High User Research Articles

Use of Over-The-Counter Analgesics Is Associated with Pain, Stress, and Quality of Life in Norwegian Adolescents: A Cross-Sectional Study.

Introduction: Approximately 20% of Norwegian adolescents are frequently using Over-the-Counter Analgesics (OTCAs). The WHO emphasizes the need for research to identify the key determinants of health problems in adolescence. Thus, our aim was to describe and explore pain, stress, and Health-Related Quality of Life (HRQOL) in Norwegian adolescents and investigate possible associations upon high/low usage of OTCAs. Methods: This cross-sectional study included 315 adolescents (92 boys, 223 girls) with an average age of 14.1 years (13-15 years). All participants reported using OTCAs. Weekly usage was categorized as high and less than weekly as low. Using a validated questionnaire, we explored the following variables: pain, as measured using the Brief Pain Inventory, stress (Perceived Stress Questionnaire), and HRQOL (KIDSSCREEN-27). Binary logistic regression models were conducted using IBM SPSS Statistics (version 27). Results: Our descriptive findings reveal that high users of OTCAs reported higher pain intensity of 3.4 (SD = 1.9) and perceived stress of 0.38 (SD = 0.18) compared to low users, who reported 2.5 (SD = 1.9) and 0.32 (SD = 0.16), respectively. High OTCA users reported lower average scores than low users across all HRQOL subscales. Binary logistic regression revealed 30% higher odds for higher levels of pain intensity and 14 times higher odds of perceived stress associated with being a high user of OTCAs compared to a low user. Conclusions: Our study shows significantly higher odds for experiencing pain and stress among adolescents using OTCAs daily-to-weekly, compared to those seldom using such medicines. Health professionals should be aware of young people who have a high consumption of OTCAs and investigate whether the use is related to pain or stress. This might be important in designing a personalized and appropriate intervention. Parents and caregivers have an important responsibility in supporting adolescents' appropriate pain management. Longitudinal studies are needed to better explore predictive factors of OTCA use in adolescents, particularly in relation to psychological variables such as stress and quality of life.

Design and Development of a Smart Fidget Toy Using Blockchain Technology to Improve Health Data Control.

This study explores the integration of blockchain technology in wearable health devices through the design and development of a Smart Fidget Toy. We aimed to investigate design challenges and opportunities of blockchain-based health devices, examine the impact of blockchain integration user experience, and assess its potential to improve data control and user trust. Using an iterative user-centered design approach, we developed a mid-fidelity prototype of a physical fidget device with a blockchain-based web application. Our key contributions include the design of a fidget toy using blockchain for secure health data management, an iterative development process balancing user needs with blockchain integration challenges, and insights into user perceptions of blockchain wearables for health. We conducted user studies, including a survey (n = 28), focus group (n = 6), interactive wireframe testing (n = 7), and prototype testing (n = 10). Our study revealed high user interest (70%) in blockchain-based data control and sharing features and improved perceived security of data (90% of users) with blockchain integration. However, we also identified challenges in user understanding of blockchain concepts, necessitating additional support. Our smart contract, deployed on the Polygon zkEVM testnet, efficiently manages data storage and retrieval while maintaining user privacy. This research advances the understanding of blockchain applications in health wearables, offering valuable insights for the future development of this field.

Algorithm-Based Mobile Texting Platform for the Self-Management of Interstitial Cystitis/Bladder Pain Syndrome: Pilot Study Evaluating Feasibility, Usability, and Potential Utility.

We developed an algorithm-based mobile texting platform for promoting self-management in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Our aim was to measure the feasibility, usability, and potential utility of the platform. A texting platform that delivered 4 treatment modules (education and behavioral modification, cognitive behavioral therapy, pelvic floor physical therapy, and guided mindfulness practices) and an automated weekly message over 6 weeks was developed. Feasibility and usability were determined using patient engagement (proportion of platform messages to which patients responded) and System Usability Scale. Satisfaction with patient-physician communication questionnaire, Pain Self-Efficacy Scale, and Interstitial Cystitis Symptom and Problem Index were administered before and after the intervention. Engagement with the platform in 52 female patients with IC/BPS [median age (IQR) 40 (30-48) years] was 76.9%. The commonest module selected by patients was pelvic floor physical therapy (50%) followed by cognitive behavioral therapy (34%) and guided mindfulness (15%). System usability score (median, IQR) was 87 (83-95), indicating high usability. Satisfaction with patient-physician communication improved significantly (median change, 4; IQR, 1-9; P < .001). Pain self-efficacy score improved from moderate impairment at baseline to minimal impairment at 6 weeks (median change, 10; IQR, 2-18; P < .001). Urinary symptoms scores also improved (median change Interstitial Cystitis Symptom Index, -3; IQR, -5 to -1.5; P < .001, Problem Index, -2; IQR, 5.5 to -0.5; P < .001). An automated mobile platform has the potential for improving access to self-management strategies and easing clinicians' challenge of counseling patients with IC/BPS during time-limited in-person visits. ClinicalTrials.gov Identifier: NCT05260112.

Strategy for scheduled downtime of hospital information system utilizing third-party applications

BackgroundThe widespread adoption of Hospital Information Systems (HIS) has brought significant benefits in healthcare quality and workflow efficiency. However, downtimes for system maintenance are inevitable and pose a considerable challenge to continuous patient care. Existing strategies, including manual prescription methods, are no longer effective due to increasing reliance on digital systems.MethodThis study implemented two main strategies to mitigate the impact of scheduled downtimes. First, we created an “Emergency query program” that switches to a read-only backup server during downtimes, allowing clinicians to view essential patient data. Second, an “Emergency prescription system” was developed based on the Microsoft Power Platform and integrated into Microsoft Teams. This allows clinicians to perform digital prescriptions even during downtimes.ResultsDuring a planned 90-minute downtime, 282 users accessed the Emergency Prescription System, resulting in 22 prescriptions from various departments. Average times for prescription confirmation and completion were 8 min and 3 s, and 18 min and 40 s, respectively. A post-downtime evaluation revealed high user satisfaction.ConclusionEssential maintenance-induced HIS downtimes are inherently disruptive to patient care process. Our deployment of an emergency query program and a Microsoft Teams-integrated emergency prescription system demonstrated robust care continuity during HIS downtime.

Efficacy and Feasibility of Web-Based ACT-Enhanced Behavioral Treatment for Skin Picking in Adults: A Randomized Waitlist-Controlled Trial

Skin picking disorder is a chronic repetitive condition that impacts daily functioning and causes significant distress. Acceptance and commitment therapy (ACT) enhanced behavioral training (A-EBT) has shown promise in targeting skin picking symptoms but is not widely disseminated among providers. This study examines the efficacy and feasibility of an eight-week fully-automated online A-EBT program for skin picking disorder. Participants with skin picking disorder (N = 84) were randomized into either an online intervention (n = 43) or a waitlist control (n = 41). All participants completed self-report assessments at baseline, mid-, post-intervention, and 1-month follow-up. Analyses used multilevel linear modeling with the full intent-to-treat sample. Results demonstrated statistically stronger improvements from baseline to 1-month follow-up in the intervention condition compared to waitlist for skin picking symptoms (SMD=0.90), skin picking-related psychological flexibility (SMD=-0.82), and well-being (SMD=-0.31), with no significant effects on distress. Treatment effects were maintained at one-month follow-up, with 29.0% of intervention participants meeting responder status, compared to 0.1% of waitlist participants. High usability and acceptability scores provide preliminary evidence of its feasibility as a fully automated intervention. These findings suggest an automated online A-EBT program may be an effective and scalable treatment for individuals with skin picking disorder.

Reliability, usability, and efficiency of video versus print instructions to teach parents a procedural task: A cross-sectional study.

To compare the reliability, usability, and efficiency of video versus print instructions to teach parents a procedural measurement task. We hypothesized that videos would outperform print in all outcomes. This cross-sectional study included parents/caregivers of children aged 0-18years with deep vein thrombosis attending the Thrombosis Clinic at The Hospital for Sick Children for post-thrombotic syndrome (PTS) assessment. Participants were randomly assigned to three instruction types: (i) video, which followed the technique used by clinicians; (ii) long pamphlet, which also followed the clinicians' technique; and (iii) short pamphlet, which explained a simplified technique. After measuring their children's arms or legs using the randomly assigned material, participants completed a usability questionnaire. The reliability of the instructions was estimated by comparing parents/caregivers versus clinicians' measurements using the intraclass correlation coefficient (ICC). Reliability, usability, and efficiency (time to task completion) were compared among the three instruction types. In total, 92 participants were randomized to video (n=31), long pamphlet (n=31), and short pamphlet (n=30). While the video had the highest usability, the short pamphlet was the most reliable and efficient. ICCs were.17 (95% confidence interval [CI]:.00-.39) for the video,.53 (95% CI:.30-.72) for the long pamphlet, and.70 (95% CI:.50-.81) for the short pamphlet. Although the video had higher usability, the short/simplified print instruction was more reliable and efficient. However, the reliability of the short pamphlet was only moderate/good, suggesting that whenever possible, measurements should still be obtained by trained clinicians.

Quantitative evaluation of pyramid belt wear using light-reflection characteristic of agglomerate coating and image processing

As a new generation of coated abrasive products with a unique pyramid-shaped structure, pyramid belt offers finer and more uniform grinding effects, and has been increasingly applied in precision grinding. However, belt wear occurs inevitably, challenging the control of shape accuracy and surface quality of ground components. Current research on pyramid belt wear is relatively limited, still lacking a universal, rapid method for observing and evaluating belt wear. In response, this paper proposes a quantitative evaluation method for pyramid belt wear using light-reflection characteristic of agglomerate coating and image processing. Firstly, a detailed analysis of the wear types and characteristics of pyramid belt is conducted. Then, focusing on the agglomerate flat wear, a method utilizing the light-reflection characteristic of agglomerate coating for observing belt wear morphology is proposed, enabling clear image capture of belt wear contours. Based on this, a wear coefficient based on the geometric characteristics of agglomerate is defined, and a quantitative evaluation method for belt wear using image processing is further proposed. The wear experiment of the belt is conducted on a robotic belt grinding platform, and experimental results show that the evaluation deviation of the proposed method from the evaluation results based on optical profilometer is within 5% at a 95% confidence interval, demonstrating the effectiveness of this method. Additionally, this method has advantages such as high computational efficiency, low cost, and good usability. Finally, the temporal evolution processes and spatial distribution patterns of belt wear and material removal rate are investigated and analyzed.

User-Friendly Features of Moda-flx Show High Usability Success Rates

User-Friendly Features of Moda-flx Show High Usability Success Rates

Patient engagement in a community-partnered hybrid health-related social needs navigation intervention for adolescents and young adults with cancer (AYA-NAV).

173 Background: Adolescent and young adult (AYAs) cancer survivors experience high rates of financial toxicity (FT), which is associated with poorer health outcomes. FT may disproportionately affect AYAs with unmet health-related social needs (HRSN), such as food or housing insecurity. Needs navigation may be an effective intervention to reduce financial distress, however, engagement has been a challenge in prior adult-directed interventions. We hypothesize that a hybrid navigation delivery model with community organization support and digital delivery will reduce financial distress and improve health outcomes. In a pilot study of AYA-NAV, an AYA-directed needs navigation intervention, we report patient engagement among participants. Methods: Eligible AYAs were 15-39 years old, Spanish- or English-speaking, receiving curative-intent treatment for cancer, and screened positive for FT (Comprehensive Score of Financial Toxicity &lt; 22) or unmet HRSN (food, housing, transportation, or utilities insecurity). Participants were referred for a consultation with the Patient Advocate Foundation (PAF), a national organization that provides case management and navigation support for people facing life limiting illness. At month 1, participants were referred to findhelp.org, a digital platform of comprehensive resources to facilitate resolution of unmet HRSN. Monthly check-ins were conducted by the study team to assess acceptability, intervention fidelity, and provide additional navigation support. We plan to enroll 30 participants on this study. Results: Of 19 AYAs that completed screening to date, 13 met criteria for FT or unmet HRSN; 13 (100%) agreed to AYA-NAV participation. To date, of 46 check-ins initiated by the study team, 33 (72%) were completed. All AYAs connected with the study team at least once during the 6-month duration of the study by text, phone, and/or in-clinic. Ten out of 13 (77%) participants reported that they spoke with a PAF case manager, and 7 (70%) of those said it was helpful. If the patient was unable to connect with PAF, more than half (55%) requested to be reconnected during a monthly check-in. Eight of the 13 (62%) participants visited findhelp.org; 6 (75%) of those found the digital platform to be helpful. Most patients referenced the high usability of findhelp.org, and 55% stated they connected to community resources via findhelp.org. Patients qualitatively reported challenges to intervention participation including medical complications, scheduling conflicts, and work commitments. Conclusions: Preliminary data demonstrate high patient engagement and intervention fidelity during a pilot feasibility study of AYA-NAV. Flexible modes for data collection and intervention delivery are important to inclusion of and retention of AYAs in hybrid navigation delivery models. Clinical trial information: NCT06072833 .

Exergames and Immersive Virtual Reality as a Novel Therapy Approach in Multiple Sclerosis: Randomised Feasibility Study

Background: Multiple sclerosis is a chronic, inflammatory, neurodegenerative autoimmune disease caused by myelin loss in the central nervous system, which leads to motor and non-motor problems. The main objective of this study was to explore whether an immersive virtual reality (IVR) exercise programme would be feasible as a form of physical therapy for people with MS (pwMS). Methods: 18 participants (13 women; 45.06 years) were assigned to an experimental group (EG, n = 8) and a control group (CG, n = 10). The EG took part in a twice-weekly IVR exergame physical therapy programme—ExeRVIEM programme. A randomised, single-blind clinical trial was conducted and was registered in clinicaltrials (NCT05870254). Results: The intervention was feasible and safe. The participants completed the programme with no adverse effects (no symptoms on the Simulator Sickness Questionnaire), high usability (System Usability Scale 90.31%), and outstandingly positive post-game experiences (Game Experience Questionnaire 3.10/4). In addition, the GE significantly improved several of their functional capacities: increased lower limb strength (Five Times Sit-to-Stand Test p = 0.042), improved functional mobility, and reduced fall risk (Timed Up and Go Test-simple p = 0.009; Timed Up and Go Test-cognitive p = 0.003). There were no statistically significant differences between the groups. Conclusions: The findings support that the use of exergames and IVR as physical therapy in pwMS is feasible and safe. Furthermore, there is the suggestion of possible benefits to participants’ functional abilities, all of which position IVR as a promising tool for the rehabilitation of this neurodegenerative pathology affecting young adults.

The role of digital health interventions in reducing obesity among primary school children: A behavioural insights perspective

This study investigates the effectiveness of a web application called "Jejak BMI 1.0" aimed at reducing obesity among primary school students by promoting healthier behaviours in children and their parents. The research objectives were to assess the usability and user experience of the application, and to evaluate its impact on children's Body Mass Index (BMI) and parental behaviours. Using a mixed-methods approach, including pre- and post-test surveys, statistical analysis, and thematic analysis, the study found significant improvements in parental behaviours and children's BMI scores. The app was well-received by participants, with high usability and functionality ratings. Despite the positive outcomes, limitations such as the short study duration and potential biases were noted. The findings underscore the potential of digital tools in public health interventions and the importance of parental involvement in addressing childhood obesity.

LOTUS: Protocol for a double-blind placebo controlled randomized trial of hemp-derived cannabidiol for the treatment of cannabis use disorder.

As cannabis legalization continues to spread across the United States, average Δ9-tetrahydrocannabinol concentrations in recreational products have significantly increased, and no prior study has evaluated effective treatments to reduce cannabis use among high potency cannabis users. Some research has found that the non-intoxicating cannabinoid cannabidiol reduces cannabis use and cannabis use disorder-related symptoms, such as affective disturbance and withdrawal. Results of these studies are promising but limited to synthetic or isolated forms of cannabidiol. Conduct a placebo-controlled randomized control trial comparing the effects of hemp-derived cannabidiol on reducing Δ9-tetrahydrocannabinol use in concentrate users with cannabis use disorder. Design. Double-blind, three-arm randomized placebo-controlled trial. Setting. University in the Denver-Boulder, CO, USA area. Study population. Community members who are heavy, stable cannabis concentrate users that meet criteria for at least moderate cannabis use disorder and are seeking to decrease or stop cannabis use. Data. Self-report demographics, substance use, and mental health characteristics, blood and urine based biomarkers and anthropometrics. Outcomes. Affective, physiological, and physical withdrawal symptoms, Δ9-tetrahydrocannabinol use. Analysis. Three-group ANOVAs and χ2 tests will be used to compare baseline variables between groups. Characteristics that differ between groups will be evaluated as potential covariates in subsequent analyses. A multilevel modeling framework will be used for primary outcome analysis to account for the repeated observations nested within participants over time. Pairwise post-hoc simple effects tests will be conducted to confirm patterns of differences. ClinicalTrials.gov NCT06107062.

Structural Design of a 10-Story Office Building using the Special Moment Frame System (SMFS) in Padang, West Sumatra

Indonesia is located at the convergence of the Eurasian, Pacific, and Indo-Australian tectonic plates, making it prone to significant earthquakes, such as the Aceh earthquake and tsunami in 2004 with a magnitude of 9.1, and the Padang earthquake in 2009 with a magnitude of 7.6, both known for their severe impacts. According to the Central Statistics Agency (BPS), there were 10,843 earthquakes in 2022. Given this high level of risk, all buildings, especially offices, must be designed to be earthquake-resistant due to high activity and user numbers. The city of Padang is categorized in Seismic Design Category D, indicating a high level of earthquake risk. The construction of a ten-story reinforced concrete building for office use is planned, referring to SNI 1726-2019 on earthquake resistance and SNI 1727-2020 on minimum loads, along with the Special Moment Resisting Frame System (SMRF). Structural analysis and modeling are conducted using ETABS software, with element dimensions based on the initial design. This analysis aims to ensure the building meets earthquake resistance requirements through response spectrum evaluation, including natural periods, inter-story drift, P-Delta effects, and checks for irregularities. Based on internal forces from ETABS V.18, reinforcement designs are prepared for structural elements such as columns, beams, slabs, and shear walls. A design capacity evaluation ensures the safety and optimal performance of the structure during an earthquake.

Playing Ping- Pong: Keeping Frail Older Adults Out Of Hospital

Abstract Background EDITH (Emergency Department in the home) is a rapid response team consisting of a doctor/Advanced Nurse Practitioner and Occupational Therapist who assess patients in their home to avoid an ED attendance. The Integrated Care Team for Older People (ICPOP) is a community-based specialist multidisciplinary team that provides assessment and intervention for frail older adults in order to maintain them living at home. The teams have developed a close working relationship and utilise each other’s services to provide right time, right place patient care with the ultimate shared goal of keeping older adults living well at home. Methods A high frequency service user was identified, and a retrospective chart review was completed between the two teams. Outcome measures such a CFS, 4AT, medical status, social supports and environment set up were noted. Patient journey was conceptualised and handover of medical responsibility from team to team was explored along with identifying other factors that maintain older adults living well in their homes. Results Over a 12-month period, patient X case was “ping ponged” between the two services. The patient attended ED with EDITH review in the home facilitating a direct discharge home. The ICPOP team provided ongoing interdisciplinary and specialised intervention. ICPOP also identified changes to medical status that warranted timely EDITH review and thus negated the need for ED attendance. Patient X avoided a hospital admission during that period due to co working and open communication between both teams. Conclusion Rapid access, timely communication and team work between the EDITH/ICPOP yielded a positive result for patient X and allowed them to remain at home, despite a high level of frailty and low threshold for hospital admission. It appears that having services working with a collaborative approach affords better outcomes for this vulnerable population and reduces pressure on hospital resources.

Teiripe sa Bhaile: ICPOP Early Supported Discharge for Frailty

Abstract Background Older adults and particularly older adults with frailty are high users of acute hospital care which results in overall higher hospital costs and reduced functional independence. Early supported discharge (ESD) was found to have a statistically significant impact in reducing length of stay in older adults admitted for medical reasons. This poster outlines the rehabilitation pathway developed by an ICPOP team to provide early supported discharge for frail older inpatients with SMART rehab goals. Methods Suitable patients are identified and assessed prior to discharge from the acute ward. Each patient receives a comprehensive geriatric assessment in their own home. All patients receive at least 2 hours of therapy per week until they have reached their goals. Standardised outcome measures including Functional Assessment Measure (FIM/FAM) and EQ5D5L are captured for each patient. Clients are discharged once they have reached their goals or are at their new functional baseline. Results 52 patients have been seen on this pathway since 2023. Hip fracture was the most common reason for referral, followed by Falls. Average length of stay on service was 40 days. Average wait time to first assessment was 1.7 days, highlighting the responsiveness of the service. 4 patients seen in 2024 live alone, indicating this service is also appropriate for patients who don’t have supports readily available in the home. FIM/FAM scores increased from 148 to 160 on average- Indicating more functional independence. Conclusion This ICPOP Rehabilitation pathway offers a safe, person-centred alternative to traditional inpatient rehabilitation. Readmission rates post discharge were low indicating the programme's safety. Given the large number of hospital bed saved without compromising functional outcomes for the patients, the ICPOP team is working on expanding this pathway.

Pilot Clinical Safety and Efficacy Evaluation of a Topical 3% Tranexamic Acid Cream and Serum Protocol for Managing Facial Hyperpigmentation in Caucasian Patients

Facial hyperpigmentation is a highly prevalent dermatological condition, characterized by dark spots on the skin resulting from excess melanin production. Hyperpigmentation significantly impacts patients’ quality of life and self-esteem. Current treatments often present disadvantages linked to poor product tolerability. A topical cosmetic approach combining three lightening active ingredients (tranexamic acid, niacinamide, vitamin C) offers a new option for treating dark spots on the skin. The present in-use test under dermatological control evaluated the clinical safety and efficacy of a cream and serum containing these three ingredients, formulated with hyaluronic acid for enhanced delivery, stability, and efficacy. A total of 22 Caucasian patients with facial hyperpigmentation, both male and female, aged between 45 and 67 years, applied the cream and serum for 8 weeks. Clinical assessments, colorimetric evaluations, standardized photography, and self-assessment questionnaires were used to measure outcomes. No serious adverse effects were recorded, and the incidence of local adverse effects was low, highlighting good tolerability of the investigated test items. In most participants, significant improvements in hyperpigmented areas were recorded. Clinical scoring by the dermatologist investigator indicated a statistically significant 13% reduction in color intensity and a 6% reduction in the size of dark spots after 8 weeks of treatment. Colorimetric evaluation showed a statistically significant 1% increase in luminosity (L* parameter) and an 8% improvement in the Individual Typological Angle (ITA°) in endpoint, indicating lighter skin spots. Subjective assessments reflected high user satisfaction, with 95% of participants noting improvements in skin hydration and luminosity, and 77% reporting a reduced appearance of dark spots. Overall, the present work supports the use of tranexamic acid, niacinamide, and vitamin C as an effective and well-tolerated combined topical management option for hyperpigmentation. This combination offers a viable alternative to classical whiteners for individuals seeking to reduce facial skin coloration imbalance and improve skin tone.

The Influence of Short Video Marketing on Consumer Brand Attitudes under New Media Environment

With the development of the Internet, it has become a convenient shopping platform for consumers. In the ear of new media and big data, the short video market has gradually become the mainstream trend of society. The research theme of this paper aims to explore the influence of short video marketing on consumer brand attitude in the context of new media. Specifically, it will analyze how factors such as content creativity and brand loyalty influence consumers perceptions and attitudes toward brands through short video marketing. In this paper, the influence of short video on brand perception and consumer brand attitude is studied. The author investigates how high quality content, user engagement and brand loyalty increase consumer brand attitude. Besides, this study aims to optimize short video marketing strategies, enhance brand influence, and analyze the impact of brand loyalty on consumers purchasing power. Overall, this study contributes to theoretical research by enriching readers understanding of new media marketing strategies while providing practical insights for consumers.

Reasons Explaining High Emergency Department Use in Patients With Mental Illnesses: Different Staff Perspectives.

For patients with mental illnesses (MIs), emergency departments (EDs) are often the entry point into the healthcare system, or their only resort for quickly accessing mental health treatment. A better understanding of the various barriers justifying high ED use among patients with MIs may help recommend targeted interventions that better meet their needs. This explorative qualitative study aimed to identify such barriers and the solutions brought forth to reduce ED use based on the perspectives of clinicians and managers working in EDs, other hospital departments or the community sector. Interviews were conducted between April 2021 and February 2022; 86 mental health professionals (22% were nurses) from four large urban ED sites in Quebec (Canada) were interviewed. Barriers were identified in relation to patient profiles, healthcare system and organisational features and professional characteristics. The key barriers that were found to explain high ED use were patients having serious MIs (e.g., psychotic disorders) or social issues (e.g., poverty), lack of coordination and patient referrals between EDs and other health services, insufficient access to mental health and addiction services and inadequacy of care. Very few solutions were implemented to improve care for high ED users. Better deployment of ED interventions in collaboration with outpatient care may be prioritised to reduce high ED use for patients with MIs. Improvements to the referral and transfer processes to outpatient care, particularly through care plans and case management programs, may be implemented to reduce high ED use and improve outpatient care among patients with multiple health and social needs.

Download to Heal: Navigating the Pixelated Path of Digital Therapeutics in Psychiatric Care.

Digital therapeutics have evolved rapidly with technological advances in healthcare. Despite their increasing use, gaps remain in understanding their regulatory frameworks, integration, and efficacy for conditions like substance use disorder, insomnia, attention deficit hyperactivity disorder, and post-traumatic stress disorder. This study evaluates FDA-approved digital therapeutics and explores their potential to revolutionize psychiatric treatments amid ongoing technological and regulatory changes. We conducted a comprehensive review of major databases, focusing on articles published up to January 2024 on FDA-approved digital therapeutics. We excluded non-English articles and those lacking empirical data or focusing on non-FDA-approved therapeutics. Our analysis covered regulatory compliance, clinical outcomes, and integration with traditional treatments. The review of nine FDA-cleared digital therapeutics revealed benefits like improved treatment accessibility and potential reductions in healthcare costs. For example, Somryst, a cognitive-behavioral therapy-based treatment for insomnia, showed that over 40 percent of users overcame chronic insomnia, and 60 percent experienced improvements without adverse effects. However, challenges remain, including low provider adoption, inadequate insurance coverage, and high user dropout rates. While digital therapeutics enhance accessibility, they face regulatory challenges, reimbursement issues, and the need for robust clinical evidence. Success depends on collaboration among stakeholders to demonstrate value, ensure safety, and integrate them into existing healthcare systems.

A conversational agent for enhanced Self-Management after cardiothoracic surgery

BackgroundEnhanced self-management is crucial for long-term survival following cardiothoracic surgery. ObjectivesThis study aimed to develop a conversational agent to enhance patient self-management after cardiothoracic surgery. MethodologyThe solution was designed and implemented following the Design Science Research Methodology. A pilot study was conducted at the hospital to assess the feasibility, usability, and perceived effectiveness of the solution. Feedback was gathered to inform further interactions. Additionally, a focus group with clinicians was conducted to evaluate the acceptability of the solution, integrating insights from the pilot study. ResultsThe conversational agent, implemented using a rule-based model, was successfully tested with patients in the cardiothoracic surgery unit (n = 4). Patients received one month of text messages reinforcing clinical team recommendations on a healthy diet and regular physical activity. The system received a high usability score, and two patients suggested adding a feature to answer user prompts for future improvements. The focus group feedback indicated that while the solution met the initial requirements, further testing with a larger patient cohort is necessary to establish personalized profiles. Moreover, clinicians recommended that future iterations prioritize enhanced personalization and interoperability with other hospital platforms. Additionally, while the use of artificial generative intelligence was seen as relevant for content personalization, clinicians expressed concerns regarding content safety, highlighting the necessity for rigorous testing. ConclusionsThis study marks a significant step towards enhancing post-cardiothoracic surgery care through conversational agents. The integration of a diversity of stakeholder knowledge enriches the solution, grants ownership and ensures its sustainability. Future research should focus on automating message generation and delivery based on patient data and environmental factors. While the integration of artificial generative intelligence holds promise for enhancing patient interaction, ensuring the safety of its content is essential.