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      Technology-Based Innovations to Foster Personalized Healthy Lifestyles and Well-Being: A Targeted Review

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          Abstract

          Background

          New community-based arrangements and novel technologies can empower individuals to be active participants in their health maintenance, enabling people to control and self-regulate their health and wellness and make better health- and lifestyle-related decisions. Mobile sensing technology and health systems responsive to individual profiles combined with cloud computing can expand innovation for new types of interoperable services that are consumer-oriented and community-based. This could fuel a paradigm shift in the way health care can be, or should be, provided and received, while lessening the burden on exhausted health and social care systems.

          Objective

          Our goal is to identify and discuss the main scientific and engineering challenges that need to be successfully addressed in delivering state-of-the-art, ubiquitous eHealth and mHealth services, including citizen-centered wellness management services, and reposition their role and potential within a broader context of diverse sociotechnical drivers, agents, and stakeholders.

          Methods

          We review the state-of-the-art relevant to the development and implementation of eHealth and mHealth services in critical domains. We identify and discuss scientific, engineering, and implementation-related challenges that need to be overcome to move research, development, and the market forward.

          Results

          Several important advances have been identified in the fields of systems for personalized health monitoring, such as smartphone platforms and intelligent ubiquitous services. Sensors embedded in smartphones and clothes are making the unobtrusive recognition of physical activity, behavior, and lifestyle possible, and thus the deployment of platforms for health assistance and citizen empowerment. Similarly, significant advances are observed in the domain of infrastructure supporting services. Still, many technical problems remain to be solved, combined with no less challenging issues related to security, privacy, trust, and organizational dynamics.

          Conclusions

          Delivering innovative ubiquitous eHealth and mHealth services, including citizen-centered wellness and lifestyle management services, goes well beyond the development of technical solutions. For the large-scale information and communication technology-supported adoption of healthier lifestyles to take place, crucial innovations are needed in the process of making and deploying usable empowering end-user services that are trusted and user-acceptable. Such innovations require multidomain, multilevel, transdisciplinary work, grounded in theory but driven by citizens’ and health care professionals’ needs, expectations, and capabilities and matched by business ability to bring innovation to the market.

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          Most cited references152

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          Behavior Change Techniques Implemented in Electronic Lifestyle Activity Monitors: A Systematic Content Analysis

          Background Electronic activity monitors (such as those manufactured by Fitbit, Jawbone, and Nike) improve on standard pedometers by providing automated feedback and interactive behavior change tools via mobile device or personal computer. These monitors are commercially popular and show promise for use in public health interventions. However, little is known about the content of their feedback applications and how individual monitors may differ from one another. Objective The purpose of this study was to describe the behavior change techniques implemented in commercially available electronic activity monitors. Methods Electronic activity monitors (N=13) were systematically identified and tested by 3 trained coders for at least 1 week each. All monitors measured lifestyle physical activity and provided feedback via an app (computer or mobile). Coding was based on a hierarchical list of 93 behavior change techniques. Further coding of potentially effective techniques and adherence to theory-based recommendations were based on findings from meta-analyses and meta-regressions in the research literature. Results All monitors provided tools for self-monitoring, feedback, and environmental change by definition. The next most prevalent techniques (13 out of 13 monitors) were goal-setting and emphasizing discrepancy between current and goal behavior. Review of behavioral goals, social support, social comparison, prompts/cues, rewards, and a focus on past success were found in more than half of the systems. The monitors included a range of 5-10 of 14 total techniques identified from the research literature as potentially effective. Most of the monitors included goal-setting, self-monitoring, and feedback content that closely matched recommendations from social cognitive theory. Conclusions Electronic activity monitors contain a wide range of behavior change techniques typically used in clinical behavioral interventions. Thus, the monitors may represent a medium by which these interventions could be translated for widespread use. This technology has broad applications for use in clinical, public health, and rehabilitation settings.
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            Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries.

            National health systems need strengthening if they are to meet the growing challenge of chronic diseases in low-income and middle-income countries. By application of an accepted health-systems framework to the evidence, we report that the factors that limit countries' capacity to implement proven strategies for chronic diseases relate to the way in which health systems are designed and function. Substantial constraints are apparent across each of the six key health-systems components of health financing, governance, health workforce, health information, medical products and technologies, and health-service delivery. These constraints have become more evident as development partners have accelerated efforts to respond to HIV, tuberculosis, malaria, and vaccine-preventable diseases. A new global agenda for health-systems strengthening is arising from the urgent need to scale up and sustain these priority interventions. Most chronic diseases are neglected in this dialogue about health systems, despite the fact that non-communicable diseases (most of which are chronic) will account for 69% of all global deaths by 2030 with 80% of these deaths in low-income and middle-income countries. At the same time, advocates for action against chronic diseases are not paying enough attention to health systems as part of an effective response. Efforts to scale up interventions for management of common chronic diseases in these countries tend to focus on one disease and its causes, and are often fragmented and vertical. Evidence is emerging that chronic disease interventions could contribute to strengthening the capacity of health systems to deliver a comprehensive range of services-provided that such investments are planned to include these broad objectives. Because effective chronic disease programmes are highly dependent on well-functioning national health systems, chronic diseases should be a litmus test for health-systems strengthening. Copyright © 2010 Elsevier Ltd. All rights reserved.
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              Resting state cortical connectivity reflected in EEG coherence in individuals with autism.

              Theoretical conceptions of autism spectrum disorder (ASD) and experimental studies of cerebral blood flow suggest abnormalities in connections among distributed neural systems in ASD. Functional connectivity was assessed with electroencephalographic coherence between pairs of electrodes in a high-density electrode array in narrow frequency bands among 18 adults with ASD and 18 control adults in an eyes closed resting state. In the theta (3-6 Hz) frequency range, locally elevated coherence was evident for the ASD group, especially within left hemisphere frontal and temporal regions. In the lower alpha range (8-10 Hz), globally reduced coherence was evident for the ASD group within frontal regions and between frontal and all other scalp regions. The ASD group exhibited significantly greater relative power between 3 and 6 Hz and 13-17 Hz and significantly less relative power between 9 and 10 Hz. Robust patterns of over- and under-connectivity are apparent at distinct spatial and temporal scales in ASD subjects in the eyes closed resting state.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                June 2016
                24 June 2016
                : 18
                : 6
                : e128
                Affiliations
                [01] 1Computational BioMedicine Laboratory (CBML) Institute of Computer Science (ICS) Foundation for Research and Technology (FORTH) HeraklionGreece
                [02] 2Institute of Electronics Engineering and Telematics of Aveiro (IEETA) University of Aveiro AveiroPortugal
                [03] 3Department of Economics, Management and Industrial Engineering University of Aveiro AveiroPortugal
                [04] 4Assoc. Professor Department of Ιnformatics Engineering Technological Educational Institute of Crete HeraklionGreece
                [05] 5Department of Electronics, Telecommunications & Informatics University of Aveiro AveiroPortugal
                [06] 6Sense Health RotterdamNetherlands
                [07] 7Department of Communication Stanford University San Francisco, CAUnited States
                [08] 8ASK Community Systems GmbH Bad SchwalbachGermany
                [09] 9Association of Community Elders’ Clubs (MELABEV) JerusalemIsrael
                Author notes
                Corresponding Author: Emmanouil G Spanakis spanakis@ 123456ics.forth.gr
                Author information
                http://orcid.org/0000-0002-8276-3559
                http://orcid.org/0000-0003-4321-9240
                http://orcid.org/0000-0001-8454-1450
                http://orcid.org/0000-0003-3783-5223
                http://orcid.org/0000-0003-4701-850X
                http://orcid.org/0000-0002-7675-1236
                http://orcid.org/0000-0002-4112-0581
                http://orcid.org/0000-0002-2990-3794
                http://orcid.org/0000-0002-2662-6023
                Article
                v18i6e128
                10.2196/jmir.4863
                4938884
                27342137
                8e719acd-34a2-4eb3-ba53-4c92de1da79e
                ©Emmanouil G Spanakis, Silvina Santana, Manolis Tsiknakis, Kostas Marias, Vangelis Sakkalis, António Teixeira, Joris H. Janssen, Henri de Jong, Chariklia Tziraki. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.06.2016.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 10 August 2015
                : 14 September 2015
                : 9 December 2015
                : 21 March 2016
                Categories
                Original Paper
                Original Paper

                Medicine
                mhealth,ehealth,lifestyle,health promotion,health behavior,persuasive technologies,cloud computing,personalized health monitoring,interoperability,wellness programs

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