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- Do smartphone applications and activity trackers increase physical activity in adults? Systematic review, meta-analysis and metaregressionPublication . Laranjo, Liliana; Ding, Ding; Heleno, Bruno; Kocaballi, A. Baki; Quiroz, Juan-Carlos; Tong, Huong Ly; Chahwan, Bahia; Neves, Ana Luisa; Gabarron, Elia; Dao, Kim Phuong; Rodrigues, David; Neves, Gisela Costa; Antunes, Maria L; Coiera, Enrico; Bates, David WTo determine the effectiveness of physical activity interventions involving mobile applications (apps) or trackers with automated and continuous self-monitoring and feedback. Design Systematic review and meta-analysis. Data sources PubMed and seven additional databases, from 2007 to 2020. Study selection Randomised controlled trials in adults (18–65 years old) without chronic illness, testing a mobile app or an activity tracker, with any comparison, where the main outcome was a physical activity measure. Independent screening was conducted. Data extraction and synthesis We conducted random effects meta-analysis and all effect sizes were transformed into standardised difference in means (SDM). We conducted exploratory metaregression with continuous and discrete moderators identified as statistically significant in subgroup analyses. Main outcome measures Physical activity: daily step counts, min/week of moderate-to- vigorous physical activity, weekly days exercised, min/week of total physical activity, metabolic equivalents. Results Thirty-five studies met inclusion criteria and 28 were included in the meta-analysis (n=7454 participants, 28% women). The meta-analysis showed a small-to- moderate positive effect on physical activity measures (SDM 0.350, 95% CI 0.236 to 0.465, I2=69%, T2=0.051) corresponding to 1850 steps per day (95% CI 1247 to 2457). Interventions including text-messaging and personalisation features were significantly more effective in subgroup analyses and metaregression. Conclusion Interventions using apps or trackers seem to be effective in promoting physical activity. Longer studies are needed to assess the impact of different intervention components on long-term engagement and effectiveness.
- Primary care physicians' decision-making processes in the context of multimorbidity: protocol of a systematic review and thematic synthesis of qualitative researchPublication . Rodrigues, David Silvério; Sousa, Paulo Faria; Basílio, Nuno; Antunes, Ana; Antunes, Maria Da Luz; Santos, Maria Isabel; Heleno, BrunoGood patient outcomes correlate with the physicians' capacity for good clinical judgement. Multimorbidity is common and it increases uncertainty and complexity in the clinical encounter. However, healthcare systems and medical education are centred on individual diseases. In consequence, recognition of the patient as the centre of the decision-making process becomes even more difficult. Research in clinical reasoning and medical decision in a real-world context is needed. The aim of the present review is to identify and synthesise available qualitative evidence on primary care physicians' perspectives, views or experiences on decision-making with patients with multimorbidity.
- Factors associated with cervical cancer screening participation among migrant women in Europe: a scoping reviewPublication . Marques, Patrícia; Nunes, Mariana; Antunes, Maria Da Luz; Heleno, Bruno; Dias, SoniaCervical cancer screening has been effective in reducing incidence and mortality of cervical cancer, leading European countries to implement screening programs. However, migrant women show lower screening participation compared to nationals. This scoping review aims to provide a synthesis of the growing evidence on factors associated with participation in cervical cancer screening among migrant women in Europe.