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Geukes SH, Bijlsma J, Meynen G, Raemaekers MAH, Ramsey NF, Simon Thomas MA, van Toor DAG, Vansteensel MJ. Neurotechnology in criminal justice: key points for neuroscientists and engineers. J Neural Eng 2024; 21:013001. [PMID: 38193322 DOI: 10.1088/1741-2552/ad1785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/20/2023] [Indexed: 01/10/2024]
Affiliation(s)
- S H Geukes
- University Medical Center Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J Bijlsma
- Willem Pompe Institute for Criminal Law and Criminology, Department of Law, Faculty of Law, Economics, Governance and Organization, Utrecht University, Utrecht, The Netherlands
- Utrecht Centre for Accountability and Liability Law, Department of Law, Faculty of Law, Economics, Governance and Organization, Utrecht University, Utrecht, The Netherlands
| | - G Meynen
- Willem Pompe Institute for Criminal Law and Criminology, Department of Law, Faculty of Law, Economics, Governance and Organization, Utrecht University, Utrecht, The Netherlands
- Utrecht Centre for Accountability and Liability Law, Department of Law, Faculty of Law, Economics, Governance and Organization, Utrecht University, Utrecht, The Netherlands
- Department of Philosophy, Faculty of Humanities, VU Amsterdam, Amsterdam, The Netherlands
- GGZ inGeest, Amsterdam, The Netherlands
| | - M A H Raemaekers
- University Medical Center Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - N F Ramsey
- University Medical Center Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M A Simon Thomas
- Institute of Jurisprudence, Constitutional and Administrative Law, Department of Law, Faculty of Law, Economics, Governance and Organization, Utrecht University, Utrecht, The Netherlands
- Montaigne Centre for the Rule of Law and Administration of Justice, Department of Law, Faculty of Law, Economics, Governance and Organization, Utrecht University, Utrecht, The Netherlands
| | - D A G van Toor
- Willem Pompe Institute for Criminal Law and Criminology, Department of Law, Faculty of Law, Economics, Governance and Organization, Utrecht University, Utrecht, The Netherlands
- Montaigne Centre for the Rule of Law and Administration of Justice, Department of Law, Faculty of Law, Economics, Governance and Organization, Utrecht University, Utrecht, The Netherlands
| | - M J Vansteensel
- University Medical Center Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
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Jakob R, Harperink S, Rudolf AM, Fleisch E, Haug S, Mair JL, Salamanca-Sanabria A, Kowatsch T. Factors Influencing Adherence to mHealth Apps for Prevention or Management of Noncommunicable Diseases: Systematic Review. J Med Internet Res 2022; 24:e35371. [PMID: 35612886 PMCID: PMC9178451 DOI: 10.2196/35371] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/31/2022] [Accepted: 04/09/2022] [Indexed: 12/14/2022] Open
Abstract
Background Mobile health (mHealth) apps show vast potential in supporting patients and health care systems with the increasing prevalence and economic costs of noncommunicable diseases (NCDs) worldwide. However, despite the availability of evidence-based mHealth apps, a substantial proportion of users do not adhere to them as intended and may consequently not receive treatment. Therefore, understanding the factors that act as barriers to or facilitators of adherence is a fundamental concern in preventing intervention dropouts and increasing the effectiveness of digital health interventions. Objective This review aimed to help stakeholders develop more effective digital health interventions by identifying factors influencing the continued use of mHealth apps targeting NCDs. We further derived quantified adherence scores for various health domains to validate the qualitative findings and explore adherence benchmarks. Methods A comprehensive systematic literature search (January 2007 to December 2020) was conducted on MEDLINE, Embase, Web of Science, Scopus, and ACM Digital Library. Data on intended use, actual use, and factors influencing adherence were extracted. Intervention-related and patient-related factors with a positive or negative influence on adherence are presented separately for the health domains of NCD self-management, mental health, substance use, nutrition, physical activity, weight loss, multicomponent lifestyle interventions, mindfulness, and other NCDs. Quantified adherence measures, calculated as the ratio between the estimated intended use and actual use, were derived for each study and compared with the qualitative findings. Results The literature search yielded 2862 potentially relevant articles, of which 99 (3.46%) were included as part of the inclusion criteria. A total of 4 intervention-related factors indicated positive effects on adherence across all health domains: personalization or tailoring of the content of mHealth apps to the individual needs of the user, reminders in the form of individualized push notifications, user-friendly and technically stable app design, and personal support complementary to the digital intervention. Social and gamification features were also identified as drivers of app adherence across several health domains. A wide variety of patient-related factors such as user characteristics or recruitment channels further affects adherence. The derived adherence scores of the included mHealth apps averaged 56.0% (SD 24.4%). Conclusions This study contributes to the scarce scientific evidence on factors that positively or negatively influence adherence to mHealth apps and is the first to quantitatively compare adherence relative to the intended use of various health domains. As underlying studies mostly have a pilot character with short study durations, research on factors influencing adherence to mHealth apps is still limited. To facilitate future research on mHealth app adherence, researchers should clearly outline and justify the app’s intended use; report objective data on actual use relative to the intended use; and, ideally, provide long-term use and retention data.
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Affiliation(s)
- Robert Jakob
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland
| | - Samira Harperink
- Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Aaron Maria Rudolf
- Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Elgar Fleisch
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland.,Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland.,Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore
| | - Severin Haug
- Swiss Research Institute for Public Health and Addiction, Zurich University, Zurich, Switzerland
| | - Jacqueline Louise Mair
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Alicia Salamanca-Sanabria
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore
| | - Tobias Kowatsch
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland.,Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland.,Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore
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Syed SA, Dixson BA, Constantino E, Regan J. The Law and Practice of Off-Label Prescribing and Physician Promotion. J Am Acad Psychiatry Law 2021; 49:53-59. [PMID: 33234538 DOI: 10.29158/jaapl.200049-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Prescription of medications for off-label indications is an increasingly common practice; recent events highlight such prescribing as one of the cornerstones of evolving clinical treatment. Clinicians are afforded substantial deference in prescribing practices and other treatments falling within the realm of the actual practice of medicine, including prescribing for off-label indications. Yet clinicians are not necessarily free to promote a medication for the same off-label indication they may have just prescribed for a patient. While trends in jurisprudence appear to be favoring clinicians' freedom to promote prescription medication for any use, in a majority of jurisdictions, the U.S. government can still bring considerable weight to bear on clinicians promoting off-label uses of prescription medications. We review the relevant laws and regulations pertaining to off-label prescription and promotion, as well as the possible legal consequences. The regulations pertaining to physician and pharmaceutical manufacturers regarding off-label drug use are complex. Suggestions are provided to help physicians better navigate the medical-legal landscape when prescribing or promoting medications for off-label use. Physician mindfulness to pertinent legal precedents will allow them to prescribe and promote medications with a higher level of critical reasoning to optimize care and reduce risk.
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Affiliation(s)
- Shariful A Syed
- Dr. Syed is Assistant Clinical Instructor, Department of Psychiatry and Behavioral Sciences, Stony Brook University Medical Center, Stony Brook, NY. Mr. Dixson is a health care and government investigations attorney in Nashville, Tennessee. Dr. Constantino is Vice-Chair for Education, Associate Clinical Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, Stony Brook University Medical Center, Stony Brook, NY. Dr. Regan is a staff psychiatrist at C.W. Bill Young VA Medical Center, Bay Pines, FL, and practicing attorney at North, Pursell & Ramos PLC, Nashville, TN.
| | - Brigham A Dixson
- Dr. Syed is Assistant Clinical Instructor, Department of Psychiatry and Behavioral Sciences, Stony Brook University Medical Center, Stony Brook, NY. Mr. Dixson is a health care and government investigations attorney in Nashville, Tennessee. Dr. Constantino is Vice-Chair for Education, Associate Clinical Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, Stony Brook University Medical Center, Stony Brook, NY. Dr. Regan is a staff psychiatrist at C.W. Bill Young VA Medical Center, Bay Pines, FL, and practicing attorney at North, Pursell & Ramos PLC, Nashville, TN
| | - Eduardo Constantino
- Dr. Syed is Assistant Clinical Instructor, Department of Psychiatry and Behavioral Sciences, Stony Brook University Medical Center, Stony Brook, NY. Mr. Dixson is a health care and government investigations attorney in Nashville, Tennessee. Dr. Constantino is Vice-Chair for Education, Associate Clinical Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, Stony Brook University Medical Center, Stony Brook, NY. Dr. Regan is a staff psychiatrist at C.W. Bill Young VA Medical Center, Bay Pines, FL, and practicing attorney at North, Pursell & Ramos PLC, Nashville, TN
| | - Judith Regan
- Dr. Syed is Assistant Clinical Instructor, Department of Psychiatry and Behavioral Sciences, Stony Brook University Medical Center, Stony Brook, NY. Mr. Dixson is a health care and government investigations attorney in Nashville, Tennessee. Dr. Constantino is Vice-Chair for Education, Associate Clinical Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, Stony Brook University Medical Center, Stony Brook, NY. Dr. Regan is a staff psychiatrist at C.W. Bill Young VA Medical Center, Bay Pines, FL, and practicing attorney at North, Pursell & Ramos PLC, Nashville, TN
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Migliarino GA. External Quality Assessment Schemes in Latin America. EJIFCC 2015; 26:226-37. [PMID: 27683496 PMCID: PMC4975360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As professionals of the clinical laboratory we must generate clinically useful results, products and services for the patients' health care. Laboratories must participate in one or more proficiency testing (PT) or external quality assessment (EQA) programs as part of routine quality assurance. Nevertheless participating per se is not enough. There are critical factors to take into consideration when selecting a PT or EQA providers. In most cases the survey's providers offer assigned values obtained from consensus of results provided by the participants for comparison, it is critical to evaluate consistency of the comparison group before interpretation and decision-making.
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Affiliation(s)
- Gabriel Alejandro Migliarino
- Biochemist Director at Gmigliarino Consultores Carlos Tejedor 1323 1 A 1706 Haedo, Buenos Aires, Argentina +54 11 4460 2527
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