Mobile phone SMS messages can enhance healthy behaviour: a meta-analysis of randomised controlled trials

Healthy behaviour, such as smoking cessation and adherence to prescribed medications, mitigates illness risk factors but health behaviour change can be challenging. Mobile phone short-message service (SMS) messages are increasingly used to deliver interventions designed to enhance healthy behaviour. This meta-analysis used a random-effects model to synthesise 38 randomised controlled trials that investigated the efficacy of SMS messages to enhance healthy behaviour. Participants (N = 19,641) lived in developed and developing countries and were diverse with respect to age, ethnicity, socioeconomic background and health behaviours targeted for change. SMS messages had a small, positive, significant effect (g = 0.291) on a broad range of healthy behaviour. This effect was maximised when multiple SMS messages per day were used (g = 0.395) compared to using lower frequencies (daily, multiple per week and once-off) (g = 0.244). The low heterogeneity in this meta-analysis (I ² = 38.619) supports reporting a summary effect size and implies that the effect of SMS messaging is robust, regardless of population characteristics or healthy behaviour targeted. SMS messaging is a simple, cost-effective intervention that can be automated and can reach any mobile phone owner. While the effect size is small, potential health benefits are well worth achieving.     

Activation of ceramide synthase 6 by celecoxib leads to a selective induction of C16:0-ceramide

Ceramides serve as bioactive molecules with important roles in cell proliferation and apoptosis. Ceramides (Cer) with different N-acyl side chains (C_14:0-Cer-C_26:0-Cer) possess distinctive roles in cell signaling and are differentially expressed in HCT-116 colon cancer cells. Celecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, exhibiting antiproliferative effects, activates the sphingolipid pathway. To elucidate the mechanism, HCT-116 cells were treated with 50 μM celecoxib leading to a significant increase of C_16:0-Cer. Interestingly, 50 μM celecoxib resulted in a 2.8-fold increase of ceramide synthase (CerS) activity as measured by a cell-based activity assay. siRNA against several CerSs revealed that CerS6 was predominantly responsible for the increase of C_16:0-Cer in HCT-116 cells. Moreover, the silencing of CerS6 partially protected HCT-116 cells from the toxic effects induced by celecoxib. Treatment of cells with celecoxib and fumonisin B1 (inhibitor of CerSs) or myriocin (inhibitor of l-serine palmitoyl transferase) or desipramine (inhibitor of acid sphingomyelinase and acid ceramidase) revealed that the increase of C_16:0-Cer results predominantly from activation of the salvage pathway. Using the nude mouse model we demonstrated that celecoxib induces also in vivo a significant increase of C_16:0-Cer in stomach, small intestine and tumor tissue. In conclusion, celecoxib causes a specific increase of C_16:0-Cer by activating CerS6 and the salvage pathway, which contribute to the toxic effects of celecoxib.     

基于SMS的医院医疗安全管理

揭示当前社会公众对医疗卫生行业提供服务的满意程度,分析民航机场与教学医院在业务安全管理上的相通性,指出医院在安全管理中暴露出的主要问题,在阐述SMS的概念、核心和优势的基础上,提出教学医院借鉴SMS成功经验在医疗安全管理目标、管理节点、管理方式、信息反馈和文化营造等方面的改进措施。     

Increase of regulatory T cells and the ratio of specific IgE to total IgE are candidates for response monitoring or prognostic biomarkers in 2-year sublingual immunotherapy (SLIT) for Japanese cedar pollinosis

The aims of this study were to examine the therapeutic effects of sublingual immunotherapy (SLIT) and to identify potential biomarkers that would predict the therapeutic response in a randomized, double-blind, placebo-controlled clinical trial. The trial was carried out over two pollinosis seasons in 2007 and 2008. Carry-over therapeutic effects were analyzed in 2009. SLIT significantly ameliorated the symptoms of pollinosis during the 2008 and 2009 pollen seasons. Cry j 1-specific cytokine production in a subgroup of patients with mild disease in the SLIT group was significantly attenuated. The ratio of specific IgE to total IgE before treatment correlated with the symptom-medication score in the SLIT group in 2008. Patients with increased Cry j 1-iTreg in the SLIT group had significantly improved QOL and QOL-symptom scores. In summary, the specific IgE to total IgE ratio and upregulation of Cry j 1-iTreg are candidates for biomarker of the clinical response to SLIT.     

Trajectory of use over time of an oral tablet and a rectal gel for HIV prevention among transgender women and men who have sex with men

We examined product adherence among 187 men who have sex with men and transgender women enrolled in a phase II, crossover trial comparing safety and acceptability of an oral tablet and a rectal gel used daily for HIV prevention. Participants reported adherence via daily text messages during 8-week periods. Trajectory analysis identified weekly patterns. Polytomous logistic regression identified characteristics associated with higher probability of trajectory group membership. We identified 3 groups per product: high-adherers (72% daily oral, 70% daily gel); decreasing-adherers (20% daily oral, 22% daily gel); and low-adherers (8% daily oral, 9% daily gel). Daily oral high-adherers (compared with low-adherers) were more likely to self-identify as male (OR?=?4.76, 95% CI:1.35–16.67), to have more sexual partners (OR?=?1.67, 95% CI:1.04–2.63), and to find the tablet easy to swallow (OR?=?2.22, 95% CI:1.08–4.76). Daily gel high-adherers (compared with low-adherers) were more likely to be older (OR?=?1.16, 95% CI:1.05–1.28), to find gel application easier at the last few applications (OR?=?2.27, 95% CI:1.01–5.00), and to report a change in routine if gel was not used (OR?=?5.26, 95% CI:1.23–100.00). Characteristics of participants likely to be high-adherers to product use vary according to product. Evaluation of acceptability prior to phase II/III trials could identify participants likely to maintain high adherence.     

Short message service (SMS) applications for disease prevention in developing countries

Background

The last decade has witnessed unprecedented growth in the number of mobile phones in the developing world, thus linking millions of previously unconnected people. The ubiquity of mobile phones, which allow for short message service (SMS), provides new and innovative opportunities for disease prevention efforts.

Objective

The aim of this review was to describe the characteristics and outcomes of SMS interventions for disease prevention in developing countries and provide recommendations for future work.

Methods

A systematic search of peer-reviewed and gray literature was performed for papers published in English, French, and German before May 2011 that describe SMS applications for disease prevention in developing countries.

Results

A total of 34 SMS applications were described, among which 5 had findings of an evaluation reported. The majority of SMS applications were pilot projects in various levels of sophistication; nearly all came from gray literature sources. Many applications were initiated by the project with modes of intervention varying between one-way or two-way communication, with or without incentives, and with educative games. Evaluated interventions were well accepted by the beneficiaries. The primary barriers identified were language, timing of messages, mobile network fluctuations, lack of financial incentives, data privacy, and mobile phone turnover.

Conclusion

This review illustrates that while many SMS applications for disease prevention exist, few have been evaluated. The dearth of peer-reviewed studies and the limited evidence found in this systematic review highlight the need for high-quality efficacy studies examining behavioral, social, and economic outcomes of SMS applications and mobile phone interventions aimed to promote health in developing country contexts.     

基于中医临床诊疗模式构建气阴两虚证动物模型的构想与初步探索

在前期研究基础上,提出“基于病证方结合的中医诊疗模式构建中医证候动物模型”的研究构想,通过寻求与证候相关疾病的关键病理环节选择合适的造模方法模拟临床特征和病理过程,并通过“以方测证”和“类证方反证”的方法动态地考察模型在不同时程证候属性.以临床常见的气阴两虚证为切入点,利用信息挖掘技术,发现益气养阴代表方生脉散所防治多种疾病的关键病理环节是缺氧和氧应激,继而发现慢性间歇性缺氧模型小鼠在一定阶段表现为:体重下降,摄食量减少,自发活动改变,心率加快、T波持续性升高等心电图异常改变、出血时间缩短等,部分模拟了气阴两虚证的主要临床表现和由虚到瘀的病机演变过程,并伴随氧化应激异常等病理变化,生脉散可明显改善上述指征,从而初步验证了所提出的建模假说及慢性间歇性缺氧模型的气阴两虚证候属性.课题组正开展进一步的研究,以期为揭示气阴两虚证的科学内涵及深入阐释益气养阴代表方的作用机理提供可靠的实验与技术平台,并为证候动物模型的构建提供思路与方法借鉴.     

生脉散对急性病毒性心肌炎临床症状及炎性损伤指标的影响

目的 :观察生脉散治疗急性病毒性心肌炎的客观疗效。方法 :将 10 2例急性病毒性心肌炎随机分为生脉组和对照组 ,其中生脉组 5 2例 ,对照组 5 0例。采用半定量积分法观察两组治疗前及治疗 4周后病人胸闷、心悸、胸痛改善情况 ,同时检测治疗前后心电图 (EKG)、2 4h动态心电图(Holter)、中和抗体、cTnI、cTnT的改变情况。结果 :生脉组在胸闷改善方面与对照组有统计学意义 (P <0 .0 1) ,两组在心悸、胸痛、心电图 (EKG )及 2 4h动态心电图 (Holter)方面也有统计学意义 (P <0 .0 5 ) ,cTnI、cTnT转阴率两组分别为 5 9%与 3 2 %、72 %与 43 % ,有统计学意义 (P <0 .0 5 ) ,中和抗体则无统计学意义 (P >0 .0 5 )。结论 :生脉散对急性病毒性心肌炎改善临床症状和炎性损伤指标修复有较好的作用。     

“医信通”对降低门诊预约挂号失约率的效果评价

目的 探讨“医信通”信息平台对提升门诊预约挂号服务质量的促进作用.方法 比较“医信通”信息平台使用前后对门诊预约失约率、违约率、门诊停/改诊的通知及时率的影响.结果 “医信通”信息平台使用后明显降低了门诊患者预约挂号失约率,降低了临时停诊造成的就诊失误率,有效控制了停/改诊率.同时,医院客服中心医务人员处理门诊停/改诊服务人均工作时长由2 312±268（min）降至467±211 （min）,工作效率明显提高.患者门诊预约类投诉事件下降,医院服务质量满意度明显提升.结论 开展“医信通”信息平台对提升门诊服务质量有积极作用,值得推广.