When Your Child Has Cancer: A Path-Analysis Model to Show the Relationships between Flourishing and Health in Parents of Children with Cancer

Background: Childhood cancer is a disease with a psychosocial impact on parents who experience health problems and distress. Their reactions depend on the relationship of multiple factors. The objective of this paper is to evaluate the interrelationships between flourishing and the variables linked to the health and wellbeing of parents of children with cancer. Methods: Mothers/fathers of children with cancer participated in an exploratory study in response to a series of questionnaires. Likert-type scales were used to measure perceived health, wellbeing, flourishing, stress, coping, and social support. Results: Out of a total of 94 children, 138 parents (60 men/78 women) are represented. Participants show physical symptoms and an unstable coping pattern. A path analysis model is presented. As to the goodness of adjustment of the statistics used, good results were obtained. Flourishing tends to coexist with wellbeing, while flourishing coexists negatively with symptoms. There is an indirect relationship between flourishing and poor health. There is a positive relationship between flourishing and coping, as well as between flourishing and satisfaction with the support received (especially from sons/daughters). This support was negatively related to the subjective health report. Conclusions: Flourishing is shown as a healthy coping strategy. The results can enrich the development of psychosocial interventions aimed at promoting adequate adaptation.

Pemberian Air Rebusan Daun Sirsak Untuk Menurunkan Tekanan Darah Pada Klien Hipertensi Di Pesisir Barat Lampung

ABSTRAK Berdasarkan laporan Kemenkes RItahun 2019 jumlah kasus hipertensi di Indonesia tahun 2014, Hipertensi dengan komplikasi (5,3%) merupakan penyebab kematian nomor 5 (lima) pada semua umur.Hipertensi dapat diatasi dengan tanaman herbal misalnya jus mentimun, daun seledri, dan salah satunya air rebusan daun sirsak. Tujuan setelah penyuluhan dan demonstrasi, diharapkan pemberian air rebusan daun sirsak dapat untuk menurunkan tekanan darah tinggi pada klien hipertensi. Adapun kegiatan yang dilakukan berupa penyuluhan menggunakan leaflet dan demonstrasi pembuatan air rebusan daun sirsak. Terdapat penurunan tekanan darah pada klien hipertensi setelah pemberian air rebusan daun sirsak selama 7 hari di Pesisir Barat Lampung. Dengan demikian, pemberian air rebusan daun sirsak pada klien hipertensi sangat efektif dalam menurunkan tekanan darah. Kata kunci: Hipertensi, Tekanan Darah, Air Rebusan Daun Sirsak ABSTRACTBased on the Republic of Indonesia's Ministry of Health report in 2019 the number of cases of hypertension in Indonesia in 2014, hypertension with complications (5.3%) is the number 5 cause of death at all ages. Hypertension can be overcome with herbal plants such as cucumber juice, celery leaves, and one of them is soursop leaf boiled water. The aim after counseling and demonstration is expected to give soursop leaf boiled water to reduce high blood pressure in hypertensive clients. The activities were carried out in the form of counseling using leaflets and demonstrations making soursop leaf cooking water. There was a decrease in blood pressure in hypertensive clients after giving soursop boiled water for 7 days in Pesisir Barat Lampung. Thus, giving soursop leaf boiled water to hypertensive clients is very effective in lowering blood pressure. Keywords: Hypertension, Blood Pressure, Soursop Leaf Stew Water.

Predicting the immediate impact of national lockdown on neovascular age-related macular degeneration and associated visual morbidity: an INSIGHT Health Data Research Hub for Eye Health report

ObjectivePredicting the impact of neovascular age-related macular degeneration (nAMD) service disruption on visual outcomes following national lockdown in the UK to contain SARS-CoV-2.Methods and analysisThis retrospective cohort study includes deidentified data from 2229 UK patients from the INSIGHT Health Data Research digital hub. We forecasted the number of treatment-naïve nAMD patients requiring anti-vascular endothelial growth factor (anti-VEGF) initiation during UK lockdown (16 March 2020 through 31 July 2020) at Moorfields Eye Hospital (MEH) and University Hospitals Birmingham (UHB). Best-measured visual acuity (VA) changes without anti-VEGF therapy were predicted using post hoc analysis of Minimally Classic/Occult Trial of the Anti-VEGF Antibody Ranibizumab in the Treatment of Neovascular AMD trial sham-control arm data (n=238).ResultsAt our centres, 376 patients were predicted to require anti-VEGF initiation during lockdown (MEH: 325; UHB: 51). Without treatment, mean VA was projected to decline after 12 months. The proportion of eyes in the MEH cohort predicted to maintain the key positive visual outcome of ≥70 ETDRS letters (Snellen equivalent 6/12) fell from 25.5% at baseline to 5.8% at 12 months (UHB: 9.8%–7.8%). Similarly, eyes with VA <25 ETDRS letters (6/96) were predicted to increase from 4.3% to 14.2% at MEH (UHB: 5.9%–7.8%) after 12 months without treatment.ConclusionsHere, we demonstrate how combining data from a recently founded national digital health data repository with historical industry-funded clinical trial data can enhance predictive modelling in nAMD. The demonstrated detrimental effects of prolonged treatment delay should incentivise healthcare providers to support nAMD patients accessing care in safe environments.Trial registration numberNCT00056836.

AUTOMOTIVE HEALTH TRACKING USING IOT AND ARDUINO

This paper is concerned with the development of an embedded system for detecting the vehicle condition by monitoring the internal parameters used in evaluating the vehicle's current health condition. An in-vehicle embedded system is being developed in this project to generate a vehicle health report (VHR) whenever the user requires it. It predicts future errors, allowing the driver to travel without interruption and avoid accidents. As a result, it warns the driver of potential errors and assists him in driving safely. The data needed to generate the health report is made up of parameter values (outputs of in-built sensors) from various systems inside the vehicle. Our framework is based on the Arduino and IoT stages, which are used to separate various parameters, for example, motor warming and fuel pipe blockage, for safe and cautious driving. The data is sent to IoT, where it can be checked by both the vehicle manufacturer via distributed computing and the vehicle owner via the Android application. The equipment unit consists of an Arduino, a WI-FI module, a portable Androidbased device, and a unique parameter checking sensors module. The ESP8266 WiFi Module is a self-contained SOC with integrated TCP/IP protocol stack that can give any microcontroller access to your WiFi network, which is used in current generation automotive.

Exploring and Characterizing Patient Multi-Behavior Engagement Trails and Patient Behavior Preference Patterns in the Pathway-Based mHealth Hypertension Self-Management: Analysis of Usage Data (Preprint)

BACKGROUND Hypertension is a long-term medical condition. Mobile health services can help out-of-hospital patients to self-manage. However, not all management is effective, which may be because the behavior mechanism and behavior preferences of patients with various characteristics in hypertension management were unclear. OBJECTIVE The purpose of this study was to (1) explore patient multi-behavior engagement trails in the pathway-based hypertension self-management; (2) discover patient behavior preference patterns; (3) identify the characteristics of patients with different behavior preferences. METHODS This study included 863 hypertensive patients who generated 295,855 usage records in the mHealth app from December 28, 2016 to July 2, 2020. Markov Chain was used to infer the patient multi-behavior engagement trails, which contained the type, quantity, time spent, sequence, and transition probability of patient behavior. K-means algorithm was used to group patients by the normalized behavior preference features: the number of behavioral states that a patient performed in each trail. The pages in the app represented the behavior states. Chi-square tests, Z-test, analysis of variances, and Bonferroni multiple comparisons were conducted to characterize the patient behavior preference patterns. RESULTS Markov Chain analysis revealed 3 types of behavior transition (one-way transition, cycle-transition, and self-transition) and 4 trails of patient multi-behavior engagement. In perform task trail (PT-T), Patients preferred to start self-management from the states of Task BP (0.29), Task Drug (0.18), and Task Weight (0.20), and spent more time on the Task Food state (35.87s). Some patients entered the states of Task BP (0.20) and Task Drug (0.25) from the Reminder Item state. In result-oriented trail (RO-T), patients spent more energy on the Ranking state (19.66s) compared the Health Report state (13.52s). In knowledge learning trail (KL-T), there was a high probability of cycle-transition (0.47, 0.31) between the states of Knowledge List and Knowledge Content. In support acquisition trail (SA-T), there was a high probability of self-transition in the Questionnaire (0.29) state. K-means analysis discovered 3 patient behavior preference patterns: only PT-T, PT-T and KL-T, and PT-T and SA-T. There were statistically significant associations between the behavior preference pattern and gender, education level, and blood pressure (BP). CONCLUSIONS This study identified the dynamic, longitudinal, and multi-dimension characteristics of patient behavior. Patients preferred to focus on BP, medications, and weight conditions, and pay attention to BP and medications using reminders. The diet management and questionnaires were complicated and difficult to implement and record. Competitive methods such as ranking were more likely to attract patients to pay attention to their own self-management states. Female patients with lower education level and poor-controlled BP were more likely to be highly involved in hypertension health education.

Setting up a pragmatic clinical trial in a low-resource setting: A qualitative assessment of GoLBeT, a trial of podoconiosis management in Northern Ethiopia

Background Clinical trials are often perceived as being expensive, difficult and beyond the capacity of healthcare workers in low-resource settings. However, in order to improve healthcare coverage, the World Health Organization (WHO) World Health Report 2013 stated that all countries need to become generators as well as recipients of data. This study is a methodological examination of the steps and processes involved in setting up the Gojjam Lymphoedema Best Practice Trial (GoLBeT; ISRCTN67805210), a highly pragmatic clinical trial conducted in northern Ethiopia. Challenges to the trial and strategies used to deal with them were explored, together with the reasons for delays. Methodology and principal findings Qualitative research methods were used to analyse emails and reports from the period between trial inception and recruitment. This analysis was complemented by interviews with key informants from the trial operational team. The Global Health Research Process Map was used as a framework against which to compare the steps involved in setting up the trial. A mini-group discussion was conducted with the trial operational team after study completion for reflection and further recommendations. This study showed that the key areas of difficulty in setting up and planning this trial were: the study design, that is, deciding on the study endpoint, where and how best to measure it, and assuring statistical power; recruitment and appropriate training of staff; planning for data quality; and gaining regulatory approvals. Collaboration, for example with statisticians, the trial steering committee, the study monitors, and members of the local community was essential to successfully setting up the trial. Conclusions and significance Lessons learnt from this trial might guide others planning pragmatic trials in settings where research is not common, allowing them to anticipate possible challenges and address them through trial design, planning and operational delivery. We also hope that this example might encourage similar pragmatic studies to be undertaken. Such studies are rarely undertaken or locally led, but are an accessible and efficient way to drive improved outcomes in public health.

Validation of Wireless Battery Management System (wBMS) – Gen2

Wireless Battery Management System (wBMS) is a primary enabler for the widespread adoption of electric cars, allowing auto Original Equipment Manufacturer (OEMs) to avoid having to rework complicated wiring diagrams for each new car and ensuring battery scalability. This article mainly focuses on the validation of an end-to-end wBMS system by performing several tests like Packet Transfer Ratio (PTR) for different configuration files, developing and implementing a health report application that generates health report in real-time, automating the process of OTA (Over the Air) upgrade which also includes automation of configuring the front-end application using a python programming language. The main intention behind developing the script to automate the OTA upgrade and health report application is to reduce the time consumed to test the system, reduce human errors, and perform the tests for any number of iterations.

Lifebook Excerpt: Assessing Health From Home

Objectives To consolidate and simplify the plethora of available information regarding health and nutrition. The Lifebook aims to serve as an accessible community resource that can help improve one's health, regardless of any health equity barriers one may experience. As the internet is filled with seemingly endless pages of information surrounding these topics, presenting a summary for those who may not have the access, time, or knowledge to conduct such a search is greatly needed. Methods By examining book and online resources, while keeping in mind the reliability of the utilized sources, several fundamental questions were answered and adapted into chapter content for the Lifebook. These questions allowed exploration of topics such as determinants of health and nutritional analysis. Results Identified that can provide users with ways to identify their personal health risks, as well as provide them with an actionable plan to move towards a healthier lifestyle. For those without internet access, it was determined that there are ten key areas of health that are commonly identified as being vital to living a healthy life. Moreover, a method to grade one's health on a traditional A-F scale, known as the “Health Report Card,” was also discussed. Although it in no way can fully replace a doctor's assessment one's health, it can be used as a good first step when examining one's health with their physician and in identifying target areas for improvement. Lastly, diet was explored. This included both specific recipes, as well as different ways to determine the nutritional value of food. With mobile phone access, some apps that allow the tracking of daily calories consumed, exercise, weight, and water intake were identified. Conclusions The Lifebook will provide consolidated and simplified information regarding health and nutrition. It may not cover every possible aspect of of these topics, however it will surely be a useful start to those wanting to take control of their health from the comfort of their own home. Funding Sources There are no funding sources associated with this research at this time.