App Group Research Articles

The Efficacy of Little Lovely Dentist and Tell Show Do in Alleviating Dental Anxiety in Iraqi Children: A Randomized Clinical Trial.

Behavior management approaches in treating children are generally viewed as techniques to enhance communication with patients to promote positive attitudes. Patients, particularly children, consider visiting a dental clinic to be a difficult and painful experience, so a dentist who treats children should have a variety of behavior management techniques. This study aimed to evaluate and compare the efficacy of Tell Show Do (TSD) and a mobile app in reducing dental anxiety among children patients. A clinical trial study with 66 children aged 6-8 years was divided into three groups by the randomization method, which was performed in two steps: the first step used a random group generator template for excel to distribute the 66 children into three groups (each group 22), and the second step by excel function (RAND) to make the sequence for children. The sample was divided into three groups; each group has 22 children: Group I (TSD), Group II mobile app (Little Lovely Dentist), and Group III control. ClI fillings of the primary molars were provided to all participants. Anxiety levels were measured using physiological methods (heart rate and oxygen saturation by pulse oximeter) and psychological methods (Venham picture test) before treatment, during the education stage, and after treatment. The statistical tests were the paired t test for intragroup comparison and one-way analysis of variance (ANOVA) for intercomparison. One-way ANOVA showed a significantly lower pulse rate in the mobile app group after treatment, significantly higher SPO2 saturation in the mobile app group than in the TSD and control groups, and significantly lower Venham scores in the mobile app group than in the control group. The use of the Little Lovely Dentist mobile app decreased dental anxiety levels in children's first dental visit more than both the TSD technique and control groups when compared.

Engage, Develop, Learn: a pilot randomized clinical trial to test if a mobile application can enhance home support for early cognitive development among children living in poverty

Mobile applications (apps) exist to promote early child development; however, few studies have examined use of these apps among low-income families. Our objectives were to measure engagement with the Engage, Develop, Learn (EDL) app and determine if it promoted engagement and behavior change among low-income caregivers. We conducted a pilot study among English and Spanish-speaking, low-income families with children ages 12 to 15 months who received either the EDL app or injury prevention text messages. Baseline data were collected and interventions delivered over two home visits. App engagement was measured using messages opened. Caregiver development-promoting behaviors were measured with STIMQ score changes from baseline to follow-up at child age 2 years. We conducted key informant interviews among families randomized to receive the EDL app to identify barriers and facilitators to app use. A total of 100 caregivers were recruited at their children's preventive care visit with 50 randomized to receive the EDL app and 50 to receive the injury prevention text messages; however, only 25 in the development app and 34 in the injury prevention group completed both home visits. Follow-up data were collected from 14 in the development app group and 30 in the injury prevention group. Over 10 weeks, 24% (6/25) remained engaged with the development app. STIMQ scores did not differ between groups. Barriers included technical difficulties accessing the app, social stressors, and 'forgetting' to use it. Our pilot randomized trial of a child development app suggests that it may not be effective for promoting behavior change among low-income caregivers due to low engagement. This pilot trial was registered with ClinicalTrials.gov (ID NCT02717390).

Challenges of Online Learning Environment Faced by Undergraduate Medical Students During Covid 19 Pandemic

Objective: This study aimed to define the challenges faced by medical students rotating in the orthopedics department and their suggestions regarding improvement during covid-19 pandemic. Study Design: A mixed method cross sectional study design. Place and Duration of Study: It was conducted on 4 and 5 year MBBS students at Shifa college of Medicine with clerkship rotation in the department of orthopedics from 16 March 2020 to 23 August 2021. Materials and Methods: Students were enquired about their comfort levels while using the internet and computer for online sessions. Data was collected through an online questionnaire and analyzed using Google forms. Frequencies, percentages, and standard deviations were calculated for qualitative variables. Results: Out of 147 study participants, 64(43.4%) students strongly agreed that they had no difficulty and were extremely comfortable using internet and computer during covid-19 pandemic. Eighty-five (58%) students used online available reading material shared on Google classrooms and what's app groups. While only 23(16%) agreed to concentrate during online sessions. One hundred and eighteen (80%) agreed with a lesser desire to study for online classes as compared to on campus. Major problems faced by the students during the pandemic included very limited patient centered learning, limited hands-on experience, less interactive sessions, problems with internet connections, technology handling and class timing issues due to time zone differences. Conclusion: We conclude that our students faced lot of challenges during Covid-19 pandemic including internet issues, lack of awareness of technology, distractions because of family, siblings and homely environment and lack of conducive learning environment like learning at bedside. Flexible class timings, multiple breaks, recorded lectures and online interaction of real patients can improve online clinical learning.

Efficacy of Mobile-Based Cognitive Training Program DoBrain in Preschool Children With or Without Developmental Disabilities: A Randomized, Single-Blind, Active-Controlled Trial.

Mobile-based cognitive training programs can be a viable alternative to in-person interventions, but their efficacies have not been established yet. In this study, we examined the efficacy of DoBrain, a mobile-based cognitive training program designed for children with developmental disabilities (DDs), in comparison with general educational apps named Junior Naver and Kakao Kids. Children aged 34 to 77 months were recruited and randomized at a 1:1 ratio to use DoBrain or general educational apps. Each group used the assigned app on a daily basis at home for 30 minutes for 24 weeks. Parents were instructed to help the children with the app usage. A total of 166 children completed the post-test visit (DoBrain group, n=85, 55.4±8.7 months old; general educational app group, n=81, 53.7±9.9 months old). The primary outcome was cognitive development measured by Psychoeducational Profile-Revised (PEP-R), administered at baseline and at post-test. DoBrain had no superior effect over general educational apps on the PEP-R Developmental Quotient. When the changes before and after app usage were compared, the DoBrain group and the general educational app group both showed declines in imitation (adjusted p=0.049 and 0.022), perception (adjusted p=0.004 and <0.001), and gross motor (adjusted p=0.003 and 0.002) domains of the PEP-R. Among the DoBrain group, children with DD showed a significantly greater gain in the eye-hand coordination domain of PEP-R compared with those without DD (adjusted p=0.047). DoBrain did not show a superior effect over general educational apps on overall cognitive development in preschool children, regardless of the presence of DD. Careful monitoring of the negative effect of mobile-based cognitive training programs is necessary.

Practice related concerns among private dental practitioners of Kerala during COVID 19 pandemic - A cross sectional study

: The sudden outbreak of Covid 19 resulted in serious financial challenges and implications among private dental practitioners. Even though dental practitioners are now trying to retrieve back to pre-Covid state, concerns persist since Covid cases are unpredictably peaking every now and then.: This cross-sectional questionnaire-based study was conducted among 497 private dental practitioners of Kerala to assess the clinical, psychological, and financial concerns during COVID-19 pandemic. Questionnaire was circulated through IDA official Whats App groups as online google forms. Data so obtained was entered and analysed using SPSStrial version 21. Qualitative variables were expressed in proportions. Association of domains with sociodemographic characteristics were assessed using Chi Square test. Main clinical concern reported by 52.3% of participants was transmission of infection to family members, main financial concern of 66.2% of participants was reduced income from practice, and 25.8% of the participants reported ‘lot of stress’. It was found that practitioners with more than 10 years’ experience had moreclinical concerns, while those with less than 10 years’ experience had more financial concerns.: Our survey highlighted the concerns of private dental practitioners of Kerala in their practice during the pandemic. It is expected that practitioners, enriched with the experience acquired during the recent outbreak will be able to efficiently redefine their scope of practice and adjust to new circumstances.

Brief App-Based Cognitive Behavioral Therapy for Anxiety Symptoms in Psychiatric Inpatients: Feasibility Randomized Controlled Trial.

Psychiatric inpatients often have limited access to psychotherapeutic education or skills for managing anxiety, a common transdiagnostic concern in severe and acute mental illness. COVID-19-related restrictions further limited access to therapy groups on inpatient psychiatric units. App-based interventions may improve access, but evidence supporting the feasibility of their use, acceptability, and effectiveness in psychiatric inpatient settings is limited. MindShift CBT is a free app based on cognitive behavioral therapy principles with evidence for alleviating anxiety symptoms in the outpatient setting. We aimed to recruit 24 participants from an acute general psychiatric inpatient ward to a 1-month randomized control study assessing the feasibility and acceptability of providing patients with severe and acute mental illness access to the MindShift CBT app for help with managing anxiety symptoms. Recruitment, data collection, analysis, and interpretation were completed collaboratively by clinician and peer researchers. Inpatients were randomized to two conditions: treatment as usual (TAU) versus TAU plus use of the MindShift CBT app over 6 days. We collected demographic and quantitative data on acceptability and usability of the intervention. Symptoms of depression, anxiety, and psychological distress were measured in pre- and poststudy surveys for preliminary signals of efficacy. We conducted individual semistructured interviews with participants in the MindShift CBT app group at the end of their trial period, which were interpreted using a standardized protocol for thematic analysis. Over 4 weeks, 33 inpatients were referred to the study, 24 consented to participate, 20 were randomized, and 11 completed the study. Of the 9 randomized participants who did not complete the study, 7 were withdrawn because they were discharged or transferred prior to study completion, with a similar distribution among both conditions. Among the enrolled patients, 65% (13/20) were admitted for a psychotic disorder and no patient was admitted primarily for an anxiety disorder. The average length of stay was 20 days (SD 4.4; range 3-21) and 35% (7/20) of patients were involuntarily admitted to hospital. Small sample sizes limited accurate interpretation of the efficacy data. Themes emerging from qualitative interviews included acceptability and usability of the app, and patient agency associated with voluntary participation in research while admitted to hospital. Our study benefitted from collaboration between peer and clinician researchers. Due to rapid patient turnover in the acute inpatient setting, additional flexibility in recruitment and enrollment is needed to determine the efficacy of using app-based psychotherapy on an acute psychiatric ward. Despite the limited sample size, our study suggests that similar interventions may be feasible and acceptable for acutely unwell inpatients. Further study is needed to compare the efficacy of psychotherapeutic apps with existing standards of care in this setting. ClinicalTrials.gov NCT04841603; https://clinicaltrials.gov/ct2/show/NCT04841603.

Effects of sleep self-monitoring via app on subjective sleep markers in student athletes.

As sleep problems are highly prevalent among university students and competitive athletes, and the application of commercial sleep technologies may be either useful or harmful, this study investigated the effects of a 2-week sleep self-monitoring on the sleep of physically active university students (n = 98, 21 ± 1.7 years). Two intervention groups used a free sleep app (Sleep Score; SleepScore Labs™, Carlsbad, CA, USA: n = 20 or Sleep Cycle; Sleep Cycle AB, Gothenburg, Sweden: n = 24) while answering online sleep diaries. They used the app analysis function in week 1 and the ‘smart alarm’ additionally in week 2. As controls, one group answered the online sleep diary without intervention (n = 21) and another the pre–post questionnaires only (n = 33). Facets of subjective sleep behaviour and the role of bedtime procrastination were analysed. Multilevel models did not show significant interactions, indicating intervention effects equal for both app groups. Sleep Cycle users showed trends toward negative changes in sleep behaviour, while the online sleep diary group showed more, tendentially positive, developments. Bedtime procrastination was a significant predictor of several variables of sleep behaviour and quality. The results indicate neither benefits nor negative effects of app-based sleep self-tracking. Thus, student athletes do not seem to be as susceptible to non-validated sleep technologies as expected. However, bedtime procrastination was correlated with poor sleep quality and should be addressed in sleep intervention programmes.

Long-term Effects of the Use of a Step Count–Specific Smartphone App on Physical Activity and Weight Loss: Randomized Controlled Clinical Trial

Some studies on weight loss promotion using smartphone apps have shown a weight loss effect but not an increase in physical activity. However, the long-term effects of smartphone apps on weight loss and increasing physical activity have not been rigorously examined to date. The aim of this study was to assess whether the use of a smartphone app will increase physical activity and reduce body weight. In this parallel randomized clinical trial, participants recruited between April 2018 and June 2019 were randomized in equal proportions to a smartphone app group (n=55) or a control group (n=54). The intention-to-treat approach was used to analyze the data from December 2019 through November 2021. Before the intervention, an hour-long lecture on weight loss instruction and increasing physical activity was conducted once for both groups. Participants in both groups were instructed to weigh themselves immediately after waking up at least once daily from the start of the intervention. Monthly emails were sent advising the participants in both groups on how to lose weight and increase physical activity in order to maintain or increase motivation. Participants in the smartphone app group were instructed to open the app at least once a day to check their step count and rank. The primary outcome was daily accelerometer-measured physical activity (step count) and the secondary outcome was body weight. Since there was a significant difference in the wear time of the accelerometer depending on the intervention period (P<.001), the number of steps and moderate-to-vigorous physical activity were also evaluated per wear time. The mean age of the 109 participants in this study was 47 (SD 8) years. At baseline, the mean daily total steps were 7259 (SD 3256) steps per day for the smartphone app group and 8243 (SD 2815) steps per day for the control group. The difference in the step count per wear time between preintervention and postintervention was significantly different between the app group and the control group (average difference [95% CI], 65 [30 to 101] steps per hour vs -9 [-56 to 39] steps per hour; P=.042). The weight loss was -2.2 kg (SD -3.1%) in the smartphone app group and -2.2 kg (SD -3.1%) in the control group, with no significant difference between the groups. In addition, when divided into weekdays (Monday through Friday) and weekends (Saturday and Sunday), there was a significant interaction between step counts (P=.004) and MVPA (P=.003) during the intervention, with the app group showing higher interaction on weekends than the control group. In this trial, the group with the smartphone app intervention showed increased physical activity, especially on weekends. However, this increased physical activity did not lead to increased weight loss. University Hospital Medical Information Network UMIN000033397; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037956.

Increasing Literature Capabilities in Early Childhood with Learning Through Youtube Social Media and Whats’App Groups

Early Childhood Education is an important period and very influential on the process of child development. At the age of 0-6 years, the development of children's abilities enters the golden age, this is because at this age the absorption and ability of children is very high, curiosity is large enough to encourage children to do various activities that can give them meaningful experience. and meaningful. This study aims to determine the description of improving early childhood literacy skills by learning through social media Youtube and WhatsApp groups. The method used in this research is descriptive qualitative. One of the problems in learning in early childhood is limited learning time at schools and less varied learning media, which results in less than optimal literacy in early childhood. Learning through social media YouTube and WhatsApp groups by means of teachers making or selecting videos. learning videos that are in accordance with the material on youtube are then watched together in class and the Youtube link is shared through the student's parents WhatsApp group then with the guidance of the children's parents watch youtube learning materials given at school. The results of research conducted at PAUD Cempaka III, Dawuhanwetan village, Kedungbanteng sub-district, showed that by learning through YouTube social media and WhatsApp groups, early childhood literacy skills have increased, through YouTube videos, children can watch material repeatedly, this certainly makes it easier for them to learn. understand the material at home.&#x0D;

Positive intervention effect of mobile health application based on mindfulness and social support theory on postpartum depression symptoms of puerperae

ObjectiveThis study investigated the effects of mobile health application designed based on mindfulness and social support theory on parenting self-efficacy and postpartum depression symptoms of puerperae.MethodsWe recruited 130 puerperae from a hospital in China and randomized them to an App use group (n = 65) and a waiting control group (n = 65). The App group underwent an 8-week app use intervention while the control group underwent no intervention. We measured four main variables (mindfulness, perceived social support, maternal parental self-efficacy and postpartum depressive symptoms) before and after the App use intervention.ResultsIn the App group, perceived social support, maternal parental self-efficacy were significantly higher and postpartum depressive symptoms was significantly lower. In the control group, there were no significant differences in any of the four variables between the pre-test and post-test.ConclusionsOur findings indicated that the mobile health application may help to improve perceived social support, maternal self-efficacy and reduce postpartum depressive symptoms. The finding of the mobile health application's effect extends our understanding of integrative effects of mindfulness and perceived social support on reduction of postpartum depressive symptoms and suggests clinical potentials in the treatment of postpartum depressive symptoms.

Effect of pelvic floor muscle training using mobile health applications for stress urinary incontinence in women: a systematic review

BackgroundPelvic floor muscle training (PFMT) is the first-line treatment for urinary incontinence, but adherence to PFMT is generally poor. Currently, a number of novel strategies exist to facilitate adherence of PFMT. We sought to determine effectiveness of mHealth app-based PFMT for treating stress urinary incontinence (SUI) or stress-predominant mixed urinary incontinence (MUI) in women. The primary objective was to assess the effects of mHealth app-based PFMT and usual treatment on severity of the symptom, the quality of life (QoL) of users and the patient’s global impression of improvement. The secondary objective was to assess how mHealth app use affects adherence of PFMT.MethodsAll randomized controlled trials and quasi-randomized controlled trials aimed at evaluating the effects of mHealth app-based PFMT in women with SUI or stress-predominant MUI were included. Twelve electronic databases, namely the Cochrane Library, PubMed, CINAHL, Embase, Web of science, OVID, SciELO, REHABDATA, PEDro database, Chinese CNKI and Wanfang and the Open Grey databases were used as search sources. The protocol was registered in PROSPERO (CRD 42020183515). This systematic review was developed following the PRISMA 2020 Checklist. The Cochrane Handbook for Systematic Reviews of Interventions for Randomized Controlled Trials was used to assess risk of bias in included studies. Two authors extracted the data into a standardized spreadsheet.ResultsSix studies that met the eligibility criteria were included. The full sample included 439 patients with treatment via mHealth app and 442 controls of usual treatment. ICIQ-UI SF, ICIQ-VS, and QUID scores decreased after follow-up in the mHealth app and control groups in six studies. ICIQ-LUTS QoL scores decreased after follow-up in the mHealth app and control groups in three studies. In only one study, ICIQ-VS QoL scores decreased after 1 month and 2 months of follow-up in the mHealth app group, but increased abruptly after 3 months of follow-up. EQ5D-VAS scores increased in both groups in one study. The percentage of PGI-I increased in the mHealth app group in three studies after follow-up. After follow-up in three studies, BPMSES scores and self-reported adherence scores increased in the mHealth app group relative to the initial time point, but in one study, at 6 months compared with 3 months of follow-up, adherence scores decreased slightly in the mHealth app group.ConclusionsThis systematic review determined that mHealth app-based PFMT showed promise from the perspective of improving both outcomes and exercise adherence.

Implementation of Web-based of E-Marketplace for UMKM at XYZ University

One of the private universities in Pekanbaru, which has nine postgraduate faculties and 10 faculties with 21 study programs. The number of the academic community is quite large, there is already a whats app group that facilitates the entire Academic Community in terms of transacting selling goods or services online. However, in practice it has not been fully effective, one of which is because there are no clear rules in trade ethics, for example, one person may only post a maximum of two products a day because if there are too many, it will overwrite other seller's product postings as well. This often happens, causing whats app groups are only dominated by one or two people who post all the products sold along with their customer testimonials. This of course can harm other sellers, it can also disturb the comfort of the group for both sellers and buyers. Therefore, to answer these problems, a market place is proposed specifically for the entire XYZ’s Academic Community. In addition to reviving UMKM at XYZ University, it is also a forum to make it easier for lecturers, employees and also students to make transactions that are comfortable and effective for both sellers and buyers. Furthermore, system development will be carried out both from adding features, android-based and matters related to user convenience in interacting with the system.

Effects of a Digital Patient Empowerment and Communication Tool on Metabolic Control in People With Type 2 Diabetes: The DeMpower Multicenter Ambispective Study.

BackgroundDiabetes is a major health care problem, reaching epidemic numbers worldwide. Reducing hemoglobin A1c (HbA1c) levels to recommended targets is associated with a marked decrease in the risk of type 2 diabetes mellitus (T2DM)–related complications. The implementation of new technologies, particularly telemedicine, may be helpful to facilitate self-care and empower people with T2DM, leading to improved metabolic control of the disease.ObjectiveThis study aimed to analyze the effect of a home digital patient empowerment and communication tool (DeMpower App) on metabolic control in people with inadequately controlled T2DM.MethodsThe DeMpower study was multicenter with a retrospective (observational: 52 weeks of follow-up) and prospective (interventional: 52 weeks of follow-up) design that included people with T2DM, aged ≥18 and ≤80 years, with HbA1c levels ≥7.5% to ≤9.5%, receiving treatment with noninsulin antihyperglycemic agents, and able to use a smartphone app. Individuals were randomly assigned (2:1) to the DeMpower app–empowered group or control group. We describe the effect of empowerment on the proportion of patients achieving the study glycemic target, defined as HbA1c≤7.5% with a ≥0.5% reduction in HbA1c at week 24.ResultsDue to the COVID-19 pandemic, the study was stopped prematurely, and 50 patients (33 in the DeMpower app–empowered group and 17 in the control group) were analyzed. There was a trend toward a higher proportion of patients achieving the study glycemic target (46% vs 18%; P=.07) in the DeMpower app group that was statistically significant when the target was HbA1c≤7.5% (64% vs 24%; P=.02) or HbA1c≤8% (85% vs 53%; P=.02). The mean HbA1c was significantly reduced at week 24 (−0.81, SD 0.89 vs −0.15, SD 1.03; P=.03); trends for improvement in other cardiovascular risk factors, medication adherence, and satisfaction were observed.ConclusionsThe results suggest that patient empowerment through home digital tools has a potential effect on metabolic control, which might be even more relevant during the COVID-19 pandemic and in a digital health scenario.

Impacts of Educational Interventions with Support of Mobile App versus Booklet for Patients with Hypertension and Metabolic Syndrome: A Secondary Data Analysis.

Background: Hypertension comorbid with metabolic syndrome could increase the development of adverse cardiovascular events. Educational interventions were effective to improve outcomes in patients. Methods: This was a secondary data analysis of participants with hypertension. The original randomized controlled trial aimed to examine the effect of app and booklet versus control among individuals diagnosed with metabolic syndrome living in the community. A 30-min health education was provided to each participant. In addition to the education, the app group received a mobile app while the booklet group received a booklet. Data were collected at baseline, week 4, week 12, and week 24. Intention-to-treat principle was followed, and generalized estimating equations was employed for data analysis. Results: A total of 118 participants with hypertension and metabolic syndrome were extracted from the three-arm trial data. The sample size was 36, 42, and 40 in the app group, booklet group, and control group, respectively. Compared to the control group, the app group showed a significant reduction on body weight and waist circumference at week 24, while the total exercise and self-efficacy for exercise were increased at week 12 and week 24 but no significant findings were observed in the booklet group. Conclusions: The educational intervention supported with app was superior to the booklet support on the outcomes of body weight, waist circumference, total exercise, and self-efficacy for exercise among patients with hypertension and metabolic syndrome in the community.

S338 The Impact of Smartphone Applications on Bowel Preparation, Compliance With Appointments, Cost-Effectiveness and Patients’ Quality of Life for the Colonoscopy Process: A Scoping Review

S338 The Impact of Smartphone Applications on Bowel Preparation, Compliance With Appointments, Cost-Effectiveness and Patients’ Quality of Life for the Colonoscopy Process: A Scoping Review

The effect of Type 2 diabetes management using a smartphone-based blood glucose management training program

Background: Diabetes education is an important factor in blood glucose control. Reinforced education is necessary for effective diabetes education. However, it is difficult to provide reinforced diabetes education within Korea's medical environment. Therefore, we want to analyze the effect of continuous diabetes education using mobile health care that can effectively provide repeated education without having to face the patient. Methods: This study is a multicenter, randomized, controlled, pre-post design study conducted to analyze the effect of a continuous diabetes education method. A total of 109 people were registered at five hospitals in south Korea, and they were randomly assigned to the app group (34 people) who received real-time coaching and repetitive training, the logbook group (37 people) who received face-to-face training after writing a blood glucose logbook, and the general group (38 people) who received a one-time diabetes education. The study was conducted for a total of 24 weeks. Twenty-one patients withdrew their consent and failed to perform an HbA1c. A final 88 patients were analyzed. The difference in HbA1c, Self-management behavior, and Quality of life before and after education was analyzed. Results: The study involved 51 (58%) male subjects, mean age was 55.8 years and mean duration of diabetes was 7.6 years. After 24 weeks of intervention, there was no significant difference in self-care behavior and quality of life between the three groups, but the HbA1c of the app group significantly decreased after education compared to the logbook group and the general group (F=4.62, p=.013). Conclusion: It can be seen through the app group that receiving real-time education is more effective in improving blood glucose management and continuous diabetes education is important.

Increasing Adherence to Prophylactic Swallowing Exercises During Head and Neck Radiotherapy: The Multicenter, Randomized Controlled PRESTO-Trial

BackgroundProphylactic swallowing exercises (PSE) during radiotherapy can significantly reduce dysphagia after radiotherapy in head and neck cancer (HNC). However, its positive effects are hampered by low adherence rates during the burdensome therapy period. Hence, the main goal of this multicenter randomized controlled trial (RCT) was to investigate the effect of 3 different service-delivery modes on actual patients’ adherence.MethodsA total of 148 oropharyngeal cancer patients treated with primary (chemo)radiotherapy were randomly assigned to a 4 weeks PSE program, either diary-supported (paper group; n = 49), app-supported (app group; n = 49) or therapist-supported (therapist group; n = 50). Participants practiced 5 days/week, daily alternating tongue strengthening exercises with chin tuck against resistance exercises. Adherence was measured as the percentage of completed exercise repetitions per week (%reps). Statistical analysis was performed by means of SPSSv27, using Linear Mixed-effects Models with post hoc pairwise testing and Bonferroni-Holm correction.ResultsAdherence and evolution of adherence over time was significantly different between the three groups (p < .001). Adherence rates decreased in all three groups during the 4 training weeks (p < .001). During all 4 weeks, the therapist group achieved the highest adherence rates, whilst the app group showed the lowest adherence rates.ConclusionsPSE adherence decreased during the first 4 radiotherapy weeks regardless of group, but with a significant difference between groups. The therapist group achieved the highest adherence rates with a rather limited decline, therefore, increasing the face-to-face contact with a speech-language therapist can overcome the well-known problem of low adherence to PSE in this population.Trial RegistrationTrial registration: ISRCTN, ISRCTN98243550. Registered December 21, 2018 – retrospectively registered, https://www.isrctn.com/ISRCTN98243550?q=gwen%20van%20nuffelen&filters=&sort=&offset=1&totalResults=2&page=1&pageSize=10&searchType=basic-search.

Inovasi Sistem Pembelajaran Matematika pada Masa Pandemi Covid 19 di MTs Al-Fajar Kandat Kediri

The purpose of this study was to determine the learning system used in mathematics subjects at MTs Al – Fajar Kandat and to obtain related information experienced by students in learning mathematics during the covid-19 pandemic. The COVID-19 pandemic has had an impact on the progress of the education sector. Therefore, teachers and schools can choose learning media that are easy to reach by students. The method used in this research is qualitative. The data was obtained from the results of an interview with a 9C grade student at MTs Al – Fajar. The results of this study are the learning system for mathematics subjects at MTs Al - Fajar Kandat using two systems, the first is a daring learning system, in which the teacher provides material by sending a You Tube link and sending assignments to the Whats App Group. Then to collect assignments via private chat to the math teacher via Whats App. Constraints experienced by students in bold learning are the lack of understanding of the material presented and students are still confused with the material. The second learning system is the offline learning system, in this system it is only carried out when there is a Mid-Semester Examination and a Final Semester Examination. In this system students carry out face-to-face exam activities using the question sheet provided by the teacher. Due to a lack of understanding when learning to be brave, the impact experienced by students in learning to be brave is that the student's grades go down.

Effect of Awake Prone Positioning in non-Intubated COVID-19 Patients with Acute Hypoxemic Respiratory Failure: A Systematic Review and Meta-Analysis.

BackgroundAwake prone positioning (APP) has been considered as a feasible treatment for patients with acute hypoxemic respiratory failure in non-intubated coronavirus disease 2019 (COVID-19). However, the efficacy and safety of APP remain uncertain. This meta-analysis aims to assess the effect of APP on intubation rate and mortality in COVID-19 patients with acute respiratory failure.MethodsRelevant studies published from January 1, 2020, to June 17, 2022, were systematically searched. The primary outcomes were the intubation rate and mortality; the secondary outcome was the incidence of adverse events.ResultsOf 5746 identified publications, 22 were eligible for inclusion in the meta-analysis (N = 5146 patients). In comparison to the non-APP group, APP could decrease the intubation rates (OR 0.64; 95% CI 0.48-0.83; P = .001), particularly in the subgroup of the daily median duration of APP > 8 h and in the subgroup of receiving high flow nasal cannula (HFNC) or non-invasive ventilation (NIV). Patients treated with APP were associated with lower mortality rates (OR 0.61; 95% CI 0.45-0.81; P = .0008), but no mortality benefit was found in the APP group in the subgroup of randomized controlled trials (RCTs). No significant difference was found in the incidence of adverse events between the groups (OR 1.13; 95% CI 0.75-1.71; P = .56).ConclusionOur results demonstrated that APP could be an effective strategy to avoid intubation without detrimental effects in non-intubated patients with COVID-19, especially for patients requiring HFNC or NIV, and the daily APP duration with the target of minimally eight hours was suggested. In the subgroup of RCTs, the pooled results did not demonstrate any benefit of APP on mortality. Given the limited number of RCTs, further high-quality RCTs are needed to confirm the results.INPLASY registration numberINPLASY2021110037.

Mother’s Milk Messaging™: trial evaluation of app and texting for breastfeeding support

BackgroundNew mothers experience BF challenges but have limited evidence-based technology-enabled support.Objectives1) Determine if using the Mother’s Milk Messaging™ app improved aspects of breastfeeding and breastfeeding rates and 2) Describe engagement as well as themes from the qualitative feedback on the app.MethodRandomized Controlled Trial National sample of primiparous, singleton mothers recruited online and then randomized using stratification by language into three arms: 1) BF text messages plus app; 2) BF text messages, app and physician-moderated private Facebook (FB) group; 3) Attention control group who received injury prevention texts. Exclusive breastfeeding rates as primary outcome and knowledge/attitude, confidence, and social support as secondary outcomes. We determined engagement through analysis of app usage metrics. We conducted and content-coded interviews with participants to learn more about app usage and BF experience. Due to the nature of the intervention participants could not be blinded.ResultsThere were a total of 346 participants in the trial, with 227 in the Intervention (n = 154 group 1 and n = 156 group 2) and 119 in the control group. Because of minimal Facebook activity, the two intervention groups 1 and 2 were combined. There were no differences in breastfeeding exclusivity and duration. (NS). Women in the intervention arm reported significantly higher confidence with breastfeeding and perceived social support to the control group (p < .05). Greater than 80% registered the app and those that engaged with the app had higher scores with time. Mothers appreciated receiving text messages and videos with reliable information. No harm was reported in this study.ConclusionMMM increased confidence with breastfeeding and with gathering social supports. Exclusively BF was high in all participants. Mothers perceived it as useful and dependable especially the texting.