bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Continued Use of Mobile Health Apps: Insights From a Longitudinal Study
Authors: Vaghefi Isaac , Tulu Bengisu 
Published: July 2019

Background
Mobile health (mHealth) apps that support individuals pursuing health and wellness goals, such as weight management, stress management, smoking cessation, and self-management of chronic conditions have been on the rise. Despite their potential benefits, the use of these tools has been limited, as most users stop using them just after a few times of use. Under this circumstance, achieving the positive outcomes of mHealth apps is less likely.

Objective
The objective of this study was to understand continued use of mHealth apps and individuals’ decisions related to this behavior.

Methods
We conducted a qualitative longitudinal study on continued use of mHealth apps. We collected data through 34 pre- and postuse interviews and 193 diaries from 17 participants over two weeks.

Results
We identified 2 dimensions that help explain continued use decisions of users of mHealth apps: users’ assessment of mHealth app and its capabilities (user experience) and their persistence at their health goals (intent). We present the key factors that influence users’ assessment of an mHealth app (interface design, navigation, notifications, data collection methods and tools, goal management, depth of knowledge, system rules, actionable recommendations, and user system fit) and relate these factors to previous literature on behavior change technology design. Using these 2 dimensions, we developed a framework that illustrated 4 decisions users might make after initial interaction with mHealth apps (to abandon use, limit use, switch app, and continue use). We put forth propositions to be explored in future research on mHealth app use.

Conclusions
This study provides insight into the factors that shape users’ decisions to continue using mHealth apps, as well as other likely decision scenarios after the initial use experience. The findings contribute to extant knowledge of mHealth use and provide important implications for design of mHealth apps to increase long-term engagement of the users.
A Promising Food-Coaching Intervention Program to Achieve Optimal Gestational Weight Gain in Overweight and Obese Pregnant Women: Pilot Randomized Controlled Trial of a Smartphone App
Authors: Li Ling-Jun , Aris Izzuddin M , Han Wee Meng , Tan Kok Hian 
Published: July 2019

Background
Traditional dietary recommendations for achieving optimal gestational weight gain are ineffective for pregnant women due to the lack of real-time communication and tedious consultation processes.

Objective
In this pilot study, we aimed to determine the feasibility of a novel food-coaching smartphone app for controlling gestational weight gain and macronutrient intake among overweight and obese pregnant women.

Methods
We designed a randomized controlled trial and recruited 30 overweight and obese pregnant women (1:1 ratio) during 18-20 weeks of gestation and followed them up after 4 and 8 weeks, respectively. Both groups received standard pregnancy dietary orientation at recruitment, while the intervention group received 8 weeks of real-time food coaching via a smartphone app. This food-coaching smartphone app (Glycoleap, Holmusk, Singapore) aimed to improve care and outcomes for people with diabetes. Pregnant women using this app were able to upload food images (eg, a picture of a meal, a drink, or a dessert) and received real-time and detailed food-coaching comments and guidance provided by professional dietitians during the day (8 AM to 8 PM). We recorded detailed characteristics during recruitment and examined anthropometry at all visits. We compared the mean differences of the 8-week gestational weight gain and macronutrient intake between the two groups.

Results
Upon study completion, three subjects dropped out from the intervention, and one gave birth prematurely in the control group. The acceptance rate of the smartphone app was 90%. More participants achieved optimal gestational weight gain per week in the intervention group (8/12, 67%) than in the control group (5/14, 36%). After the 8-week intervention, women in the intervention group appeared to have lower gestational weight gain (mean difference=–0.08 kg; 95% CI –1.80 to 1.63) and cholesterol intake (mean difference=–31.73 mg; 95% CI –102.91 to 39.45) than those in the control group.

Conclusions
Our findings showed that this food-coaching smartphone app is feasible and favorable for weight gain control and cholesterol intake control among overweight and obese pregnant women. Although our results were not significant (perhaps, attributed to the small sample size), it provided proof of concept for the feasibility of applying such technology in future randomized controlled trials with a larger sample size, an earlier intervention onset, and a longer follow-up for overweight and obese pregnant women.
Underage JUUL Use Patterns: Content Analysis of Reddit Messages
Authors: Zhan Yongcheng , Zhang Zhu , Okamoto Janet M , Zeng Daniel D , Leischow Scott J 
Published: July 2019

Background
The popularity of JUUL (an e-cigarette brand) among youth has recently been reported in news media and academic papers, which has raised great public health concerns. Little research has been conducted on the age distribution, geographic distribution, approaches to buying JUUL, and flavor preferences pertaining to underage JUUL users.

Objective
The aim of this study was to analyze social media data related to demographics, methods of access, product characteristics, and use patterns of underage JUUL use.

Methods
We collected publicly available JUUL-related data from Reddit. We extracted and summarized the age, location, and flavor preference of subreddit UnderageJuul users. We also compared common and unique users between subreddit UnderageJuul and subreddit JUUL. The methods of purchasing JUULs were analyzed by manually examining the content of the Reddit threads.

Results
A total of 716 threads and 2935 comments were collected from the subreddit UnderageJuul before it was shut down. Most threads did not mention a specific age, but ages ranged from 13 years to greater than 21 years in those that did. Mango, mint, and cucumber were the most popular among the 7 flavors listed on JUUL’s official website, and 336 subreddit UnderageJuul threads mentioned 7 discreet approaches to circumvent relevant legal regulations to get JUUL products, the most common of which was purchasing JUUL from other Reddit users (n=181). Almost half of the UnderageJuul users (389/844, 46.1%) also participated in discussions on the main JUUL subreddit and sought information across multiple Reddit forums. Most (64/74, 86%) posters were from large metropolitan areas.

Conclusions
The subreddit UnderageJuul functioned as a forum to explore methods of obtaining JUUL and to discuss and recommend specific flavors before it was shut down. About half of those using UnderageJuul also used the more general JUUL subreddit, so a forum still exists where youths can attempt to share information on how to obtain JUUL and other products. Exploration of such social media data in real time for rapid public health surveillance could provide early warning for significant health risks before they become major public health threats.
Analysis of Digital Documentation Speed and Sequence Using Digital Paper and Pen Technology During the Refugee Crisis in Europe: Content Analysis
Authors: Kehe Kai , Girgensohn Roland , Swoboda Walter , Bieler Dan , Franke Axel , Helm Matthias , Kulla Martin , Luepke Kerstin , Morwinsky Thomas , Blätzinger Markus , Rossmann Katalyn 
Published: July 2019

Background
The Syria crisis has forced more than 4 million people to leave their homeland. As a result, in 2016, an overwhelming number of refugees reached Germany. In response to this, it was of utmost importance to set up refugee camps and to provide humanitarian aid, but a health surveillance system was also implemented in order to obtain rapid information about emerging diseases.

Objective
The present study describes the effects of using digital paper and pen (DPP) technology on the speed, sequence, and behavior of epidemiological documentation in a refugee camp.

Methods
DPP technology was used to examine documentation speed, sequence, and behavior. The data log of the digital pens used to fill in the documentation was analyzed, and each pen stroke in a field was recorded using a timestamp. Documentation time was the difference between first and last stroke on the paper, which includes clinical examination and translation.

Results
For three months, 495 data sets were recorded. After corrections had been made, 421 data sets were considered valid and subjected to further analysis. The median documentation time was 41:41 min (interquartile range 29:54 min; mean 45:02 min; SD 22:28 min). The documentation of vital signs ended up having the strongest effect on the overall time of documentation. Furthermore, filling in the free-text field clinical findings or therapy or measures required the most time (mean 16:49 min; SD 20:32 min). Analysis of the documentation sequence revealed that the final step of coding the diagnosis was a time-consuming step that took place once the form had been completed.

Conclusions
We concluded that medical documentation using DPP technology leads to both an increase in documentation speed and data quality through the compliance of the data recorders who regard the tool to be convenient in everyday routine. Further analysis of more data sets will allow optimization of the documentation form used. Thus, DPP technology is an effective tool for the medical documentation process in refugee camps.
An Immersive Virtual Reality Platform for Assessing Spatial Navigation Memory in Predementia Screening: Feasibility and Usability Study
Authors: Ijaz Kiran , Ahmadpour Naseem , Naismith Sharon L , Calvo Rafael A 
Published: July 2019

Background
Traditional methods for assessing memory are expensive and have high administrative costs. Memory assessment is important for establishing cognitive impairment in cases such as detecting dementia in older adults. Virtual reality (VR) technology can assist in establishing better quality outcome in such crucial screening by supporting the well-being of individuals and offering them an engaging, cognitively challenging task that is not stressful. However, unmet user needs can compromise the validity of the outcome. Therefore, screening technology for older adults must address their specific design and usability requirements.

Objective
This study aimed to design and evaluate the feasibility of an immersive VR platform to assess spatial navigation memory in older adults and establish its compatibility by comparing the outcome to a standard screening platform on a personal computer (PC).

Methods
VR-CogAssess is a platform integrating an Oculus Rift head-mounted display and immersive photorealistic imagery. In a pilot study with healthy older adults (N=42; mean age 73.22 years, SD 9.26), a landmark recall test was conducted, and assessment on the VR-CogAssess was compared against a standard PC (SPC) setup.

Results
Results showed that participants in VR were significantly more engaged (P=.003), achieved higher landmark recall scores (P=.004), made less navigational mistakes (P=.04), and reported a higher level of presence (P=.002) than those in SPC setup. In addition, participants in VR indicated no significantly higher stress than SPC setup (P=.87).

Conclusions
The study findings suggest immersive VR is feasible and compatible with SPC counterpart for spatial navigation memory assessment. The study provides a set of design guidelines for creating similar platforms in the future.
The Effect of the Interactive Mobile Health and Rehabilitation System on Health and Psychosocial Outcomes in Spinal Cord Injury: Randomized Controlled Trial
Authors: Kryger Michael Alan , Crytzer Theresa M , Fairman Andrea , Quinby Eleanor J , Karavolis Meredith , Pramana Gede , Setiawan I Made Agus , McKernan Gina Pugliano , Parmanto Bambang , Dicianno Brad E 
Published: July 2019

Background
Individuals with spinal cord injury (SCI) are at risk for secondary medical complications, such as urinary tract infections (UTIs) and pressure injuries, that could potentially be mitigated through improved self-management techniques. The Interactive Mobile Health and Rehabilitation (iMHere) mobile health (mHealth) system was developed to support self-management for individuals with disabilities.

Objective
The main objective of this study was to determine if the use of iMHere would be associated with improved health outcomes over a 9-month period. A secondary objective was to determine if the use of iMHere would be associated with improved psychosocial outcomes. Phone usage, app usage, and training time data were also collected to analyze trends in iMHere use.

Methods
Overall, 38 participants with SCI were randomized into either the intervention group who used the iMHere system and received standard care or the control group who received standard care without any technology intervention. Health outcomes were recorded for the year before entry into the study and during the 9 months of the study. Participants completed surveys at baseline and every 3 months to measure psychosocial outcomes.

Results
The intervention group had a statistically significant reduction in UTIs (0.47 events per person; P=.03; number needed to treat=2.11). Although no psychosocial outcomes changed significantly, there was a nonsignificant trend toward a reduction in mood symptoms in the intervention group compared with the control group meeting the threshold for clinical significance. Approximately 34 min per participant per month were needed on average to manage the system and provide technical support through this mHealth system.

Conclusions
The use of the iMHere mHealth system may be a valuable tool in the prevention of UTIs or reductions in depressive symptoms. Given these findings, iMHere has potential scalability for larger populations.

Trial Registration
ClinicalTrials.gov NCT02592291; https://clinicaltrials.gov/ct2/show/NCT02592291.
Nurse-Driven mHealth Implementation Using the Technology Inpatient Program for Smokers (TIPS): Mixed Methods Study
Authors: Blok Amanda C , Sadasivam Rajani S , Hogan Timothy P , Patterson Angela , Day Nicole , Houston Thomas K 
Published: July 2019

Background
Smoking is the leading cause of preventable death and disease, yet implementation of smoking cessation in inpatient settings is inconsistent. The Technology Inpatient Program for Smokers (TIPS) is an implementation program designed to reach smokers with a mobile health (mHealth) intervention using stakeholder-supported strategies.

Objective
The purpose of this study was to determine the impact of the TIPS implementation strategies on smoker-level engagement of the mHealth intervention during care transition.

Methods
We examined varying intensities (passive motivational posters only and posters + active nurse-led facilitation) of TIPS strategies on four hospital units located in two sites. Unit-level and smoker-level adoption was monitored during active implementation (30 weeks) and sustainability follow-up (30 weeks). Process measures reflecting the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework, stakeholder reported adaptations of strategies, and formative evaluation data were collected and analyzed.

Results
For our smoker-level reach, 103 smokers signed up for the mHealth intervention in-hospital, with minimal decline during sustainability follow-up. While posters + nurse facilitation did not lead to higher reach than posters alone during active implementation (27 vs 30 signed up), it did lead to higher engagement of smokers (85.2% vs 73.3% completion of the full 2-week intervention). TIPS strategy adoption and fidelity varied by unit, including adoption of motivational posters (range: weeks 1 and 5), fidelity of posters (0.4% to 16.2% of posters missing per unit weekly) and internal facilitation of nurse training sessions (average of 2 vs 7.5 by site). Variable maintenance costs of the program totaled US $6.63 (US $683.28/103) per smoker reached. Reported family-member facilitation of mHealth sign-up was an observation of unintended behavior.

Conclusions
TIPS is a feasible and low-cost implementation program that successfully engages smokers in an mHealth intervention and sustains engagement after discharge. Further testing of nurse facilitation and expanding reach to patient family and friends as an implementation strategy is needed.
Utilization, Safety, and Technical Performance of a Telemedicine System for Prehospital Emergency Care: Observational Study
Authors: Felzen Marc , Beckers Stefan Kurt , Kork Felix , Hirsch Frederik , Bergrath Sebastian , Sommer Anja , Brokmann Jörg Christian , Czaplik Michael , Rossaint Rolf 
Published: July 2019

Background
As a consequence of increasing emergency medical service (EMS) missions requiring an EMS physician on site, we had implemented a unique prehospital telemedical emergency service as a new structural component to the conventional physician-based EMS in Germany.

Objective
We sought to assess the utilization, safety, and technical performance of this telemedical emergency service.

Methods
We conducted a retrospective analysis of all primary emergency missions with telemedical consultation of an EMS physician in the City of Aachen (250,000 inhabitants) during the first 3 operational years of our tele-EMS system. Main outcome measures were the number of teleconsultations, number of complications, and number of transmission malfunctions during teleconsultations.

Results
The data of 6265 patients were analyzed. The number of teleconsultations increased during the run-in period of four quarters toward full routine operation from 152 to 420 missions per quarter. When fully operational, around the clock, and providing teleconsultations to 11 mobile ambulances, the number of teleconsultations further increased by 25.9 per quarter (95% CI 9.1-42.6; P=.009). Only 6 of 6265 patients (0.10%; 95% CI 0.04%-0.21%) experienced adverse events, all of them not inherent in the system of teleconsultations. Technical malfunctions of single transmission components occurred from as low as 0.3% (95% CI 0.2%-0.5%) during two-way voice communications to as high as 1.9% (95% CI 1.6%-2.3%) during real-time vital data transmissions. Complete system failures occurred in only 0.3% (95% CI 0.2%-0.6%) of all teleconsultations.

Conclusions
The Aachen prehospital EMS is a frequently used, safe, and technically reliable system to provide medical care for emergency patients without an EMS physician physically present. Noninferiority of the tele-EMS physician compared with an on-site EMS physician needs to be demonstrated in a randomized trial.
THE FIGHT AGAINST ‘ADATS AND SHARI‘A IN THE FAMILY LIFE OF KUMYKS IN THE FIRST SOVIET DECADES
Authors: GUSEYNOV Yu. M. 
Published: July 2019

The article is devoted to the correlation between the norms of ‘adat and shari‘a in the Kumyk family life in the fi rst years of Soviet power. During this period, on the territory of the entire state, including Dagestan, Soviet legal doctrine was actively introduced with its own laws, principles and rules.The new laws of the country of the Soviets sharply contradicted the traditional norms of the Kumyks. This contradiction has been expressed in many issues, including family and domestic. At fi rst, the Soviet leadership strongly supported the norms of ‘adat and shari‘a. This was refl ected in the invitation to the dualistic marriage-according to the Soviet and shari‘a laws. However, by the end of the 20s of the 20th century, an ideological campaign unfolded against the ‘adat and shari‘a norms.
OVERCOMING STEREOTYPES (FACTORS WHICH PROVOKE ISLAMOPHOBIA)
Authors: STEPANYANTS M. T. 
Published: July 2019

In the modern world Islamophobia is one of the most dangerous types of negative stereotypes that give rise to prejudices, discrimination and even aggression. Laypeople and politicians, scholars and theologians bear responsibility for multiplication and distribution of stereotyping in media. The journalists too often are not capable to distinguish religion from its believers. Islam and Muslims are not synonyms: in fact, we are talking about behavioral paradigms of the believers, not about their sacred teaching. Evaluation of Islam as radical, fanatic, intolerant, terrorist, etc., is unjustifi ed and inconsistent. The article argues inadmissibility of using the most common polar adjectives like “radical” and “traditional” for defi ning Islam. It is proposed to carry out the fundamental distinction between the actors at the political front and the participants of ideological and theological polemics. In the fi rst case, it would be appropriate to name «the radicals» as the militant fanatics, while «the traditionalists» as the tolerant Muslims. In the second case, it might be more precise to name one side as the Muslim orthodoxy, while the opposite side — renewal movement or religious reconstruction. The need to free debates involving both the reputable theologians and the ordinary Muslims is urgent. This kind of discussion might help both scholars and media representatives to free themselves from stereotypes that instigate Islamophobia.
IRANIAN POLITICAL ISLAM AND THE YEMENI CRISIS
Authors: KHAIRULLIN T. R. 
Published: July 2019

The article is devoted to the analysis of the features of a rather specifi c project of Islamism promoted by the Islamic Republic of Iran. Iranian Islamism is based on the ideas of Ayatollah Khomeini about the ideal “Islamic state”, in which Islam has close contact with politics, with the government of the country. However, after the death of Ayatollah Khomeini, the country’s new elite became more pragmatic about the mission of spreading the Shi‘ite version of Islam. In particular, emphasis was placed on rapprochement with those countries and groups that showed friendly feelings to Tehran. In many respects this concerned the countries of the Arab region in which the Shi‘a community was present or prevailed. One of these states is Yemen. In particular, Iran’s participation in the Yemeni crisis, in which Tehran is trying to strengthen its own positions and prevent the strengthening of Saudi positions in Yemen by means of the Zaydi group of the Houthi, is being considered.
THEORETICAL AND METHODOLOGICAL BASIS FOR THE STUDY OF THE CRIMEAN TATAR ETHNOPOLITICAL PROCESS
Authors: AKHMADEEV K. N. 
Published: July 2019

The article is devoted to such an important phenomenon in modern political science as the ethno-political process, as well as theoretical and methodological grounds for the study of the Crimean Tatar ethnopolitical process, which is one of the most ambiguous and controversial cases not only in modern Russia, but also in the world. The contradictory nature of the Crimean Tatar ethnopolitical process is determined by the controversy from the point of view of international law of the territory of Crimea — the main area of the process. Particular attention is paid to the theoretical and methodological features of the study of the ethnopolitical process as a category of political science. The essence and content of such a phenomenon as ethnopolitical mobilization and the possibility of using theoretical developments in this fi eld to study the Crimean Tatar ethnopolitical process are revealed.