bluuebunny/crossref_metadata_2025 huggingface dataset:
The Living House of Pedawa Village: Ordering the domestic life of the dwellers
Authors: Agusintadewi Ni Ketut
Published: July 2020

The paper explores the traditional houses in the village of Pedawa, one of the indigenous settlements in the north of Bali concerning their social-cultural life. A qualitative inquiry with ethnography as the research approach carried out the study. The study reveals that the specific aspects of cultural life, particularly the belief system and worldview, articulate and order the domestic life of the dwellers. Home-making with material culture, evidenced by domestic spaces and spatial arrangement, is designed to give positive cosmic energy to the family.
Keywords: domestic life; living house; Pedawa dwellers.
eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v5i14.2212
An Overview of Rainwater Harvesting for Sustainable Future in Malaysia
Authors: Shaari Shazwan Mohamed
Published: July 2020

This paper looks into the types of Rainwater Harvesting System (RWH), system, benefits, water governance and community awareness and level of acceptance of RWH implementation for future sustainability. RWH is not new in Malaysia, successful studies and existing projects can be as indicators for Malaysia to move further. This paper will discuss the benefits of RWH, types of system, water governance and level of public acceptance. A case study of RWH project in Sarawak will be discussed too as part of author contribution in these fields of research.
Keywords: Rainwater harvesting system, sustainable future, case study, knowledge transfer
eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v5i14.2232
Conceptual Framework of Residential Satisfaction
Authors: Abdullah Mohamad Isa , Zainul Abidin Nurzafira , Basrah Noraliza , Alias Muhammad Nazim
Published: July 2020

Residential satisfaction is described as a sense of comfort, with what one needs or wants to achieve in a building. The paper aims to establish a residential satisfaction framework that will consist of essential determinants. Comprehensive analysis of the literature is undertaken to determine criteria which consist of characteristics of housing, neighbourhoods' characteristics, social demographic characteristics, behavioural characteristics. These characteristics become one concept of residential framework serve the purpose of measuring the level of residential satisfaction. With this framework, it will help the researcher specifically define and collect information to obtain specific data.  
Keywords: Residential; Satisfaction; Housing.
eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v5i14.2239
Technology Acceptance in Mobile Health: Scoping Review of Definitions, Models, and Measurement
Authors: Nadal Camille , Sas Corina , Doherty Gavin
Published: July 2020

Background

Designing technologies that users will be interested in, start using, and keep using has long been a challenge. In the health domain, the question of technology acceptance is even more important, as the possible intrusiveness of technologies could lead to patients refusing to even try them. Developers and researchers must address this question not only in the design and evaluation of new health care technologies but also across the different stages of the user’s journey. Although a range of definitions for these stages exists, many researchers conflate related terms, and the field would benefit from a coherent set of definitions and associated measurement approaches.

Objective

This review aims to explore how technology acceptance is interpreted and measured in mobile health (mHealth) literature. We seek to compare the treatment of acceptance in mHealth research with existing definitions and models, identify potential gaps, and contribute to the clarification of the process of technology acceptance.

Methods

We searched the PubMed database for publications indexed under the Medical Subject Headings terms “Patient Acceptance of Health Care” and “Mobile Applications.” We included publications that (1) contained at least one of the terms “acceptability,” “acceptance,” “adoption,” “accept,” or “adopt”; and (2) defined the term. The final corpus included 68 relevant studies.

Results

Several interpretations are associated with technology acceptance, few consistent with existing definitions. Although the literature has influenced the interpretation of the concept, usage is not homogeneous, and models are not adapted to populations with particular needs. The prevalence of measurement by custom surveys suggests a lack of standardized measurement tools.

Conclusions

Definitions from the literature were published separately, which may contribute to inconsistent usage. A definition framework would bring coherence to the reporting of results, facilitating the replication and comparison of studies. We propose the Technology Acceptance Lifecycle, consolidating existing definitions, articulating the different stages of technology acceptance, and providing an explicit terminology. Our findings illustrate the need for a common definition and measurement framework and the importance of viewing technology acceptance as a staged process, with adapted measurement methods for each stage.
Process Evaluation of an eHealth Intervention (Food4toddlers) to Improve Toddlers' Diet: Randomized Controlled Trial
Authors: Røed Margrethe , Vik Frøydis Nordgård , Hillesund Elisabet Rudjord , Van Lippevelde Wendy , Medin Anine Christine , Øverby Nina Cecilie
Published: July 2020

Background

Parents seek trustworthy information online to promote healthy eating for their toddlers. Such information must be perceived as relevant and easy to implement and use.

Objective

The objectives of this study were to conduct a process evaluation of the electronic health (eHealth) intervention (Food4toddlers) targeting food environment, parental feeding practices, and toddlers’ diet and to examine possible differences in these areas according to education and family composition.

Methods

A 2-armed randomized controlled trial, including 298 parent–toddler dyads from Norway, was conducted in 2017. In total, 148 parents in the intervention group received access to an intervention website for 6 months. Data on website usage were retrieved from the learning management platform used (NEO). Participants’ satisfaction with the intervention was asked for in a postintervention questionnaire. Chi-square and t tests were used to examine differences in usage and satisfaction between education and family composition groups.

Results

Most participants were mothers (144/148, 97.2%), lived in two-adult households (148/148, 100%), and were born in Norway (132/148, 89.1%). Mean parental age was 31.5 years (SD 4.2). More than 87.8% (129/147) had a university education degree and 56.5% (83/147) had over 4 years of university education. Most (128/148, 86.5%) intervention participants entered the website at least once (mean days of access 7.4 [SD 7.1]). Most parents reported the website as appropriate to the child’s age (71/83, 86%) and self-explanatory (79/83, 95%) and appreciated the interface (52/83, 63%) and layout (46/83, 55%). In total, 61% (51/83) stated that they learned something new from the intervention. Parents with over 4 years of university education and in 1-child households used the intervention website more than those with 4 years or less of university education (8.4 vs 5.9 days in total, P=.04) and households with more than 1 child (8.3 vs 5.8 days in total, P=.04), respectively.

Conclusions

The Food4toddlers intervention website was found to be relevant by most participants in the intervention group, although usage of the website differed according to educational level and family composition. For eHealth interventions to be effective, intervention materials such as websites must be used by the target group. Our results highlight the need to include users from different groups when developing interventions.

Trial Registration

ISRCTN Registry ISRCTN92980420; http://www.isrctn.com/ISRCTN92980420
Personal Health Information Inference Using Machine Learning on RNA Expression Data from Patients With Cancer: Algorithm Validation Study
Authors: Kweon Solbi , Lee Jeong Hoon , Lee Younghee , Park Yu Rang
Published: July 2020

Background

As the need for sharing genomic data grows, privacy issues and concerns, such as the ethics surrounding data sharing and disclosure of personal information, are raised.

Objective

The main purpose of this study was to verify whether genomic data is sufficient to predict a patient's personal information.

Methods

RNA expression data and matched patient personal information were collected from 9538 patients in The Cancer Genome Atlas program. Five personal information variables (age, gender, race, cancer type, and cancer stage) were recorded for each patient. Four different machine learning algorithms (support vector machine, decision tree, random forest, and artificial neural network) were used to determine whether a patient's personal information could be accurately predicted from RNA expression data. Performance measurement of the prediction models was based on the accuracy and area under the receiver operating characteristic curve. We selected five cancer types (breast carcinoma, kidney renal clear cell carcinoma, head and neck squamous cell carcinoma, low-grade glioma, and lung adenocarcinoma) with large samples sizes to verify whether predictive accuracy would differ between them. We also validated the efficacy of our four machine learning models in analyzing normal samples from 593 cancer patients.

Results

In most samples, personal information with high genetic relevance, such as gender and cancer type, could be predicted from RNA expression data alone. The prediction accuracies for gender and cancer type, which were the best models, were 0.93-0.99 and 0.78-0.94, respectively. Other aspects of personal information, such as age, race, and cancer stage, were difficult to predict from RNA expression data, with accuracies ranging from 0.0026-0.29, 0.76-0.96, and 0.45-0.79, respectively. Among the tested machine learning methods, the highest predictive accuracy was obtained using the support vector machine algorithm (mean accuracy 0.77), while the lowest accuracy was obtained using the random forest method (mean accuracy 0.65). Gender and race were predicted more accurately than other variables in the samples. On average, the accuracy of cancer stage prediction ranged between 0.71-0.67, while the age prediction accuracy ranged between 0.18-0.23 for the five cancer types.

Conclusions

We attempted to predict patient information using RNA expression data. We found that some identifiers could be predicted, but most others could not. This study showed that personal information available from RNA expression data is limited and this information cannot be used to identify specific patients.
Methods and Evaluation Criteria for Apps and Digital Interventions for Diabetes Self-Management: Systematic Review
Authors: Larbi Dillys , Randine Pietro , Årsand Eirik , Antypas Konstantinos , Bradway Meghan , Gabarron Elia
Published: July 2020

Background

There is growing evidence that apps and digital interventions have a positive impact on diabetes self-management. Standard self-management for patients with diabetes could therefore be supplemented by apps and digital interventions to increase patients’ skills. Several initiatives, models, and frameworks suggest how health apps and digital interventions could be evaluated, but there are few standards for this. And although there are many methods for evaluating apps and digital interventions, a more specific approach might be needed for assessing digital diabetes self-management interventions.

Objective

This review aims to identify which methods and criteria are used to evaluate apps and digital interventions for diabetes self-management, and to describe how patients were involved in these evaluations.

Methods

We searched CINAHL, EMBASE, MEDLINE, and Web of Science for articles published from 2015 that referred to the evaluation of apps and digital interventions for diabetes self-management and involved patients in the evaluation. We then conducted a narrative qualitative synthesis of the findings, structured around the included studies’ quality, methods of evaluation, and evaluation criteria.

Results

Of 1681 articles identified, 31 fulfilled the inclusion criteria. A total of 7 articles were considered of high confidence in the evidence. Apps were the most commonly used platform for diabetes self-management (18/31, 58%), and type 2 diabetes (T2D) was the targeted health condition most studies focused on (12/31, 38%). Questionnaires, interviews, and user-group meetings were the most common methods of evaluation. Furthermore, the most evaluated criteria for apps and digital diabetes self-management interventions were cognitive impact, clinical impact, and usability. Feasibility and security and privacy were not evaluated by studies considered of high confidence in the evidence.

Conclusions

There were few studies with high confidence in the evidence that involved patients in the evaluation of apps and digital interventions for diabetes self-management. Additional evaluation criteria, such as sustainability and interoperability, should be focused on more in future studies to provide a better understanding of the effects and potential of apps and digital interventions for diabetes self-management.
Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review
Authors: Kruse Clemens , Fohn Joanna , Wilson Nakia , Nunez Patlan Evangelina , Zipp Stephanie , Mileski Michael
Published: July 2020

Background

Rising telehealth capabilities and improving access to older adults can aid in improving health outcomes and quality of life indicators. Telehealth is not being used ubiquitously at present.

Objective

This review aimed to identify the barriers that prevent ubiquitous use of telehealth and the ways in which telehealth improves health outcomes and quality of life indicators for older adults.

Methods

This systematic review was conducted and reported in accordance with the Kruse protocol and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Reviewers queried the following four research databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed (MEDLINE), Web of Science, and Embase (Science Direct). Reviewers analyzed 57 articles, performed a narrative analysis to identify themes, and identified barriers and reports of health outcomes and quality of life indicators found in the literature.

Results

Reviewers analyzed 57 studies across the following five interventions of telehealth: eHealth, mobile health (mHealth), telemonitoring, telecare (phone), and telehealth video calls, with a Cohen κ of 0.75. Reviewers identified 14 themes for barriers. The most common of which were technical literacy (25/144 occurrences, 17%), lack of desire (19/144 occurrences, 13%), and cost (11/144 occurrences, 8%). Reviewers identified 13 medical outcomes associated with telehealth interventions. The most common of which were decrease in psychological stress (21/118 occurrences, 18%), increase in autonomy (18/118 occurrences, 15%), and increase in cognitive ability (11/118 occurrences, 9%). Some articles did not report medical outcomes (18/57, 32%) and some did not report barriers (19/57, 33%).

Conclusions

The literature suggests that the elimination of barriers could increase the prevalence of telehealth use by older adults. By increasing use of telehealth, proximity to care is no longer an issue for access, and thereby care can reach populations with chronic conditions and mobility restrictions. Future research should be conducted on methods for personalizing telehealth in older adults before implementation.

Trial Registration

PROSPERO CRD42020182162; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020182162.

International Registered Report Identifier (IRRID)

RR2-10.2196/15490
Perceived Need for Psychosocial Support After Aortic Dissection: Cross-Sectional Survey (Preprint)
Authors: Meinlschmidt Gunther , Berdajs Denis , Moser-Starck Roger , Frick Alexander , Gross Sebastian , Schurr Ulrich , Eckstein Friedrich S , Hunziker Sabina , Schaefert Rainer
Published: July 2020

BACKGROUND

The gold standard management of aortic dissection, a life-threatening condition, includes multidisciplinary approaches. Although mental distress following aortic dissection is common, evidence-based psychosocial interventions for aortic dissection survivors are lacking.

OBJECTIVE

The aim of this study is to identify the perceived psychosocial needs of aortic dissection survivors by surveying patients, their relatives, and health professionals to inform the development of such interventions.

METHODS

This study used a cross-sectional survey and collected responses from 41 participants (27 patients with aortic dissection, 8 relatives of patients with aortic dissection, and 6 health professionals) on key topics, types of interventions, best timing, anticipated success, and the intended effects and side effects of psychosocial interventions after aortic dissection.

RESULTS

The principal intervention topics were “changes in everyday life” (28/41, 68%, 95% CI 54.5%-82.9%), “anxiety” (25/41, 61%, 95% CI 46.2%-76.2%), “uncertainty” (24/41, 59%, 95% CI 42.9%-73.2%), “tension/distress” (24/41, 59%, 95% CI 43.9%-73.8%), and “trust in the body” (21/41, 51%, 95% CI 35.9%-67.5%). The most commonly indicated intervention types were “family/relative therapy” (21/41, 51%, 95% CI 35%-65.9%) and “anxiety treatment” (21/41, 51%, 95% CI 35%-67.5%). The most recommended intervention timing was “during inpatient rehabilitation” (26/41, 63%, 95% CI 47.6%-77.5%) followed by “shortly after inpatient rehabilitation” (20/41, 49%, 95% CI 32.4%-65%). More than 95% (39/41) of respondents anticipated a benefit from psychosocial interventions following aortic dissection dissection, expecting a probable improvement in 68.6% (95% CI 61.4%-76.2%) of aortic dissection survivors, a worse outcome for 5% (95% CI 2.9%-7.9%), and that 6% (95% CI 1.8%-10.4%) would have negative side effects due to such interventions.

CONCLUSIONS

Our findings highlight a substantial need for psychosocial interventions in aortic dissection survivors and indicate that such interventions would be a success. They provide a basis for the development and evaluation of interventions as part of state-of-the-art aortic dissection management.
The Association Between State-Level Racial Attitudes Assessed From Twitter Data and Adverse Birth Outcomes: Observational Study (Preprint)
Authors: Nguyen Thu T , Adams Nikki , Huang Dina , Glymour M Maria , Allen Amani M , Nguyen Quynh C
Published: July 2020

BACKGROUND

In the United States, racial disparities in birth outcomes persist and have been widening. Interpersonal and structural racism are leading explanations for the continuing racial disparities in birth outcomes, but research to confirm the role of racism and evaluate trends in the impact of racism on health outcomes has been hampered by the challenge of measuring racism. Most research on discrimination relies on self-reported experiences of discrimination, and few studies have examined racial attitudes and bias at the US national level.

OBJECTIVE

This study aimed to investigate the associations between state-level Twitter-derived sentiments related to racial or ethnic minorities and birth outcomes.

METHODS

We utilized Twitter’s Streaming application programming interface to collect 26,027,740 tweets from June 2015 to December 2017, containing at least one race-related term. Sentiment analysis was performed using support vector machine, a supervised machine learning model. We constructed overall indicators of sentiment toward minorities and sentiment toward race-specific groups. For each year, state-level Twitter-derived sentiment data were merged with birth data for that year. The study participants were women who had singleton births with no congenital abnormalities from 2015 to 2017 and for whom data were available on gestational age (n=9,988,030) or birth weight (n=9,985,402). The main outcomes were low birth weight (birth weight ≤2499 g) and preterm birth (gestational age <37 weeks). We estimated the incidence ratios controlling for individual-level maternal characteristics (sociodemographics, prenatal care, and health behaviors) and state-level demographics, using log binomial regression models.

RESULTS

The accuracy for identifying negative sentiments on comparing the machine learning model to manually labeled tweets was 91%. Mothers living in states in the highest tertile for negative sentiment tweets referencing racial or ethnic minorities had greater incidences of low birth weight (8% greater, 95% CI 4%-13%) and preterm birth (8% greater, 95% CI 0%-14%) compared with mothers living in states in the lowest tertile. More negative tweets referencing minorities were associated with adverse birth outcomes in the total population, including non-Hispanic white people and racial or ethnic minorities. In stratified subgroup analyses, more negative tweets referencing specific racial or ethnic minority groups (black people, Middle Eastern people, and Muslims) were associated with poor birth outcomes for black people and minorities.

CONCLUSIONS

A negative social context related to race was associated with poor birth outcomes for racial or ethnic minorities, as well as non-Hispanic white people.
Data Integration in the Brazilian Public Health System for Tuberculosis: Use of the Semantic Web to Establish Interoperability (Preprint)
Authors: Pellison Felipe Carvalho , Rijo Rui Pedro Charters Lopes , Lima Vinicius Costa , Crepaldi Nathalia Yukie , Bernardi Filipe Andrade , Galliez Rafael Mello , Kritski Afrânio , Abhishek Kumar , Alves Domingos
Published: July 2020

BACKGROUND

Interoperability of health information systems is a challenge due to the heterogeneity of existing systems at both the technological and semantic levels of their data. The lack of existing data about interoperability disrupts intra-unit and inter-unit medical operations as well as creates challenges in conducting studies on existing data. The goal is to exchange data while providing the same meaning for data from different sources.

OBJECTIVE

To find ways to solve this challenge, this research paper proposes an interoperability solution for the tuberculosis treatment and follow-up scenario in Brazil using Semantic Web technology supported by an ontology.

METHODS

The entities of the ontology were allocated under the definitions of Basic Formal Ontology. Brazilian tuberculosis applications were tagged with entities from the resulting ontology.

RESULTS

An interoperability layer was developed to retrieve data with the same meaning and in a structured way enabling semantic and functional interoperability.

CONCLUSIONS

Health professionals could use the data gathered from several data sources to enhance the effectiveness of their actions and decisions, as shown in a practical use case to integrate tuberculosis data in the State of São Paulo.
Process Evaluation of an eHealth Intervention (Food4toddlers) to Improve Toddlers' Diet: Randomized Controlled Trial (Preprint)
Authors: Røed Margrethe , Vik Frøydis Nordgård , Hillesund Elisabet Rudjord , Van Lippevelde Wendy , Medin Anine Christine , Øverby Nina Cecilie
Published: July 2020

BACKGROUND

Parents seek trustworthy information online to promote healthy eating for their toddlers. Such information must be perceived as relevant and easy to implement and use.

OBJECTIVE

The objectives of this study were to conduct a process evaluation of the electronic health (eHealth) intervention (Food4toddlers) targeting food environment, parental feeding practices, and toddlers’ diet and to examine possible differences in these areas according to education and family composition.

METHODS

A 2-armed randomized controlled trial, including 298 parent–toddler dyads from Norway, was conducted in 2017. In total, 148 parents in the intervention group received access to an intervention website for 6 months. Data on website usage were retrieved from the learning management platform used (NEO). Participants’ satisfaction with the intervention was asked for in a postintervention questionnaire. Chi-square and t tests were used to examine differences in usage and satisfaction between education and family composition groups.

RESULTS

Most participants were mothers (144/148, 97.2%), lived in two-adult households (148/148, 100%), and were born in Norway (132/148, 89.1%). Mean parental age was 31.5 years (SD 4.2). More than 87.8% (129/147) had a university education degree and 56.5% (83/147) had over 4 years of university education. Most (128/148, 86.5%) intervention participants entered the website at least once (mean days of access 7.4 [SD 7.1]). Most parents reported the website as appropriate to the child’s age (71/83, 86%) and self-explanatory (79/83, 95%) and appreciated the interface (52/83, 63%) and layout (46/83, 55%). In total, 61% (51/83) stated that they learned something new from the intervention. Parents with over 4 years of university education and in 1-child households used the intervention website more than those with 4 years or less of university education (8.4 vs 5.9 days in total, P=.04) and households with more than 1 child (8.3 vs 5.8 days in total, P=.04), respectively.

CONCLUSIONS

The Food4toddlers intervention website was found to be relevant by most participants in the intervention group, although usage of the website differed according to educational level and family composition. For eHealth interventions to be effective, intervention materials such as websites must be used by the target group. Our results highlight the need to include users from different groups when developing interventions.

CLINICALTRIAL

ISRCTN Registry ISRCTN92980420; http://www.isrctn.com/ISRCTN92980420
An eHealth platform for monitoring ketogenic diet therapies in patients with refractory epilepsy (Preprint)
Authors: Gabri Mariano Rolando , Armeno Marisa , Schinkoethe Timo , Korman Daniela , Verini Antonella , Reyes Gabriela , Caraballo Roberto
Published: July 2020

UNSTRUCTURED

Ketogenic diet therapies (KDTs) are high-fat, low-carbohydrate, and moderate-protein interventions that have been used over the years to control seizures in patients with treatment-refractory epilepsy and certain inborn errors of metabolism. The mechanism of action of KDTs is thought to be related to molecular changes that are the result of increased systemic ketone-body concentration and decreased glucose levels leading to a reduction in seizure frequency. Therefore, systemic ketone bodies and glucose levels are measured daily in these patients. “My Keto Life” was developed as a dynamic and easy to use web- and App-based monitoring and support tool for epilepsy patients on KDTs. Using this eHealth tool patients are able to regularly record self-measured values, such as ketone bodies, glucose levels, and seizures, to monitor adherence and allow real-time intervention by physicians and nutritionists. Based on non-structured interviews with experts in metabolism, epileptologists, and nutritionists from the KDT team at Hospital Garrahan, Buenos Aires, Argentina, a suitable digital platform was designed and developed to improve care of epilepsy patients on KDTs. Daily self-tracking of ketone bodies and glucose levels, the dynamic recording of food intake, supplements, and antiseizure medications by users, real-time monitoring by and communication with physicians and nutritionists, and personalized reminders for taking anti seizure medications, supplements, and ketone measures are the most prominent features of this tool. “My Keto Life” is a rapid and iterative eHealth tool developed together with physicians and nutritionists for the adequate management of epilepsy patients on KDTs in order to promote patient engagement, facilitate monitoring by physicians, and optimize treatment leading to better therapeutic outcomes.
Impact of Remote Titration Combined With Telemonitoring on the Optimization of Guideline-Directed Medical Therapy for Patients With Heart Failure: Internal Pilot of a Randomized Controlled Trial (Preprint)
Authors: Artanian Veronica , Ross Heather J , Rac Valeria E , O'Sullivan Mary , Brahmbhatt Darshan H , Seto Emily
Published: July 2020

BACKGROUND

To improve health outcomes in patients with heart failure, guideline-directed medical therapy (GDMT) should be optimized to target doses. However, GDMT remains underutilized, with less than 25% of patients receiving target doses in clinical practice. Telemonitoring could provide reliable and real-time physiological data for clinical decision support to facilitate remote GDMT titration.

OBJECTIVE

This paper aims to present findings from an internal pilot study regarding the effectiveness of remote titration facilitated by telemonitoring.

METHODS

A 2-arm randomized controlled pilot trial comparing remote titration versus standard care in a heart function clinic was conducted. Patients were randomized to undergo remote medication titration facilitated by data from a smartphone-based telemonitoring system or standard titration performed during clinic visits.

RESULTS

A total of 42 patients with new-onset (10/42, 24%) and existing (32/42, 76%) heart failure and a mean age of 55.29 (SD 11.28) years were randomized between January and June 2019. Within 6 months of enrollment, 86% (18/21) of patients in the intervention group achieved optimal doses versus 48% (10/21) of patients in the control group. The median time to dose optimization was 11.0 weeks for the intervention group versus 18.8 weeks for the control group. The number of in-person visits in the intervention group was 54.5% lower than in the control group.

CONCLUSIONS

The results of this pilot study suggest that remote titration facilitated by telemonitoring has the potential to increase the proportion of patients who achieve optimal GDMT doses, decrease time to dose optimization, and reduce the number of clinic visits. Remote titration may facilitate optimal and efficient titration of patients with heart failure while reducing the burden for patients to attend in-person clinic visits.

CLINICALTRIAL

ClinicalTrials.gov NCT04205513; https://clinicaltrials.gov/ct2/show/NCT04205513

INTERNATIONAL REGISTERED REPORT

RR2-10.2196/preprints.19705
Forecasting the Requirement for Nonelective Hospital Beds in the National Health Service of the United Kingdom: Model Development Study (Preprint)
Authors: Shah Kanan , Sharma Akarsh , Moulton Chris , Swift Simon , Mann Clifford , Jones Simon
Published: July 2020

BACKGROUND

Over the last decade, increasing numbers of emergency department attendances and an even greater increase in emergency admissions have placed severe strain on the bed capacity of the National Health Service (NHS) of the United Kingdom. The result has been overcrowded emergency departments with patients experiencing long wait times for admission to an appropriate hospital bed. Nevertheless, scheduling issues can still result in significant underutilization of bed capacity. Bed occupancy rates may not correlate well with bed availability. More accurate and reliable long-term prediction of bed requirements will help anticipate the future needs of a hospital’s catchment population, thus resulting in greater efficiencies and better patient care.

OBJECTIVE

This study aimed to evaluate widely used automated time-series forecasting techniques to predict short-term daily nonelective bed occupancy at all trusts in the NHS. These techniques were used to develop a simple yet accurate national health system–level forecasting framework that can be utilized at a low cost and by health care administrators who do not have statistical modeling expertise.

METHODS

Bed occupancy models that accounted for patterns in occupancy were created for each trust in the NHS. Daily nonelective midnight trust occupancy data from April 2011 to March 2017 for 121 NHS trusts were utilized to generate these models. Forecasts were generated using the three most widely used automated forecasting techniques: exponential smoothing; Seasonal Autoregressive Integrated Moving Average; and Trigonometric, Box-Cox transform, autoregressive moving average errors, and Trend and Seasonal components. The NHS Modernisation Agency’s recommended forecasting method prior to 2020 was also replicated.

RESULTS

The accuracy of the models varied on the basis of the season during which occupancy was forecasted. For the summer season, percent root-mean-square error values for each model remained relatively stable across the 6 forecasted weeks. However, only the trend and seasonal components model (median error=2.45% for 6 weeks) outperformed the NHS Modernisation Agency’s recommended method (median error=2.63% for 6 weeks). In contrast, during the winter season, the percent root-mean-square error values increased as we forecasted further into the future. Exponential smoothing generated the most accurate forecasts (median error=4.91% over 4 weeks), but all models outperformed the NHS Modernisation Agency’s recommended method prior to 2020 (median error=8.5% over 4 weeks).

CONCLUSIONS

It is possible to create automated models, similar to those recently published by the NHS, which can be used at a hospital level for a large national health care system to predict nonelective bed admissions and thus schedule elective procedures.
Using Open-source Intelligence to Identify Early Signals of COVID-19 in Indonesia (Preprint)
Authors: Thamtono Yoser , Moa Aye , MacIntyre Chandini Raina
Published: July 2020

BACKGROUND

Indonesia claimed zero cases of COVID-19 up until 2 March 2020. Given high travel volume between China and Indonesia, there were doubts over the lack of reported cases.

OBJECTIVE

This study aims to identify the early signals of pneumonia of unknown cause as a proxy for COVID-19 in Indonesia

METHODS

Using open-source data of pneumonia of unknown cause in Indonesia between 1 November 2019 to 31 March 2020 obtained from EpiWATCH, an open-source epidemic observatory, a descriptive analysis was performed to identify the trend of pneumonia of unknown cause in Indonesia prior to official notification of COVID-19 cases.

RESULTS

A rise in reports of pneumonia of unknown cause is identified in Indonesia starting from late January 2020. There were 304 reported cases of pneumonia of unknown cause, 30 of which occurred prior to the identification of the first COVID-19 cases on 2 March 2020. The early signals of pneumonia of unknown cause in Indonesia may indicate possible unrecognised circulation of SARS-CoV-2 prior to official detection

CONCLUSIONS

Open source data can provide early signals of epidemics, especially in countries where surveillance, testing or reporting is low
The Relation Between Official WhatsApp-Distributed COVID-19 News Exposure and Psychological Symptoms: Cross-Sectional Survey Study (Preprint)
Authors: Liu Jean C J , Tong Eddie M W
Published: July 2020

BACKGROUND

In a global pandemic, digital technology offers innovative methods to disseminate public health messages. As an example, the messenger app WhatsApp was adopted by both the World Health Organization and government agencies to provide updates on the coronavirus disease (COVID-19). During a time when rumors and excessive news threaten psychological well-being, these services allow for rapid transmission of information and may boost resilience.

OBJECTIVE

In this study, we sought to accomplish the following: (1) assess well-being during the pandemic; (2) replicate prior findings linking exposure to COVID-19 news with psychological distress; and (3) examine whether subscription to an official WhatsApp channel can mitigate this risk.

METHODS

Across 8 weeks of the COVID-19 outbreak (March 7 to April 21, 2020), we conducted a survey of 1145 adults in Singapore. As the primary outcome measure, participants completed the Depression, Anxiety, and Stress Scale (DASS-21). As predictor variables, participants also answered questions pertaining to the following: (1) their exposure to COVID-19 news; (2) their use of the Singapore government’s WhatsApp channel; and (3) their demographics.

RESULTS

Within the sample, 7.9% of participants had severe or extremely severe symptoms on at least one DASS-21 subscale. Depression scores were associated with increased time spent receiving COVID-19 updates, whereas use of the official WhatsApp channel emerged as a protective factor (b=–0.07, t[863]=–2.04, P=.04). Similarly, increased anxiety scores were associated with increased exposure to both updates and rumors, but this risk was mitigated by trust in the government’s WhatsApp messages (b=–0.05, t[863]=–2.13, P=.03). Finally, although stress symptoms increased with the amount of time spent receiving updates, these symptoms were not significantly related to WhatsApp use.

CONCLUSIONS

Our findings suggest that messenger apps may be an effective medium for disseminating pandemic-related information, allowing official agencies to reach a broad sector of the population rapidly. In turn, this use may promote public well-being amid an “infodemic.”

CLINICALTRIAL

ClinicalTrials.gov NCT04305574; https://clinicaltrials.gov/ct2/show/NCT04305574
Infection Control Behavior at Home During the COVID-19 Pandemic: Observational Study of a Web-Based Behavioral Intervention (Germ Defence) (Preprint)
Authors: Ainsworth Ben , Miller Sascha , Denison-Day James , Stuart Beth , Groot Julia , Rice Cathy , Bostock Jennifer , Hu Xiao-Yang , Morton Katherine , Towler Lauren , Moore Michael , Willcox Merlin , Chadborn Tim , Gold Natalie , Amlôt Richard , Little Paul , Yardley Lucy
Published: July 2020

BACKGROUND

To control the COVID-19 pandemic, people should adopt protective behaviors at home (self-isolation, social distancing, putting shopping and packages aside, wearing face coverings, cleaning and disinfecting, and handwashing). There is currently limited support to help individuals conduct these behaviors.

OBJECTIVE

This study aims to report current household infection control behaviors in the United Kingdom and examine how they might be improved.

METHODS

This was a pragmatic cross-sectional observational study of anonymous participant data from Germ Defence between May 6-24, 2020. Germ Defence is an open-access fully automated website providing behavioral advice for infection control within households. A total of 28,285 users sought advice from four website pathways based on household status (advice to protect themselves generally, to protect others if the user was showing symptoms, to protect themselves if household members were showing symptoms, and to protect a household member who is at high risk). Users reported current infection control behaviors within the home and intentions to change these behaviors.

RESULTS

Current behaviors varied across all infection control measures but were between sometimes (face covering: mean 1.61, SD 1.19; social distancing: mean 2.40, SD 1.22; isolating: mean 2.78, SD 1.29; putting packages and shopping aside: mean 2.75, SD 1.55) and quite often (cleaning and disinfecting: mean 3.17, SD 1.18), except for handwashing (very often: mean 4.00, SD 1.03). Behaviors were similar regardless of the website pathway used. After using Germ Defence, users recorded intentions to improve infection control behavior across all website pathways and for all behaviors (overall average infection control score mean difference 0.30, 95% CI 0.29-0.31).

CONCLUSIONS

Self-reported infection control behaviors other than handwashing are lower than is optimal for infection prevention, although handwashing is much higher. Advice using behavior change techniques in Germ Defence led to intentions to improve these behaviors. Promoting Germ Defence within national and local public health and primary care guidance could reduce COVID-19 transmission.
Los principios fundamentales de la ética en la función pública uruguaya
Authors: Correa Freitas Rubén
Published: July 2020

Se analiza el concepto de ética en la doctrina y en el derecho positivo uruguayo, así como los principios y las normas que surgen de las Convenciones Internacionales contra la Corrupción ratificadas por el Uruguay, a la luz del nuevo Código de Ética en la Función Pública, aprobado por la Ley Nº 19.823 de fecha 18 de setiembre de 2019. Se procura precisar el fenómeno de la corrupción como un flagelo que afecta a todas las sociedades modernas y en especial a las Administraciones Públicas. Asimismo, se estudian los principios fundamentales que surgen de la Constitución de la República y del nuevo Código de Ética en la Función Pública, procurando una interpretación que facilite la efectiva aplicación y cumplimiento de los mismos en el ámbito de la Administración Pública uruguaya.
Ciudad de México. Mujeres, política, participación y opinión pública
Authors: Fernández Poncela Anna María
Published: July 2020

Este texto se propone realizar una aproximación general, descriptiva y panorámica de la presencia y participación de las mujeres en la política institucional de la Ciudad de México en las últimas décadas y en la actualidad. En primer lugar, se expone un recuento de su evolución histórico-cuantitativa en cargos políticos. En segundo lugar, se presenta una exposición de cultura política y preferencias electorales, de mujeres y hombres en dicha ciudad en nuestros días. También se analiza la situación de las mujeres en la política y la opinión pública según sexo, en 2012 y 2018. Sobre el primer punto, se observó el incremento progresivo en la participación política de las mujeres hasta llegar a la paridad. Con respecto al segundo, se muestra cómo, para algunas cuestiones, hubo sesgos de género, aunque en muchas características de la cultura política las semejanzas entre los sexos fueron más importantes.
La cobertura periodística de los feminicidios en México. Heterogeneidad y variación
Authors: Salazar Rebolledo María Grisel , De la Garza Castro Paulina
Published: July 2020

¿Cómo cubre la prensa mexicana los feminicidios? Los encuadres mediáticos tienen efectos en la manera en que los individuos conciben e interpretan los problemas públicos. Se ha documentado que la prensa retrata los feminicidios como incidentes aislados y tiende a la revictimización, a la justificación del agresor y a la utilización primordial de fuentes policiacas. Para México, la mayoría de estos patrones se ha confirmado, pero la utilización generalizada de estos encuadres es discutible. En este trabajo identificamos los encuadres en la cobertura de dos casos de feminicidio distinguiendo tres ejes de variación: periódicos, casos y tiempo. Analizamos 172 notas periodísticas publicadas en cuatro diarios de circulación nacional entre mayo y noviembre de 2017. Los resultados contribuyen a cuestionar la existencia de encuadres noticiosos generalizados, al sugerir una agenda de investigación enfocada en las diferencias entre hábitos, prácticas, rutinas y valores.
Fake News, trolls y otros encantos. Cómo funcionan (para bien y para mal) las redes sociales por Ernesto Calvo y Natalia Aruguete
Authors: Rivero Ezequiel Alexander , Zanotti Juan Martín
Published: July 2020

Fake News, trolls y otros encantos es una apuesta interdisciplinaria, una triangulación teórico-empírica entre los estudios de la comunicación, la ciencia política y la estadística. El trabajo de Calvo y Aruguete recupera categorías de análisis de textos clásicos y otros más actuales. Establece, además, un diálogo crítico con planteamientos teóricos pensados en otros contextos mediáticos para actualizarlos a la luz de las formas de conversación pública mediada por redes sociales digitales.
A Second Way to Read McLuhan’s Footnotes to Innis
Authors: Brian Chrystall Andrew
Published: July 2020

Background Marshall McLuhan claimed his work was a footnote to Harold A. Innis. His claims have been used to argue that McLuhan and Innis offer a coherent system of thought, with a systematic methodology and common set of basic assumptions and presuppositions. This article questions that species of argument and looks to deepen our understanding of the McLuhan-Innis relationship.

Analysis McLuhan is read as an analogist, and his footnotes (plural) are interpreted as deliberate violations of normative patterns of academic use in the satiric tradition of Thomas Nashe and the Scriblerus Club.

Conclusion and implications McLuhan is repositioned apropos of Innis, figures conventionally associated with the Toronto School of Communication Theory and historians who address themselves to the theme of orality and literacy. This article also invites a reconsideration of McLuhan in relation to the digital era, his contributions to epistemology and understanding media.
Examining How Newcomer Women to Canada Use Social Media for Social Support
Authors: Zaher Zulfia
Published: July 2020

Background This study utilized an exploratory sequential mixed-method research design to examine how newcomer women in Canada use social media for support to enhance their mental well-being.

Analysis The qualitative findings revealed that social media helped these newcomer women both before and after their arrival in Canada. The quantitative results showed that newcomer women mostly use social media for receiving information, followed by esteem support, networking, and emotional support.

Conclusion and implications The effectiveness of social media was dependent on the participants’ socioeconomic and migration status. Social media were evidently useful for resisting and coping with stress and contributed to online community connectedness. However, using social media was a source of concern for refugee women due to personal safety, immigration proceedings, and customs.
Quantum Zeno Dynamics from General Quantum Operations
Authors: Burgarth Daniel , Facchi Paolo , Nakazato Hiromichi , Pascazio Saverio , Yuasa Kazuya
Published: July 2020

We consider the evolution of an arbitrary quantum dynamical semigroup of a finite-dimensional quantum system under frequent kicks, where each kick is a generic quantum operation. We develop a generalization of the Baker-Campbell-Hausdorff formula allowing to reformulate such pulsed dynamics as a continuous one. This reveals an adiabatic evolution. We obtain a general type of quantum Zeno dynamics, which unifies all known manifestations in the literature as well as describing new types.