bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Smart Bracelets to Assess Heart Rate Among Students During Physical Education Lessons: Feasibility, Reliability, and Validity Study
Authors: Sun Jiangang , Liu Yang 
Published: June 2020

Background
An increasing number of wrist-worn wearables are being examined in the context of health care. However, studies of their use during physical education (PE) lessons remain scarce.

Objective
We aim to examine the reliability and validity of the Fizzo Smart Bracelet (Fizzo) in measuring heart rate (HR) in the laboratory and during PE lessons.

Methods
In Study 1, 11 healthy subjects (median age 22.0 years, IQR 3.75 years) twice completed a test that involved running on a treadmill at 6 km/h for 12 minutes and 12 km/h for 5 minutes. During the test, participants wore two Fizzo devices, one each on their left and right wrists, to measure their HR. At the same time, the Polar Team2 Pro (Polar), which is worn on the chest, was used as the standard. In Study 2, we went to 10 schools and measured the HR of 24 students (median age 14.0 years, IQR 2.0 years) during PE lessons. During the PE lessons, each student wore a Polar device on their chest and a Fizzo on their right wrist to measure HR data. At the end of the PE lessons, the students and their teachers completed a questionnaire where they assessed the feasibility of Fizzo. The measurements taken by the left wrist Fizzo and the right wrist Fizzo were compared to estimate reliability, while the Fizzo measurements were compared to the Polar measurements to estimate validity. To measure reliability, intraclass correlation coefficients (ICC), mean difference (MD), standard error of measurement (SEM), and mean absolute percentage errors (MAPE) were used. To measure validity, ICC, limits of agreement (LOA), and MAPE were calculated and Bland-Altman plots were constructed. Percentage values were used to estimate the feasibility of Fizzo.

Results
The Fizzo showed excellent reliability and validity in the laboratory and moderate validity in a PE lesson setting. In Study 1, reliability was excellent (ICC>0.97; MD<0.7; SEM<0.56; MAPE<1.45%). The validity as determined by comparing the left wrist Fizzo and right wrist Fizzo was excellent (ICC>0.98; MAPE<1.85%). Bland-Altman plots showed a strong correlation between left wrist Fizzo measurements (bias=0.48, LOA=–3.94 to 4.89 beats per minute) and right wrist Fizzo measurements (bias=0.56, LOA=–4.60 to 5.72 beats per minute). In Study 2, the validity of the Fizzo was lower compared to that found in Study 1 but still moderate (ICC>0.70; MAPE<9.0%). The Fizzo showed broader LOA in the Bland-Altman plots during the PE lessons (bias=–2.60, LOA=–38.89 to 33.69 beats per minute). Most participants considered the Fizzo very comfortable and easy to put on. All teachers thought the Fizzo was helpful.

Conclusions
When participants ran on a treadmill in the laboratory, both left and right wrist Fizzo measurements were accurate. The validity of the Fizzo was lower in PE lessons but still reached a moderate level. The Fizzo is feasible for use during PE lessons.
Assessment of Data Usage of Cancer e-Interventions (ADUCI) Framework for Health App Use of Cancer Patients and Their Caregivers: Framework Development Study
Authors: Heynsbergh Natalie , O Seung Chul (Eric) , Livingston Patricia M 
Published: June 2020

Background
Multimedia interventions can provide a cost-effective solution to public health needs; however, user engagement is low. Multimedia use within specific populations such as those affected by cancer differs from that of the general population. To our knowledge, there are no frameworks on how to accurately assess usage within this population to ensure that interventions are appropriate for the end users. Therefore, a framework was developed to improve the accuracy of determining data usage. Formative work included creating a data usage framework during target audience testing for smartphone app development and analysis in a pilot study.

Objective
The purpose of this study was to develop a framework for assessing smartphone app usage among people living with cancer and their caregivers.

Methods
The frequency and duration of use were compared based on manual data extraction from two previous studies and the newly developed Assessment of Data Usage of Cancer e-Interventions (ADUCI) Framework.

Results
Manual extraction demonstrated that 279 logins occurred compared with 241 when the ADUCI Framework was applied. The frequency of use in each section of the app also decreased when the ADUCI Framework was used. The total duration of use was 91,256 seconds (25.3 hours) compared with 53,074 seconds (14.7 hours) when using the ADUCI Framework. The ADUCI Framework identified 38 logins with no navigation, and there were 15 discrepancies in the data where time on a specific page of the app exceeded the login time. Practice recommendations to improve user engagement and capturing usage data include tracking data use in external websites, having a login function on apps, creating a five-star page rating functionality, using the ADUCI Framework to thoroughly clean usage data, and validating the Framework between expected and observed use.

Conclusions
Applying the ADUCI Framework may eliminate errors and allow for more accurate analysis of usage data in e-research projects. The Framework can also improve the process of capturing usage data by providing a guide for usage data analysis to facilitate evidence-based assessment of user engagement with apps.
Technology Evaluation and Assessment Criteria for Health Apps (TEACH-Apps): Pilot Study
Authors: Camacho Erica , Hoffman Liza , Lagan Sarah , Rodriguez-Villa Elena , Rauseo-Ricupero Natali , Wisniewski Hannah , Henson Philip , Torous John 
Published: June 2020

Background
Despite the emergence of app evaluation tools, there remains no well-defined process receptive to diverse local needs, rigorous standards, and current content. The need for such a process to assist in the implementation of app evaluation across all medical fields is evident. Such a process has the potential to increase stakeholder engagement and catalyze interest and engagement with present-day app evaluation models.

Objective
This study aimed to develop and pilot test the Technology Evaluation and Assessment Criteria for Health apps (TEACH-apps).

Methods
Tailoring a well-known implementation framework, Replicating Effective Programs, we present a new process to approach the challenges faced in implementing app evaluation tools today. As a culmination of our experience implementing this process and feedback from stakeholders, we present the four-part process to aid the implementation of mobile health technology. This paper outlines the theory, evidence, and initial versions of the process.

Results
The TEACH-apps process is designed to be broadly usable and widely applicable across all fields of health. The process comprises four parts: (1) preconditions (eg, gathering apps and considering local needs), (2) preimplementation (eg, customizing criteria and offering digital skills training), (3) implementation (eg, evaluating apps and creating educational handouts), and (4) maintenance and evolution (eg, repeating the process every 90 days and updating content). TEACH-apps has been tested internally at our hospital, and there is growing interest in partnering health care facilities to test the system at their sites.

Conclusions
This implementation framework introduces a process that equips stakeholders, clinicians, and users with the foundational tools to make informed decisions around app use and increase app evaluation engagement. The application of this process may lead to the selection of more culturally appropriate and clinically relevant tools in health care.
Determinants of Medical Practice Variation Among Primary Care Physicians: Protocol for a Three Phase Study
Authors: Shashar Sagi , Codish Shlomi , Ellen Moriah , Davidson Ehud , Novack Victor 
Published: June 2020

Background
One of the greatest challenges of modern health systems is the choice and use of resources needed to diagnose and treat patients. Medical practice variation (MPV) is a broad term which entails the differences between health care providers inclusive of both the overuse and underuse. In this paper, we describe a 3-phase research protocol examining MPV in primary care.

Objective
We aim to identify the potential targets for behavioral modification interventions to reduce the variation in practice patterns and thus improve health care, decrease costs, and prevent disparities in care.

Methods
The first phase will delineate the variation in primary care practice over a wide range of services and long follow-up period (2003-2017), the second will examine the 3 determinants of variation (ie, patient, physician, and clinic characteristics), and attempt to derive the unexplained variance. In the third phase, we will assess a novel component that might contribute to the previously unexplained variance - the physicians’ personal behavioral characteristics (such as risk aversion, fear of malpractice, stress from uncertainty, empathy, and burnout).

Results
This work was supported by the research grant from Israel National Institute for Health Policy Research (Grant No. 2014/134). Soroka University Medical Center Institutional Ethics Committee has approved the updated version of the study protocol (SOR-14-0063) in February 2019. All relevant data for phases 1 and 2, including patient, physician, and clinic, were collected from the Clalit Health Services data set in 2019 and are currently being analyzed. The evaluation of the individual physician characteristics (eg, risk aversion) by the face-to-face questionnaires was started on 2018 and remains in progress. We intend to publish the results during 2020-2021.

Conclusions
Based on the results of our study, we aim to propose a list of potential targets for focused behavioral intervention. Identifying new targets for such an intervention can potentially lead to a decrease in the unwarranted variation in the medical practice. We suggest that such an intervention will result in optimization of the health system, improvement of health outcomes, reduction of disparities in care and savings in cost.

International Registered Report Identifier (IRRID)
DERR1-10.2196/18673
Adherence of Female Health Care Workers to the Use a Web-Based Tool for Improving and Modifying Lifestyle: Prospective Target Group Pilot Study
Authors: Jukic Tomislav , Ihan Alojz , Petek Šter Marija , Strojnik Vojko , Stubljar David , Starc Andrej 
Published: June 2020

Background
Health care professionals are exposed to the psychological and physiological effects of stress, which is a well-known risk factor for various mental and physical health problems.

Objective
The aims of this study were to assess the adherence of female health care workers to use a web-based tool for improving and modifying lifestyle and to identify the potential factors influencing their adherence.

Methods
A prospective, observational study was performed. A total of 80 female health care workers (physicians and gradated nurses) from 2 university medical centers and female members of a family medicine society participated. Participants completed a questionnaire that inquired about their basic demographic data and physical fitness. Physical fitness was assessed by the Rockport Fitness Walking Test. Adherence to a web-based application (24@life) was followed for 3 months and the number of log-ins into the application was counted.

Results
The study was conducted from March to October 2019. Significantly high workload has been detected in all groups (P<.05), except in the general practitioner with normal workload group. The graduated nurse working in the surgery room group showed chronic stress with elevated S-cortisol levels (>690 nmol/L); activated cellular immune system with elevated concentrations of lymphocytes (reference 1.1-2.5 × 109 cells/L), CD3 cells (reference 0.7-1.9 × 109 cells/L), CD8 cells (reference 0.2-0.7 × 109 cells/L), and HLA-DR/CD3 cells (reference 0.04-0.2 × 109 cells/L); and the worst quality of sleep (mean 2.8 [SD 1.2]). Only 32 of 80 participants (40%) were adherent to the web-based application. Participants most frequently viewed web pages on areas of physical activity (497 times) and nutrition (332 times). No factors or participant’s characteristics such as weight (odds ratio [OR] 1.026, 95% CI 0.977-1.078), BMI (OR 0.993, 95% CI 0.834-1.184), age (OR 0.970, 95% CI 0.910-1.034), or stress level (OR 0.997, 95% CI 0.995-1.000) were identified to affect the adherence rates.

Conclusions
Female health care workers exposed to high workload did not find the web-based application useful for improving and modifying their lifestyle. Therefore, other strategies that might help health care workers facing stress and improve their lifestyle should be identified.
Patient Experiences of Rehabilitation and the Potential for an mHealth System with Biofeedback After Breast Cancer Surgery: Qualitative Study
Authors: Brennan Louise , Kessie Threase , Caulfield Brian 
Published: June 2020

Background
Physiotherapy-led home rehabilitation after breast cancer surgery can protect against the development of upper limb dysfunction and other disabling consequences of surgery. A variety of barriers can limit physical rehabilitation outcomes, and patients may benefit from more support during this time. Mobile health (mHealth) systems can assist patients during rehabilitation by providing exercise support, biofeedback, and information. Before designing mHealth systems for a specific population, developers must first engage with users to understand their experiences and needs.

Objective
The aims of this study were to explore patients’ rehabilitation experiences and unmet needs during home rehabilitation after breast cancer surgery and to understand their experiences of mHealth technology and the requirements they desire from an mHealth system.

Methods
This was the first stage of a user-centered design process for an mHealth system. We interviewed 10 breast cancer survivors under the two main topics of “Rehabilitation” and “Technology” and performed a thematic analysis on the interview data.

Results
Discussions regarding rehabilitation focused on the acute and long-term consequences of surgery; unmet needs and lack of support; self-driven rehabilitation; and visions for high-quality rehabilitation. Regarding technology, participants reported a lack of mHealth options for this clinical context and using non-cancer–specific applications and wearables. Participants requested an mHealth tool from a reliable source that provides exercise support.

Conclusions
There are unmet needs surrounding access to physiotherapy, information, and support during home rehabilitation after breast cancer surgery that could be addressed with an mHealth system. Breast cancer survivors are open to using an mHealth system and require that it comes from a reliable source and focuses on supporting exercise performance.
Acceptability and Utility of an Open-Access, Online Single-Session Intervention Platform for Adolescent Mental Health
Authors: Schleider Jessica Lee , Dobias Mallory , Sung Jenna , Mumper Emma , Mullarkey Michael C 
Published: June 2020

Background
Many youths with mental health needs are unable to access care. Single-session interventions (SSIs) have helped reduce youth psychopathology across multiple trials, promising to broaden access to effective, low-intensity supports. Online, self-guided SSIs may be uniquely scalable, particularly if they are freely available for as-needed use. However, the acceptability of online SSI and their efficacy have remained unexamined outside of controlled trials, and their practical utility is poorly understood.

Objective
We evaluated the perceived acceptability and proximal effects of Project YES (Youth Empowerment & Support), an open-access platform offering three online SSIs for youth internalizing distress.

Methods
After selecting one of three SSIs to complete, participants (ages 11-17 years) reported pre- and post-SSI levels of clinically relevant outcomes that SSIs may target (eg, hopelessness, self-hate) and perceived SSI acceptability. User-pattern variables, demographics, and depressive symptoms were collected to characterize youths engaging with YES.

Results
From September 2019 through March 2020, 694 youths accessed YES, 539 began, and 187 completed a 30-minute, self-guided SSI. SSI completers reported clinically elevated depressive symptoms, on average, and were diverse on several dimensions (53.75% non-white; 78.10% female; 43.23% sexual minorities). Regardless of SSI selection, completers reported pre- to post-program reductions in hopelessness (dav=0.53; dz=0.71), self-hate (dav=0.32; dz=0.61), perceived control (dav=0.60; dz=0.72) and agency (dav=0.39; dz=0.50). Youths rated all SSIs as acceptable (eg, enjoyable, likely to help peers).

Conclusions
Results support the perceived acceptability and utility of open-access, free-of-charge SSIs for youth experiencing internalizing distress.

Trial Registration
Open Science Framework; osf.io/e52p3
MENGGALI NILAI-NILAI PELESTARIAN LINGKUNGAN GEOGRAFIS PADA BEBERAPA DESAIN SENI PEWAYANGAN BALI
Authors: Suryana I Gede Putu Eka , Antara I Gede Made Yudi 
Published: June 2020

Lingkungan merupakan tempat yang menyediakan berbagai sumberdaya sekaligus permasalahan dalam menghadapi pembangunan yang berkelanjutan. Perspektif global mengajarkan kita berpikir secara global dan bertindak secara lokal. Pelajaran yang dapat kita petik dari hal tersebut adalah nilai-nilai kearifan lokal yang beberapa berasal dari warisan budaya yang diperoleh secara turun temurun dapat dijadikan bahan, pedoman yang mungkin saja relevan untuk diterapkan saat ini. Adapun metodologi yang dirancang terdiri dari pengumpulan data terkait data produk seni dalam pewayangan Bali. Pewayangan Bali dipilih karena sangat karena seagai penyampaian pesan yang kaya makna. Setelah data terkumpul maka dilanjutkan identifikasi dan analisis. Analisis yang dilakukan melibatkan analisis hermeneutik. Hasil analisis yang diperoleh adalah dalam salah satu parwa cerita pewayangan yakni Adi Parwa yang mengisahkan adanya pencarian tirta amerta, memperoleh konsep saat ini yang kita kenal sebagai Padmasana. Padmasana ini yang dikenal sebagai bangunan religious oleh umat hindu menggunakan metode analisis hermeneutic coba diabstraksi kembali secara fungsionalitas untuk menginspirasi tindakan kitaKata Kunci : Nilai, Pelestarian Lingkungan, Seni, Wayang
KAJIAN INFLOW, OUTFLOW DAN WATER BALANCE DANAU BERATAN DI DATARAN TINGGI BEDUGUL BALI
Authors: Atmaja Dewa Made 
Published: June 2020

Pengetahuan tentang imbangan air merupakan suatu komponen yang tidak dapat dipisahkan antara lain: pengaliran masuk (inflow), pengaliran keluar (outflow), dan timbunan air. Penelitian bertujuan untuk: 1) mengetahui variasi inflow (curah hujan, limpasan), 2) mengetahui variasi aliran outflow (evaporasi, pemakaian air), 3) mengetahui water balance yang terjadi di Danau Beratan. Objek penelitian ini adalah kuantitas air Danau Beratan, metode pengumpulan data yang digunakan adalah metode observasi, metode interview/wawancara, dan metode studi dokumentasi. Analisis data dalam penelitian ini seluruhnya menggunakan metode deskriptif kuantitatif.Hasil penelitian ini menunjukan bahwa, variasi pengaliran masuk (inflow) Danau Beratan rata-rata bulanan terendah selama 5 tahun terdapat pada bulan September sebesar 3,18 x 106 m3 dan rata-rata bulanan tertinggi terdapat pada bulan Januari sebesar 269,63 x 106 m3. Besar pengaliran masuk (inflow) tahunan rata-rata sebesar 107,50 x 106 m3. Adanya variasi pengaliran masuk (inflow) tersebut disebabkan oleh faktor vegetasi penutup lahan (land cover vegetation); topografi serta kemiringan lereng. Variasi pengaliran keluar (outflow) Danau Beratan rata-rata bulanan terendah selama 5 tahun terdapat November sebesar 27,3 x 106 m3 dan rata-rata bulan tertinggi terdapat pada bulan Maret sebesar 27,4 x 106 m3. Pengaliran ke luar (outflow) tahunan rata-rata sebesar 328,32 x 106 m3. Imbangan air periode tahun 2013-2017 memiliki nilai pengaliran masuk (inflow) bulanan lebih besar daripada pengaliran ke luar (outflow), yaitu sebesar 961,64 x 106 m3 atau dengan imbangan rata-rata tiap bulannya sebesar 80,14 x 106 m3. Berdasarkan analisa debit perubahan timbunan air selama 5 tahun dari tahun 2013-2017, menunjukan rata-rata imbangan air bulanan tertinggi terdapat pada bulan Januari dan Desember sebesar 312,22 x 106 m3 (positif), sedangkan terendah terdapat pada bulan Agustus sebesar -24,14 x 106 m3 (negatif).
Analisis Kekeringan Berdasarkan Bentuklahan Di Das Bompon
Authors: Rahmi Maulida , Setiawan M. Anggri , Mardiatno Djati 
Published: June 2020

Analisis kerawanan kekeringan dipengaruhi oleh kondisi satuan bentuklahan yang bervariasi pada wilayah kajian. Tujuan dari penelitian ini adalah (1) Memetakan kerawanan kekeringan menggunakan pengharkatan, (2) Menganalisis kerawanan kekeringan berdasarkan bentuklahan. Metode yang digunakan untuk memetakan kerawanan kekeringan yaitu pendekatan geomorfologi, pembobotan atau skoring diberikan pada setiap satuan bentuklahan sebagai indikator yang digunakan untuk menilai kelas kerawanan. Semakin besar pengaruh yang diberikan oleh indikator maka semakin besar pula skor atau pengharkatan yang diberikan. Hasil penelitian menunjukkan bahwa satuan bentuklahan interfluve dan lereng atas perbukitan memiliki tingkat kerawanan kekeringan tinggi. Kelas kerawanan kategori tinggi ditandai dengan kemunculan airtanah yang sulit ditemui. Kerawanan kekeringan kelas sedang berada pada bentuklahan lereng tengah perbukitan dan lereng bawah perbukitan. Bentuklahan lereng kaki koluvial dan dataran aluvial berada pada tingkat kekeringan kelas rendah, hal ini sesuai dengan kondisi yang ditemukan di lapangan, yaitu kemunculan airtanah yang mudah ditemui. Kekeringan pada satuan bentuklahan ditandai oleh kondisi morfologi dan lokasi ditemukannya mataair yang muncul di tekuk lereng. Penggunaan metode untuk kajian kekeringan dengan skala detail baik secara kualitatif dan kuantitatif perlu dilakukan lagi untuk menemukan perkembangan metode yang tepat dalam melakukan analisis kajian kekeringan dari segi sosial. Kata kunci: Bentuklahan; Daerah Aliran Sungai (DAS); Geomorfologi; Kerawanan; Kekeringan