Understanding Users’ Behavior towards Applications Privacy Policies

Recently, smartphone usage has increased tremendously, and smartphones are being used as a requirement of daily life, equally by all age groups. Smartphone operating systems such as Android and iOS have made it possible for anyone with development skills to create apps for smartphones. This has enabled smartphone users to download and install applications from stores such as Google Play, App Store, and several other third-party sites. During installation, these applications request resource access permissions from users. The resources include hardware and software like contact, memory, location, managing phone calls, device state, messages, camera, etc. As per Google’s permission policy, it is the responsibility of the user to allow or deny any permissions requested by an app. This leads to serious privacy violation issues when an app gets illegal permission granted by a user (e.g., an app might request for granted map permission and there is no need for map permission in the app, and someone can thereby access your location by this app). This study investigates the behavior of the user when it comes to safeguarding their privacy while installing apps from Google Play. In this research, first, seven different applications with irrelevant permission requests were developed and uploaded to two different Play Store accounts. The apps were live for more than 12 months and data were collected through Play Store analytics as well as the apps’ policy page. The preliminary data analysis shows that only 20% of users showed concern regarding their privacy and security either through interaction with the development team through email exchange or through commenting on the platform and other means accordingly.

“What Do We Do For Snacks?”: The Perceived Role of Parks and Recreation Administrators in the Youth Sports Food Environment

Dietary intake is influenced by multiple systems, as highlighted in the Social- Ecological Model, including community influences like community programs. In this context, parks and recreation administrators may have a role in the types of snacks and beverages provided during youth sports. The current study focused on understanding park administrators’ experiences relative to the youth sports environment, including their responsibility and influence on the food environment. This was an exploratory qualitative case study conducted in Utah. Semi-structured interviews with parks and recreation administrators were completed via phone by a research assistant. A qualitative case study analysis was conducted by two researchers. In addition to the interviews, the websites of all the park and recreation sites were searched and phone calls were made to check physical locations for nutrition fliers/information. Three themes emerged through qualitative case study analysis. The first theme was the administrators’ role in the youth parks and recreation activities. The second theme was the administrators’ awareness of the food environment within youth sports. The final theme was the administrators’ role in influencing more nutritious snacks at these youth sporting activities. The results from this case study suggest that the parks and recreation administrators within Utah valued the importance of nutritional snacks and beverages within youth sporting activities and were supportive of the food environment improving. Several of the parks and recreation administrators in this study agreed that their further involvement (i.e., guidelines on snacks and beverages) in the youth sports food environment could improve the environment and better effect youth who are participating, thus enhancing opportunities to improve overall health and well-being. The results from this study show that administrators could bring awareness to youth sports nutrition and support guidelines for the types of snacks and beverages brought to youth sporting activities. Administrators could work with dietitians to develop information that would be appropriate to distribute to youth sports participants and parents. Providing information about what kinds of snacks to bring has the possibility to improve the conditions of the youth sports food environment. Additionally, consideration for policy changes in youth sports and recreation center facilities could be explored.

use of digital tablets eases the way to compassionate care during the COVID-19 pandemic

Objective: A patient communication program was implemented as a response to hospitals visiting restrictive policies during the COVID-19 pandemic. The aim of the program was to facilitate communication between patients and families, mainly through the use of digital tablets; thus program performance was evaluated by selecting the number of calls performed, the average call time, and the percentage of patients that used the program more than once. Methods: A communication service for hospitalized patients who did not have access to a personal electronic device or were unable to use their electronic device was launched at different MUHC hospitals. A dedicated team of re-deployed employees was available to help patients connect with their loved ones using a hospital tablet or telephone. Results: A total of 806 calls were performed between April and November 2020. Eighty one percent of the calls were performed during the non-visitors policy implementation, being video calls preferred over phone calls. The average call time was 15 min, 34% of the patients had a video call with their loved one more than once and 40% of the calls were performed in the intensive care unit. Conclusion: The patient communication program can be described as a new delivery model of compassionate care. It was effective, helped reduce patients’ isolation and met the needs of family members and caregivers during the hospital non-visitors policy directed by the Ministère de la Santé et des Services Sociaux de Québec during the Covid-19 pandemic.

Prenatal Telemedicine During COVID-19: Patterns of Use and Barriers to Access

Lay Summary To protect pregnant patients from infection during the COVID pandemic, maternity care providers turned to video and phone visits (“telemedicine”) to provide as much prenatal care as possible. To evaluate this change in our prenatal care program, we surveyed 164 pregnant people who had participated in a virtual prenatal visit about their care. Participants reported both positive and negative experiences, ranging from appreciation for having a safer option than in-person visits during the pandemic, to problems due to poor internet connection, lack of privacy, and lack of access to necessary equipment. Although 77.4% of respondents indicated they would recommend telemedicine to a friend, our program evaluation highlights the fact that the ability to participate in virtual care is not equally distributed. Unless steps are taken to address this problem, relying on telemedicine for a significant portion of prenatal care could result in widening disparities in prenatal care and outcomes. Policymakers and healthcare systems which provide telemedicine must address issues of access to technology and connectivity to avoid adding to maternal health disparities. Objective To evaluate patient experience with a prenatal telemedicine visit and identify barriers to accessing telemedicine among rural pregnant people in northern New England during the beginning of the COVID-19 pandemic. Materials and Methods We conducted a post-visit electronic survey of pregnant people who successfully participated in a prenatal telemedicine visit at a rural academic medical center in Northern New England. Nineteen questions were included in five domains; 1) engagement with prenatal care; 2) barriers to telemedicine and in person healthcare; 3) experience of prenatal care; 4) remote pregnancy surveillance tools; 5) sources of COVID-19 information. Results Responses were obtained from 164 pregnant people. Forty percent of participants had participated in an audio-only telemedicine visit, and 60% in a video telemedicine visit. The visit was easy or somewhat easy for 79% of respondents and somewhat difficult or difficult for 6.8%. The most common barrier to accessing telemedicine was poor internet or phone connectivity, followed by childcare responsibilities, lack of equipment and lack of privacy. Participants also engaged in additional remote prenatal care including phone calls with registered nurses (7.6%), communication with the obstetrics team through a secure health messaging portal (21.1%) and home health monitoring (76.3%). Discussion and Conclusions In this survey evaluating the experience of pregnant people participating in a prenatal telemedicine visit during the COVID-19 pandemic, respondents had a positive experience with telemedicine overall, but also identified significant barriers to participation including issues with connectivity and lack of equipment for the visit. Most participants used telemedicine in combination with other tools for remote self-care.

The Potential Impact of Adjunct Digital Tools and Technology to Help Distressed and Suicidal Men: An Integrative Review

Suicidal men feel the need to be self-reliant and that they cannot find another way out of relationship or socioeconomic issues. Suicide prevention is of crucial importance worldwide. The much higher rate of suicide in men engenders action. The prelude is a subjective experience that can be very isolating and severely distressing. Men may not realize a change in their thinking and behaviors, which makes it more difficult to seek and get help, thereby interrupting a “downward spiral”. Stoicism often prevents men from admitting to their personal struggle. The lack of “quality” connections and “non-tailored” therapies has led to a high number of men “walking out” on traditional clinical approaches. But there are complicated relationships in motivations and formative behaviors of suicide with regards to emotional state, psychiatric disorders, interpersonal life events and suicidal behavior method selection. Middle-aged and older men have alternated as the most at-risk of suicide. There is no one solution that applies to all men, but digital tools may be of assistance (e.g., video conferences, social networks, telephone calls, and emails). Digital interventions require higher levels of effectiveness for distress and suicidality but self-guided approaches may be the most suitable for men especially where linked with an integrated online suicide prevention platform (e.g., quick response with online chats, phone calls, and emails). Furthermore, technology-enabled models of care offer promise to advance appropriate linking to mental health services through better and faster understanding of the specific needs of individuals (e.g., socio-cultural) and the type and level of suicidality experienced. Long-term evidence for suicidality and its evaluation may benefit from progressing human computer-interaction and providing impetus for an eminent integrated digital platform.

Protocol of a parallel group Randomized Control Trial (RCT) for Mobile-assisted Medication Adherence Support (Ma-MAS) intervention among Tuberculosis patients

Background Non-adherence to Tuberculosis (TB) medication is a serious threat to TB prevention and control programs, especially in resource-limited settings. The growth of the popularity of mobile phones provides opportunities to address non-adherence, by facilitating direct communication more frequently between healthcare providers and patients through SMS texts and voice phone calls. However, the existing evidence is inconsistent about the effect of SMS interventions on TB treatment adherence. Such interventions are also seldom developed based on appropriate theoretical foundations. Therefore, there is a reason to approach this problem more rigorously, by developing the intervention systematically with evidence-based theory and conducting the trial with strong measurement methods. Methods This study is a single-blind parallel-group design individual randomized control trial. A total of 186 participants (93 per group) will be individually randomized into one of the two groups with a 1:1 allocation ratio by a computer-generated algorithm. Group one (intervention) participants will receive daily SMS texts and weekly phone calls concerning their daily medication intake and medication refill clinic visit reminder and group two (control) participants will receive the same routine standard treatment care as the intervention group, but no SMS text and phone calls. All participants will be followed for two months of home-based self-administered medication during the continuation phases of the standard treatment period. Urine test for the presence of isoniazid (INH) drug metabolites in urine will be undertaken at the random point at the fourth and eighth weeks of intervention to measure medication adherence. Medication adherence will also be assessed by self-report measurements using the AIDS Clinical Trial Group adherence (ACTG) and Visual Analogue Scales (VAS) questionnaires, and clinic appointment attendance registration. Multivariable regression model analysis will be employed to assess the effect of the Ma-MAS intervention at a significance level of P-value < 0.05 with a 95% confidence interval. Discussion For this trial, a mobile-assisted medication adherence intervention will first be developed systematically based on the Medical Research Council framework using appropriate behavioural theory and evidence. The trial will then evaluate the effect of SMS texts and phone calls on TB medication adherence. Evidence generated from this trial will be highly valuable for policymakers, program managers, and healthcare providers working in Ethiopia and beyond. Trial registration The trial is registered in the Pan-Africa Clinical Trials Registry with trial number PACTR202002831201865.

A 10-year Retrospective Study of Lung Cancer in Uganda

Background: Lung cancer is a leading cause of cancer-related deaths in Uganda. In this study, we aimed to describe the baseline characteristics and survival of patients with lung cancer at Uganda Cancer Institute (UCI). Methodology: We retrospectively reviewed medical records of all patients with a histological diagnosis of lung cancer registered at UCI between January 2008 and August 2018. Data on demographic, clinical, and treatment characteristics, and vital status were abstracted and analyzed. Patients with undocumented vital status on the medical records were contacted through phone calls. We determined survival as time from histological diagnosis to death. The Kaplan-Meier survival analysis was performed to estimate the median survival time and the 5-year overall survival rate. Results: Of the 207 patients enrolled, 56.5% (n=117) were female, median age was 60 years (range: 20-94), 78.7% (n=163) were never-smokers and 18 (8.7%) were living with HIV. Presumptive anti-tuberculosis treatment was given to 23.2% (n=48). Majority had non-small cell lung cancer (96.6%, n=200) with 74.5% (n=149) adenocarcinoma and 19% (n=38) squamous cell carcinoma. All had advanced (stage III or IV) disease with 96.1% (n=199) in stage IV. Chemotherapy (44.9%, n=93) and biological therapy (34.8%, n=72) were the commonest treatments used. Overall survival at 6 months, 1-, 2- and 5-years was 41.7%, 29.7%, 11.8% and 1.7% respectively. The median survival time was 4.4 months and was not different between NSCLC and SCLC (4.5 vs. 3.9 months respectively, p=.335). Conclusion: In Uganda, adenocarcinoma is the predominant histologic subtype of lung cancer predominantly occurring in females and non-smokers. Patients present late with advanced disease and poor overall survival. Public awareness should be heightened to facilitate early screening and improve outcomes.

Towards Device Independent Eavesdropping on Telephone Conversations with Built-in Accelerometer

Motion sensors in modern smartphones have been exploited for audio eavesdropping in loudspeaker mode due to their sensitivity to vibrations. In this paper, we further move one step forward to explore the feasibility of using built-in accelerometer to eavesdrop on the telephone conversation of caller/callee who takes the phone against cheek-ear and design our attack Vibphone. The inspiration behind Vibphone is that the speech-induced vibrations (SIV) can be transmitted through the physical contact of phone-cheek to accelerometer with the traces of voice content. To this end, Vibphone faces three main challenges: i) Accurately detecting SIV signals from miscellaneous disturbance; ii) Combating the impact of device diversity to work with a variety of attack scenarios; and iii) Enhancing feature-agnostic recognition model to generalize to newly issued devices and reduce training overhead. To address these challenges, we first conduct an in-depth investigation on SIV features to figure out the root cause of device diversity impacts and identify a set of critical features that are highly relevant to the voice content retained in SIV signals and independent of specific devices. On top of these pivotal observations, we propose a combo method that is the integration of extracted critical features and deep neural network to recognize speech information from the spectrogram representation of acceleration signals. We implement the attack using commodity smartphones and the results show it is highly effective. Our work brings to light a fundamental design vulnerability in the vast majority of currently deployed smartphones, which may put people's speech privacy at risk during phone calls. We also propose a practical and effective defense solution. We validate that it is feasible to prevent audio eavesdropping by using random variation of sampling rate.