bluuebunny/crossref_metadata_2025 huggingface dataset:
Step-Based Metrics and Overall Physical Activity in Children With Overweight or Obesity: Cross-Sectional Study
Authors: Migueles Jairo H , Cadenas-Sanchez Cristina , Aguiar Elroy J , Molina-Garcia Pablo , Solis-Urra Patricio , Mora-Gonzalez Jose , García-Mármol Eduardo , Shiroma Eric J , Labayen Idoia , Chillón Palma , Löf Marie , Tudor-Locke Catrine , Ortega Francisco B
Published: December 2019

Background

Best-practice early interventions to increase physical activity (PA) in children with overweight and obesity should be both feasible and evidence based. Walking is a basic human movement pattern that is practical, cost-effective, and does not require complex movement skills. However, there is still a need to investigate how much walking—as a proportion of total PA level—is performed by children who are overweight and obese in order to determine its utility as a public health strategy.

Objective

This study aimed to (1) investigate the proportion of overall PA indicators that are explained by step-based metrics and (2) study step accumulation patterns relative to achievement of public health recommendations in children who are overweight and obese.

Methods

A total of 105 overweight and obese children (mean 10.1 years of age [SD 1.1]; 43 girls) wore hip-worn accelerometers for 7 days. PA volumes were derived using the daily average of counts per 15 seconds, categorized using standard cut points for light-moderate-vigorous PA (LMVPA) and moderate-to-vigorous PA (MVPA). Derived step-based metrics included volume (steps/day), time in cadence bands, and peak 1-minute, 30-minute, and 60-minute cadences.

Results

Steps per day explained 66%, 40%, and 74% of variance for counts per 15 seconds, LMVPA, and MVPA, respectively. The variance explained was increased up to 80%, 92%, and 77% by including specific cadence bands and peak cadences. Children meeting the World Health Organization recommendation of 60 minutes per day of MVPA spent less time at zero cadence and more time in cadence bands representing sporadic movement to brisk walking (ie, 20-119 steps/min) than their less-active peers.

Conclusions

Step-based metrics, including steps per day and various cadence-based metrics, seem to capture a large proportion of PA for children who are overweight and obese. Given the availability of pedometers, step-based metrics could be useful in discriminating between those children who do or do not achieve MVPA recommendations.

Trial Registration

ClinicalTrials.gov NCT02295072; https://clinicaltrials.gov/ct2/show/NCT02295072
Effectiveness of a Digital Lifestyle Change Program in Obese and Type 2 Diabetes Populations: Service Evaluation of Real-World Data
Authors: Idris Iskandar , Hampton James , Moncrieff Fiona , Whitman Michael
Published: December 2019

Background

The prevalence of type 2 diabetes mellitus (T2DM) and obesity is increasing, and the way people interact with health care is evolving. People traditionally access advice and support to improve their lifestyle and learn more about the self-management of T2DM in a face-to-face setting. Although these services have a strong evidence base, they have limitations for reaching specific groups of people. Digital programs could provide a new delivery model to help more people access health education and behavior change support, but long-term data supporting these programs are limited.

Objective

The purpose of this service evaluation was to analyze the weight change of people who participated in OurPath (also known as Second Nature), a UK-based digital lifestyle change program, for either weight management or diabetes-related weight management and structured education at 6 and 12 months.

Methods

Participants either paid to access the program privately (self-funded clients) or were referred by their general practitioner to participate in the program free of charge (funded by the National Health Service). Additional follow-up support was provided to help people to maintain lifestyle changes. To retrospectively assess potential weight loss, the analysis included data from participants who submitted weight readings at baseline and 6 and 12 months after starting the program. Changes in weight after 6 and 12 months were primary outcome measures.

Results

For the 896 participants who submitted baseline and 6- and 12-month data, a significant change in mean weight of −7.12 kg (−7.50%; SD 6.37; P<.001) was observed at 6 months. Data from the same participants at 12 months showed a change in mean weight when compared with a baseline of −6.14 kg (−6.48%; SD 6.97; P<.001).

Conclusions

The data presented here had several limitations, and there were too many uncertainties to make any reliable conclusions. However, these results suggest that digital lifestyle change programs could provide a new way to help people to access nutritional advice and support to achieve weight loss. Further research into digital education and coaching platforms is needed to establish their effectiveness.
Use of Teleconsultations in a Regional Stereotactic Radiosurgery Service: Pilot Study
Authors: O'Cathail Micheal , Aznar-Garcia Luis , Sivanandan Ananth , Diver Claire , Patel Poulam , Tang Pui-Shan , Christian Judith
Published: December 2019

Background

The National Health Service Long Term Plan details plans to make digital interactions available to all patients in 5 years. Teleconsultations can improve access to specialist services; however, there is a lack of evidence for the use of teleconsultations in an oncology setting in the United Kingdom.

Objective

We aim to describe a service evaluation of teleconsultations for patients attending a regional brain metastases clinic. These patients have unique travel restrictions that prevent them from driving.

Methods

From April to October 2018, all patients attending the brain metastases clinic were offered the choice of teleconsultation in place of a face-to-face appointment. Feedback was assessed using a satisfaction questionnaire, and data of all clinic attendances were collected.

Results

A total of 69 individual patients had 119 appointments over the duration of the pilot, of which 36 (30.2%) were new patient appointments and 73 (61.3%) were follow-ups. Of the 69 patients, 24 (35%) took part in teleconsultations (41/119, 34.5%). User satisfaction was high, and no patients who took part in a teleconsultation reverted to face-to-face appointments. These patients avoided 2521 miles (61.6 miles per appointment) of hospital-associated travel and travel costs of £441.48 (US $599.83) to £10.78 (US $14.65) per appointment.

Conclusions

Teleconsultations appear to be acceptable in this cohort of patients with brain metastases attending a regional stereotactic radiosurgery service with the potential for significant savings in travel and expenses.
Preliminary Effects of a Mobile Interactive Supervised Therapy Intervention on People Living With HIV: Pilot Randomized Controlled Trial
Authors: Pang Yan , Molton James Steven , Ooi Wei Tsang , Paton Nicholas Iain , He Hong-Gu
Published: December 2019

Background

As people living with HIV infection require lifelong treatment, nonadherence to medication will reduce their chance of maintaining viral suppression and increase the risk of developing drug resistance and HIV transmission.

Objective

This study aimed to evaluate the efficacy of a mobile app, Mobile Interactive Supervised Therapy (MIST), for improving adherence to oral HIV medications among HIV-infected adults in Singapore.

Methods

We conducted a two-group pilot randomized controlled trial (RCT) with a process evaluation, in which 40 HIV-infected participants with once-daily medication regimes were recruited from a public tertiary hospital in Singapore and randomly assigned equally to either the intervention (receiving MIST and routine care) or control (receiving routine care only) groups. The intervention lasted for 2 months. The outcome of antiretroviral therapy (ART) adherence was measured by a 7-day recall self-report (SR), pill count (PC), an electronic medical device—Medication Event Monitoring System (MEMS)—and a mobile app—MIST (for the intervention group only). In total, 20 participants from the intervention group were interviewed at the end of the intervention to assess the acceptability of MIST. Data were collected at baseline and at 1-month and 2-month postintervention.

Results

All participants had excellent medication adherence at baseline (median 100, IQR 100-100). The use of MIST did not result in a significant improvement in ART adherence when measured by the SR, PC, and MEMS, as compared with the control group at 1-month (P values >.99, .86, and .74, respectively) and 2-month (P values=.80, .84, and .82, respectively) postintervention. ART adherence also did not improve in each group over the same period. MIST was perceived to be a beneficial tool based on the process evaluation results.

Conclusions

Although MIST did not enhance medication adherence to HIV treatments, mainly owing to the ceiling effect, it was perceived to be beneficial among the participants of this study. Our process evaluation provided useful data to further develop MIST for bigger and long-term mobile phone app–assisted intervention RCTs in the future.

Trial Registration

ClinicalTrials.gov NCT03794648; https://clinicaltrials.gov/ct2/show/NCT03794648
A Values-Tailored Web-Based Intervention for New Mothers to Increase Infant Vaccine Uptake: Development and Qualitative Study
Authors: Dempsey Amanda , Kwan Bethany M , Wagner Nicole M , Pyrzanowski Jennifer , Brewer Sarah E , Sevick Carter , Narwaney Komal , Resnicow Kenneth , Glanz Jason
Published: December 2019

Background

Vaccine hesitancy among parents leads to childhood undervaccination and outbreaks of vaccine-preventable disease. As the reasons for vaccine hesitancy are diverse, there is often not enough time during regular clinical visits for medical providers to adequately address all the concerns that parents have. Providing individually tailored vaccine information via the internet before a clinical visit may be a good mechanism for effectively allaying parents’ vaccination concerns while also being time efficient. Including tailoring based on values is a promising, but untested, approach to message creation.

Objective

This study aimed to describe the process by which we developed a Web-based intervention that is being used in an ongoing randomized controlled trial aimed at improving the timeliness of infant vaccination by reducing parental vaccine hesitancy.

Methods

Development of the intervention incorporated evidence-based health behavior theories. A series of interviews, surveys, and feedback sessions were used to iteratively develop the intervention in collaboration with vaccination experts and potential end users.

Results

In all, 41 specific content areas were identified to be included in the intervention. User feedback elucidated preferences for specific design elements to be incorporated throughout the website. The tile-based architecture chosen for the website was perceived as easy to use. Creating messages that were two-sided was generally preferred over other message formats. Quantitative surveys identified associations between specific vaccine values and vaccination beliefs, suggesting that values tailoring should vary, depending on the specific belief being endorsed.

Conclusions

Using health behavior theories, qualitative and quantitative data, and significant expert and end user input, we created a novel, Web-based intervention to improve infant vaccination timeliness. The intervention is based on tailoring messages according to each individual’s values and beliefs. This intervention is currently being tested in a controlled randomized clinical trial.
Responses of Conversational Agents to Health and Lifestyle Prompts: Investigation of Appropriateness and Presentation Structures
Authors: Kocaballi Ahmet Baki , Quiroz Juan C , Rezazadegan Dana , Berkovsky Shlomo , Magrabi Farah , Coiera Enrico , Laranjo Liliana
Published: December 2019

Background

Conversational agents (CAs) are systems that mimic human conversations using text or spoken language. Their widely used examples include voice-activated systems such as Apple Siri, Google Assistant, Amazon Alexa, and Microsoft Cortana. The use of CAs in health care has been on the rise, but concerns about their potential safety risks often remain understudied.

Objective

This study aimed to analyze how commonly available, general-purpose CAs on smartphones and smart speakers respond to health and lifestyle prompts (questions and open-ended statements) by examining their responses in terms of content and structure alike.

Methods

We followed a piloted script to present health- and lifestyle-related prompts to 8 CAs. The CAs’ responses were assessed for their appropriateness on the basis of the prompt type: responses to safety-critical prompts were deemed appropriate if they included a referral to a health professional or service, whereas responses to lifestyle prompts were deemed appropriate if they provided relevant information to address the problem prompted. The response structure was also examined according to information sources (Web search–based or precoded), response content style (informative and/or directive), confirmation of prompt recognition, and empathy.

Results

The 8 studied CAs provided in total 240 responses to 30 prompts. They collectively responded appropriately to 41% (46/112) of the safety-critical and 39% (37/96) of the lifestyle prompts. The ratio of appropriate responses deteriorated when safety-critical prompts were rephrased or when the agent used a voice-only interface. The appropriate responses included mostly directive content and empathy statements for the safety-critical prompts and a mix of informative and directive content for the lifestyle prompts.

Conclusions

Our results suggest that the commonly available, general-purpose CAs on smartphones and smart speakers with unconstrained natural language interfaces are limited in their ability to advise on both the safety-critical health prompts and lifestyle prompts. Our study also identified some response structures the CAs employed to present their appropriate responses. Further investigation is needed to establish guidelines for designing suitable response structures for different prompt types.
Descriptive Evaluation and Accuracy of a Mobile App to Assess Fall Risk in Seniors: Retrospective Case-Control Study
Authors: Rabe Sophie , Azhand Arash , Pommer Wolfgang , Müller Swantje , Steinert Anika
Published: December 2019

Background

Fall-risk assessment is complex. Based on current scientific evidence, a multifactorial approach, including the analysis of physical performance, gait parameters, and both extrinsic and intrinsic risk factors, is highly recommended. A smartphone-based app was designed to assess the individual risk of falling with a score that combines multiple fall-risk factors into one comprehensive metric using the previously listed determinants.

Objective

This study provides a descriptive evaluation of the designed fall-risk score as well as an analysis of the app’s discriminative ability based on real-world data.

Methods

Anonymous data from 242 seniors was analyzed retrospectively. Data was collected between June 2018 and May 2019 using the fall-risk assessment app. First, we provided a descriptive statistical analysis of the underlying dataset. Subsequently, multiple learning models (Logistic Regression, Gaussian Naive Bayes, Gradient Boosting, Support Vector Classification, and Random Forest Regression) were trained on the dataset to obtain optimal decision boundaries. The receiver operating curve with its corresponding area under the curve (AUC) and sensitivity were the primary performance metrics utilized to assess the fall-risk score's ability to discriminate fallers from nonfallers. For the sake of completeness, specificity, precision, and overall accuracy were also provided for each model.

Results

Out of 242 participants with a mean age of 84.6 years old (SD 6.7), 139 (57.4%) reported no previous falls (nonfaller), while 103 (42.5%) reported a previous fall (faller). The average fall risk was 29.5 points (SD 12.4). The performance metrics for the Logistic Regression Model were AUC=0.9, sensitivity=100%, specificity=52%, and accuracy=73%. The performance metrics for the Gaussian Naive Bayes Model were AUC=0.9, sensitivity=100%, specificity=52%, and accuracy=73%. The performance metrics for the Gradient Boosting Model were AUC=0.85, sensitivity=88%, specificity=62%, and accuracy=73%. The performance metrics for the Support Vector Classification Model were AUC=0.84, sensitivity=88%, specificity=67%, and accuracy=76%. The performance metrics for the Random Forest Model were AUC=0.84, sensitivity=88%, specificity=57%, and accuracy=70%.

Conclusions

Descriptive statistics for the dataset were provided as comparison and reference values. The fall-risk score exhibited a high discriminative ability to distinguish fallers from nonfallers, irrespective of the learning model evaluated. The models had an average AUC of 0.86, an average sensitivity of 93%, and an average specificity of 58%. Average overall accuracy was 73%. Thus, the fall-risk app has the potential to support caretakers in easily conducting a valid fall-risk assessment. The fall-risk score’s prospective accuracy will be further validated in a prospective trial.
A Mobile Phone–Based Support Intervention to Increase Use of Postabortion Family Planning in Cambodia: Cost-Effectiveness Evaluation
Authors: Hill Jeremy , McGinn Jourdan , Cairns John , Free Caroline , Smith Chris
Published: December 2019

Background

Despite progress over the last decade, there is a continuing unmet need for contraception in Cambodia. Interventions delivered by mobile phone could help increase uptake and continuation of contraception, particularly among hard-to-reach populations, by providing interactive personalized support inexpensively wherever the person is located and whenever needed.

Objective

The objective of this study was to evaluate the cost-effectiveness of mobile phone–based support added to standard postabortion family planning care in Cambodia, according to the results of the MOTIF (MObile Technology for Improved Family planning) trial.

Methods

A model was created to estimate the costs and effects of the intervention versus standard care. We adopted a societal perspective when estimating costs, including direct and indirect costs for users. The incremental cost-effectiveness ratio was calculated for the base case, as well as a deterministic and probabilistic sensitivity analysis, which we compared against a range of likely cost-effectiveness thresholds.

Results

The incremental cost of mobile phone–based support was estimated to be an additional US $8160.49 per 1000 clients, leading to an estimated 518 couple-years of protection (CYPs) gained per 1000 clients and 99 disability-adjusted life-years (DALYs) averted. The incremental cost-effectiveness ratio was US $15.75 per additional CYP and US $82.57 per DALY averted. The model was most sensitive to personnel and mobile service costs. Assuming a range of cost-effectiveness thresholds from US $58 to US $176 for Cambodia, the probability of the intervention being cost-effective ranged from 11% to 95%.

Conclusions

This study demonstrates that the cost-effectiveness of the intervention delivered by mobile phone assessed in the MOTIF trial lies within the estimated range of the cost-effectiveness threshold for Cambodia. When assessing value in interventions to improve the uptake and adherence of family planning services, the use of interactive mobile phone messaging and counselling for women who have had an abortion should be considered as an option by policy makers.

Trial Registration

ClinicalTrials.gov NCT01823861; https://clinicaltrials.gov/ct2/show/NCT01823861
A Possible Mobile Health Solution in Orthopedics and Trauma Surgery: Development Protocol and User Evaluation of the Ankle Joint App
Authors: Dittrich Florian , Back David Alexander , Harren Anna Katharina , Jäger Marcus , Landgraeber Stefan , Reinecke Felix , Beck Sascha
Published: December 2019

Background

Ankle sprains are one of the most frequent sports injuries. With respect to the high prevalence of ankle ligament injuries and patients’ young age, optimizing treatment and rehabilitation is mandatory to prevent future complications such as chronic ankle instability or osteoarthritis.

Objective

In modern times, an increasing amount of smartphone usage in patient care is evident. Studies investigating mobile health (mHealth)–based rehabilitation programs after ankle sprains are rare. The aim of this study was to expose any issues present in the development process of a medical app as well as associated risks and chances.

Methods

The development process of the Ankle Joint App was defined in chronological order using a protocol. The app’s quality was evaluated using the (user) German Mobile App Rating Scale (MARS-G) by voluntary foot and ankle surgeons (n=20) and voluntary athletes (n=20).

Results

A multidisciplinary development team built a hybrid app with a corresponding backend structure. The app’s content provides actual medical literature, training videos, and a log function. Excellent interrater reliability (interrater reliability=0.92; 95% CI 0.86-0.96) was obtained. The mean overall score for the Ankle Joint App was 4.4 (SD 0.5). The mean subjective quality scores were 3.6 (surgeons: SD 0.7) and 3.8 (athletes: SD 0.5). Behavioral change had mean scores of 4.1 (surgeons: SD 0.7) and 4.3 (athletes: SD 0.7). The medical gain value, rated by the surgeons only, was 3.9 (SD 0.6).

Conclusions

The data obtained demonstrate that mHealth-based rehabilitation programs might be a useful tool for patient education and collection of personal data. The achieved (user) MARS-G scores support a high quality of the tested app. Medical app development with an a priori defined target group and a precisely intended purpose, in a multidisciplinary team, is highly promising. Follow-up studies are required to obtain funded evidence for the ankle joints app’s effects on economical and medical aspects in comparison with established nondigital therapy paths.
Influence of Organizational Issues on Nurse Administrators’ Support to Staff Nurses’ Use of Smartphones for Work Purposes in the Philippines: Focus Group Study
Authors: Bautista John Robert , Lin Trisha T C , Theng Yin-Leng
Published: December 2019

Background

Studies show that nurses use their own smartphones for work purposes, and there are several organizational issues related to this. However, it is unclear what these organizational issues are in the Philippines and the influence they have on nurse administrators’ (ie, superiors) support to staff nurses’ (ie, subordinates) use of smartphones for work purposes.

Objective

Drawing from the Organizational Support Theory (OST), this study aimed to identify organizational issues that influence nurse administrators’ support to staff nurses’ use of smartphones for work purposes.

Methods

Between June and July 2017, 9 focus groups with 43 nurse administrators (ie, head nurses, nurse supervisors, and nurse managers) were conducted in 9 tertiary-level general hospitals in Metro Manila, the Philippines. Drawing from OST, issues were classified as those that encouraged or inhibited nurse administrators to support nurses’ use of smartphones for work purposes.

Results

Nurse administrators were encouraged to support nurses’ use of smartphones for work purposes when (1) personal smartphones are superior to workplace technologies, (2) personal smartphones resolve unit phone problems, and (3) policy is unrealistic to implement. Conversely, issues that inhibited nurse administrators to support nurses’ use of smartphones for work purposes include (1) smartphone use for nonwork purposes and (2) misinterpretation by patients.

Conclusions

Nurse administrators in the Philippines faced several organizational issues that encouraged or inhibited support to staff nurses’ use of smartphones for work purposes. Following OST, the extent of their support can influence staff nurses’ perceived organizational support on the use of smartphones for work purposes, Overall, the findings highlight the role and implication of organizational support in the context of smartphone consumerization in hospital settings, especially in developing countries.
Predicting Breast Cancer in Chinese Women Using Machine Learning Techniques: Algorithm Development (Preprint)
Authors: Hou Can , Zhong Xiaorong , He Ping , Xu Bin , Diao Sha , Yi Fang , Zheng Hong , Li Jiayuan
Published: December 2019

BACKGROUND

Risk-based breast cancer screening is a cost-effective intervention for controlling breast cancer in China, but the successful implementation of such intervention requires an accurate breast cancer prediction model for Chinese women.

OBJECTIVE

This study aimed to evaluate and compare the performance of four machine learning algorithms on predicting breast cancer among Chinese women using 10 breast cancer risk factors.

METHODS

A dataset consisting of 7127 breast cancer cases and 7127 matched healthy controls was used for model training and testing. We used repeated 5-fold cross-validation and calculated AUC, sensitivity, specificity, and accuracy as the measures of the model performance.

RESULTS

The three novel machine-learning algorithms (XGBoost, Random Forest and Deep Neural Network) all achieved significantly higher area under the receiver operating characteristic curves (AUCs), sensitivity, and accuracy than logistic regression. Among the three novel machine learning algorithms, XGBoost (AUC 0.742) outperformed deep neural network (AUC 0.728) and random forest (AUC 0.728). Main residence, number of live births, menopause status, age, and age at first birth were considered as top-ranked variables in the three novel machine learning algorithms.

CONCLUSIONS

The novel machine learning algorithms, especially XGBoost, can be used to develop breast cancer prediction models to help identify women at high risk for breast cancer in developing countries.
Efficacy of an activity tracker-and app intervention to increase physical activity in the entire family: Pilot single-arm intervention study (Preprint)
Authors: Schoeppe Stephanie , Salmon Jo , Williams Susan L. , Power Deborah , Alley Stephanie , Rebar Amanda L. , Hayman Melanie , Duncan Mitch J. , Vandelanotte Corneel
Published: December 2019

BACKGROUND

Interventions using activity trackers and smartphone apps have demonstrated their ability to increase physical activity in children and adults. However, they have not been tested in entire families. Further, few family-centred interventions have actively involved both parents, and assessed intervention efficacy separately for children, mothers and fathers.

OBJECTIVE

This study aimed to examine the short-term efficacy of an activity tracker and app intervention to increase physical activity in the entire family (children, mothers and fathers).

METHODS

This was a pilot single-arm intervention study with pre-post measures. Between 2017-2018, 40 families (58 children aged 6-10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family program in Queensland, Australia. Using commercial activity trackers combined with apps (Garmin Vivofit Jr for children, Vivofit 3 for adults), the intervention included individual and family-level goal-setting, self-monitoring, performance feedback, family step challenges, family social support and modelling, weekly motivational text messages, and an introductory session delivered face-to-face or via telephone. Parent surveys were used to assess intervention efficacy measured as pre-post intervention changes in moderate-to-vigorous physical activity (MVPA) in children, mothers and fathers.

RESULTS

Thirty-eight families completed the post intervention survey (95% retention). At post intervention, MVPA had increased in children by 58 min/day (boys: 54 min/day, girls: 62 min/day; all P < .001). In mothers, MVPA increased by 27 min/day (P < .001), and in fathers, it increased by 31 min/day (P < .001). Furthermore, the percentage of children meeting Australia’s physical activity guidelines for children (≥60 MVPA min/day) increased from 34% to 89% (P < .001). The percentage of mothers and fathers meeting Australia’s physical activity guidelines for adults (≥150 MVPA min/week) increased from 8% to 57% (P < .001) in mothers, and from 21% to 68% (P < .001) in fathers.

CONCLUSIONS

Findings suggest that an activity tracker and app intervention is an efficacious approach to increasing physical activity in entire families to meet national physical activity guidelines. The Step it Up Family program warrants further testing in a larger, randomised controlled trial to determine its long-term impact.

CLINICALTRIAL

No trial registration as this is not an RCT. It is a pilot single-arm intervention study
Stakeholders’ Usage of a Publicly Available Collection of Agricultural Injury Reports from News Media: A Five-Year Analysis of Website Usage and Visitor Analytics (Preprint)
Authors: Burke Richard , Pilz Matthew , Redmond Emily , Gorucu Serap , Weichelt Bryan
Published: December 2019

UNSTRUCTURED

Agriculture, Fishing, and Forestry is the most dangerous occupation in the United States. AgInjuryNews.org is a news report-based online sentinel surveillance project that has collected news and media reports of agricultural injuries since early 2015. We aimed to provide a brief report on visitor acquisition, retention, and usage as well as monitor the efficacy of a Facebook.com social media marketing campaign. Since its inception, AgInjuryNews.org hosted 9,281 unique visitors. New users from major cities and areas housing agricultural research centers were most prominent with agricultural centers returning in larger numbers, comparatively. Users were acquired mostly through web searches, partnerships with other agencies, and paid Facebook.com advertisements. These paid advertisements recruited nearly 4000 new users, however retention and engagement was low. This analysis shows that AgInjuryNews.org is steadily growing and has further informed how to continue to recruit and engage new users.
Effects of a WhatsApp-Delivered Education Intervention to Enhance Breast Cancer Knowledge in Women: Mixed-Methods Study (Preprint)
Authors: Pereira Antonio Augusto Claudio , Destro Juliana Regina , Picinin Bernuci Marcelo , Garcia Lucas França , Rodrigues Lucena Tiago Franklin
Published: December 2019

BACKGROUND

Breast cancer is the leading cause of cancer-related death in the female population. Health education interventions based on the use of mobile technologies enable the development of health self-care skills and have emerged as alternative strategies for the control of breast cancer. In previous studies, WhatsApp has stood out as a useful tool in health education strategies; however, it has not yet been applied for breast cancer education.

OBJECTIVE

This study aimed to analyze the potential of WhatsApp as a health education tool used to improve women's knowledge on the risk reduction of breast cancer. It also aimed to understand how women feel sensitized within the WhatsApp group throughout the intervention and how they incorporate information posted to improve knowledge about early detection and risk reduction methods.

METHODS

The study involved a pre-post health educational intervention with 35 women (aged 45-69 years) included in a WhatsApp group to share information (audio, video, text, and images) over 3 weeks on the early detection and risk reduction of breast cancer. Data were collected through questionnaires on topics related to risk reduction, as well as qualitative content analysis of group interactions. Effectiveness and feasibility were analyzed through conversations and the comparison of the scores obtained in the questionnaires before and after the intervention.

RESULTS

A total of 293 messages were exchanged (moderator 120 and users 173). The average scores of the participants were 11.21 and 13.68 points before and after the educational intervention, respectively, with sufficient sample evidence that the difference was significant (P<.001). The intervention enabled women to improve their knowledge on all topics addressed, especially “myths and truths,” “incidence,” “clinical manifestations,” and “protective factors.” Some themes emerged from the interactions in the group, including group dynamics, general doubts, personal narratives, religious messages, daily news, and events.

CONCLUSIONS

The use of groups for women in WhatsApp for health education purposes seems to be a viable alternative in strategies on breast cancer control, especially as it provides a space for the exchange of experiences and disinhibition. However, the need for a moderator to answer the questions and the constant distractions by members of the group represent important limitations that should be considered when improving this strategy.
Sekolah Kader Protector Jaten: Upaya peningkatan pengetahuan dan keterampilan kader remaja posbindu PTM di Dusun Jaten, Yogyakarta
Authors: Najiyati Ifa , Mahardany Beauty Octavia , Yulyana Yana , Supriyati Supriyati , Wicaksana Anggi Lukman
Published: December 2019

Data from the Community and Family Health Care (CFHC) Faculty of Medicine, Public Health,and Nursing Universitas Gadjah Mada (UGM) in 2018 indicated that 32.6% of families in Jaten had hypertension. The results of community analysis indicated that non-communicable diseases (NCDs) were a major problem in Jaten. One of the measures to control NCDs is through integrated development and coaching post (called by posbindu PTM). The target age of posbindu PTM started from adolescence which is 15 years old. Adolescents are vulnerable group. Biological and psychological changes in adolescence have consequences that can affect their health for a lifetime. Posbindu PTM in Jaten was established in March 2018. However, the participation of adolescents was low. Early Detection and Disease Prevention by Jaten’s Adolescent Program (Protector Jaten) is designed to provide access and health services for adolescents. This program began with recruiting adolescents to be cadres and continued with cadre school. Adolescent cadres were equipped with knowledge and skills to do their duties in posbindu PTM. This study aimed to assess and explore School for Adolescent Cadres Protector Jaten to increase knowledge and skills of adolescent cadres about implementation of posbindu PTM. The design of this study was a pre-experimentalwith one group pre-test post-test design and mixed methods using the Kirkpatrick model level 1 and 2. The quantitative method was carried out using a questionnaire to 11 adolescent cadres. The qualitative method used observation to measure skills and semi-structural interviews on 5 adolescent cadres about the effect of School for Adolescent Cadres Protector Jaten. Total of 63,6% adolescent cadres were females with range of ages between 22 and 24 years old. The mean score of adolescent cadres’ knowledge was 6,5 and 8,6 for pre and post School for Adolescent Cadres Protector Jaten. There was a significant effectof School for Adolescent Cadres Protector Jaten on adolescent cadres’s knowledge (p = 0,003). There was increasing skills of adolescent cadres about the implementation of posbindu PTM. The result of interview showed that School for Adolescent Cadres Protector Jaten improved the knowledge, skill, and awareness in preventing NCDs. School for Adolescent Cadres Protector Jaten increased knowledge and skills about the implementation of posbindu PTM. Adolescent cadres still require assistance in implementing posbindu PTM as well as a refreshing program to maintain the implementation of posbindu PTM.
Problems related to acute respiratory infection among under-5 children in Sorong, West Papua: a community diagnosis approach
Authors: Thamrin Edo Prabudi , Utami Risma Kristi , Santoso Fabianto , Thamrin Ayu Ashari , Ain Siti Syahral , Pakasi Trevino Aristarkus
Published: December 2019

Acute respiratory infections (ARIs) are the leading cause of morbidity and mortality in children under five years, with a periodic prevalence of 25.9% in West Papua (2013). This study aims to explain the factors associated with ARIs in under-5 children in Sorong District, West Papua. This cross-sectional study was conducted in two districts, where trained medical students interviewed 135 mothers/caregivers by using a structured questionnaire and interviewed cadres and health workers for qualitative observation. About 85.5% of respondents stated that their children had ARIs in the previous two weeks (n=135), much higher than the data from Sorong District Health Office, which only reached 24.63%. Dominant risk factors were large household size, smoking at home, and improper handwashing habits. Only half of the respondents went to a physician in a primary care facility. Nearly half of the respondents had difficulty in accessing the facility. The majority of caregivers used over-the-counter or traditional medicine. Around 70% of respondents in Makbon Subdistrict did nothing to prevent the transmission of ARIs among children. ARIs remains a massive problem in the Sorong district. We need to educate the mothers/caregivers about the rational use of medicine and the prevention of ARIs, and also advocate for better access to clean water, sanitation, and healthcare facilities.
Survey of basic life support knowledge in security officer of the company along The Daendles Highway
Authors: Istiroha Istiroha , Basri Ahmad Hasan
Published: December 2019

Giving first aid to traffic accident victims are often not carried out by medical personnel or competent people. The first helper in traffic accidents on the Daendles Highway is the neighboring community and security officers. The purpose of this study was to describe the knowledge level of security officers concerning basic life support in order to give first aid for the accidents along the Daendles Highway of Manyar Subdistrict, Gresik. This study used a descriptive design with a cross-sectional approach. The respondents in this study were 45 security officers of the company, which is spread along the Daendles Highway of Manyar Subdistrict, Gresik, East Java. The sample was taken by purposive sampling. Data were taken using questionnaires then analyzed by univariate techniques with SPSS 16. The results showed that security with good knowledge was 31.11%, sufficient knowledge was 55.56%, and insufficient knowledge was 13.33%. The characteristic group of respondents who had good knowledge was aged 26-35 years with a working period of 1-5 years and > 5 years, while the characteristics of the respondents who had insufficient knowledge were aged 36-45 years with a working period of 1-5 years and> 5 years. Increasing knowledge and skill about basic life support are needed to reduce mortality and increase the life expectancy of victims while waiting for help from medical personnel.
Implementation of interprofessional education in community setting
Authors: Asmara Fatikhu Yatuni , Bakri Saekhol , Dewi Dian Puspita , Afifah Diana Nur , Kristina Tri Nur
Published: December 2019

Community health problem(s) needs to be solved collaboratively among the health care team. Interprofessional Education (IPE) is implemented to facilitate health students to collaborate before they join in the working world. The purpose of this study was to identify the experience of students, lecturers, and family members in the implementation of IPE in a community setting. All (465) sixth semester medical, nursing, and nutrition students in the Faculty of Medicine Universitas Diponegoro participated in the IPE program. Each small group contains 4-5 students who worked together in the community setting to identify family health problems, implement interventions, and evaluate the results. Focus Group Discussion (FGD) was conducted to evaluate the implementation. Twenty-four medical, nursing, and nutrition students, eight lecturers, and five family members were involved in this study. FGD was conducted separately among groups. The implementation is divided into four phases, namely, preparation, process, evaluation, and benefit. Unclear competencies and roles-responsibilities of each student in the program was the most problem faced during preparation, while obstacles during the process were difficult to set a schedule among team members. Conducting an objective assessment of both methods and tools needs to be concerned in the evaluation phase. However, students, lecturers, and family members appreciated the program and preferred to sustain the program. IPE can be implemented in a community setting to solve health problems and it can facilitate students to collaborate in a team, but it needs to be settled including preparation, process, and evaluation.
Empty Fruit Bunches as Potential Source for Biosilica Fertilizer for Oil Palm
Authors: Santi Laksmita Prima , Kalbuadi Donny Nugroho , Goenadi Didiek Hadjar
Published: December 2019

In Indonesia, the development of oil palm plantations has been going on a pervasive way; they covered about 14.03 million hectares in 2017. This massive coverage of land might then generate a tremendous amount of biomass per year, both in the form of both solid and liquid wastes. The processing of fresh fruit bunches (FFB) in palm oil mill (POM) produces wastes that primarily in the form of empty fruit bunches (EFB), which is amounting of up to 25% (w/w) of FFB. It has been being indicated that EFB contains a considerable amount of silica (Si) which attracts the Indonesian Research Institute for Biotechnology and Bioindustry (IRIBB) to investigate the potential use of EFB as a source of bio-available Si, in the form of H4SiO4 (mono silicic acid, BioSilAc). The experiment was carried out at Sungai Mirah Minting Estate, PT Bumitama Gunajaya Agro-Central Kalimantan. The EFB material was obtained from POM and chopped into 2.5-5.0 cm in size. A four-week bio-decomposition process was employed by using bio-decomposers containing Trichoderma pseudokoningii, T. polysporum, and Phanerochaete chrysosporium. Chemical analyses of composted EFB were conducted before and 28-days after decomposer application. The presence of Si in the compost was observed by scanning electron microscopy (SEM).  The effect of Si-containing EFB compost on the immature and mature oil palm was evaluated. Seven treatments, i.e. combination of EFB compost and BioSilAc application with reduced-dosages of NPK fertilisers were arranged in a random block design with three replicates. The results show that large quantities of silica bodies attached to the surface of EFB fibres and amounting to 0.44% soluble Si. The FFB data indicated that the application of 75% NPK + 500 kg composted EFB + 2 L BioSilAc/ha/year on a five-year-old plant resulted in higher yield than that obtained from 100% standard dosage of NPK. The study also revealed that the application of EFB compost reduced 50% of BioSilAc dosage.
Genetic Identification of Freshwater Fish Species Through DNA Barcoding from Lake Lebo Taliwang, West Nusa Tenggara
Authors: Arisuryanti Tuty , Hasan Rika Lathif , Ayu Khadija Lung , Ratman Nofita , Hakim Lukman
Published: December 2019

Lake Lebo Taliwang is one of the lakes in the West Nusa Tenggara with high freshwater fish species diversity. However, the species identification of freshwater fish species from Lake Lebo Taliwang using DNA barcoding is very limited. Therefore, the objective of this study was to identify seven samples of freshwater fish species collected from Lake Lebo Taliwang based on COI mitochondrial gene as a DNA barcoding marker and establish library COI sequences of Indonesian freshwater fish. We are using a standard DNA analysis and data obtained from this study was then examined using Nucleotide BLAST and the phylogenetic tree was analyzed using the Neighbour-Joining (NJ) method with Kimura 2 Parameter (K2P) model. The results revealed that among the seven samples of freshwater fishes collected from the Lake Lebo Taliwang, three samples were identified as Anabas testudineus, the other three samples were Barbodes binotatus and one sample was Trichopodus trichopterus. The level of similarity of these freshwater fish samples referred to the database from the GenBank and BOLD was between 98-100%. The NJ tree supports the clade of each species identified in this study. This occurrence indicated that DNA barcoding by using the COI mitochondrial gene was proven to be able to identify the freshwater fish samples accurately.
ANTI-INFLAMMATORY ACTIVITY OF MARINE SPONGE CALLYSPONGIA SP. AND ITS ACUTE TOXICITY
Authors: ADRYAN FRISTIOHADY  , WAHYUNI WAHYUNI  , FADHLIYAH MALIK  , LA ODE MUHAMMAD JULIAN PURNAMA  , BARU SADARUN  , SAHIDIN I
Published: December 2019

Objective: This study aims to investigate the anti-inflammatory effect of the ethanolic extract of Callyspongia sp. using stabilization of the human red blood cell (HRBC) membrane method and its acute toxicity using brine shrimp lethality test (BSLT) method.

Methods: Callyspongia sp. was macerated with 96% ethanol. Extract characterized and screened for the secondary metabolite. Anti-inflammatory activity by stabilization of the HRBC membrane method with a varied dose of 50 ppm; 100 ppm; 200 ppm; 400 ppm; 800 ppm; 1600 ppm; and 3200 ppm. Solutions observed using a photometer to describing stability and ability in preventing membranes hemolytic and statistically analyzed using SPSS. Acute toxicity carried out by the BSLT method and analyzed using Minitab®ver. 17.2.1.

Results: The phytochemical screening was indicating that Callyspongia sp. contains flavonoid, alkaloid, and terpenoid. The results of the anti-inflammatory activity test showed that the percentage value of stability and hemolysis of extracts with doses of 50, 100, 200, 400, 800, 1600, and 3200 ppm were 55% and 45%, 63% and 37%, 70% and 30%, 74% and 26%, 80% and 20%, 87% and 13%, and 97% and 3%, respectively. It showed that extract of sponge Callyspongia sp. in all varied dose has activity in stabilizing the HRBC membrane thus can be potential as an anti-inflammatory. The results of acute toxicity assay showed that the value of LC50 was 1281.45 μg/ml and categorized as nontoxic to Artemia salina Leach.

Conclusion: Various concentrations of Callyspongia sp. effective as an anti-inflammatory in stabilizing HRBC, and categorized as safe.
PHYTOCHEMICAL AND ANTIOXIDANT ACTIVITY OF BALIOSPERMUM MONTANUM (WILLD.) MUELL. ARG.
Authors: RAVEESHA HR  , SUSHMA BK
Published: December 2019

Objective: The present study was carried out to evaluate the phytochemical constituents and antioxidant potential of the leaf, stem, root, and stem-derived callus extracts of Baliospermum montanum.

Methods: An in vitro regeneration protocol was developed for the induction of callus from stem segments cultured on Murashige and Skoog (MS) medium supplemented with different concentrations and combination of 6-benzylaminopurine (BAP), 6-furfurylaminopurine (KIN), 1-naphthaleneacetic acid, and 2, 4-dichlorophenoxyacetic acid. The total phenol, flavonoid, and tannin content were determined according to standard methods. The antioxidant activity of methanolic extract was evaluated using 2, 2-diphenyl-l-picrylhydrazyl (DPPH) and reducing power assays.

Results: The maximum callus induction was observed on MS medium supplemented with a combination of KIN (0.5 mg/L) + BAP (3.0 mg/L). Methanolic extract of root and aqueous extract of leaf exhibited higher content of phenols. Whereas total flavonoids and tannin were maximum in methanolic extract of leaf compared to other extracts. The methanolic extract of B. montanum leaf had greater antioxidant activity than stem, root, and callus by DPPH and reducing power assays.

Conclusion: Our study suggests that the methanolic extracts of B. montanum showed potent free radical scavenging activity. Further studies are necessary for isolation and characterization of phytochemical compounds.