K4Health
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This Digital Health Resource Library houses three legacy collections previously maintained by the Knowledge for Health (K4Health) Project. K4Health’s work was made possible by the support of the American People through the United States Agency for International Development (USAID) . K4Health was supported from 2008-2019 by USAID's Office of Population and Reproductive Health, Bureau for Global Health, under cooperative agreements with the Johns Hopkins University. K4Health was implemented by the Johns Hopkins Center for Communication Programs (CCP) in collaboration with FHI 360, Management Sciences for Health (MSH), and IntraHealth International. The K4Health Project ended in September 2019.
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Browsing K4Health by Subject "Biometric identifiers"
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- ItemAcceptability and user satisfaction of a smartphone-based, interactive blood glucose management system in women with gestational diabetes mellitus.(2014-12-31) Hirst, Jane E; Mackillop, Lucy; Loerup, Lise; Kevat, Dev A; Bartlett, Katy; Gibson, Oliver; Kenworthy, Yvonne; Levy, Jonathan C; Tarassenko, Lionel; Farmer, AndrewThe increase in gestational diabetes mellitus GDM is challenging maternity services We have developed an interactive smartphone based remote blood glucose BG monitoring system GDm health The objective was to determine women s satisfaction with using the GDm health system and their attitudes toward their diabetes care In a service development program involving 52 pregnant women September 2012 to June 2013 BG was monitored using GDm health from diagnosis until delivery Following birth women completed a structured questionnaire assessing 1 general satisfaction 2 equipment issues and 3 relationship with the diabetes care team Responses were scored on a 7 point Likert type scale Reliability and validity of the questionnaire were assessed using statistical methods Of 52 women 49 completed the questionnaire 32 had glucose tolerance test confirmed GDM gestation at recruitment 29 4 weeks mean SD and 17 women previous GDM recommended for BG monitoring 18 6 weeks In all 45 of 49 women agreed their care was satisfactory and the best for them 47 of 49 and 43 of 49 agreed the equipment was convenient and reliable respectively 42 of 49 agreed GDm health fitted into their lifestyle and 46 of 49 agreed they had a good relationship with their care team Written comments supported these findings with very positive reactions from the majority of women Cronbach s alpha was 89 with factor analysis corresponding with question thematic trends This pilot demonstrates that GDm health is acceptable and convenient for a large proportion of women Effects on clinical and economic outcomes are currently under investigation in a randomized trial clinicaltrials gov NCT01916694
- ItemAn assessment by nurses and mothers of a 'Road-to-Health' Book in the Western Cape.(2006-02-02) Harrison, D; Harker, H; Heese, H deV; Mann, M DTo evaluate English Afrikaans and Xhosa mother retained Road to Health Book RTH book for children and an electronic calculator
- ItemCommunity based weighing of newborns and use of mobile phones by village elders in rural settings in Kenya: a decentralised approach to health care provision.(2012-05-07) Gisore, Peter; Shipala, Evelyn; Otieno, Kevin; Rono, Betsy; Marete, Irene; Tenge, Constance; Mabeya, Hillary; Bucher, Sherri; Moore, Janet; Liechty, Edward; Esamai, FabianBACKGROUND Identifying every pregnancy regardless of home or health facility delivery is crucial to accurately estimating maternal and neonatal mortality Furthermore obtaining birth weights and other anthropometric measurements in rural settings in resource limited countries is a difficult challenge Unfortunately for the majority of infants born outside of a health care facility pregnancies are often not recorded and birth weights are not accurately known Data from the initial 6 months of the Maternal and Neonatal Health MNH Registry Study of the Global Network for Women and Children s Health study area in Kenya revealed that up to 70 of newborns did not have exact weights measured and recorded by the end of the first week of life nearly all of these infants were born outside health facilities METHODS To more completely obtain accurate birth weights for all infants regardless of delivery site village elders were engaged to assist in case finding for pregnancies and births All elders were provided with weighing scales and mobile phones as tools to assist in subject enrollment and data recording Subjects were instructed to bring the newborn infant to the home of the elder as soon as possible after birth for weight measurement The proportion of pregnancies identified before delivery and the proportion of births with weights measured were compared before and after provision of weighing scales and mobile phones to village elders Primary outcomes were the percent of infants with a measured birth weight recorded within 7 days of birth and the percent of women enrolled before delivery RESULTS The recorded birth weight increased from 43 5 7 to 97 1 1 The birth weight distributions between infants born and weighed in a health facility and those born at home and weighed by village elders were similar In addition a significant increase in the percent of subjects enrolled before delivery was found CONCLUSIONS Pregnancy case finding and acquisition of birth weight information can be successfully shifted to the community level
- ItemComputer-aided anthropometry in the evaluation of dysmorphic children.(2004-09-02) Zankl, AndreasOBJECTIVE Although anthropometry is widely regarded as the technique of choice for the evaluation of dysmorphic features among children it is only rarely used in clinical practice Possible reasons for this are the limited access of pediatricians to appropriate reference values and the time consuming way measurements must be plotted onto growth charts This article describes a computer program that overcomes these problems and greatly facilitates the use of anthropometric measurements in pediatric medicine DESIGN A computer program for PalmOS based handheld computers that compares entered anthropometric measurements with age and gender matched reference values was developed The software is distributed free of charge and can be downloaded www medgen unizh ch abase RESULTS The ABase software contains age and gender matched reference values for 18 anthropometric measures frequently used for the evaluation of dysmorphic children The proband s age is automatically calculated from the entered birth date and can be corrected for prematurity Entered measurements are compared with the internal reference values the results are displayed as percentile ranks or z scores and are plotted on digital growth charts CONCLUSIONS The presented software makes anthropometric reference values easily accessible on the ward or in the clinic and greatly reduces the time needed to plot the measurements onto growth charts This should promote more widespread use of anthropometry in pediatric medicine
- ItemDaily life stress and the cortisol awakening response: testing the anticipation hypothesis.(2013-01-03) Powell, Daniel J; Schlotz, WolffThe cortisol awakening response CAR is a distinct facet of the circadian cortisol rhythm associated with various health conditions and risk factors It has repeatedly been suggested that the CAR could be a result of the anticipated demands of the upcoming day stress anticipation and could support coping with daily life stress In a sample of 23 healthy participants CARs were assessed on two consecutive days by measures of salivary cortisol upon awakening S1 and 30 and 45 minutes later which were aggregated to the area under the curve increase AUCI Stress anticipation was assessed immediately after awakening On the same days daily life stress and distress were assessed six times per day based on a quasi randomized design using handheld computers Associations were tested by day using regression analysis and standard multilevel mixed effects models for longitudinal data The CAR AUCI moderated the effect of daily life stress on distress higher CAR increases were associated with attenuated distress responses to daily life stress on both days day 1 p 039 day 2 p 004 adjusted for age gender sleep quality time of awakening and oral contraceptive use Lagged effects and redundancy models showed that this effect was not due to prior day CAR increases but specific for same day CARs On day 2 associations between daily life stress and distress were stronger when individuals showed a higher S1 cortisol level but this effect was similar for S1 on day 1 and the day 2 effect of S1 became non significant when S1 on day 1 was controlled No associations were found between stress anticipation and CARs Findings indicate that the CAR increase is associated with successful coping with same day daily life stress
- ItemDialBetics: A Novel Smartphone-based Self-management Support System for Type 2 Diabetes Patients.(2014-05-30) Waki, Kayo; Fujita, Hideo; Uchimura, Yuji; Omae, Koji; Aramaki, Eiji; Kato, Shigeko; Lee, Hanae; Kobayashi, Haruka; Kadowaki, Takashi; Ohe, KazuhikoNumerous diabetes management systems and programs for improving glycemic control to meet guideline targets have been proposed using IT technology But all of them allow only limited or no real time interaction between patients and the system in terms of system response to patient input few studies have effectively assessed the systems usability and feasibility to determine how well patients understand and can adopt the technology involved DialBetics is composed of 4 modules 1 data transmission module 2 evaluation module 3 communication module and 4 dietary evaluation module A 3 month randomized study was designed to assess the safety and usability of a remote health data monitoring system and especially its impact on modifying patient lifestyles to improve diabetes self management and thus clinical outcomes Fifty four type 2 diabetes patients were randomly divided into 2 groups 27 in the DialBetics group and 27 in the non DialBetics control group HbA1c and fasting blood sugar FBS values declined significantly in the DialBetics group HbA1c decreased an average of 0 4 from 7 1 1 0 to 6 7 0 7 compared with an average increase of 0 1 in the non DialBetics group from 7 0 0 9 to 7 1 1 1 P 015 The DialBetics group FBS decreased an average of 5 5 mg dl compared with a non DialBetics group average increase of 16 9 mg dl P 019 BMI improvement although not statistically significant because of the small sample size was greater in the DialBetics group DialBetics was shown to be a feasible and an effective tool for improving HbA1c by providing patients with real time support based on their measurements and inputs
- ItemFeasibility of home-based cardiac telerehabilitation: Results of TeleInterMed study.(2015-07-14) Piotrowicz, Ewa; Korzeniowska-Kubacka, Iwona; Chrapowicka, Agnieszka; Wolszakiewicz, Jadwiga; Dobraszkiewicz-Wasilewska, Barbara; Batogowski, Marek; Piotrowski, Walerian; Piotrowicz, RyszardBACKGROUND Cardiac rehabilitation CR is recommended as an important component of a comprehensive approach to cardiovascular disease CVD patients Data have shown that a small percentage of eligible patients participate in CR despite their well established benefits Applying telerehabilitation provides an opportunity to improve the implementation of and adherence to CR The purpose of the study was to evaluate a wide implementation and feasibility of home based cardiac telerehabilitation HTCR in patients suffering from CVD and to assessits safety patients acceptance of and adherence to HTCR METHODS The study included 365 patients left ventricular ejection fraction 56 8 aged 58 10 years They participated in 4 week HTCR based on walking nordic walking or cycloergometer training HTCR was telemonitored with a device adjusted to register electrocardiogram ECG recording and to transmit data via mobile phone to the monitoring center The moments of automatic ECG registration were pre set and coordinated with CR The influence on physical capacity was assessed by comparing changes in time of exercise test functional capacity 6 min walking test distance from the beginning and the end of HTCR At the end of the study patients filled in a questionnaire in order to assess their acceptance of HTCR RESULTS HTCR resulted in a significant improvement in all parameters There were neither deaths nor adverse events during HTCR Patients accepted HTCR including the need for interactive everyday collaboration with the monitoring center There were only 0 8 non adherent patients CONCLUSIONS HTCR is a feasible safe form of rehabilitation well accepted by patients The adherence to HTCR was high and promising
- ItemIntegrated rapid-diagnostic-test reader platform on a cellphone.(2012-07-05) Mudanyali, Onur; Dimitrov, Stoyan; Sikora, Uzair; Padmanabhan, Swati; Navruz, Isa; Ozcan, AydoganWe demonstrate a cellphone based rapid diagnostic test RDT reader platform that can work with various lateral flow immuno chromatographic assays and similar tests to sense the presence of a target analyte in a sample This compact and cost effective digital RDT reader weighing only 65 g mechanically attaches to the existing camera unit of a cellphone where various types of RDTs can be inserted to be imaged in reflection or transmission modes under light emitting diode LED based illumination Captured raw images of these tests are then digitally processed within less than 0 2 s per image through a smart application running on the cellphone for validation of the RDT as well as for automated reading of its diagnostic result The same smart application then transmits the resulting data together with the RDT images and other related information e g demographic data to a central server which presents the diagnostic results on a world map through geo tagging This dynamic spatio temporal map of various RDT results can then be viewed and shared using internet browsers or through the same cellphone application We tested this platform using malaria tuberculosis TB and HIV RDTs by installing it on both Android based smartphones and an iPhone Providing real time spatio temporal statistics for the prevalence of various infectious diseases this smart RDT reader platform running on cellphones might assist healthcare professionals and policymakers to track emerging epidemics worldwide and help epidemic preparedness
- ItemM-BRIDGE: Wireless portable onbody aggregator and visualizer system for Wireless Body Sensor Network.(2013-10-10) Phyo Wai, Aung Aung; Ge, YuAdvances made in electronics intelligent and wireless technologies enable individuals to self observe their health states anywhere anytime The shift in self care becomes a promising paradigm to alleviate burdens on centralized institutional care As a result Wireless Body Sensor Network WBSN personal health solutions can be seen increasingly although medical community still has concerns on their usability and applicability Especially there is still lacking in portable wireless wearable gateway to integrate WBSN into existing healthcare solutions To fulfill this gap we design and develop MobilE on Body aGgregator and vIsualizer Device M BRIDGE system using Android smart phone Our proposed solution fully supports the needs of flexible device interfacing data aggregation efficient data distribution and user friendly visualization We also explain how M BRIDGE s unique features and operation can complement with and fulfill the deficiency of existing WBSN healthcare solutions We finally present the details of implementation and technical evaluation as well as discussion on the potential issues and future works
- ItemM-HELP: a miniaturized total health examination system launched on a mobile phone platform.(2013-10-29) Yu, Yang; Li, Jingjing; Liu, JingBACKGROUND A timely health examination is of great significance for incipient disease detection and prevention However conventional examinations generally rely heavily on bulky and expensive instrumentation which is not easily available To address technical barriers an innovative highly miniaturized and integrated health examination system Mobile Health Examination Launched on the Phone M HELP was developed MATERIALS AND METHODS Based on the design of a multifunctional Android Google Mountain View CA application and the development of different wireless biomedical sensor modules a mobile phone was incorporated into a central terminal for personal health examination More than 12 parameters including electrocardiogram heart sound and eye test as well as others covered the majority of the crucial parameters in a total health examination and have been successfully established and incorporated into the system Unlike the conventional examination the M HELP system could generate electronic health records and send them to physicians via e mails or multimedia messages This significantly simplifies the general health examination with much lower cost and fewer temporal and spatial restrictions RESULTS For proof of concept a bench scale test recruiting 11 volunteer subjects showed that the average time spent on a total health examination with M HELP system was about 28 min CONCLUSIONS This article clarifies the basic concept of a total health examination on the platform of a mobile phone demonstrates the basic features of the M HELP system with group tests and suggests the practical future application of the new system and the scientific issues thus raised
- ItemMicrofluidic CD4+ and CD8+ T lymphocyte counters for point-of-care HIV diagnostics using whole blood.(2013-12-05) Watkins, Nicholas N; Hassan, Umer; Damhorst, Gregory; Ni, Hengkan; Vaid, Awais; Rodriguez, William; Bashir, RashidRoughly 33 million people worldwide are infected with HIV disease burden is highest in resource limited settings One important diagnostic in HIV disease management is the absolute count of lymphocytes expressing the CD4 and CD8 receptors The current diagnostic instruments and procedures require expensive equipment and trained technicians In response we have developed microfluidic biochips that count CD4 and CD8 lymphocytes in whole blood samples without the need for off chip sample preparation The device is based on differential electrical counting and relies on five on chip modules that in sequence chemically lyses erythrocytes quenches lysis to preserve leukocytes enumerates cells electrically depletes the target cells CD4 or CD8 with antibodies and enumerates the remaining cells electrically We demonstrate application of this chip using blood from healthy and HIV infected subjects Erythrocyte lysis and quenching durations were optimized to create pure leukocyte populations in less than 1 min Target cell depletion was accomplished through shear stress based immunocapture using antibody coated microposts to increase the contact surface area and enhance depletion efficiency With the differential electrical counting method device based CD4 and CD8 T cell counts closely matched control counts obtained from flow cytometry over a dynamic range of 40 to 1000 cells l By providing accurate cell counts in less than 20 min from samples obtained from one drop of whole blood this approach has the potential to be realized as a handheld battery powered instrument that would deliver simple HIV diagnostics to patients anywhere in the world regardless of geography or socioeconomic status
- ItemMobile contact tracing and counseling for STI's: there's not an app for that.(2011-05-02) McGee, Summer
- ItemParent and youth assessments of a handheld wireless device to enhance diabetes mellitus management.(2006-03-07) Hanauer, David A; Wentzell, Katherine; Tovar, Allison; Zeuhlke, Jessica; Kumar, Vikram; Laffel, Lori M B
- ItemParent-child interaction using a mobile and wireless system for blood glucose monitoring.(2006-01-11) Gammon, Deede; Årsand, Eirik; Walseth, Ole Anders; Andersson, Niklas; Jenssen, Martin; Taylor, TedBACKGROUND Children with type 1 diabetes and their parents face rigorous procedures for blood glucose monitoring and regulation Mobile telecommunication systems show potential as an aid for families self management of diabetes OBJECTIVE A prototype designed to automatically transfer readings from a child s blood glucose monitor to their parent s mobile phone was tested In this formative stage of development we sought insights into the appropriateness of the concept feasibility of use and ideas for further development and research METHODS During four months a self selected sample of 15 children aged 9 to 15 years with type 1 diabetes and their parents n 30 used the prototype approximately three times daily Parent and child experiences were collected through questionnaires and through interviews with 9 of the parents RESULTS System use was easily integrated into everyday life and parents valued the sense of reassurance offered by the system Parents ongoing struggle to balance control of their children with allowing independence was evident For children who measured regularly use appeared to reduce parental intrusions For those who measured irregularly however parental reminders eg nagging appeared to increase Although increased reminders could be considered a positive outcome they can potentially increase parent child conflict and thus also undermine proper metabolic control Parents felt that system appropriateness tapered off with the onset of adolescence partly due to a potential sense of surveillance from the child s perspective that could fuel oppositional behavior Parental suggestions for further developments included similar alerts of irregular insulin dosages and automatically generated dietary and insulin dosage advice CONCLUSIONS User enthusiasm suggests that such systems might find a consumer market regardless of whether or not they ultimately improve health outcomes Thus more rigorous studies are warranted to inform guidelines for appropriate use Potentially fruitful approaches include integrating such systems with theory based parenting interventions and approaches that can aid in interpreting and responding to experiences of surveillance virtual presence and balances of power in e mediated relationships
- ItemA personalized food allergen testing platform on a cellphone.(2013-01-24) Coskun, Ahmet F; Wong, Justin; Khodadadi, Delaram; Nagi, Richie; Tey, Andrew; Ozcan, AydoganWe demonstrate a personalized food allergen testing platform termed iTube running on a cellphone that images and automatically analyses colorimetric assays performed in test tubes toward sensitive and specific detection of allergens in food samples This cost effective and compact iTube attachment weighing approximately 40 grams is mechanically installed on the existing camera unit of a cellphone where the test and control tubes are inserted from the side and are vertically illuminated by two separate light emitting diodes The illumination light is absorbed by the allergen assay which is activated within the tubes causing an intensity change in the acquired images by the cellphone camera These transmission images of the sample and control tubes are digitally processed within 1 s using a smart application running on the same cellphone for detection and quantification of allergen contamination in food products We evaluated the performance of this cellphone based iTube platform using different types of commercially available cookies where the existence of peanuts was accurately quantified after a sample preparation and incubation time of 20 min per test This automated and cost effective personalized food allergen testing tool running on cellphones can also permit uploading of test results to secure servers to create personal and or public spatio temporal allergen maps which can be useful for public health in various settings
- ItemUniversal access to essential vital signs monitoring.(2013-09-23) Ansermino, J MarkMuch more than a telephone today s mobile device has become an integral part of the way we interface with the world Mobile devices have the computing capability display and battery power to become powerful medical devices that measure vital signs and provide intelligent interpretation or immediate transmission of information The widespread adoption of mobile devices even in low resource settings promises to make vital signs monitoring available anywhere and at low cost This readily available computing power will also extend the utility of vital signs monitoring to new clinical indications especially with the use of additional processing and integration of information This review will focus on the universal promotion of pulse oximetry and advanced processing of plethysmography to assess variables such as respiratory rate capillary refill time and fluid responsiveness and how these measurements may assist with perioperative monitoring diagnosis and management of pneumonia in children and preeclampsia in pregnancy when combined with mobile devices
- ItemWireless Holter transmission in suspected dysrhythmias.(2006-10-03) Schickendantz, Sabine; Pillekamp, Frank; Emmel, Mathias; Sreeram, Narayanswami; Brockmeier, KonradBACKGROUND In patients with a history of possible dysrhythmias documentation of an episode is mandatory before any form of treatment is given Holter recordings with wireless telemetry offer the possibility of continuously recording electrocardiograms for days or even weeks with instantaneous analysis of the data in the physician s office METHODS Thirty seven patients 20 male median age 8 4 years range 0 1 22 years were investigated by using a telemetric Holter system M120 Schiller Switzerland that is intermittent transmission of the electrocardiographic data to a remote server using cell phone frequencies with a median duration of the recordings of 6 5 days range 1 42 days RESULTS Recording quality was sufficient in all patients Problems were related to electrode disconnections only which were adjusted by contacting the patients Twenty eight of 37 recordings showed decisive findings Of the 28 patients no treatment was indicated in 16 patients as subjective symptoms did not correlate with dysrhythmias psychotherapy was indicated in 2 patients antiarrhythmic medication was initiated or intensified in 5 patients radiofrequency ablation was successfully performed in 5 patients and 1 patient received an ICD In 6 of 9 patients with negative Holter findings a loop recorder implantation Medtronic Minneapolis Minn was indicated In 1 patient no dysrhythmias were recorded however when invasively investigated ventricular tachycardia was detected and successfully treated by radiofrequency ablation In 2 patients no decision has been made to date CONCLUSIONS Wireless Holter recordings are useful in detecting dysrhythmias with rare occurrence are less expensive and less invasive compared with implantable loop recorders and offer the patient rather wide geographic ranges with sufficient signal quality