Necrotizing fasciitis (NF) is an aggressive and potentially life-threatening infection of the superficial fascia and surrounding skin, fat, fascia, muscle, and other soft tissue structures. Here, we outline the rare case of a 26-year-old man with a periorbital Streptococcus pyogenes A NF infection. Our case report underscores a unique instance of periorbital NF, distinctively presenting without any predisposing risk factors, shedding light on its presentation, treatment, and pathophysiology.
{"title":"Periorbital Necrotizing Fasciitis: Case Presentation.","authors":"Ryan S Huang, Nikhil S Patil, Yasser Khan","doi":"10.2196/52507","DOIUrl":"10.2196/52507","url":null,"abstract":"<p><p>Necrotizing fasciitis (NF) is an aggressive and potentially life-threatening infection of the superficial fascia and surrounding skin, fat, fascia, muscle, and other soft tissue structures. Here, we outline the rare case of a 26-year-old man with a periorbital Streptococcus pyogenes A NF infection. Our case report underscores a unique instance of periorbital NF, distinctively presenting without any predisposing risk factors, shedding light on its presentation, treatment, and pathophysiology.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":" ","pages":"e52507"},"PeriodicalIF":2.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Loneliness affects the quality of life of people all around the world. Loneliness is also shown to be directly associated with mental health issues and is often the cause of mental health problems. It is also shown to increase the risk of heart diseases and other physical illnesses. Loneliness is studied both from the social and medical sciences perspectives. There are also interventions on the basis of health informatics, information and communication technologies (ICTs), social media, and other technological solutions. In the literature, loneliness is studied from various angles and perspectives ranging from biological to socioeconomical and through anthropological understandings of technology. From the ICT and technological sides, there are multiple reviews studying the effectiveness of intervention strategies and solutions. However, there is a lack of a comprehensive review on loneliness that engulfs the psychological, social, and technological studies of loneliness. From the perspective of loneliness informatics (ie, the application of health informatics practices and tools), it is important to understand the psychological and biological basis of loneliness. When it comes to technological interventions to fight off loneliness, the majority of interventions focus on older people. While loneliness is highest among older people, theoretical and demographical studies of loneliness give a U-shaped distribution age-wise to loneliness; that is, younger people and older people are the demographics most affected by loneliness. But the strategies and interventions designed for older people cannot be directly applied to younger people. We present the dynamics of loneliness in younger people and also provide an overview of the technological interventions for loneliness in younger people. This paper presents an approach wherein the studies carried out from the perspectives of digital health and informatics are discussed in detail. A comprehensive overview of the understanding of loneliness and the study of the overall field of tools and strategies of loneliness informatics was carried out. The need to study loneliness in younger people is addressed and particular digital solutions and interventions developed for younger people are presented. This paper can be used to overcome the challenges of technological gaps in the studies and strategies developed for loneliness. The findings of this study show that the majority of interventions and reviews are focused on older people, with ICT-based and social media-based interventions showing promise for countering the effects of loneliness. There are new technologies, such as conversational agents and robots, which are tailored to the particular needs of younger people. This literature review suggests that the digital solutions developed to overcome loneliness can benefit people, and younger people in particular, more if they are made interactive in order to retain users.
{"title":"Understanding Loneliness in Younger People: Review of the Opportunities and Challenges for Loneliness Interventions.","authors":"Hurmat Ali Shah, Mowafa Househ","doi":"10.2196/45197","DOIUrl":"10.2196/45197","url":null,"abstract":"<p><p>Loneliness affects the quality of life of people all around the world. Loneliness is also shown to be directly associated with mental health issues and is often the cause of mental health problems. It is also shown to increase the risk of heart diseases and other physical illnesses. Loneliness is studied both from the social and medical sciences perspectives. There are also interventions on the basis of health informatics, information and communication technologies (ICTs), social media, and other technological solutions. In the literature, loneliness is studied from various angles and perspectives ranging from biological to socioeconomical and through anthropological understandings of technology. From the ICT and technological sides, there are multiple reviews studying the effectiveness of intervention strategies and solutions. However, there is a lack of a comprehensive review on loneliness that engulfs the psychological, social, and technological studies of loneliness. From the perspective of loneliness informatics (ie, the application of health informatics practices and tools), it is important to understand the psychological and biological basis of loneliness. When it comes to technological interventions to fight off loneliness, the majority of interventions focus on older people. While loneliness is highest among older people, theoretical and demographical studies of loneliness give a U-shaped distribution age-wise to loneliness; that is, younger people and older people are the demographics most affected by loneliness. But the strategies and interventions designed for older people cannot be directly applied to younger people. We present the dynamics of loneliness in younger people and also provide an overview of the technological interventions for loneliness in younger people. This paper presents an approach wherein the studies carried out from the perspectives of digital health and informatics are discussed in detail. A comprehensive overview of the understanding of loneliness and the study of the overall field of tools and strategies of loneliness informatics was carried out. The need to study loneliness in younger people is addressed and particular digital solutions and interventions developed for younger people are presented. This paper can be used to overcome the challenges of technological gaps in the studies and strategies developed for loneliness. The findings of this study show that the majority of interventions and reviews are focused on older people, with ICT-based and social media-based interventions showing promise for countering the effects of loneliness. There are new technologies, such as conversational agents and robots, which are tailored to the particular needs of younger people. This literature review suggests that the digital solutions developed to overcome loneliness can benefit people, and younger people in particular, more if they are made interactive in order to retain users.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"12 ","pages":"e45197"},"PeriodicalIF":2.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10654910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Background: </strong>Electronic health records and IT infrastructure in primary care allow for digital documentation and access to information, which can be used to guide evidence-based care and monitor patient safety and quality of care. Quality indicators specified by regulatory authorities can be automatically computed and presented to primary care staff. However, the implementation of digital information systems (DIS) in health care can be challenging, and understanding factors such as relative advantage, compatibility, complexity, trialability, and observability is needed to improve the success and rate of adoption and diffusion.</p><p><strong>Objective: </strong>This study aims to explore how DIS are used and perceived by health care professionals in primary care.</p><p><strong>Methods: </strong>This study used quantitative assessment to gather survey data on the use and potential of DIS in health care in Sweden from the perspectives of primary care personnel in various roles. The digital questionnaire was designed to be short and contained 3 sections covering respondent characteristics, current use of platforms, and perceptions of decision support tools. Data were analyzed using descriptive statistics, nonparametric hypothesis testing, ordinal coefficient α, and confirmatory factor analysis.</p><p><strong>Results: </strong>The study collected responses from participants across 10 regions of Sweden, comprising 31.9% (n=22) from private clinics and 68.1% (n=47) from public clinics. Participants included administrators (18/69, 26.1%), a medical strategist (1/69, 1.4%), and physicians (50/69, 72.5%). Usage frequency varied as follows: 11.6% (n=8) used DIS weekly, 24.6% (n=17) monthly, 27.5% (n=19) a few times a year, 26.1% (n=18) very rarely, and 10.1% (n=7) lacked access. Administrators used DIS more frequently than physicians (P=.005). DIS use centered on quality improvement and identifying high-risk patients, with differences by role. Physicians were more inclined to use DIS out of curiosity (P=.01). Participants desired DIS for patient follow-up, lifestyle guidance, treatment suggestions, reminders, and shared decision-making. Administrators favored predictive analysis (P<.001), while physicians resisted immediate patient identification (P=.03). The 5 innovation attributes showed high internal consistency (α>.7). These factors explained 78.5% of questionnaire variance, relating to complexity, competitive advantage, compatibility, trialability, and observability. Factors 2, 3, and 4 predicted intention to use DIS, with factor 2 alone achieving the best accuracy (root-mean-square=0.513).</p><p><strong>Conclusions: </strong>Administrators and physicians exhibited role-based DIS use patterns highlighting the need for tailored approaches to promote DIS adoption. The study reveals a link between positive perceptions and intention to use DIS, emphasizing the significance of considering all factors for successful health care integration
{"title":"A Pragmatic Mapping of Perceptions and Use of Digital Information Systems in Primary Care in Sweden: Survey Study.","authors":"Anita Sant'Anna, Jens Nygren","doi":"10.2196/49973","DOIUrl":"10.2196/49973","url":null,"abstract":"<p><strong>Background: </strong>Electronic health records and IT infrastructure in primary care allow for digital documentation and access to information, which can be used to guide evidence-based care and monitor patient safety and quality of care. Quality indicators specified by regulatory authorities can be automatically computed and presented to primary care staff. However, the implementation of digital information systems (DIS) in health care can be challenging, and understanding factors such as relative advantage, compatibility, complexity, trialability, and observability is needed to improve the success and rate of adoption and diffusion.</p><p><strong>Objective: </strong>This study aims to explore how DIS are used and perceived by health care professionals in primary care.</p><p><strong>Methods: </strong>This study used quantitative assessment to gather survey data on the use and potential of DIS in health care in Sweden from the perspectives of primary care personnel in various roles. The digital questionnaire was designed to be short and contained 3 sections covering respondent characteristics, current use of platforms, and perceptions of decision support tools. Data were analyzed using descriptive statistics, nonparametric hypothesis testing, ordinal coefficient α, and confirmatory factor analysis.</p><p><strong>Results: </strong>The study collected responses from participants across 10 regions of Sweden, comprising 31.9% (n=22) from private clinics and 68.1% (n=47) from public clinics. Participants included administrators (18/69, 26.1%), a medical strategist (1/69, 1.4%), and physicians (50/69, 72.5%). Usage frequency varied as follows: 11.6% (n=8) used DIS weekly, 24.6% (n=17) monthly, 27.5% (n=19) a few times a year, 26.1% (n=18) very rarely, and 10.1% (n=7) lacked access. Administrators used DIS more frequently than physicians (P=.005). DIS use centered on quality improvement and identifying high-risk patients, with differences by role. Physicians were more inclined to use DIS out of curiosity (P=.01). Participants desired DIS for patient follow-up, lifestyle guidance, treatment suggestions, reminders, and shared decision-making. Administrators favored predictive analysis (P<.001), while physicians resisted immediate patient identification (P=.03). The 5 innovation attributes showed high internal consistency (α>.7). These factors explained 78.5% of questionnaire variance, relating to complexity, competitive advantage, compatibility, trialability, and observability. Factors 2, 3, and 4 predicted intention to use DIS, with factor 2 alone achieving the best accuracy (root-mean-square=0.513).</p><p><strong>Conclusions: </strong>Administrators and physicians exhibited role-based DIS use patterns highlighting the need for tailored approaches to promote DIS adoption. The study reveals a link between positive perceptions and intention to use DIS, emphasizing the significance of considering all factors for successful health care integration","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"12 ","pages":"e49973"},"PeriodicalIF":2.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: In Japan, incidents of falsified expiration dates on popular cookie brands and health hazards associated with frozen Chinese dumplings have raised food safety awareness. To prevent the intentional contamination of food by foreign substances, large food manufacturing companies have adopted the concept of food defense.
Objective: The aim of this study was to assess people's willingness to pay for food protection measures. In addition, the impact of participants' personalities and considerations regarding their purchase choices on how much they were willing to pay when shopping for food and other products were measured.
Methods: A questionnaire on willingness to pay for food hygiene and food defense was administered via a web survey and 1414 responses were included in the analysis. Univariate logistic regression analyses were performed with individuals willing and unwilling to pay additional costs as the objective variable and other questionnaire items as explanatory variables. A principal component analysis was performed on 12 questions regarding how much additional money people were willing to pay, and the principal component scores and other questions were examined for implications and other information.
Results: Approximately one-third of the respondents stated that they were unwilling to pay additional costs and reported a willingness to consume delivery food even if it contained items that were not part of the original order. The first principal component reflected the extent to which people were willing to pay additional money, and if so, how much. This tendency existed even if the individual foods and amounts varied. The third principal component reflected the amount of extra money that people were willing to pay, which was determined by the amount people had to pay toward food safety measures. Those who answered "zero" were more likely to believe that consumers should not have to pay to ensure food safety. The second principal component reflected an axis separating food defense and food hygiene. Some items not directly related to food were correlated with this axis.
Conclusions: In Japan, the concept of food hygiene is well-established and is generally taken for granted. In contrast, the concept of food defense is relatively new and has not yet fully penetrated the Japanese market. Our research shows that people who think that clothing brands provided added value to clothing products may have similar feelings about food defense. In addition, food hygiene efforts to prevent outbreaks of food poisoning are common in Japan and have been established as the basis of food safety. While food defense efforts are spreading, mainly in companies, it is presumed that they are valuable for the general public as supplementary measures to routine (or basic) food hygiene.
{"title":"Consumer Willingness to Pay for Food Defense and Food Hygiene in Japan: Cross-Sectional Study.","authors":"Shinya Matsumoto, Yoshiyuki Kanagawa, Kiwamu Nagoshi, Takemi Akahane, Tomoaki Imamura, Manabu Akahane","doi":"10.2196/43936","DOIUrl":"10.2196/43936","url":null,"abstract":"<p><strong>Background: </strong>In Japan, incidents of falsified expiration dates on popular cookie brands and health hazards associated with frozen Chinese dumplings have raised food safety awareness. To prevent the intentional contamination of food by foreign substances, large food manufacturing companies have adopted the concept of food defense.</p><p><strong>Objective: </strong>The aim of this study was to assess people's willingness to pay for food protection measures. In addition, the impact of participants' personalities and considerations regarding their purchase choices on how much they were willing to pay when shopping for food and other products were measured.</p><p><strong>Methods: </strong>A questionnaire on willingness to pay for food hygiene and food defense was administered via a web survey and 1414 responses were included in the analysis. Univariate logistic regression analyses were performed with individuals willing and unwilling to pay additional costs as the objective variable and other questionnaire items as explanatory variables. A principal component analysis was performed on 12 questions regarding how much additional money people were willing to pay, and the principal component scores and other questions were examined for implications and other information.</p><p><strong>Results: </strong>Approximately one-third of the respondents stated that they were unwilling to pay additional costs and reported a willingness to consume delivery food even if it contained items that were not part of the original order. The first principal component reflected the extent to which people were willing to pay additional money, and if so, how much. This tendency existed even if the individual foods and amounts varied. The third principal component reflected the amount of extra money that people were willing to pay, which was determined by the amount people had to pay toward food safety measures. Those who answered \"zero\" were more likely to believe that consumers should not have to pay to ensure food safety. The second principal component reflected an axis separating food defense and food hygiene. Some items not directly related to food were correlated with this axis.</p><p><strong>Conclusions: </strong>In Japan, the concept of food hygiene is well-established and is generally taken for granted. In contrast, the concept of food defense is relatively new and has not yet fully penetrated the Japanese market. Our research shows that people who think that clothing brands provided added value to clothing products may have similar feelings about food defense. In addition, food hygiene efforts to prevent outbreaks of food poisoning are common in Japan and have been established as the basis of food safety. While food defense efforts are spreading, mainly in companies, it is presumed that they are valuable for the general public as supplementary measures to routine (or basic) food hygiene.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"12 ","pages":"e43936"},"PeriodicalIF":2.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Existing digital mental health interventions mainly focus on the symptoms of specific mental disorders, but do not focus on Maladaptive Personalities and Interpersonal Schemas (MPISs). As an initial step toward considering personalities and schemas in intervention programs, there is a need for the development of tools for measuring core personality traits and interpersonal schemas known to cause psychological discomfort among potential users of digital mental health interventions. Thus, the MPIS was developed.
Objective: The objectives of this study are to validate the MPIS by comparing 2 models of the MPIS factor structure and to understand the characteristics of the MPIS by assessing its correlations with other measures.
Methods: Data were collected from 234 participants who were using web-based community sites in South Korea, including university students, graduate students, working professionals, and homemakers. All the data were gathered through web-based surveys. Confirmatory factor analysis was used to compare a single-factor model with a 5-factor model. Reliability and correlation analyses with other scales were performed.
Results: The results of confirmatory factor analysis indicated that the 5-factor model (χ2550=1278.1; Tucker-Lewis index=0.80; comparative fit index=0.81; and Root Mean Square Error of Approximation=0.07) was more suitable than the single-factor model (χ2560=2341.5; Tucker-Lewis index=0.52; comparative fit index=0.54; and Root Mean Square Error of Approximation=0.11) for measuring maladaptive personality traits and interpersonal relationship patterns. The internal consistency of each factor of the MPIS was good (Cronbach α=.71-.88), and the correlations with existing measures were statistically significant. The MPIS is a validated 35-item tool for measuring 5 essential personality traits and interpersonal schemas in adults aged 18-39 years.
Conclusions: This study introduced the MPIS, a concise and effective questionnaire capable of measuring maladaptive personality traits and interpersonal relationship schemas. Through analysis, the MPIS was shown to reliably assess these psychological constructs and validate them. Its web-based accessibility and reduced item count make it a valuable tool for mental health assessment. Future applications include its integration into digital mental health care services, allowing easy web-based administration and aiding in the classification of psychological therapy programs based on the obtained results.
{"title":"Validation of a Brief Internet-Based Self-Report Measure of Maladaptive Personality and Interpersonal Schema: Confirmatory Factor Analysis.","authors":"Hyeonseong Kim, Seohyun Jeong, Inae Hwang, Kiyoung Sung, Woori Moon, Min-Sup Shin","doi":"10.2196/48425","DOIUrl":"10.2196/48425","url":null,"abstract":"<p><strong>Background: </strong>Existing digital mental health interventions mainly focus on the symptoms of specific mental disorders, but do not focus on Maladaptive Personalities and Interpersonal Schemas (MPISs). As an initial step toward considering personalities and schemas in intervention programs, there is a need for the development of tools for measuring core personality traits and interpersonal schemas known to cause psychological discomfort among potential users of digital mental health interventions. Thus, the MPIS was developed.</p><p><strong>Objective: </strong>The objectives of this study are to validate the MPIS by comparing 2 models of the MPIS factor structure and to understand the characteristics of the MPIS by assessing its correlations with other measures.</p><p><strong>Methods: </strong>Data were collected from 234 participants who were using web-based community sites in South Korea, including university students, graduate students, working professionals, and homemakers. All the data were gathered through web-based surveys. Confirmatory factor analysis was used to compare a single-factor model with a 5-factor model. Reliability and correlation analyses with other scales were performed.</p><p><strong>Results: </strong>The results of confirmatory factor analysis indicated that the 5-factor model (χ<sup>2</sup><sub>550</sub>=1278.1; Tucker-Lewis index=0.80; comparative fit index=0.81; and Root Mean Square Error of Approximation=0.07) was more suitable than the single-factor model (χ<sup>2</sup><sub>560</sub>=2341.5; Tucker-Lewis index=0.52; comparative fit index=0.54; and Root Mean Square Error of Approximation=0.11) for measuring maladaptive personality traits and interpersonal relationship patterns. The internal consistency of each factor of the MPIS was good (Cronbach α=.71-.88), and the correlations with existing measures were statistically significant. The MPIS is a validated 35-item tool for measuring 5 essential personality traits and interpersonal schemas in adults aged 18-39 years.</p><p><strong>Conclusions: </strong>This study introduced the MPIS, a concise and effective questionnaire capable of measuring maladaptive personality traits and interpersonal relationship schemas. Through analysis, the MPIS was shown to reliably assess these psychological constructs and validate them. Its web-based accessibility and reduced item count make it a valuable tool for mental health assessment. Future applications include its integration into digital mental health care services, allowing easy web-based administration and aiding in the classification of psychological therapy programs based on the obtained results.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05952063; https://www.clinicaltrials.gov/study/NCT05952063.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"12 ","pages":"e48425"},"PeriodicalIF":2.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10576229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alina Napetschnig, Klara Brixius, Wolfgang Deiters
Background: Virtual reality (VR) applications are gaining growing significance, particularly among older adults. These applications can provide valuable support to older adults by offering immersive VR content that positively influences various aspects of their daily lives, including activities of daily living. Furthermore, VR applications can contribute to the enhancement of cognitive and motor skills, ultimately leading to an improved quality of life for older individuals. Nevertheless, to ensure a positive impact, it is crucial to develop VR experiences that are tailored to the needs and preferences of the users.
Objective: This study aims to develop a core set of quality criteria and guidelines for the development of user-centered VR applications specifically designed for older adults (target group).
Methods: The multistep qualitative study design comprised several key stages, beginning with a systematic literature search. This was followed by a framework analysis aimed at identifying a core set of criteria. Subsequently, these criteria underwent validation through expert workshops. The outcomes achieved through this iterative process were organized and categorized into criteria, accompanied by explanations detailing the underlying categories or codes.
Results: The quality criteria core set for older adults-friendly VR applications has been developed through an iterative process. It is divided into 2 distinct parts, each containing criteria categorized into specific areas. The first part includes the following categories: (1) quality assurance of medical/health content, (2) data protection provisions, (3) quality requirements, (4) consumer protection, and (5) interoperability. The second part includes the following categories: (1) graphic/quality, (2) 3D character/avatar, (3) providing in-game instructions and prompts, (4) interaction, (5) navigation, and (6) promotion of user motivation and loyalty to use. The results imply a differentiated scope as well as a differentiated granularity of the criteria.
Conclusions: Considering the ongoing advancement of VR technology and the diverse needs within the older adult demographic, it is essential to assess the quality criteria core set results on an individual basis.
{"title":"Development of a Core Set of Quality Criteria for Virtual Reality Applications Designed for Older Adults: Multistep Qualitative Study.","authors":"Alina Napetschnig, Klara Brixius, Wolfgang Deiters","doi":"10.2196/45433","DOIUrl":"10.2196/45433","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) applications are gaining growing significance, particularly among older adults. These applications can provide valuable support to older adults by offering immersive VR content that positively influences various aspects of their daily lives, including activities of daily living. Furthermore, VR applications can contribute to the enhancement of cognitive and motor skills, ultimately leading to an improved quality of life for older individuals. Nevertheless, to ensure a positive impact, it is crucial to develop VR experiences that are tailored to the needs and preferences of the users.</p><p><strong>Objective: </strong>This study aims to develop a core set of quality criteria and guidelines for the development of user-centered VR applications specifically designed for older adults (target group).</p><p><strong>Methods: </strong>The multistep qualitative study design comprised several key stages, beginning with a systematic literature search. This was followed by a framework analysis aimed at identifying a core set of criteria. Subsequently, these criteria underwent validation through expert workshops. The outcomes achieved through this iterative process were organized and categorized into criteria, accompanied by explanations detailing the underlying categories or codes.</p><p><strong>Results: </strong>The quality criteria core set for older adults-friendly VR applications has been developed through an iterative process. It is divided into 2 distinct parts, each containing criteria categorized into specific areas. The first part includes the following categories: (1) quality assurance of medical/health content, (2) data protection provisions, (3) quality requirements, (4) consumer protection, and (5) interoperability. The second part includes the following categories: (1) graphic/quality, (2) 3D character/avatar, (3) providing in-game instructions and prompts, (4) interaction, (5) navigation, and (6) promotion of user motivation and loyalty to use. The results imply a differentiated scope as well as a differentiated granularity of the criteria.</p><p><strong>Conclusions: </strong>Considering the ongoing advancement of VR technology and the diverse needs within the older adult demographic, it is essential to assess the quality criteria core set results on an individual basis.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"12 ","pages":"e45433"},"PeriodicalIF":2.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10568390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41123386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manping Guo, Yiming Wang, Qiaoning Yang, Rui Li, Yang Zhao, Chenfei Li, Mingbo Zhu, Yao Cui, Xin Jiang, Song Sheng, Qingna Li, Rui Gao
With the rapid development of science, technology, and engineering, large amounts of data have been generated in many fields in the past 20 years. In the process of medical research, data are constantly generated, and large amounts of real-world data form a "data disaster." Effective data analysis and mining are based on data availability and high data quality. The premise of high data quality is the need to clean the data. Data cleaning is the process of detecting and correcting "dirty data," which is the basis of data analysis and management. Moreover, data cleaning is a common technology for improving data quality. However, the current literature on real-world research provides little guidance on how to efficiently and ethically set up and perform data cleaning. To address this issue, we proposed a data cleaning framework for real-world research, focusing on the 3 most common types of dirty data (duplicate, missing, and outlier data), and a normal workflow for data cleaning to serve as a reference for the application of such technologies in future studies. We also provided relevant suggestions for common problems in data cleaning.
{"title":"Normal Workflow and Key Strategies for Data Cleaning Toward Real-World Data: Viewpoint.","authors":"Manping Guo, Yiming Wang, Qiaoning Yang, Rui Li, Yang Zhao, Chenfei Li, Mingbo Zhu, Yao Cui, Xin Jiang, Song Sheng, Qingna Li, Rui Gao","doi":"10.2196/44310","DOIUrl":"10.2196/44310","url":null,"abstract":"<p><p>With the rapid development of science, technology, and engineering, large amounts of data have been generated in many fields in the past 20 years. In the process of medical research, data are constantly generated, and large amounts of real-world data form a \"data disaster.\" Effective data analysis and mining are based on data availability and high data quality. The premise of high data quality is the need to clean the data. Data cleaning is the process of detecting and correcting \"dirty data,\" which is the basis of data analysis and management. Moreover, data cleaning is a common technology for improving data quality. However, the current literature on real-world research provides little guidance on how to efficiently and ethically set up and perform data cleaning. To address this issue, we proposed a data cleaning framework for real-world research, focusing on the 3 most common types of dirty data (duplicate, missing, and outlier data), and a normal workflow for data cleaning to serve as a reference for the application of such technologies in future studies. We also provided relevant suggestions for common problems in data cleaning.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"12 ","pages":"e44310"},"PeriodicalIF":2.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41175065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Background: </strong>Managing reusable medical devices incurs substantial health care costs and complexity, particularly in integrated care settings. This complexity hampers care quality, safety, and costs. Studying logistical innovations within integrated care can provide insights to medical devices use among staff effectively.</p><p><strong>Objective: </strong>This study aimed to establish the feasibility of a logistical intervention through outsourcing and a web portal. The goal was to provide insights into users' acceptability of the intervention, on whether the intervention was successfully implemented, and on the intervention's preliminary efficacy, thus benefiting practitioners and researchers.</p><p><strong>Methods: </strong>This paper presents a mixed methods feasibility study at a large chain-wide health care provider in the Netherlands. The intervention entailed outsourcing noncritical reusable medical devices and introducing a web portal for device management. A questionnaire gauged perceived ordering and delivery times, satisfaction with the ordering and delivery process, compliance with safety and hygiene certification, and effects on the care delivery process. Qualitative data in the form of observations, documentation, and interviews were used to identify implementing challenges. Using on-site stocktaking and data from information systems, we analyzed the utilization, costs, and rental time of medical devices before and after the intervention for wheelchairs and anti-pressure ulcer mattresses.</p><p><strong>Results: </strong>Looking at the acceptability of the intervention, a high user satisfaction with the ordering and delivery process was reported (rated on a 5-point Likert scale). With respect to preliminary efficacy, we noted a reduction in the utilization of wheelchairs (on average, 1106, SD 106 fewer utilization d/mo), and a halted increase in the utilization of anti-pressure ulcer mattresses. In addition, nurses who used the web portal reported shorter ordering times for wheelchairs (-2.7 min) and anti-pressure ulcer mattresses (-3.1 min), as well as shorter delivery times for wheelchairs (-0.5 d). Moreover, an increase in device certification was reported (average score of 1.9, SD 1.0), indicating higher levels of safety and hygiene standards. In theory, these improvements should translate into better outcomes in terms of costs and the quality of care. However, we were unable to establish a reduction in total care costs or a reduced rental time per device. Furthermore, respondents did not identify improvements in safety or the quality of care. Although implementation challenges related to the diverse supply base and complexities with different care financers were observed, the overall implementation of the intervention was considered successful.</p><p><strong>Conclusions: </strong>This study confirms the feasibility of our intervention, in terms of acceptability, implementation success, and preliminary efficacy.
{"title":"Outsourcing the Management of Reusable Medical Devices in a Chain-Wide Care Setting: Mixed Methods Feasibility Study.","authors":"Bart A C Noort, Paul Buijs, Oskar Roemeling","doi":"10.2196/41409","DOIUrl":"10.2196/41409","url":null,"abstract":"<p><strong>Background: </strong>Managing reusable medical devices incurs substantial health care costs and complexity, particularly in integrated care settings. This complexity hampers care quality, safety, and costs. Studying logistical innovations within integrated care can provide insights to medical devices use among staff effectively.</p><p><strong>Objective: </strong>This study aimed to establish the feasibility of a logistical intervention through outsourcing and a web portal. The goal was to provide insights into users' acceptability of the intervention, on whether the intervention was successfully implemented, and on the intervention's preliminary efficacy, thus benefiting practitioners and researchers.</p><p><strong>Methods: </strong>This paper presents a mixed methods feasibility study at a large chain-wide health care provider in the Netherlands. The intervention entailed outsourcing noncritical reusable medical devices and introducing a web portal for device management. A questionnaire gauged perceived ordering and delivery times, satisfaction with the ordering and delivery process, compliance with safety and hygiene certification, and effects on the care delivery process. Qualitative data in the form of observations, documentation, and interviews were used to identify implementing challenges. Using on-site stocktaking and data from information systems, we analyzed the utilization, costs, and rental time of medical devices before and after the intervention for wheelchairs and anti-pressure ulcer mattresses.</p><p><strong>Results: </strong>Looking at the acceptability of the intervention, a high user satisfaction with the ordering and delivery process was reported (rated on a 5-point Likert scale). With respect to preliminary efficacy, we noted a reduction in the utilization of wheelchairs (on average, 1106, SD 106 fewer utilization d/mo), and a halted increase in the utilization of anti-pressure ulcer mattresses. In addition, nurses who used the web portal reported shorter ordering times for wheelchairs (-2.7 min) and anti-pressure ulcer mattresses (-3.1 min), as well as shorter delivery times for wheelchairs (-0.5 d). Moreover, an increase in device certification was reported (average score of 1.9, SD 1.0), indicating higher levels of safety and hygiene standards. In theory, these improvements should translate into better outcomes in terms of costs and the quality of care. However, we were unable to establish a reduction in total care costs or a reduced rental time per device. Furthermore, respondents did not identify improvements in safety or the quality of care. Although implementation challenges related to the diverse supply base and complexities with different care financers were observed, the overall implementation of the intervention was considered successful.</p><p><strong>Conclusions: </strong>This study confirms the feasibility of our intervention, in terms of acceptability, implementation success, and preliminary efficacy.","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"12 ","pages":"e41409"},"PeriodicalIF":1.9,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10548324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41167432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Han Joo Chae, Ji-Been Kim, Gwanmo Park, David Michael O'Sullivan, Jinwook Seo, Jung-Jun Park
<p><strong>Background: </strong>Insufficient physical activity due to social distancing and suppressed outdoor activities increases vulnerability to diseases like cardiovascular diseases, sarcopenia, and severe COVID-19. While bodyweight exercises, such as squats, effectively boost physical activity, incorrect postures risk abnormal muscle activation joint strain, leading to ineffective sessions or even injuries. Avoiding incorrect postures is challenging for novices without expert guidance. Existing solutions for remote coaching and computer-assisted posture correction often prove costly or inefficient.</p><p><strong>Objective: </strong>This study aimed to use deep neural networks to develop a personal workout assistant that offers feedback on squat postures using only mobile devices-smartphones and tablets. Deep learning mimicked experts' visual assessments of proper exercise postures. The effectiveness of the mobile app was evaluated by comparing it with exercise videos, a popular at-home workout choice.</p><p><strong>Methods: </strong>Twenty participants were recruited without squat exercise experience and divided into an experimental group (EXP) with 10 individuals aged 21.90 (SD 2.18) years and a mean BMI of 20.75 (SD 2.11) and a control group (CTL) with 10 individuals aged 22.60 (SD 1.95) years and a mean BMI of 18.72 (SD 1.23) using randomized controlled trials. A data set with over 20,000 squat videos annotated by experts was created and a deep learning model was trained using pose estimation and video classification to analyze the workout postures. Subsequently, a mobile workout assistant app, Home Alone Exercise, was developed, and a 2-week interventional study, in which the EXP used the app while the CTL only followed workout videos, showed how the app helps people improve squat exercise.</p><p><strong>Results: </strong>The EXP significantly improved their squat postures evaluated by the app after 2 weeks (Pre: 0.20 vs Mid: 4.20 vs Post: 8.00, P=.001), whereas the CTL (without the app) showed no significant change in squat posture (Pre: 0.70 vs Mid: 1.30 vs Post: 3.80, P=.13). Significant differences were observed in the left (Pre: 75.06 vs Mid: 76.24 vs Post: 63.13, P=.02) and right (Pre: 71.99 vs Mid: 76.68 vs Post: 62.82, P=.03) knee joint angles in the EXP before and after exercise, with no significant effect found for the CTL in the left (Pre: 73.27 vs Mid: 74.05 vs Post: 70.70, P=.68) and right (Pre: 70.82 vs Mid: 74.02 vs Post: 70.23, P=.61) knee joint angles.</p><p><strong>Conclusions: </strong>EXP participants trained with the app experienced faster improvement and learned more nuanced details of the squat exercise. The proposed mobile app, offering cost-effective self-discovery feedback, effectively taught users about squat exercises without expensive in-person trainer sessions.</p><p><strong>Trial registration: </strong>Clinical Research Information Service KCT0008178 (retrospectively registered); https://cris.nih.go.kr/cri
{"title":"An Artificial Intelligence Exercise Coaching Mobile App: Development and Randomized Controlled Trial to Verify Its Effectiveness in Posture Correction.","authors":"Han Joo Chae, Ji-Been Kim, Gwanmo Park, David Michael O'Sullivan, Jinwook Seo, Jung-Jun Park","doi":"10.2196/37604","DOIUrl":"10.2196/37604","url":null,"abstract":"<p><strong>Background: </strong>Insufficient physical activity due to social distancing and suppressed outdoor activities increases vulnerability to diseases like cardiovascular diseases, sarcopenia, and severe COVID-19. While bodyweight exercises, such as squats, effectively boost physical activity, incorrect postures risk abnormal muscle activation joint strain, leading to ineffective sessions or even injuries. Avoiding incorrect postures is challenging for novices without expert guidance. Existing solutions for remote coaching and computer-assisted posture correction often prove costly or inefficient.</p><p><strong>Objective: </strong>This study aimed to use deep neural networks to develop a personal workout assistant that offers feedback on squat postures using only mobile devices-smartphones and tablets. Deep learning mimicked experts' visual assessments of proper exercise postures. The effectiveness of the mobile app was evaluated by comparing it with exercise videos, a popular at-home workout choice.</p><p><strong>Methods: </strong>Twenty participants were recruited without squat exercise experience and divided into an experimental group (EXP) with 10 individuals aged 21.90 (SD 2.18) years and a mean BMI of 20.75 (SD 2.11) and a control group (CTL) with 10 individuals aged 22.60 (SD 1.95) years and a mean BMI of 18.72 (SD 1.23) using randomized controlled trials. A data set with over 20,000 squat videos annotated by experts was created and a deep learning model was trained using pose estimation and video classification to analyze the workout postures. Subsequently, a mobile workout assistant app, Home Alone Exercise, was developed, and a 2-week interventional study, in which the EXP used the app while the CTL only followed workout videos, showed how the app helps people improve squat exercise.</p><p><strong>Results: </strong>The EXP significantly improved their squat postures evaluated by the app after 2 weeks (Pre: 0.20 vs Mid: 4.20 vs Post: 8.00, P=.001), whereas the CTL (without the app) showed no significant change in squat posture (Pre: 0.70 vs Mid: 1.30 vs Post: 3.80, P=.13). Significant differences were observed in the left (Pre: 75.06 vs Mid: 76.24 vs Post: 63.13, P=.02) and right (Pre: 71.99 vs Mid: 76.68 vs Post: 62.82, P=.03) knee joint angles in the EXP before and after exercise, with no significant effect found for the CTL in the left (Pre: 73.27 vs Mid: 74.05 vs Post: 70.70, P=.68) and right (Pre: 70.82 vs Mid: 74.02 vs Post: 70.23, P=.61) knee joint angles.</p><p><strong>Conclusions: </strong>EXP participants trained with the app experienced faster improvement and learned more nuanced details of the squat exercise. The proposed mobile app, offering cost-effective self-discovery feedback, effectively taught users about squat exercises without expensive in-person trainer sessions.</p><p><strong>Trial registration: </strong>Clinical Research Information Service KCT0008178 (retrospectively registered); https://cris.nih.go.kr/cri","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"12 ","pages":"e37604"},"PeriodicalIF":2.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10523222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10224097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}