Background: This research focuses on improving epidemic monitoring systems by incorporating advanced technologies to enhance the surveillance of diseases more effectively than before. Considering the drawbacks associated with surveillance methods in terms of time consumption and efficiency, issues highlighted in this study includes the integration of Artificial Intelligence (AI) in early detection, decision support and predictive modeling, big data analytics in data sharing, contact tracing and countering misinformation, Internet of Things (IoT) devices in real time disease monitoring and Geographic Information Systems (GIS) for geospatial artificial intelligence (GeoAI) applications and disease mapping. The increasing intricacy and regular occurrence of disease outbreaks underscore the pressing necessity for improvements in public health monitoring systems. This research delves into the developments and their utilization in detecting and handling infectious diseases while exploring how these progressions contribute to decision making and policy development, in public healthcare. Methodology: This review systematically analyzes how technological tools are being used in epidemic monitoring by conducting a structured search across online literature databases and applying eligibility criteria to identify relevant studies on current technological trends in public health surveillance. Results: The research reviewed 69 articles from 2019 to 2023 focusing on emerging trends in epidemic intelligence. Most of the studies emphasized the integration of artificial intelligence with technologies like big data analytics, geographic information systems, and the Internet of Things for monitoring infectious diseases. Conclusions: The expansion of publicly accessible information on the internet has opened a new pathway for epidemic intelligence. This study emphasizes the importance of integrating information technology tools such as AI, big data analytics, GIS, and the IoT in epidemic intelligence surveillance to effectively track infectious diseases. Combining these technologies helps public health agencies in detecting and responding to health threats.

Background: The internet + nursing service is an important initiative for implementing the strategy of healthy China and actively responding to the aging of the population. However, the current literature on residents' awareness and willingness to participate is insufficient and presents large variations and limitations. Therefore, this study aims to systematically evaluate the awareness and willingness of Chinese residents to participate in internet + nursing service to comprehensively understand the level of awareness and acceptance of this emerging service model among Chinese residents and to provide strong support for relevant policy formulation and service optimization. Methods: The PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, SinoMed, and VIP databases were electronically searched to collect cross-sectional studies related to the awareness and willingness of Chinese residents to participate in internet + nursing service from inception to January 2024. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias of the included studies. Results: A total of 27 cross-sectional studies involving 11,761 subjects were included. The results of the meta-analysis showed that the percentage of Chinese residents willing to participate in internet + nursing service was 76.3% (95% CI [71.2%, 81.3%]). The results of the subgroup analysis showed that residents who lived in Western regions (82.1%), had employee medical insurance (85.9%), were suffering from other diseases (89.2%), were under the age of 60 (87.8%), were not married (78.9%), and had an undergraduate degree or above (85.5%) had a relatively high willingness to participate in internet + nursing service. The rate of awareness of internet + nursing service among Chinese residents was 48.6% (95% CI [24.1%, 73.2%]), which shows a downwards trend over time (67.4% in 2019, 56.1% in 2020, and 45.1% in 2021). Conclusion: The willingness to participate in internet + nursing service among Chinese residents is high, but the awareness rate is low. It is necessary to improve the awareness and willingness of Chinese residents to use internet + nursing service through various channels and aspects of publicity and promotion to achieve the goal of innovating the health service model, accurately connecting with the diverse health needs of people, and actively responding to the aging population.

ObjectiveInternet-based cognitive behavior therapy (ICBT) may provide an accessible alternative to face-to-face treatment, but the evidence base in adolescents is limited. This systematic review and meta-analysis aims to comprehensively assess the efficacy of ICBT in addressing depression among adolescents.MethodsFour electronic databases were searched on June 8, 2023. Randomized controlled trials (RCTs) evaluating the efficacy of ICBT for depression in adolescents were included. The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook. Furthermore, the GRADE approach was employed to gauge the certainty of the obtained evidence. Meta-analysis was conducted using RevMan 5.4, and Egger's test was implemented through Stata for assessment of potential publication bias.ResultsA total of 18 RCTs involving 1683 patients were included. In comparison to control groups like attention control, waiting list, and treatment as usual, our meta-analysis findings elucidate a significant reduction in depression scores (SMD = −0.42, 95 % CI: [−0.74, −0.11], p .05).ConclusionResults provide evidence of the efficacy of ICBT to reduce depressive and anxiety symptoms in adolescents. These research findings are of vital significance for the establishment of evidence-based treatment guidelines in the digital era.Trial registrationPROSPERO registration: CRD42021277562

Objective: Internet-based cognitive behavior therapy (ICBT) may provide an accessible alternative to face-to-face treatment, but the evidence base in adolescents is limited. This systematic review and meta-analysis aims to comprehensively assess the efficacy of ICBT in addressing depression among adolescents. Methods: Four electronic databases were searched on June 8, 2023. Randomized controlled trials (RCTs) evaluating the efficacy of ICBT for depression in adolescents were included. The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook. Furthermore, the GRADE approach was employed to gauge the certainty of the obtained evidence. Meta-analysis was conducted using RevMan 5.4, and Egger's test was implemented through Stata for assessment of potential publication bias. Results: A total of 18 RCTs involving 1683 patients were included. In comparison to control groups like attention control, waiting list, and treatment as usual, our meta-analysis findings elucidate a significant reduction in depression scores (SMD = -0.42, 95 % CI: [-0.74, -0.11], p .05). Conclusion: Results provide evidence of the efficacy of ICBT to reduce depressive and anxiety symptoms in adolescents. These research findings are of vital significance for the establishment of evidence-based treatment guidelines in the digital era. Trial registration: PROSPERO registration: CRD42021277562.

OBJECTIVES: Behavioral eHealth interventions can enhance self-management and improve well-being in people with chronic pain. The development of these interventions calls for a user-centered approach to ensure that patient needs are appreciated. However, it may be challenging to involve patients; particularly during the early stages of the process. Fictional user profiles, known as Personas, can represent needs and guide designing eHealth interventions. This article provides a comprehensive overview of the use of Personas in the development of behavioral eHealth interventions for people with chronic pain with the aim to identify benefits and challenges. METHODS: Bibliographic databases (Medline, Web of Science Core Collection, PsycInfo, CINAHL) and registries (PubMed Central, medaRxiv) were systematically searched. In a double-reviewing process, n = 6830 hits and n = 351 full-texts were screened and read. Ten peer-reviewed studies published between 2017 and 2022 were included in the narrative synthesis. FINDINGS: Ten studies reported using "Pain Personas" in the development of eHealth interventions for such purposes as to gain a shared understanding of the user and to discuss solutions in team meetings, or for patients to identify with (if Personas are included in the intervention). Personas were based on qualitative and/or quantitative data. However, the procedure for creating Personas was only described in half of the included studies (n = 5). These five studies provided descriptive details of the Personas (i.e., picture, name, narrative of their pain behavior, technological skills, and motivation). CONCLUSIONS: Although Personas have been used by pain researchers in recent projects and were highlighted as an important ingredient in the development process, available design guidelines for the creation and use of Personas are not followed or communicated transparently. Benefits and challenges when using Personas in the development of eHealth interventions for people with chronic pain are discussed to support future eHealth efforts and to improve the quality of eHealth innovation in the field of pain.

PURPOSE: To assess and summarize the effects of internet-based interventions on diabetes control and self-management of older adults with diabetes. METHODS: PubMed, Web of Science and three Chinese databases were searched to identified articles published in until December 2021. Clinical trials if they covered the effects of internet-based interventions on diabetes control and self-management of older adults with diabetes were included. All data analysis were performed by Review Manager 5.3. RESULTS: Sixteen studies with a total of 5604 participants met the inclusion criteria. Our primary outcomes included HbA1c control and self-management. (1) HbA1c control: results indicated statistically difference and high heterogeneity [Q = 112.9, df = 8, p < 0.001, I2 = 93%], in the subgroup analysis of studies in China, results showed a significant influence of internet-based interventions on HbA1c control [Q = 21.31, df = 5, p = 0.03, I2 = 77%]; (2) self-management: in the subgroup analysis of study duration ≤ 6 months [Q = 84.62, df = 2, p < 0.001, I2 = 98%]. CONCLUSION: Internet-based interventions are promising on diabetes control and self-management of older adults with diabetes, but still preliminary due to the heterogeneity of intervention components and the limited number of higher methodological quality trials. AVAILABILITY OF DATA AND MATERIAL: Applicable.

BACKGROUND: Computerized psychological interventions can overcome logistical and psychosocial barriers to the use of mental health care in the Veterans Affairs and Department of Defense settings. OBJECTIVE: In this systematic review, we aim to outline the existing literature, with the goal of describing: the scope and quality of the available literature, intervention characteristics, study methods, study efficacy, and study limitations and potential directions for future research. METHODS: Systematic searches of two databases (PsycINFO and PubMed) using PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines were conducted from inception until November 15, 2020. The following inclusion criteria were used: the study was published in an English language peer-reviewed journal, participants were randomly allocated to a computerized psychological intervention or a control group (non-computerized psychological intervention active treatment or nonactive control group), an intervention in at least one treatment arm was primarily delivered through the computer or internet with or without additional support, participants were veterans or service members, and the study used validated measures to examine the effect of treatment on psychological outcomes. RESULTS: This review included 23 studies that met the predefined inclusion criteria. Most studies were at a high risk of bias. Targeted outcomes, participant characteristics, type of support delivered, adherence, and participant satisfaction were described. Most of the examined interventions (19/24, 79%) yielded positive results. Study limitations included participant characteristics limiting study inference, high rates of attrition, and an overreliance on self-reported outcomes. CONCLUSIONS: Relatively few high-quality studies were identified, and more rigorous investigations are needed. Several recommendations for future research are discussed, including the adoption of methods that minimize attrition, optimize use, and allow for personalization of treatment.

BACKGROUND: Mental health difficulties in children and adolescents are highly prevalent; however, only a minority receive adequate mental health care. Internet-delivered interventions offer a promising opportunity to increase access to mental health treatment. Research has demonstrated their effectiveness as a treatment for depression and anxiety in adults. This work provides an up-to-date examination of the available intervention options and their effectiveness for children and young people (CYP). OBJECTIVE: In this systematic review and meta-analysis, we aimed to determine the evidence available for the effectiveness of internet-delivered interventions for treating anxiety and depression in CYP. METHODS: Systematic literature searches were conducted throughout November 2020 using PubMed, PsycINFO, and EBSCO academic search complete electronic databases to find outcome trials of internet-delivered interventions treating symptoms of anxiety and/or depression in CYP by being either directly delivered to the CYP or delivered via their parents. Studies were eligible for meta-analysis if they were randomized controlled trials. Risk of bias and publication biases were evaluated, and Hedges g between group effect sizes evaluating intervention effects after treatment were calculated. Meta-analyses used random-effects models as per protocol. RESULTS: A total of 23 studies met the eligibility criteria for the systematic review, of which 16 were included in the meta-analyses, including 977 participants in internet-delivered treatment conditions and 1008 participants in control conditions across 21 comparisons. Random-effects models detected a significant small effect for anxiety symptoms (across 20 comparisons; Hedges g=-0.25, 95% CI -0.38 to -0.12; P<.001) and a small but not significant effect for depression (across 13 comparisons; Hedges g=-0.27, 95% CI -0.55 to 0.01; P=.06) in favor of internet-delivered interventions compared with control groups. Regarding secondary outcomes, there was a small effect of treatment across 9 comparisons for impaired functioning (Hedges g=0.52, 95% CI 0.24-0.80; P<.001), and 5 comparisons of quality of life showed no effect (Hedges g=-0.01, 95% CI -0.23 to 0.21; P=.94). CONCLUSIONS: The results show that the potential of internet-delivered interventions for young people with symptoms of anxiety or depression has not been tapped into to date. This review highlights an opportunity for the development of population-specific interventions and their research to expand our current knowledge and build an empirical base for digital interventions for CYP.

BACKGROUND: Health kiosks are publicly accessible computing devices that provide access to services, including health information provision, clinical measurement collection, patient self-check-in, telemonitoring, and teleconsultation. Although the increase in internet access and ownership of smart personal devices could make kiosks redundant, recent reports have predicted that the market will continue to grow. OBJECTIVE: We seek to clarify the current and future roles of health kiosks by investigating the settings, roles, and clinical domains in which kiosks are used; whether usability evaluations of health kiosks are being reported, and if so, what methods are being used; and what the barriers and facilitators are for the deployment of kiosks. METHODS: We conducted a scoping review using a bibliographic search of Google Scholar, PubMed, and Web of Science databases for studies and other publications between January 2009 and June 2020. Eligible papers described the implementation as primary studies, systematic reviews, or news and feature articles. Additional reports were obtained by manual searching and querying the key informants. For each article, we abstracted settings, purposes, health domains, whether the kiosk was opportunistic or integrated with a clinical pathway, and whether the kiosk included usability testing. We then summarized the data in frequency tables. RESULTS: A total of 141 articles were included, of which 134 (95%) were primary studies, and 7 (5%) were reviews. Approximately 47% (63/134) of the primary studies described kiosks in secondary care settings. Other settings included community (32/134, 23.9%), primary care (24/134, 17.9%), and pharmacies (8/134, 6%). The most common roles of the health kiosks were providing health information (47/134, 35.1%), taking clinical measurements (28/134, 20.9%), screening (17/134, 12.7%), telehealth (11/134, 8.2%), and patient registration (8/134, 6.0%). The 5 most frequent health domains were multiple conditions (33/134, 24.6%), HIV (10/134, 7.5%), hypertension (10/134, 7.5%), pediatric injuries (7/134, 5.2%), health and well-being (6/134, 4.5%), and drug monitoring (6/134, 4.5%). Kiosks were integrated into the clinical pathway in 70.1% (94/134) of studies, opportunistic kiosks accounted for 23.9% (32/134) of studies, and in 6% (8/134) of studies, kiosks were used in both. Usability evaluations of kiosks were reported in 20.1% (27/134) of papers. Barriers (e.g., use of expensive proprietary software) and enablers (e.g., handling of on-demand consultations) of deploying health kiosks were identified. CONCLUSIONS: Health kiosks still play a vital role in the health care system, including collecting clinical measurements and providing access to web-based health services and information to those with little or no digital literacy skills and others without personal internet access. We identified research gaps, such as training needs for teleconsultations and scant reporting on usability evaluation methods.

Nowadays, the study of how new media and technologies can be used to carry out health education by bringing these tools closer to the elderly population is interesting. It is a way of offering them access not only to greater knowledge, but to greater communication and relationship with their surroundings, a range of new possibilities and resources at their disposal that also represent a way to reduce the generation gap and bring them closer to the rest of the community. Objectives: to evaluate and analyze the studies that show the efficacy of interventions based on the use of information and communication technologies for the promotion of active aging in people older than or equal to 65 years who live in the community. Data sources, study eligibility criteria: the search for the articles was carried out from January 2012 to March 2021, in 6 databases (Pubmed, Cochrane Library, Scopus, Scielo, Google Academic and WOS) based on the clinical question, using the keywords derived from the DeCS and MeSH thesauri, combined with the Boolean operators "AND", "NOT" and "OR". The search was limited to publications from the last 9 years, in English and Spanish. Results: after applying the selection criteria and evaluating the quality of the methodology, 7.91% (n = 17) of the 215 results were included with filters: 7 systematic review, 5 of Cohorts and 5 of Randomized Controlled Trial. Conclusions and implications of key findings: the use of communication technologies reduces the feeling of loneliness, as well as the use of virtual reality to exercise, train memory or perform rehabilitation. The most difficult barrier to overcome is the prior ignorance of the majority of the elderly to the technology that is overcome by working as a team throughout the community, especially in the health and educational sector, as well as the family or social nucleus.

BACKGROUND: The COVID-19 pandemic has had adverse impacts on mental health and substance use worldwide. Systematic reviews suggest eHealth interventions can be effective at addressing these problems. However, strong positive eHealth outcomes are often tied to the intensity of web-based therapist guidance, which has time and cost implications that can make the population scale-up of more effective interventions difficult. A way to offset cost while maintaining the intensity of therapist guidance is to offer eHealth programs to groups rather than more standard one-on-one formats. OBJECTIVE: This systematic review aims to assess experimental evidence for the effectiveness of live health professional-led group eHealth interventions on mental health, substance use, or bereavement among community-dwelling adults. Within the articles selected for our primary aim, we also seek to examine the impact of interventions that encourage physical activity compared with those that do not. METHODS: Overall, 4 databases (MEDLINE, CINAHL, PsycINFO, and the Cochrane Library) were searched in July 2020. Eligible studies were randomized controlled trials (RCTs) of eHealth interventions led by health professionals and delivered entirely to adult groups by videoconference, teleconference, or webchat. Eligible studies reported mental health, substance use, or bereavement as primary outcomes. The results were examined by outcome, eHealth platform, and intervention length. Postintervention data were used to calculate effect size by study. The findings were summarized using the Synthesis Without Meta-Analysis guidelines. Risk of bias was assessed using the Cochrane Collaboration Tool. RESULTS: Of the 4099 identified studies, 21 (0.51%) RCTs representing 20 interventions met the inclusion criteria. These studies examined mental health outcomes among 2438 participants (sample size range: 47-361 participants per study) across 7 countries. When effect sizes were pooled, live health professional-led group eHealth interventions had a medium effect on reducing anxiety compared with inactive (Cohen d=0.57) or active control (Cohen d=0.48), a medium to small effect on reducing depression compared with inactive (Cohen d=0.61) or active control (Cohen d=0.21), and mixed effects on mental distress and coping. Interventions led by videoconference, and those that provided 8-12 hours of live health professional-led group contact had more robust effects on adult mental health. Risk of bias was high in 91% (19/21) of the studies. Heterogeneity across interventions was significant, resulting in low to very low quality of evidence. No eligible RCT was found that examined substance use, bereavement, or physical activity. CONCLUSIONS: Live eHealth group interventions led by health professionals can foster moderate improvements in anxiety and moderate to small improvements in depression among community-based adults, particularly those delivered by videoconference and those providing 8-12 hours of synchronous engagement.

Web-based interventions are increasingly used for the prevention, treatment and aftercare of mental disorders. A crucial factor to the efficacy of such online programmes is adherence to the intervention content and procedure. It has been frequently suggested that adherence in web-based interventions is low and little is known about which factors influence adherence. To increase intervention uptake and completion, studies increasingly include interventions with some form of guidance. Guided interventions have been shown to have higher efficacy, however, evidence for the impact on adherence is limited and mixed. This meta-analysis explored the impact of human guidance on intervention completion in web-based mental health interventions. A total of 22 studies were included with interventions primarily targeting symptoms of depression and anxiety disorders. Results showed that guidance significantly increases the average amount of intervention completion [g = 0.29, 95% confidence interval (CI) 0.18-0.40] and the proportion of intervention completers [log odds ratio (OR) = 0.50, 95% CI 0.34-0.66] with small effects. On average, full completion rates were 12% higher in guided intervention groups. This meta-analysis demonstrated that guidance in web-based mental health interventions does increase adherence, but more research is required to better understand the specific mechanisms between guidance, adherence and outcomes.

OBJECTIVE: Over the last 10 years, online interventions to improve mental health have increased significantly. This study's primary objective was to determine the effectiveness of online interventions in improving the mental health of pediatric, adolescent, and young adult (PAYA) cancer survivors. The secondary objective was to identify the independent variables associated with online intervention efficacy for mental health improvement. METHODS: On June 25-30, 2021, we searched the Medline, PsycINFO, EMBASE, and Cochrane databases for eligible English language publications that reported randomized controlled trials of online interventions aimed at improving mental health among PAYA cancer survivors. The results were analyzed using a systematic review and a three-level meta-analysis. RESULTS: Thirteen studies met the inclusion criteria. In six (42%) studies, the intervention focused on physical activity enhancement, while ten (77%) studies used self-directed interventions. Online interventions were more efficacious, compared to control conditions, in improving sleep g = 0.35 (95% CI 0.04-0.66) and psychological well-being g = 0.32 (95% CI 0.09-0.56), but not for reducing the symptoms of depression g = 0.17 (95% CI -0.13 to 0.47), anxiety g = 0.05 (95% CI -0.15 to 0.25), and pain g = 0.13 (95% CI -0.13 to 0.39). CONCLUSION: Online interventions were generally effective in improving mental health in PAYA cancer survivors, although negative results were found in some critical outcomes. More high-quality evidence is needed for definite conclusions to be drawn.

BACKGROUND: Technological interventions used to treat illnesses and promote health are grouped under the umbrella term of digital therapeutics. The use of digital therapeutics is becoming increasingly common in mental health. Although many technologies are currently being implemented, research supporting their usability, efficacy, and risk requires further examination, especially for those interventions that can be used without support. OBJECTIVE: This review aims to identify the evidence-based, self-directed, technology-based methods of care that can be used in adult patients after they are discharged from mental health services. The interventions reviewed are automated with no human input required (either at the patient's or at the technology's end), so the patients can implement them without any support. METHODS: A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and PROSPERO (International Prospective Register of Systematic Reviews) guidelines in 3 databases: PubMed, Web of Science, and OVID. The inclusion criteria were self-directed, automated, and technology-based interventions related to mental health, primarily for adults, having a solid evaluation process. The interventions had to be self-directed, in that the participants could use the technology without any external guidance. RESULTS: We identified 36 papers that met the inclusion criteria: 26 randomized controlled trials, 9 nonrandomized controlled trial quantitative studies, and 1 qualitative study. The technologies used included websites, automated text messaging, phone apps, videos, computer software, and integrated voice response. There were 22 studies focused on internet-based cognitive behavioral therapies as a therapeutic paradigm compared with the waitlist, web-based human-delivered therapy, and other interventions. Among these studies, 14 used paradigms other than the internet-based cognitive behavioral therapy. Of the 8 studies comparing guided and unguided digital care, 3 showed no differences, 3 favored guided interventions, and 2 favored unguided interventions. The research also showed that dropout rates were as high as 80%, citing potential problems with the acceptability of the suggested technologies. CONCLUSIONS: There is limited research on the efficacy and suitability of self-directed technology-based care options for mental health. Digital technologies have the potential to bridge the gap between ambulatory care and independent living. However, these interventions may need to be developed collaboratively with the users to encourage their acceptability and to avoid high dropout rates.

BACKGROUND: With the projected upsurge in the percentage of people with some form of disability, there has been a significant increase in the need for assistive mobility devices. However, for mobility aids to be effective, such devices should be adapted to the user's needs. This can be achieved by improving the confidence of the acquired information (interaction between the user, the environment, and the device) following design specifications. Therefore, there is a need for literature review on the adaptability of assistive mobility devices. OBJECTIVE: In this study, we aim to review the adaptability of assistive mobility devices and the role of the internet of medical things in terms of the acquired information for assistive mobility devices. We review internet-enabled assistive mobility technologies and non-internet of things (IoT) assistive mobility devices. These technologies will provide awareness of the status of adaptive mobility technology and serve as a source and reference regarding information to health care professionals and researchers. METHODS: We performed a literature review search on the following databases of academic references and journals: Google Scholar, ScienceDirect, Institute of Electrical and Electronics Engineers, Springer, and websites of assistive mobility and foundations presenting studies on assistive mobility found through a generic Google search (including the World Health Organization website). The following keywords were used: assistive mobility OR assistive robots, assistive mobility devices, internet-enabled assistive mobility technologies, IoT Framework OR IoT Architecture AND for Healthcare, assisted navigation OR autonomous navigation, mobility AND aids OR devices, adaptability of assistive technology, adaptive mobility devices, pattern recognition, autonomous navigational systems, human-robot interfaces, motor rehabilitation devices, perception, and ambient assisted living. RESULTS: We identified 13,286 results (excluding titles that were not relevant to this study). Then, through a narrative review, we selected 189 potential studies (189/13,286, 1.42%) from the existing literature on the adaptability of assistive mobility devices and IoT frameworks for assistive mobility and conducted a critical analysis. Of the 189 potential studies, 82 (43.4%) were selected for analysis after meeting the inclusion criteria. On the basis of the type of technologies presented in the reviewed articles, we proposed a categorization of the adaptability of smart assistive mobility devices in terms of their interaction with the user (user system interface), perception techniques, and communication and sensing frameworks. CONCLUSIONS: We discussed notable limitations of the reviewed literature studies. The findings revealed that an improvement in the adaptation of assistive mobility systems would require a reduction in training time and avoidance of cognitive overload. Furthermore, sensor fusion and classification accuracy are critical for achieving real-world testing requirements. Finally, the trade-off between cost and performance should be considered in the commercialization of these devices.

Objectives: The recovery after tonsil surgery is often troublesome for children and caregivers often feel insecure regarding optimal post-operative care for their children at home. The aim was to study what the current literature reports regarding the effect of post-operative telephone counselling and Internet support on pain and recovery after paediatric tonsil surgery.Method: A systematic literature review was conducted where only randomised clinical trials were included.Outcome measures: Primary outcome measure was pain after surgery. Secondary outcomes also included nausea, anxiety, children's knowledge, use of analgesics, fluid intake and health care service use.Results: Only four studies fulfilled the inclusion criteria. The studies were heterogeneous, ren-dering a meta-analysis impossible. The results of the included studies showed a possible positive effect on postoperative pain, as well as level of anxiety, use of analgesics, fluid intake and health care service use. However, the studies were few with few included participants.Conclusion: There were indications, but no definitive evidence supporting the positive effect of telephone counselling or Internet-based support on pain and recovery after tonsil surgery in children. More research is needed to further examine these effects.ClinicalTrials.gov 12/03/2017 (NCT03292068).

INTRODUCTION: The unique attributes of distributed ledger blockchain systems including robust security, immutability, transparency, and decentralisation, make them highly suitable solutions for many healthcare-related problems. This review examines the potential applications for blockchain technology in the field of orthopaedics, by taking a systematic approach to the evolving blockchain literature and mapping potential use cases against the current needs of orthopaedic practice. METHOD: A literature search was performed using Pubmed, EMBASE, OVID and the Cochrane library with the primary aim of identifying detailed accounts of blockchain solutions and use cases in healthcare. These articles were then reviewed and mapped against current orthopaedic practice to illustrate applications specific to that specialty. RESULTS: One hundred and forty-one papers were identified which described case studies, simulations, or detailed proposals of blockchain solutions in healthcare. Most studies described blockchain solutions at the simulated or prototype testing phase, with only 10 case studies describing blockchains in "real-world" use. The most frequently cited use cases for blockchain technology involved the storage, security and sharing of electronic medical records. Other blockchain solutions focused on the "Internet of Things", research, COVID 19, supply chains and radiology. There were no solutions focusing specifically on orthopaedics. Many of the described blockchain solutions had considerable scope for application in orthopaedic practice however, providing the potential for greater inter-institutional collaboration, cross border data exchange, enhanced patient participation, and more robust and transparent research practices. CONCLUSION: Blockchain solutions for healthcare are increasing in number and scope and have multiple applications relevant to orthopaedic practice. The orthopaedic community needs to be aware of this innovative and growing field of computer science so that surgeons can leverage the power of blockchain safely for the future of orthopaedics.

BACKGROUND: Mental ill-health presents a major public health problem. A potential part solution that is receiving increasing attention is computer-delivered psychological therapy, particularly during the COVID-19 pandemic as health care systems moved to remote service delivery. However, computerized cognitive behavioral therapy (cCBT) requires active engagement by service users, and low adherence may minimize treatment effectiveness. Therefore, it is important to investigate the acceptability of cCBT to understand implementation issues and maximize potential benefits. OBJECTIVE: This study aimed to produce a critical appraisal of published reviews about the acceptability of cCBT for adults. METHODS: An umbrella review informed by the Joanna Briggs Institute (JBI) methodology identified systematic reviews about the acceptability of cCBT for common adult mental disorders. Acceptability was operationalized in terms of uptake of, dropping out from, or completion of cCBT treatment; factors that facilitated or impeded adherence; and reports about user, carer, and health care professional experience and satisfaction with cCBT. Databases were searched using search terms informed by relevant published research. Review selection and quality appraisal were guided by the JBI methodology and the AMSTAR tool and undertaken independently by 2 reviewers. RESULTS: The systematic searches of databases identified 234 titles, and 9 reviews (covering 151 unique studies) met the criteria. Most studies were comprised of service users with depression, anxiety, or specifically, panic disorder or phobia. Operationalization of acceptability varied across reviews, thereby making it difficult to synthesize results. There was a similar number of guided and unguided cCBT programs; 34% of guided and 36% of unguided users dropped out; and guidance included email, telephone, face-to-face, and discussion forum support. Guided cCBT was completed in full by 8%-74% of the participants, while 94% completed one module and 67%-84% completed some modules. Unguided cCBT was completed in full by 16%-66% of participants, while 95% completed one module and 54%-93% completed some modules. Guided cCBT appeared to be associated with adherence (sustained via telephone). A preference for face-to-face CBT compared to cCBT (particularly for users who reported feeling isolated), internet or computerized delivery problems, negative perceptions about cCBT, low motivation, too busy or not having enough time, and personal circumstances were stated as reasons for dropping out. Yet, some users favored the anonymous nature of cCBT, and the capacity to undertake cCBT in one's own time was deemed beneficial but also led to avoidance of cCBT. There was inconclusive evidence for an association between sociodemographic variables, mental health status, and cCBT adherence or dropping out. Users tended to be satisfied with cCBT, reported improvements in mental health, and recommended cCBT. Overall, the results indicated that service users' preferences were important considerations regarding the use of cCBT. CONCLUSIONS: The review indicated that "one size did not fit all" regarding the acceptability of cCBT and that individual tailoring of cCBT is required in order to increase population reach, uptake, and adherence and therefore, deliver treatment benefits and improve mental health.

BACKGROUND: Digital health resources are being increasingly used to support women with substance use concerns. Although empirical research has demonstrated that these resources have promise, the available evidence for their benefit in women requires further investigation. Evidence supports the capacity of interventions that are sex-, gender-, and trauma-informed to improve treatment access and outcomes and to reduce health system challenges and disparities. Indeed, both sex- and gender-specific approaches are critical to improve health and gender equity. Violence and trauma are frequent among those with substance use concerns, but they disproportionately affect those who identify as female or women, further underscoring the need for trauma-informed care as well. OBJECTIVE: The objective of this investigation was to evaluate the evidence supporting the efficacy or effectiveness of online or mobile interventions for risky or harmful substance use in adults who identify as female or women, or who report a history of trauma. METHODS: This scoping review is based on an academic search in MEDLINE, APA PsycINFO, Embase, Cochrane Central, and CINAHL, as well as a grey literature search in US and Canadian government and funding agency websites. Of the 7807 records identified, 465 remained following title and abstract screening. Of these, 159 met all eligibility criteria and were reviewed and synthesized. RESULTS: The 159 records reflected 141 distinct studies and 125 distinct interventions. Investigations and the interventions evaluated predominantly focused on alcohol use or general substance use. Evaluated digital health resources included multisession and brief-session interventions, with a wide range of therapeutic elements. Multisession online and mobile interventions exhibited beneficial effects in 86.1% (105/122) of studies. Single-session interventions similarly demonstrated beneficial effects in 64.2% (43/67) of study conditions. Most investigations did not assess gender identity or conduct sex- or gender-based analyses. Only 13 investigations that included trauma were identified. CONCLUSIONS: Despite the overall promise of digital health interventions for substance use concerns, direct or quantitative evidence on the efficacy or effectiveness of interventions in females or women specifically is weak.

Objectives: The recovery after tonsil surgery is often troublesome for children and caregivers often feel insecure regarding optimal post-operative care for their children at home.The aim was to study what the current literature reports regarding the effect of post-operative telephone counselling and Internet support on pain and recovery after paediatric tonsil surgery. Method: A systematic literature review was conducted where only randomised clinical trials were included. Outcome measures: Primary outcome measure was pain after surgery. Secondary outcomes also included nausea, anxiety, children's knowledge, use of analgesics, fluid intake and health care service use. Results: Only four studies fulfilled the inclusion criteria. The studies were heterogeneous, rendering a meta-analysis impossible. The results of the included studies showed a possible positive effect on postoperative pain, as well as level of anxiety, use of analgesics, fluid intake and health care service use. However, the studies were few with few included participants. Conclusion: There were indications, but no definitive evidence supporting the positive effect of telephone counselling or Internet-based support on pain and recovery after tonsil surgery in children. More research is needed to further examine these effects.ClinicalTrials.gov 12/03/2017 (NCT03292068).