Impact of hemodialysis on the wellbeing of chronic kidney diseases patients: a pre-post analysis

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Um-e-Kalsoom ◽  
Sabiha Khan ◽  
Israr Ahmad
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Perceived Social Support ◽  
Kidney Diseases ◽  
Chronic Kidney Diseases ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
The Impact

Abstract Background Hemodialysis may have serious psychological impact upon patients suffering from chronic kidney diseases. The aim of the present study is to investigate the impact of hemodialysis on the wellbeing of individuals with chronic kidney diseases (CKD). Result A sample consists of (N = 100) CKD patients referred from neurology ward of Leady Reading Hospital Peshawar. Data was collected from both male (50%) and female (50%) in 2017. Participants were divided into two groups on the basis of pre-set criteria. In group I, individuals with 4–5 stage of CKD referred first time for dialysis treatment were recruited. Group II comprised of CKD patients with 1–3 stage. Demographic data sheet, Pakistan Anxiety and Depression, WHO Quality of Life scale, and Perceived Social support scale (PSS) were used to test the hypotheses. Paired sample t test was use to see the difference between pre- and post-analysis of depression, anxiety, QOL, and PSS in group I (experimental group). Results suggests significant difference on depression (p > .001), anxiety (p > .001), and QOL (p > .001), while no significant difference was reported on perceived social support (p <.673). Findings also indicate no significant difference between group I and group II on QOL depression, anxiety, and PSS. Conclusion The findings concluded that patients under hemodialysis treatment suffered from depression, anxiety, and poor quality of life.

Quality Assessment of HTA reports: a Critical Appraisal Toolkit within an institutional HTA program

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Bossi ◽  
M Tringali ◽  
P Colombo ◽  
C Mazzali ◽  
G Puleo ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Critical Appraisal ◽  
Population Aging ◽  
Clinical Effectiveness ◽  
Evidence Based ◽  
Lombardy Region ◽  
Double Blinded ◽  
Sustainable Health ◽  
Local Healthcare

Abstract Issue With population aging, increased demand for healthcare and limited availability of economic and human resources, well-functioning and sustainable health systems have to rely on rigorous and evidence-based assessments of complex technologies' clinical effectiveness and safety. The Lombardy Region in Northern Italy has a well-established HTA program that offers technical support to its hospitals' network to produce and to review Health Technology Assessment (HTA) reports. Description of the Problem To better coordinate the HTA network and to reduce self-referencing of University and Community hospitals, Lombardy Region carried out an intense field training and distance learning from year 2017, with a project aimed at involving health care professionals in an accurate evaluation of technologies in 18 HTA reports. The regional HTA Supporting Centre developed a Toolkit for the critical appraisal of reports and supporting literature to improve the quality of hospital-based reports. Results In compliance with the regional Law DGR XI/1046 17.12.2018 and the framework proposed, during year 2019 hospitals used the Toolkit to help writing complete and good quality HTA reports on 37 different technologies. With a Public Health resident internship, the Toolkit was revised, extended and then used in 2020 by the hospital's HTA network during the double blinded peer review, mandated by the regional Law DGR XI/2672 16.12.2019, of the year 2019 HTA reports. Detailed results will be presented at the conference. Lessons We observed an increase in number of HTA reports from 2018 to 2019, a greater language's and format's homogeneity and an improvement in the quality of some reports, which will be submitted to the Regional HTA Committee for appraisal and reimbursement. Key messages The development and use of a Critical Appraisal Toolkit in an Regional HTA program can help hospitals write complete and good quality HTA reports. A centrally supported quality improvement of distributed assessment activities in a network of hospitals can enhance the production of HTA reports, relevant to the needs of a local healthcare system.

scholarly journals The role of a clinician amid the rise of mobile health technology

2019 ◽  
Vol 26 (11) ◽  
pp. 1385-1388 ◽  
Author(s):  
William E Yang ◽  
Lochan M Shah ◽  
Erin M Spaulding ◽  
Jane Wang ◽  
Helen Xun ◽  
...  
Keyword(s):  
Mobile Health ◽  
Healthy Lifestyle ◽  
Clinical Care ◽  
Critical Role ◽  
Lifestyle Changes ◽  
Mhealth Intervention ◽  
Early Results ◽  
Modification Technique ◽  
Behavior Modification Technique

Abstract Mobile health (mHealth) interventions have demonstrated promise in improving outcomes by motivating patients to adopt and maintain healthy lifestyle changes as well as improve adherence to guideline-directed medical therapy. Early results combining behavioral economic strategies with mHealth delivery have demonstrated mixed results. In reviewing these studies, we propose that the success of a mHealth intervention links more strongly with how well it connects patients back to routine clinical care, rather than its behavior modification technique in isolation. This underscores the critical role of clinician-patient partnerships in the design and delivery of such interventions, while also raising important questions regarding long-term sustainability and scalability. Further exploration of our hypothesis may increase opportunities for multidisciplinary clinical teams to connect with and engage patients using mHealth technologies in unprecedented ways.

scholarly journals Investigating Factors Associated with Depressive Symptoms of Chronic Kidney Diseases in China with Type 2 Diabetes

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Xu Wang ◽  
Biyu Shen ◽  
Xun Zhuang ◽  
Xueqin Wang ◽  
Weiqun Weng
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Regression Analysis ◽  
Depressive Symptoms ◽  
Kidney Diseases ◽  
Chronic Kidney Diseases ◽  
Factors Associated

Aim.To assess the depressive symptoms status of chronic kidney diseases in Nantong, China, with type 2 diabetes and to identify factors associated with depressive symptoms.Methods.In this cross-sectional analytic study, 210 type 2 diabetic patients were recruited from the Second Affiliated Hospital of Nantong University. Depressive symptoms were assessed with the depression subscale of the Hospital Anxiety and Depression Scale (HAD-D). The quality of life was measured with the RAND 36-Item Health Survey (SF-36). And the independent risk factors of depressive symptoms were assessed by using a stepwise forward model of logistic regression analysis.Results.The mean age of the study subjects was 57.66 years (SD: 11.68). Approximately 21.4% of subjects reported depressive symptoms (n=45). Forward stepwise logistic regression analysis showed that female gender (P=0.010), hypertension (P=0.022), Stage IV (P=0.003), and Stage V (P<0.001) were significant risk factors for depressive symptoms. The quality of life of individuals with HAD-D score <11 was significantly better compared with individuals with HAD-D score ≥ 11.Conclusions.These results indicate that clinicians should be aware that female patients with chronic kidney diseases with T2DM in their late stage with hypertension are at a marked increased risk of depressive symptoms. Providing optimal care for the psychological health of this population is vital.

scholarly journals Comprehensively addressing postpartum maternal health: a content and image review of commercially available mobile health apps

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laura Tucker ◽  
Alan Cuevas Villagomez ◽  
Tamar Krishnamurti
Keyword(s):  
Maternal Health ◽  
Health Information ◽  
Mobile Health ◽  
Rating Scale ◽  
The United States ◽  
People Of Color ◽  
Evidence Based ◽  
Or Education ◽  
Google Play

Abstract Background The United States is currently facing a maternal morbidity and mortality crisis, with the highest rates of any resource-rich nation. In efforts to address this, new guidelines for postpartum care suggest that mobile health (mHealth) apps can help provide complementary clinical support for new mothers during the postpartum period. However, to date no study has evaluated the quality of existing mHealth tools targeted to this time period in terms of sufficiency of maternal health information, inclusivity of people of color, and app usability. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to review the peripartum apps from the Apple and Google Play stores in either the Health/Fitness, Medical, or Education categories. Apps were evaluated for extent and quality of maternal health information and inclusivity of people of color using an a priori coding scheme. App usability was evaluated using the Mobile Application Rating Scale (MARS) score. Results Of the 301 apps from the Apple and Google Play stores, 25 met criteria for final evaluation. Of the 30 maternal health topics coded for, the median number addressed by apps was 19.5 (65%). Peripartum behaviors were more frequently addressed than peripartum outpatient care topics and peripartum acute health risks. The coverage of maternal health information and inclusivity of people of color in app imagery both correlated positively with the MARS usability score of the app. Only 8 apps (32%) portrayed greater than 24% images of people of color- the percent of non-white Americans according to 2019 census estimates. There was no correlation between MARS usability score and number of app users, as estimated by number of ratings for the app available on the app store. In addition, apps with evidence-based maternal health information had greater MARS engagement, information, and aesthetics scores. However, presence of evidence-based information did not correlate with greater numbers of app users. Conclusions Current commercially available peripartum apps range widely in quality. Overall current app offerings generally do not provide adequate maternal health information and are not optimally accessible to the target users in terms of inclusivity of women of color or app usability. Apps delivering evidence-based information and more usable design are more likely to meet these standards but are not more likely to be downloaded by users.

The Role of the CX3CL1-CX3CR1 Axis in Renal Disease

2021 ◽  
Author(s):  
Diana Hamdan ◽  
Lisa A. Robinson
Keyword(s):  
Therapeutic Potential ◽  
Kidney Diseases ◽  
Transmembrane Protein ◽  
Soluble Form ◽  
Protective Effects ◽  
Chronic Kidney Diseases ◽  
The Family ◽  
Soluble Species ◽  
And Function

Excessive infiltration of immune cells into the kidney is a key feature of acute and chronic kidney diseases. The family of chemokines are key drivers of this process. CX3CL1 (fractalkine) is one of two unique chemokines synthesized as a transmembrane protein which undergoes proteolytic cleavage to generate a soluble species. Through interacting with its cognate receptor, CX3CR1, CX3CL1 was originally shown to act as a conventional chemoattractant in the soluble form, and as an adhesion molecule in the transmembrane form. Since then, other functions of CX3CL1 beyond leukocyte recruitment have been described, including cell survival, immunosurveillance, and cell-mediated cytotoxicity. This review summarizes diverse roles of CX3CL1 in kidney disease and potential uses as a therapeutic target and novel biomarker. As the CX3CL1-CX3CR1 axis has been shown to contribute to both detrimental and protective effects in various kidney diseases, a thorough understanding of how the expression and function of CX3CL1 are regulated is needed to unlock its therapeutic potential.

Caring for Older Adults During and After Critical Illness

2021 ◽  
pp. 216-234
Author(s):  
Maria C. Duggan ◽  
Julie Van ◽  
E. Wesley Ely
Keyword(s):  
Older Adults ◽  
Critical Illness ◽  
Health Care Professionals ◽  
Interdisciplinary Approach ◽  
Adverse Outcomes ◽  
Evidence Based ◽  
Complex Population ◽  
Multiple Domains ◽  
Over Time

Over half of people with critical illness are older adults, and the number of older adults admitted to intensive care units has been increasing over time. Older adults have increased vulnerability to disease, disability, and adverse outcomes across many domains. To address this most effectively, a unique, interdisciplinary approach is necessary to optimize not only survival but also functional status and quality of life. A shortage of health care professionals equipped to care for the aging population makes it imperative that all professionals become aware of basic principles of caring for older adults. To equip them to care for this complex population, this chapter provides an overview of how aging impacts multiple domains of an older person with critical illness and describes evidence-based approaches to caring for older adults with critical illness.

scholarly journals Characterization of IL-19, -20, and -24 in acute and chronic kidney diseases reveals a pro-fibrotic role of IL-24

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Domonkos Pap ◽  
Apor Veres-Székely ◽  
Beáta Szebeni ◽  
Réka Rokonay ◽  
Anna Ónody ◽  
...  
Keyword(s):  
Animal Models ◽  
Mononuclear Cells ◽  
Kidney Diseases ◽  
Ischemia Reperfusion ◽  
Renal Diseases ◽  
Peripheral Blood Mononuclear ◽  
Chronic Kidney Diseases ◽  
Tgf Β1

Abstract Background Recently, the role of IL-19, IL-20 and IL-24 has been reported in renal disorders. However, still little is known about their biological role. Methods Localization of IL-20RB was determined in human biopsies and in the kidneys of mice that underwent unilateral ureteral obstruction (UUO). Renal Il19, Il20 and Il24 expression was determined in ischemia/reperfusion, lipopolysaccharide, streptozotocin, or UUO induced animal models of kidney diseases. The effects of H2O2, LPS, TGF-β1, PDGF-B and IL-1β on IL19, IL20 and IL24 expression was determined in peripheral blood mononuclear cells (PBMCs). The extents of extracellular matrix (ECM) and α-SMA, Tgfb1, Pdgfb, and Ctgf expression were determined in the kidneys of Il20rb knockout (KO) and wild type (WT) mice following UUO. The effect of IL-24 was also examined on HK-2 tubular epithelial cells and NRK49F renal fibroblasts. Results IL-20RB was present in the renal biopsies of patients with lupus nephritis, IgA and diabetic nephropathy. Amount of IL-20RB increased in the kidneys of mice underwent UUO. The expression of Il19, Il20 and Il24 increased in the animal models of various kidney diseases. IL-1β, H2O2 and LPS induced the IL19, IL20 and IL24 expression of PBMCs. The extent of ECM, α-SMA, fibronectin, Tgfb1, Pdgfb, and Ctgf expression was lower in the kidney of Il20rb KO compared to WT mice following UUO. IL-24 treatment induced the apoptosis and TGF-β1, PDGF-B, CTGF expression of HK-2 cells. Conclusions Our data confirmed the significance of IL-19, IL-20 and IL-24 in the pathomechanism of renal diseases. Furthermore, we were the first to demonstrate the pro-fibrotic effect of IL-24.

scholarly journals Relationships between the Older Adult’s Cognitive Decline and Quality of Life: The Mediating Role of the Assistive Mobile Health Applications

2019 ◽  
Vol 13 (10) ◽  
pp. 42
Author(s):  
Murtaja Ali Saare ◽  
Azham Hussain ◽  
Wong Seng Yue
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Cognitive Decline ◽  
Mobile Health ◽  
Mediating Role ◽  
Mobile Health Applications ◽  
Conceptual Explanation ◽  
Health Applications

This article examines the link between the older adult’s cognitive decline, and Assistive Mobile Health Applications in terms of quality of life as researcher has found scarcity in explaining the mediating role of assistive mobile health applications towards the quality of life of older adults with cognitive decline. Researchers have identified the importance of using assistive mobile health applications in connection of the older adult’s cognitive decline. However, it remained unaddressed in the explaining the mediating role of assistive mobile health application. Therefore, this paper aims to provide an insight that the adoption of assistive m-health applications will provide this population with potential solution to their challenging aging life, hence, enhancing their quality of life. In addition, this paper is only a conceptual explanation, as it aims to identify the possible reasons that influence their Smartphone adoption. Factors were identified using a systematic literature review on relevant peer reviewed papers. The study summarized the empirical evidences which were used to support the conceptual explanation. It is expected that this work will lead towards the empirical findings on the explanation of the mediating role of the assistive mobile health applications to address the relationship of older adult’s cognitive decline and quality of life. This paper providesdirections for future studies in improving the quality of life of older adults.

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