Standardized evaluation of the quality and persuasiveness of mobile health applications for diabetes management

This study evaluates diabetes self-management mobile health applications available from European app stores with respect to quality, concordance with recommended self-management tasks and implementation of persuasive system design principles. The European Play Store and Apple App Store were systematically searched and relevant apps were tested. Two raters independently assessed app quality using the Mobile Application Rating Scale and conducted a content analysis of provided persuasive system design principles and self-management tasks. A total of 2,269 mobile health applications were identified and 120 could be included in the evaluation. The overall quality was rated as moderate M = 3.20 (SD = 0.39, min = 2.31, max = 4.62), with shortcomings in the subcategories of engagement (M = 2.80, SD = 0.67) and information quality (M = 2.26, SD = 0.48). Scientific evidence is available for 8% of the apps. The reviewed apps implemented a median of three persuasive system design principles (range 0-15) and targeted a median of 4.5 (range 1-8) self-management tasks, however, with a lack of information about psychosocial coping strategies. Most available diabetes self-management apps lack a scientific evidence base. Persuasive system design features are underrepresented and may form a promising tool to improve app quality. Furthermore, the interaction of physical and behavioral health should be improved in existing diabetes self-management mobile health applications.

[Healing process of claw lesions in dairy cows in alpine mountain pastures]

The field study investigated severity, localisation and incidence of claw lesions of dairy cows and their healing process during a period of three months on selected mountain pastures in the central part of Switzerland. In 60 cows, which were at least 120 days in their lactation, the healing process was compared with the biochemical profiles. In 141 cows 197 claw lesions were recorded. Diagnosed were only sole ulcers (38%) and white line lesions (62%). In the first and second half of the summer term, the number of claw lesions was equal, although more severe lesions occurred mainly during the second half (89%). The lesions were treated surgically and the affected claw was elevated on a wood block or a plastic shoe. Average time for formation of a close layer of horn was 14 days. A delayed healing process was observed in dairy cows with an milk yield over 5500 kg per lactation, as well as in the second half of the summer term. Cows with a delayed healing process had significantly higher concentrations of free fatty acids and beta-hydroxybutyrate, and higher plasma enzyme activities for AST than cows with adequate healing process. This indicates that cows with a relatively high milk production touch upon the limits of their physical capacity under harder conditions on alpine pastures, which may affect also the healing process of claw lesions.

[Proton spin tomography imaging of the rotator cuff in calcific tendinitis of the shoulder]

An analysis of the MR-images of 75 patients with calcifying tendinitis of the shoulder was performed. The aim of the study was to recognize characteristic findings of the calcific deposits and their relation to the involved tendons as well as the coincidence with additional degenerative alterations of the rotator cuff. The calcifications can be demonstrated with high accuracy (> 95%) in T1-weighted images as areas of decreased signal intensity. It is possible to characterize the calcifications similar to Gärtner's radiologic classification differentiating form and density of the calcific deposits as well as their delimitation to the tendon structure. In T2-images there frequently is a perifocal band of increased signal intensity which can be identified as an oedema around the calcification. Analysing two perpendicular planes the calcifications can be assigned to the corresponding anatomical structure. 83 percent were located in the supraspinatus tendon above the humeral head or in the superior part of the subscapularis tendon. Degenerative areas of the rotator cuff are demonstrated as small zones of increased signal intensity, abnormal morphology or discontinuity of the tendon. Only in one patient a partial tear could be found; 11 percent showed variable signs of degenerative alteration of the involved tendon.

Relationship between calcifying tendinitis and subacromial impingement: a prospective radiography and magnetic resonance imaging study

In a prospective study radiographs and magnetic resonance images of 75 patients with calcifying tendinitis of the rotator cuff were analyzed. The aim was to evaluate any relation between calcifying tendinitis and subacromial impingement. A total of 83% of the calcifications were located in the supraspinatus or the adjoining part of the subscapularis tendon. On T1-weighted images they could be demonstrated with high accuracy as areas of decreased signal intensity. A magnetic resonance imaging categorization of the calcium deposits was carried out by means of a differentiation of form, outline, and density. A partial rotator cuff tear was found in one shoulder; in 11% variable aspects of degenerative alteration of the affected tendon were seen. By analysis of the radiographic outlet view 16% of the cases had a type III acromion. In conclusion, little correlation exists between calcifying tendinitis and additional findings associated with subacromial impingement.