Publications
167 results found
Salamanca-Sanabria A, Jabir AI, Lin X, et al., 2023, Exploring the Perceptions of mHealth Interventions for the Prevention of Common Mental Disorders in University Students in Singapore: Qualitative Study., J Med Internet Res, Vol: 25
BACKGROUND: Mental health interventions delivered through mobile health (mHealth) technologies can increase the access to mental health services, especially among university students. The development of mHealth intervention is complex and needs to be context sensitive. There is currently limited evidence on the perceptions, needs, and barriers related to these interventions in the Southeast Asian context. OBJECTIVE: This qualitative study aimed to explore the perception of university students and mental health supporters in Singapore about mental health services, campaigns, and mHealth interventions with a focus on conversational agent interventions for the prevention of common mental disorders such as anxiety and depression. METHODS: We conducted 6 web-based focus group discussions with 30 university students and one-to-one web-based interviews with 11 mental health supporters consisting of faculty members tasked with student pastoral care, a mental health first aider, counselors, psychologists, a clinical psychologist, and a psychiatrist. The qualitative analysis followed a reflexive thematic analysis framework. RESULTS: The following 6 main themes were identified: a healthy lifestyle as students, access to mental health services, the role of mental health promotion campaigns, preferred mHealth engagement features, factors that influence the adoption of mHealth interventions, and cultural relevance of mHealth interventions. The interpretation of our findings shows that students were reluctant to use mental health services because of the fear of stigma and a possible lack of confidentiality. CONCLUSIONS: Study participants viewed mHealth interventions for mental health as part of a blended intervention. They also felt that future mental health mHealth interventions should be more personalized and capable of managing adverse events such as suicidal ideation.
Tudor Car L, 2023, Smartphone apps for point-of-care information summaries: systematic assessment of the quality and content, BMJ Evidence-Based Medicine, ISSN: 2515-446X
Kingsland M, Barnes C, Doherty E, et al., 2022, Identifying topics for future Cochrane Public Health reviews, JOURNAL OF PUBLIC HEALTH, Vol: 44, Pages: E578-E581, ISSN: 1741-3842
Soon CSL, Car LT, Ng CJ, et al., 2022, What Is the Utility of Posters? Qualitative Study of Participants at a Regional Primary Healthcare Conference in Asia, MEDICAL SCIENCE EDUCATOR, Vol: 32, Pages: 1405-1412
Chan FHF, Goh ZZS, Zhu X, et al., 2022, Subjective cognitive complaints in end-stage renal disease: a systematic review and meta-analysis, HEALTH PSYCHOLOGY REVIEW, ISSN: 1743-7199
Martinengo L, Jabir AI, Goh WWT, et al., 2022, Conversational Agents in Health Care: Scoping Review of Their Behavior Change Techniques and Underpinning Theory, JOURNAL OF MEDICAL INTERNET RESEARCH, Vol: 24, ISSN: 1438-8871
Dhinagaran DA, Car LT, 2022, Public perceptions of a healthy lifestyle change conversational agent in Singapore: A qualitative study, DIGITAL HEALTH, Vol: 8, ISSN: 2055-2076
Subramaniam M, Lau JH, Asharani P, et al., 2022, Sources of information on diabetes and its demographic correlates: a nationwide survey among Singapore residents, HEALTH PROMOTION INTERNATIONAL, Vol: 37, ISSN: 0957-4824
Dhinagaran DA, Martinengo L, Ho M-HR, et al., 2022, Designing, Developing, Evaluating, and Implementing a Smartphone-Delivered, Rule-Based Conversational Agent (DISCOVER): Development of a Conceptual Framework, JMIR MHEALTH AND UHEALTH, Vol: 10, ISSN: 2291-5222
Peng Ng MS, Jabir AI, De Rong Ng T, et al., 2022, Evaluating TESLA-G, a gamified, Telegram-delivered, quizzing platform for surgical education in medical students: a protocol for a pilot randomised controlled trial
<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Online multiple-choice question (MCQ) quizzes are popular in medical education due to their ease of access and ability for test-enhanced learning. However, a general lack of motivation among students often results in decreasing usage over time. We aim to address this limitation by developing Telegram Education for Surgical Learning and Application Gamified (TESLA-G), an online platform for surgical education that incorporates game elements into conventional MCQ quizzes.</jats:p></jats:sec><jats:sec><jats:title>Methods and analysis</jats:title><jats:p>This online, pilot randomised control trial will be conducted over two weeks. Fifty full-time undergraduate medical students will be recruited and randomised into an intervention group (TESLA-G) and an active control group (non-gamified quizzing platform) with a 1:1 allocation ratio, stratified by year of study.</jats:p><jats:p>We will evaluate TESLA-G in the area of endocrine surgery education. Our platform is designed based on Bloom’s taxonomy of learning domains: questions are created in blocks of 5 questions per endocrine surgery topic, with each question corresponding to one level on Bloom’s taxonomy. This structure promotes mastery while boosting student engagement and motivation. All questions are created by two board-certified general surgeons and one endocrinologist, and validated by the research team.</jats:p><jats:p>The feasibility and acceptability of the pilot study will be assessed by participant recruitment and retention rates, acceptability of the intervention, adherence and task completion rate, fidelity of the intervention delivery, and perception of the intervention. The effectiveness of the intervention (TESLA-G) compared to the control will be assessed by improvement in knowledge from pre- to post-intervent
Soon MKS, Martinengo L, Lu J, et al., 2022, The Use of Telegram in Surgical Education: Exploratory Study., JMIR Med Educ, Vol: 8, ISSN: 2369-3762
BACKGROUND: The COVID-19 pandemic has disrupted medical education, shifting learning online. Social media platforms, including messaging apps, are well integrated into medical education. However, Telegram's role in medical education remains relatively unexplored. OBJECTIVE: This study aims to explore the perceptions of medical students regarding the role of messaging apps in medical education and their experience of using Telegram for surgical education. METHODS: A Telegram channel "Telegram Education for Surgery Learning and Application (TESLA)" was created to supplement medical students' learning. We invited 13 medical students who joined the TESLA channel for at least a month to participate in individual semistructured interviews. Interviews were conducted via videoconferencing using an interview guide and were then transcribed and analyzed by 2 researchers using inductive thematic content analysis. RESULTS: Two themes were identified: (1) learning as a medical student and (2) the role of mobile learning (mLearning) in medical education. Students shared that pandemic-related safety measures, such as reduced clinic allocations and the inability to cross between wards, led to a decrease in clinical exposure. Mobile apps, which included proprietary study apps and messaging apps, were increasingly used by students to aid their learning. Students favored Telegram over other messaging apps and reported the development of TESLA as beneficial, particularly for revision and increasing knowledge. CONCLUSIONS: The use of apps for medical education increased during the COVID-19 pandemic. Medical students commonly used apps to consolidate their learning and revise examination topics. They found TESLA useful, relevant, and trustworthy.
Chen S, Sam XH, Soong A, et al., 2022, Recruitment of general practitioners in China: a scoping review of strategies and challenges, BMC PRIMARY CARE, Vol: 23
Tudor Car L, Chan FHF, Lin X, et al., 2022, Information needs and sources of information among people with depression and anxiety: a scoping review, BMC Psychiatry, Vol: 22, ISSN: 1471-244X
Background: Previous studies have identified substantial unmet information needs in people with depression and anxiety. Sufficient information about the disorder, treatment, available services, and strategies for self-management is essential as it may influence quality of care and patients’ quality of life. This scoping review aimed to provide a broad overview of information needs of people with depression and anxiety as well as the sources that they use to seek this information.Methods: We included all primary research published in English that investigated information needs or information sources in people with depression or anxiety, with no restrictions imposed on the study design, location, setting, or participant characteristics. Six electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, LISTA, Web of Science) and the grey literature (Google and Google Scholar) were searched for relevant studies published up to November 2021. Two reviewers independently screened articles and extracted data. Narrative synthesis was performed to identify key themes of information needs and information sources. Factors associated with information needs/sources such as demographic variables and symptom severity were also identified.Results: Fifty-six studies (comprising 8320 participants) were included. Information needs were categorised into seven themes, including general facts, treatment, lived experience, healthcare services, coping, financial/legal, and other information. The most frequently reported needs in both people with depression and anxiety were general facts and treatment information. Subclinical samples who self-reported depressive/anxious symptoms appeared less interested in treatment information than patients with clinical diagnoses. Information sources were summarised into five categories: health professionals, written materials, media, interpersonal interactions, and organisational resources. Health professionals and media (including the internet) were th
GBD 2019 Diabetes and Air Pollution Collaborators, 2022, Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2·5 air pollution, 1990-2019: an analysis of data from the Global Burden of Disease Study 2019, The Lancet Planetary Health, Vol: 6, Pages: e586-e600, ISSN: 2542-5196
BACKGROUND: Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. METHODS: We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure-response curve from the extracted relative risk estimates using the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. FINDINGS: In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68-4·83) deaths per 100 000 population and 167 (117-223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49-17·5) of deaths and 13·6% (9·73-17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22-9·53) of deaths and 5·92% (3·81-8·64) of DALYs by household air pollution. High burdens, in
Tudor Car L, Kyaw BM, Teo A, et al., 2022, Outcomes, measurement instruments and their validity evidence in randomised trials on virtual, augmented and mixed reality in undergraduate medical education: a systematic mapping review, JMIR Serious Games, Vol: 10, ISSN: 2291-9279
Background: Extended reality, encompassing virtual, augmented and mixed reality, is increasingly used in medical education. Studies assessing effectiveness of these new educational modalities should measure relevant outcomes using outcome measurement tools with validity evidence. Our aim was to determine the choice of outcomes, measurement instruments and the use of measurement instruments with validity evidence in randomized controlled trials (RCTs) on the effectiveness of virtual reality (VR), augmented reality (AR) and mixed reality (MR) in medical student education.Methods: We conducted a systematic mapping review. We searched seven major bibliographic databases from January 1990 to April 2020. Two reviewers screened the citations and extracted data independently from the included studies. We report our findings in line with PRISMA guidelines.Results: Of 127 retrieved RCTs, 116 were on VR, eleven on AR. No RCTs on MR in medical student education were found. Of the studies on VR, 64 studies were on VR simulators, 31 studies on screen-based VR, 9 on VR patient simulations and 12 on VR serious games. Most studies reported only one outcome and immediate, post-intervention assessment data. Skills outcome was the most common outcome in studies on VR simulators, VR patient simulations and AR. Knowledge was the most common outcome in studies on screen-based VR and VR serious games. Less common outcomes included participants’ attitudes, satisfaction, cognitive or mental load, learning efficacy, engagement and/or self-efficacy beliefs, emotional state, competency developed and patient outcomes. At least one form of validity evidence was found in around half of the studies on VR simulator, VR patient simulations, VR serious games and AR, and in only a quarter of studies on screen-based VR. Most studies used assessment methods that were implemented in a non-digital format such as paper-based written exercises or in-person assessments where examiners observed performan
Tudor Car L, Tudor Car L, Poon S, et al., 2022, Digital education for health professionals: An evidence map, conceptual framework and research agenda, Journal of Medical Internet Research, Vol: 24, Pages: 1-21, ISSN: 1438-8871
BackgroundHealth professions education has undergone major changes with the advent and adoption of digital technologies worldwide. To enable robust and relevant research in digital health professions education, it is essential to map the existing evidence, identify gaps and research priorities.MethodsWe searched for systematic reviews on digital education of practicing and student healthcare professionals. We searched Medline, Embase, Cochrane Library, ERIC, CINAHL, and grey literature sources from January 2014 to July 2020. Two authors independently screened the studies, extracted the data, and synthesized the findings. We outlined the key characteristics of the included reviews, the quality of the evidence they synthesized, and recommendations for future research. We mapped the empiric findings and research recommendations against a newly developed conceptual framework. ResultsWe identified 77 eligible systematic reviews. All included experimental studies and evaluated the effectiveness of digital education interventions in different healthcare disciplines or of different digital education modalities. Most reviews included studies on various digital education modalities (N=22), virtual reality (N=19) and online education (N=10). Most reviews focused on health professions education in general (N=36), surgery (N=13) and nursing (N=11). The reviews mainly assessed participants’ skills (N=51) and knowledge (N=49) and included data from high-income countries (N=53). Our novel conceptual framework of digital health professions education comprises six key domains (context, infrastructure, education, learners, research, and quality improvement) and 16 subdomains. Finally, we identified in these reviews 61 unique questions for future research; these mapped to framework domains of education (29 recommendations), context (17), infrastructure (9), learners (3), and research (3). Conclusions We have identified a large number of research questions regarding digital educat
Martinengo L, Stona A-C, Car LT, et al., 2022, Education on Depression in Mental Health Apps: Systematic Assessment of Characteristics and Adherence to Evidence-Based Guidelines, JOURNAL OF MEDICAL INTERNET RESEARCH, Vol: 24, ISSN: 1438-8871
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- Citations: 2
Cousin E, Duncan BB, Stein C, et al., 2022, Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019, The Lancet Diabetes & Endocrinology, Vol: 10, Pages: 177-192, ISSN: 2213-8587
BackgroundDiabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.MethodsWe used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990–2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals.FindingsIn 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (−
Haowen J, Vimalesvaran S, King Wang J, et al., 2022, Virtual reality in medical students’ education: a scoping review, JMIR Medical Education, Vol: 8, Pages: 1-24, ISSN: 2369-3762
Purpose: Virtual reality (VR) is a digital education modality that produces a virtual manifestation of the real world and it has been increasingly used in medical education. As VR encompasses different modalities, tools and applications, there is a need to explore how VR has been employed in medical education. The objective of this scoping review is to map existing research on the use of VR in undergraduate medical education and to identify areas of future research.Method: We performed a search of 4 bibliographic databases in December 2020, with data extracted using a standardized data extraction form. The data was narratively synthesized and reported in line with the Joanna Briggs Institute (JBI) methodology for scoping reviews. Results: Of 114 included studies, 69 studies (61%) reported the use of commercially available surgical VR simulators. Other VR modalities included 3D models (15 [14%]) and virtual worlds (20 [18%]), mainly used for anatomy education. Most of the VR modalities included were semi-immersive (68 [60%]) and of high interactivity (79 [70%]). There is limited evidence on the use of more novel VR modalities such as mobile VR and virtual dissection tables (8 [7%]), as well as the use of VR for training of non-surgical and non-psychomotor skills (20 [18%]) or in group setting (16 [14%]). Only 3 studies reported the use conceptual frameworks or theories in the design of VR.Conclusion: Despite extensive research available on VR in medical education, there continues to be important gaps in the evidence. Future studies should explore the use of VR for the development of non-psychomotor skills and in areas other than surgery and anatomy.
Keller R, Hartmann S, Teepe GW, et al., 2022, Digital Behavior Change Interventions for the Prevention and Management of Type 2 Diabetes: Systematic Market Analysis, JOURNAL OF MEDICAL INTERNET RESEARCH, Vol: 24, ISSN: 1438-8871
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- Citations: 2
Tan BY, Thach T, Munro YL, et al., 2021, Complex Lifestyle and Psychological Intervention in Knee Osteoarthritis: Scoping Review of Randomized Controlled Trials, INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 18
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- Citations: 3
Ollier J, Neff S, Dworschak C, et al., 2021, Elena+ Care for COVID-19, a Pandemic Lifestyle Care Intervention: Intervention Design and Study Protocol (vol 9, 625640,2021), FRONTIERS IN PUBLIC HEALTH, Vol: 9
Car LT, Teng YS, How JW, et al., 2021, Priorities for family physician and general practitioner recruitment and retention in Singapore: a PRIORITIZE study, BMC FAMILY PRACTICE, Vol: 22
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- Citations: 1
Dhinagaran DA, Sathish T, Kowatsch T, et al., 2021, Public perceptions of diabetes, healthy living and conversational agents in Singapore: a needs assessment, JMIR Formative Research, Vol: 5, Pages: 1-15, ISSN: 2561-326X
Background:The incidence of chronic diseases such as type 2 diabetes is on the rise in countries worldwide, including Singapore. Health professional-delivered healthy lifestyle interventions have been shown to prevent type 2 diabetes. Yet ongoing personalised guidance from health professionals is not feasible or affordable at the population level. Novel digital interventions delivered using mobile technology such as conversational agents are a potential alternative for delivery of healthy lifestyle change behavioural interventions to the public.Objective:We explored Singaporeans’ perceptions on and experience of healthy living, diabetes and mobile health interventions (apps and conversational agents). This survey was done to help inform the design and development of a conversational agent focusing on healthy lifestyle change.Methods:This qualitative study was conducted over Aug and Sept 2019. 20 participants were recruited from relevant healthy living Facebook pages and groups. Semi-structured interviews were conducted in person or over the telephone using an interview guide. Interviews were transcribed and analysed in parallel by two researchers using Burnard’s method, a structured approach for thematic content analysis.Results:The collected data was organised into four main themes: (1) use of conversational agents, (2) ubiquity of smartphone applications, (3) understanding of diabetes and (4) barriers and facilitators to a healthy living in Singapore. Most participants used health-related mobile applications as well as conversational agents unrelated to healthcare. They provided diverse suggestions for future conversational agent-delivered interventions. Participants also highlighted several knowledge gaps in relation to diabetes and healthy living. In terms of barriers to healthy living, frequent dining out, high stress levels, lack of work-life balance and dearth of free time to engage in physical activity were mentioned. In contrast, discipline, pre
Ward JL, Azzopardi PS, Francis KL, et al., 2021, Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019, The Lancet, Vol: 398, Pages: 1593-1618, ISSN: 0140-6736
BackgroundDocumentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10–24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.MethodsWe report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10–24 years by age group (10–14 years, 15–19 years, and 20–24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10–24 years with that in children aged 0–9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10–24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017).FindingsIn 2019 there were 1·49 million deaths (95% uncertainty interval 1·39–1·59) worldwide in people aged 10–24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or mater
Ollier J, Neff S, Dworschak C, et al., 2021, Elena plus Care for COVID-19, a Pandemic Lifestyle Care Intervention: Intervention Design and Study Protocol, FRONTIERS IN PUBLIC HEALTH, Vol: 9
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- Citations: 1
Micah AE, Cogswell IE, Cunningham B, et al., 2021, Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990–2050, The Lancet, Vol: 398, Pages: 1317-1343, ISSN: 0140-6736
BackgroundThe rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020.MethodsWe estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050.FindingsIn 2019, health spending globally reached $8·8 trillion (95% uncertainty interval [UI] 8·7–8·8) or $1132 (1119–1143) per person. Spending on health varied within and across income groups and geogra
Teepe GW, Da Fonseca A, Kleim B, et al., 2021, Just-in-Time Adaptive Mechanisms of Popular Mobile Apps for Individuals With Depression: Systematic App Search and Literature Review, JOURNAL OF MEDICAL INTERNET RESEARCH, Vol: 23, ISSN: 1438-8871
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Paulson KR, Kamath AM, Alam T, et al., 2021, Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019, The Lancet, Vol: 398, Pages: 870-905, ISSN: 0140-6736
BackgroundSustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival.MethodsWe completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index.FindingsGlobal U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3–74·0) in 2000 to 37·1 (33·2–41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8–29·5) in 2000 to 17·9 (16·3–19·8) in 2019.
Tudor Car L, 2021, The choice of behavioral change techniques in conversational agents in healthcare: a scoping review protocol, JMIR Research Protocols, Vol: 10, Pages: 1-5, ISSN: 1929-0748
Background:Conversational agents or chatbots are computer programs that simulate conversations with users. Conversational agents are increasingly used for delivery of behavior change interventions in health care. Behavior change is complex and comprises the use of one or several components collectively known as behavioral change techniques (BCTs).Objective:The objective of this scoping review is to identify the BCTs that are used in behavior change–focused interventions delivered via conversational agents in health care.Methods:This scoping review will be performed in line with the Joanna Briggs Institute methodology and will be reported according to the PRISMA extension for scoping reviews guidelines. We will perform a comprehensive search of electronic databases and grey literature sources, and will check the reference lists of included studies for additional relevant studies. The screening and data extraction will be performed independently and in parallel by two review authors. Discrepancies will be resolved through consensus or discussion with a third review author. We will use a data extraction form congruent with the key themes and aims of this scoping review. BCTs employed in the included studies will be coded in line with BCT Taxonomy v1. We will analyze the data qualitatively and present it in diagrammatic or tabular form, alongside a narrative summary.Results:To date, we have designed the search strategy and performed the search on April 26, 2021. The first round of screening of retrieved articles is planned to begin soon.Conclusions:Using appropriate BCTs in the design and delivery of health care interventions via conversational agents is essential to improve long-term outcomes. Our findings will serve to inform the development of future interventions in this area.International Registered Report Identifier (IRRID):PRR1-10.2196/30166JMIR Res Protoc 2021;10(7):e30166
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