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Abstract People with epilepsy frequently under- or inaccurately report their seizures, which poses a challenge for evaluating their treatment. The introduction of epilepsy health apps provides a novel approach that could improve seizure documentation. This study assessed the documentation performance of an app-based seizure diary and a conventional paper seizure diary. At two tertiary epilepsy centers patients were asked to use one of two offered methods to report their seizures (paper or app diary) during their stay in the epilepsy monitoring unit. The performances of both methods were assessed based on the gold standard of video-EEG annotations. In total 89 adults (54 paper and 35 app users) with focal epilepsy were included in the analysis, of which 58 (33 paper and 25 app users) experienced at least one seizure and made at least one seizure diary entry. We observed a high precision of 85.7% for the app group, whereas the paper group’s precision was lower due to overreporting (66.9%). Sensitivity was similar for both methods. Our findings imply that performance of seizure self-reporting is patient-dependent but is more precise for patients who are willing to use digital apps. This may be relevant for treatment decisions and future clinical trial design.

The sudden appearance and devastating effects of the COVID-19 pandemic resulted in the need for multiple adaptive changes in societies, business operations and healthcare systems across the world. This review describes the development and increased use of digital technologies such as chat bots, electronic diaries, online questionnaires and even video gameplay to maintain effective treatment standards for individuals with mental health conditions such as depression, anxiety and post-traumatic stress syndrome. We describe how these approaches have been applied to help meet the challenges of the pandemic in delivering mental healthcare solutions. The main focus of this narrative review is on describing how these digital platforms have been used in diagnostics, patient monitoring and as a treatment option for the general public, as well as for frontline medical staff suffering with mental health issues. [ABSTRACT FROM AUTHOR]

Developing methods to record Alternating Hemiplegia of Childhood (AHC) spells is essential for clinical trials and patient care. Test the following hypotheses: 1) Video-library training improves participants' ability to correctly identify AHC spells. 2) A custom-designed event-calendar with weekly reviews results in consistent documentation of such events over time. 3) Use of an electronic diary (e-Diary) to register events is a useful tool. 1) A video-library of AHC type spells was developed along with specific training; the effect of the training was tested in 36 caregivers. 2) An event-calendar was similarly developed and provided to 5 caregivers with weekly videoconference meetings for 8 weeks. 3) An e-Diary was developed and offered to 33 patients; time of usage and caregivers' feedback (telephone interview) were analyzed. 1) Video-library training: Wilcoxon test showed improvement in caregiver identification of spells (p = 0.047), Cohen's Kappa demonstrated high degree of agreement between caregivers'-experts' classifications (>0.9). 2) Event-calendar: 96.42% of entries had complete information; this did not change during follow up (p = 0.804). 3) e-Diary: whereas 52% of respondents used the e-Diary when offered (duration: 10.5 ± 8.1 months), 96.3% indicated they would use it in future studies. Those who used it for 13 months, were very likely to use it during the rest of that year. Video-library training improved spell identification. Calendar with weekly reviews resulted in a sustained and consistent record keeping. Caregivers' e-Diary feedback was encouraging with long-term usage in many. These approaches could be helpful for AHC and, potentially, in similar disorders. [Display omitted] • To record Alternating Hemiplegia of Childhood related spells, we developed: • Video-library with caregiver training procedure that improved spell identification. • Event-Calendar that resulted in sustained and consistent record keeping. • e-Diary that half of the respondents used. • Such approaches could be helpful for AHC care and research and for similar disorders. [ABSTRACT FROM AUTHOR]

Background. Epilepsy is a debilitating chronic medical condition affecting many patients globally. A seizure diary is used in monitoring and managing patients with epilepsy. In South Africa, no standardized diary is currently being used. Objective. This study intended to develop a consensus among experts managing patients with epilepsy on the content of a seizure Methods. The modified Delphi method consisted of three survey rounds spanning six months. Using a three-point Likert scale questionnaire, in round one, the panelists were required to choose option (definitely required, optional, and not required) for 50 and comment on the contents of the diary. In round two, items were added based on comments from the panelists. In three, panelists were allowed to deliberate further on unresolved items and change their responses in view of the group responses. The consensus was determined as an a priori threshold 70% on items definitely required, optional, or not required. Results. Eleven local and two international panelists were enrolled in this study. Twelve completed all three rounds. The consensus was achieved in 21 of 50 items in round 1, three of seven in round 2, and one of two items in round 3, of which 18 definitely required as contents of a seizure diary. Conclusions. Based on expert opinions, the modified Delphi determined the essential contents of a seizure diary for use patients with epilepsy in South Africa. [ABSTRACT FROM AUTHOR]

The paper focuses on inequalities in access to digital technologies and their influence on education (electronic diaries in particular) across secondary schools in Bulgaria. It tries to answer the following research question: does the impact of digital technologies on access to the educational process depend on the existence of social inequalities and horizontal differences between and within schools? The theoretical framework is based on Bruno Latour's Actor-network theory, Bourdieu's capital theory, as well the concept of technical capital. The research methodology includes case studies of three different types of schools with qualitative methods of data collection: interviews and focus groups with key stakeholders such as principals, students, teachers, and parents. According to the different social actors in the educational process, the usage of electronic diaries makes it significantly easier to access, store and distribute information, but not for all groups of children and their parents. The analysis of three different types of schools reveals the presence of significant differentiation and inequalities in the Bulgarian education system. The results show that the theories of Bourdieu and Latour are suitable for analysis of the Bulgarian education system. Based on the obtained results it is concluded that a comprehensive reform in the education system requires not only educational innovations but also adequate and long-term changes in all fields of society. [ABSTRACT FROM AUTHOR]

Background: Epilepsy is a neurological disease affecting adults and children globally. A seizure diary is one of the self-management tools for tracking seizures. This study aims to ascertain the experience of a new seizure diary by persons completing the diary in the Free State and Northern Cape of South Africa. Methods: Adult patients with epilepsy attending Universitas Academic Hospital epilepsy clinic in Bloemfontein, clinics in Kimberley and the casualty department of Kimberley hospital (Robert Mangaliso Sobukwe hospital) received a new seizure diary. After using the diary for 6 months, participants (patients, relatives or caregivers) completed a questionnaire. Results: A total of 139 epilepsy patients received a new seizure diary; 67 previously diary-unexposed participants and 33 participants who had previous exposure to a seizure diary. The majority of participants, namely 91% of previously diary-unexposed and 84.9% of participants who had previous exposure to the seizure diary, understood the new seizure diary. Participants who had previous exposure to a seizure diary were predominantly very positive about the new diary because it had more information. However, 21.2% indicated that they preferred the old one because it was easier to complete. Conclusion: Patients, caregivers or relatives from both groups used the new seizure diary and provided important information about their experience with the new diary. Despite a few complaints about using the new diary, most participants who had previous exposure to a seizure diary preferred the new seizure diary. Contribution: This study explored participants’ opinions of the new seizure diary.

Background: Epilepsy is responsible for a significant proportion of the world's disease burden, affecting around 50 million people globally. A seizure diary is a self-management tool for epilepsy focusing on self-monitoring, tracking seizures and other symptoms. This study aimed to determine the perceptions and attitudes to the seizure diary in patients with epilepsy in the Free State and Northern Cape of South Africa. Methods: This cross-sectional survey method included adult patients with epilepsy attending Universitas Academic Hospital Specialist Epilepsy Clinic in Bloemfontein and local clinics in Kimberley (City, Beaconsfield and Betty Gatsewe), as well as the casualty department of Kimberley hospital (Robert Mangaliso Sobukwe Hospital). The Kimberley patients were diary-unexposed, while the Bloemfontein patients were patients who had previous exposure to the seizure diary. Results: A total of 182 patients with epilepsy were recruited for the study, of whom 65 were patients who had previous exposure to the seizure diary, and 117 were unexposed. In the patients who had previous exposure to the seizure diary, 64 (98.5%) found the diary useful, but 15 (23.1%) reported having various challenges with using the seizure diary. Almost all of the patients who had previous exposure to the seizure diary, 64 (98.5%), were willing to continue to use the diary, while 112 (95.7%) of the diary-unexposed patients were also willing to use the diary. Conclusion: Information from some patients using the diary confirms various challenges with its use; however, most patients support the continued usage of the diary. [ABSTRACT FROM AUTHOR]

Background: Epilepsy is a neurological disease affecting adults and children globally. A seizure diary is one of the self-management tools for tracking seizures. This study aims to ascertain the experience of a new seizure diary by persons completing the diary in the Free State and Northern Cape of South Africa. Methods: Adult patients with epilepsy attending Universitas Academic Hospital epilepsy clinic in Bloemfontein, clinics in Kimberley and the casualty department of Kimberley hospital (Robert Mangaliso Sobukwe hospital) received a new seizure diary. After using the diary for 6 months, participants (patients, relatives or caregivers) completed a questionnaire. Results: A total of 139 epilepsy patients received a new seizure diary; 67 previously diary-unexposed participants and 33 participants who had previous exposure to a seizure diary. The majority of participants, namely 91% of previously diary-unexposed and 84.9% of participants who had previous exposure to the seizure diary, understood the new seizure diary. Participants who had previous exposure to a seizure diary were predominantly very positive about the new diary because it had more information. However, 21.2% indicated that they preferred the old one because it was easier to complete. Conclusion: Patients, caregivers or relatives from both groups used the new seizure diary and provided important information about their experience with the new diary. Despite a few complaints about using the new diary, most participants who had previous exposure to a seizure diary preferred the new seizure diary. Contribution: This study explored participants' opinions of the new seizure diary. [ABSTRACT FROM AUTHOR]

Objective: To compare the effect of a once-daily extended-release methylphenidate formulation (PRC-063) versus placebo on sleep, measured via daily electronic diary in two clinical trials in pediatric (6–12 years) and adult (≥18 years) patients with attention deficit hyperactivity disorder (ADHD). Method: A diary was completed by adult patients or parents/caregivers of pediatric patients during two randomized, double-blind, placebo-controlled laboratory classroom studies. Following dose optimization of PRC-063, patients were randomized to 1 week of double-blind treatment with PRC-063 or placebo before attending a full-day laboratory classroom session. Results: In the studies, 148 pediatric patients and 239 adult patients were randomized to either PRC-063 or placebo. When compared with the diaries of placebo patients, the sleep diaries in both pediatric and adult patients showed no statistical difference in total sleep time, efficiency, or latency. Conclusion: PRC-063 did not impact subjective measures of sleep versus placebo in pediatric and adult patients with ADHD. [ABSTRACT FROM AUTHOR]

Background: Epilepsy is a chronic and debilitating condition affecting people of all ages in many nations. Healthcare practitioners look for effective ways to track patients' seizures, and a seizure diary is one of the methods used. This scoping review sought to identify current norms and practices for using seizure diaries to manage epilepsy. Method: A scoping review was performed by screening relevant studies and identifying themes, categories and subcategories. Results: A total of 1125 articles were identified from the database; 46 full-text articles were assessed for eligibility, of which 23 articles were selected. The majority (48%) of the studies were prospective studies. The majority (65%) of the articles were studies conducted in the United States. The themes identified were types of seizure diaries used in clinical practice, contents and structure of a standardised seizure diary, the use and efficacy of seizure diaries in medicine and challenges relating to using a seizure diary for patient management. Conclusion: The study revealed that a seizure diary remains a relevant tool in managing epilepsy. The two forms of diaries in use are electronic and paper-based diaries. The high cost of data and the expensive devices required to access electronic diaries make it unsuitable in a resource-limited setting. Despite its disadvantages, imperfections and inadequacies, the paper-based diary is still relevant for managing patients with epilepsy in resource-limited settings. Contribution: This study reviewed the literature to find the current norms and practices in using seizure diaries. The benefits of the different formats were emphasised. [ABSTRACT FROM AUTHOR]

Background: Introduction of new tobacco products in the United States, including those that may be lower on the risk continuum than traditional combustible cigarettes, requires premarket authorization by the US Food and Drug Administration and information on the potential impact of the products on consumer behaviors. Efficient recruitment and data capture processes are needed to collect relevant information in a near-to-real-world environment. Objective: The aim of this pilot study was to develop and test a protocol for an actual use study of a new tobacco product. The product included in this study was a commercially available oral nicotine pouch. Through the process of study design and execution, learnings were garnered to inform the design, execution, analysis, and report writing of future full-scale actual use studies with tobacco products. Methods: A small sample (n=100) of healthy adult daily smokers of 7 or more cigarettes per day were recruited to participate in an 8-week prospective observational study conducted at 4 geographically dispersed sites in the United States. A smartphone-based customized electronic diary (eDiary) was employed to capture daily tobacco product use, including 1 week of baseline smoking and 6 weeks during which participants were provided with oral nicotine pouches for use as desired. Results: Online screening procedures with follow-up telephone interviews and on-site enrollment were successfully implemented. Of 100 participants, 97 completed the study, with more than half (59/99, 60%) identifying as dual- or poly-users of cigarettes and other types of tobacco products at baseline. There was more than 90% (91-93/99, 92%-94%) compliance with daily eDiary reporting, and the majority (92/99, 93%) of participants expressed satisfaction with the study processes. Product use data from the eDiary indicated that after an initial period of trial use, pouches per day increased among those continuing to use the products, while per day average cigarette consumption decreased for 82% (79/97) of all study participants. At the end of the week 6, 16% (15/97) of participants had reduced their cigarette consumption by more than half. Conclusions: The design of this study, including recruiting, enrollment, eDiary use, and oversight, was successfully implemented through the application of a detailed protocol, a user-friendly eDiary, electronically administered questionnaires, and remote monitoring procedures. High-resolution information was obtained on prospective changes in tobacco product use patterns in the context of availability of a new tobacco product. Future, larger actual use studies will provide important evidence supporting the role that alternatives to combustible cigarettes may play in smoking reduction and/or cessation and lowering the population health burden of tobacco and nicotine-containing products. [ABSTRACT FROM AUTHOR]

Bread, the most consumed floury product in the world, is one of the most wasted food products across the food supply chain. Yet, there is a paucity of research examining the magnitude of bread waste and behavioural drivers associated with it at the household level. This study analyses the incidence, behavioural drivers and disposal pathways of bread waste using a sample of 1462 households in Australia and a 7-day electronic diary method. Behavioural drivers related to bread waste were modelled using logistic regression models. The findings suggest that bread rolls, sliced bread and flat bread are the three most wasted bread products in Australian households. Higher grocery shopping frequency, 'just-in-case' buying, family households with young children and takeaway meal ordering are associated with higher bread waste. Bread disposal pathway analysis revealed that 55% of bread and bakery products are discarded through general waste bins, highlighting the immense potential of utilising bread waste in industrial processes such as biofuel production. Addressing bread and bakery waste can significantly contribute to achieving the SDG12.3 goal of halving the per capita food waste by 2030. • Household bread waste behaviours and disposal pathways analysed. • Bread and bakery waste represent 12% of total edible food wasted. • Sliced bread, bread rolls and flatbread are the most commonly discarded breads. • Just-in-case buying, and family households are associated with high bread waste. • 55% of bread and bakery waste is discarded through general waste bins. [ABSTRACT FROM AUTHOR]

Suicide and suicide-related behaviors are prevalent yet notoriously difficult to predict. Specifically, short-term predictors and correlates of suicide risk remain largely unknown. Ecological momentary assessment (EMA) may be used to assess how suicidal thoughts and behaviors (STBs) unfold in real-world contexts. We conducted a systematic literature review of EMA studies in suicide research to assess (1) how EMA has been utilized in the study of STBs (i.e., methodology, findings), and (2) the feasibility, validity and safety of EMA in the study of STBs. We identified 45 articles, detailing 23 studies. Studies mainly focused on examining how known longitudinal predictors of suicidal ideation perform within shorter (hourly, daily) time frames. Recent studies have explored the prospects of digital phenotyping of individuals with suicidal ideation. The results indicate that suicidal ideation fluctuates substantially over time (hours, days), and that individuals with higher mean ideation also have more fluctuations. Higher suicidal ideation instability may represent a phenotypic indicator for increased suicide risk. Few studies succeeded in establishing prospective predictors of suicidal ideation beyond prior ideation itself. Some studies show negative affect, hopelessness and burdensomeness to predict increased ideation within-day, and sleep characteristics to impact next-day ideation. The feasibility of EMA is encouraging: agreement to participate in EMA research was moderate to high (median = 77%), and compliance rates similar to those in other clinical samples (median response rate = 70%). More individuals reported suicidal ideation through EMA than traditional (retrospective) self-report measures. Regarding safety, no evidence was found of systematic reactivity of mood or suicidal ideation to repeated assessments of STBs. In conclusion, suicidal ideation can fluctuate substantially over short periods of time, and EMA is a suitable method for capturing these fluctuations. Some specific predictors of subsequent ideation have been identified, but these findings warrant further replication. While repeated EMA assessments do not appear to result in systematic reactivity in STBs, participant burden and safety remains a consideration when studying high-risk populations. Considerations for designing and reporting on EMA studies in suicide research are discussed.

Background: An electronic diary embedded in a mobile device to monitor lifestyle can be as effective as traditional methods. However, the efficacy of self-monitoring multiple behaviors for dietary intake has not been well studied in people with diabetes., Objective: This study aimed to compare the effect of using technology-assisted self-monitoring versus paper diaries on changes in dietary intake., Methods: This is a secondary analysis of data collected from 39 people with type 2 diabetes as part of a 3-month pilot clinical trial. Changes in energy intake and the contribution of total fat intake and total carbohydrate intake to total calories (%) from baseline to after intervention (3 months) were evaluated., Results: In total, 26 (67%) of the 39 participants preferred mobile diaries over paper diaries. Participants in the mobile diary group showed slightly higher self-monitoring adherence. Linear mixed modeling results indicated a significant overall decrease in total energy intake (P=.005), dietary fat intake (P=.01), and carbohydrate intake (P=.08) from baseline to 3 months. No significant group differences were detected (P>.05)., Conclusions: The implementation of a 3-month, multiple-behavior, self-monitoring intervention in Diabetes Self-Management Education programs has resulted in successful reduction in dietary intake (energy, fat, and carbohydrate), whichever self-monitoring method is chosen by participants according to their preferences. Long-term studies are needed to confirm our findings on dietary intake and examine other behavioral and disease outcomes that require monitoring., (©Jisook Ko, Jing Wang, Ngozi Mbue, Susan Schembre, Stanley Cron. Originally published in JMIR Formative Research (https://formative.jmir.org), 20.08.2024.)

This study examines the clinical utility of an electronic diary (ED) in the monitoring of the clinical manifestations of fibromyalgia (FM), compared to traditional paper-pencil self-reports. Fourteen women with FM completed an interview, several questionnaires, and an ED for a week (several times a day) recording pain, fatigue, sleep, difficulty in thinking, emotional distress, difficulty in daily functioning, coping with the disease, and stress. There were no differences in symptoms throughout the different moments of the day. A sleep latency of 45.36 minutes and sleep duration of 6.25 hours was observed. Significant correlations were found between ED measures depending on the time of day, and between ED measures and questionnaires. The ED showed to be useful for the evaluation of FM symptomatology and could be a key component in psychological intervention programs. [ABSTRACT FROM AUTHOR]

Aim: To determine whether our E-diary can be used to diagnose migraine and provide more reliable migraine-related frequency numbers compared to patients' self-reported estimates. Methods: We introduced a self-developed E-diary including automated algorithms differentiating headache and migraine days, indicating whether a patient has migraine. Reliability of the E-diary diagnosis in combination with two previously validated E-questionnaires was compared to a physician's diagnosis as gold standard in headache patients referred to the Leiden Headache Clinic (n = 596). In a subset of patients with migraine (n = 484), self-estimated migraine-related frequencies were compared to diary-based results. Results: The first migraine screening approach including an E-headache questionnaire, and the E-diary revealed a sensitivity of 98% and specificity of 17%. In the second approach, an E-migraine questionnaire was added, resulting in a sensitivity of 79% and specificity of 69%. Mean self-estimated monthly migraine days, non-migrainous headache days and days with acute medication use were different from E-diary-based results (absolute mean difference ± standard deviation respectively 4.7 ± 5.0, 6.2 ± 6.6 and 4.3 ± 4.8). Conclusion: The E-diary including algorithms differentiating headache and migraine days showed usefulness in diagnosing migraine. The use emphasised the need for E-diaries to obtain reliable information, as patients do not reliably recall numbers of migraine days and acute medication intake. Adding E-diaries will be helpful in future headache telemedicine. [ABSTRACT FROM AUTHOR]

Background: Ecological Momentary Assessment (EMA), a term coined in 1994 by Stone and Schiffman, is a modality by which participants can record their symptoms, triggers and thoughts in real time. This data is recorded electronically through the use of smartphones, tablets, and smartwatches as subjects live their daily lives. EMA can be thought of as an electronic diary by which a subject can respond to alerts by entering their observations several times throughout the day. These assessments involve different discrete methodologies such as interpersonal interaction diaries, ambulatory physiological monitoring, and collection of medication compliance data. EMA was developed to counteract the recall bias and inter-evaluator discrepancies that can occur during regularly scheduled outpatient appointments. Methods: A literature review was done using EMA as the search criteria. Results: Davidson et al discussed the use of EMA in suicidality through the use of paper journals, personal digital assistants and cellphones. The paper outlined two sampling schemes; event-based sampling which asks participants to respond to questions each time they experienced a behavior and time-based sampling which asks for responses at a set period of time. Bell et al, 2017 reviewed the application of EMA in treatment of psychotic disorders and reviewed current literature. Schueller et al, 2017 analyzed the use of EMA for depression and anxiety providing mechanisms, study designs and therapeutic measures that can be incorporated for design of an EMA for depression and anxiety. Smith et al 2019 reviewed EMA in the assessment of eating disorders (ED) by looking at realms of type, frequency and temporal sequencing of ED symptoms in natural environment. The use of EMA for child and adolescent patients using mobile based utilization was researched by Heron et al., 2017. Using these modalities children and adolescents may have improved reporting of pain, treatment adherence, sleep and disease symptoms. Raugh et al 2019 studied EMA for psychophysiological assessments. EMA was used for monitoring of EKG, Blood pressure, EEG, electroculography, electromyography and other variables. Conclusions: There are multiple advantages and disadvantages to EMA. Advantages include participants avoiding recall bias and providing real time assessments. Treatment is not dependent on respondent’s bias and immediate interventions can be enacted. EMA also allows a remote alert to providers and can be used for research. Disadvantages of EMA include it being dependent on equipment, technology and network connectivity. There is a risk of attrition as well as possible redundancy. There is a need for detailed study modeling. EMA requires motivation on the part of the participant to respond and participate regularly. Additionally, encryption is necessary to safeguard such sensitive data. More research is required investigating the benefits of this method.

Most of the scientific research on alcohol consumption behavior in humans is laboratory-based, as reflected by the ratio of laboratory vs. real-life contributions to this handbook. Studies in daily life, although having a long history in addiction research (Shiffman et al., Ann Behav Med 16:203-209, 1994), are in the minority. This is surprising, given that patients with substance use disorders are suffering in daily life and not in the laboratory setting. In other words, drinking patterns and symptoms of alcohol use disorder evolve not in the lab but in daily life, where patients show difficulties in limiting their alcohol intake accompanied with all kinds of related problems. The ultimate goal of all interventions, independent of being tailored toward restricted drinking or abstinence, is again an altered behavior in real life. Translated to practice, patients' behavior in the lab may not translate to daily life, often showing minimal ecological validity. Therefore, we have to question to which degree lab-based research findings translate into daily life. Fortunately, the current digital revolution provided us with more and more tools, enabling us to monitor, analyze, and change behavior in human everyday life. Our chapter does not intend to give a comprehensive overview of the daily life research on alcohol consumption over the last few decades as others do (Morgenstern et al., Alcohol Res Curr Rev 36:109, 2014; Piasecki, Alcohol Clin Exp Res 43:564-577, 2019; Shiffman, Psychol Asses 21:486-497, 2009; Votaw and Witkiewitz, Clin Psychol Sci 9:535-562, 2021; Wray et al., Alcohol Res Curr Rev 36:19-27, 2014). Instead, we aim at the following: first, to highlight the key advantages of ecological momentary assessment to motivate scientists to add daily life research components to their laboratory research and, second, to provide some guidance on how to begin with daily life research., (© 2024. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Ana B Gago-Veiga,1 Josué Pagán,2,3 Kevin Henares,2,4 Patricia Heredia,1 Nuria González-García,5 María-Irene De Orbe,4 Jose L Ayala,3,4 Mónica Sobrado,1 Jose Vivancos1 1Headache Unit, Department of Neurology, Instituto de Investigación Sanitaria Hospital, Universitario de la Princesa, Madrid, Spain; 2Department of Electronic Engineering, Universidad Politécnica de Madrid, Madrid, Spain; 3Center for Computational Simulation, Universidad Politécnica de Madrid, Madrid, Spain; 4Department of Computer and Automation Architecture, Universidad Complutense de Madrid, Madrid, Spain; 5Headache Unit, Hospital Clínico Universitario San Carlos, Madrid, Spain Purpose: Premonitory symptoms (PSs) of migraine are those that precede pain in a migraine attack. Previous studies suggest that treatment during this phase may prevent the onset of pain; however, this approach requires that patients be able to recognize their PSs. Our objectives were to evaluate patients’ actual ability to predict migraine attacks based on their PSs and analyze whether good predictors meet any characteristic profile. Patients and methods: This prospective, observational study included patients with migraine with and without aura. Patients’ baseline characteristics were recorded. During a 2-month follow-up period, patients used a mobile application to record what they believed to be PSs and later to record the onset of pain, if this occurred. When a migraine attack ended, patients had to complete a form on the characteristics of the episode (including the presence of PSs not identified prior to the attack). Results: Fifty patients were initially selected. A final total of 34 patients were analyzed, recording 229 attacks. Of whom, 158 (69%) were accompanied by PSs and were recorded prior to the pain onset in 63 (27.5%) cases. A total of 67.6% of the patients were able to predict at least one attack, but only 35.3% were good predictors (>50% of attacks). There were only 11 cases in which a patient erroneously reported their PSs (positive predictive value: 85.1%). Good predictors were not differentiated by any specific clinical characteristic. However, a range of symptoms were particularly predictive; these included photophobia, drowsiness, yawning, increased thirst, and blurred vision. Conclusion: A large majority of patients with migraine experienced a PS and were able to predict at least one attack. Besides, only a small percentage of patients were considered as good predictors; however, they could not be characterized by any specific profile. Nonetheless, when patients with migraine believed that they were experiencing PSs, they were frequently correct. Keywords: migraine, premonitory symptoms, prediction, real-time, electronic diary, machine learning

Background: Headache diaries and recall questionnaires are frequently used to assess headache frequency and severity in clinical and research settings. Methods: Using 20 weeks of data from an intervention trial with 182 participants, we evaluated concordance between an electronic headache diary administered on a daily basis and designed to capture the presence and severity of headaches on an hourly basis (the headache diary) and a recall questionnaire, with retrospective estimation of the number of headache days assessed on a monthly basis. We further examined whether the duration or severity of headaches assessed by the electronic diary impacted concordance between these two measures. Results: Over the course of four 28-day periods, people with migraine participating in a dietary intervention reported an average of 13.7 and 11.1 headache days in the headache diary and recall questionnaire, respectively. Conclusion: Over time, the concordance between headache days reported in these two measures tended to increase; however, the recall questionnaire headache estimates were lower than the diary measures in all four periods. When analysis was restricted to headaches lasting 8 hours or more, the number of headache days was more closely aligned with days reported in the recall questionnaire, indicating that the accuracy of recall estimates is likely to be influenced by headache duration. Restriction of analyses to moderate-to-severe headaches did not change results as much as headache duration. The findings indicate that recall questionnaires administered on a monthly basis may underestimate headache frequency and therefore should not be used interchangeably with headache diaries. Clinical Trials.gov Identifier : NCT02012790 [ABSTRACT FROM AUTHOR]

Katriina I Anttila,1,2 Minna J Anttila,1 Marjo H Kurki,1 Maritta A Välimäki1,3,4 1Department of Nursing Science, University of Turku, Turku, 2Helsinki University Hospital, Children and Adolescents, Child Psychiatry, Helsinki, 3Turku University Hospital, Development Unit, Turku, Finland; 4School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong, People’s Republic of China Abstract: Social relationships among adolescents with mental disorders are demanding. Adolescents with depressive symptoms may have few relationships and have difficulties sharing their problems. Internet may offer reliable and easy to use tool to collect real-time information from adolescents. The aim of this study is to explore how adolescents describe their social relationships with an electronic diary. Mixed methods were used to obtain a broad picture of adolescents’ social relationships with the data gathered from network maps and reflective texts written in an electronic diary. Adolescents who visited an outpatient clinic and used an intervention (N=70) designed for adolescents with signs of depression were invited to use the electronic diary; 29 did so. The quantitative data gathered in the electronic diary were summarized with descriptive statistics, and the qualitative data were categorized using a thematic analysis with an inductive approach. We found that social relationships among adolescents with signs of depression can vary greatly in regards to the number of existing relationships (from lacking to 21) and the quality of the relationships (from trustful to difficult). However, the relationships may change, and the adolescents are also willing to build up their social relationships. Professionals need to be aware of the diversity of adolescents’ social relationships and their need for personalized support. Keywords: adolescent, depression, electronic diary, internet, social relationship

Popular descriptions of studying frequency show remarkable discrepancies: students complain about their workload, and alumni describe freedom and pleasure. Unfortunately, empirical evidence on student time use is sparse. To investigate time use and reveal contributing psychological factors, we conducted an e-diary study. One hundred fifty-four students reported their time use and valence hourly over 7 days, both at the start of the semester and during their examination period. Motivational problems, social support and self-control were assessed once via questionnaires. Whereas the mean academic time use was in the expected range, the between-subject differences were substantial. We used multilevel modeling to separately analyze the within- and between-subject associations of valence as within factor and time use and social support, self-control, and motivation as between factors and time use. The analyses revealed the importance of affective factors on a within-subject level. Before studying, valence was already low, and it deteriorated further during studying. As expected at the between-subject level, motivational problems were related to less time studying, whereas surprisingly, self-control had no effect. The findings at the start of the semester were replicated in the examination period.

Introduction: A voiding diary (VD) is a key element in the evaluation of patients with overactive bladder (OAB) at initial presentation and during treatment to assess its effectiveness. In order to be clinically relevant, it must be performed over 3 days according to the International Continence Society (ICS). Unfortunately, some patients find it cumbersome. We aimed to evaluate the reliability and patient satisfaction when using a connected tank device., Material and Method: We conducted a single-center prospective study including 41 patients. Each patient completed a paper voiding diary and then a diary with Diary Pod® (DP) or inversely depending on the study arm. Data from 34 patients were collected. After completion of both diaries, patients completed a satisfaction questionnaire sent by email via GoogleForm. Study statistics were performed with Jamovi® and Excel® software., Result: Data from 34 patients were analyzed. There was a statically significant difference (P=0.046) between the mean volume calculated from the paper VD and that calculated from the connected VD (DP). There was no statistically significant difference (P=0.112) between the mean number of daytime voids, mean number of nighttime voids (P=0.156), mean water intake (P=0.183) reported on the paper VD and the connected VD. Thirteen (42%) paper VD and 1 connected VD did not include documentation of the presence or absence of urine leakage or urgency. There was no statistically significant difference between the two calendars regarding the presence or absence of urine leakage (P=0.180) and urinary urgency (P=0.564). Eighty-four percent (26/31) preferred the connected tank to the usual method (paper/pen), while 55% (17/31) and 29% (9/31) of the participants respectively answered that the DP was "very definitely" or "definitely" an aid for performing VD. Nevertheless, 39% (12/31) and 55% (17/31) considered its price to be high or fair and only 22% (7/31) were inclined to buy it., Conclusion: This study showed that the Diary connected reservoir Pod® is a reliable and innovative tool for voiding schedules. It facilitates data collection for the majority of patients (83%) and could, through better patient compliance, provide better quality data and help their interpretation by the physician. These factors could encourage the implementation of the connected voiding diary as a diagnostic tool. It would also be used for the assessment of treatment effectiveness in daily clinical practice as well as in research. Its cost remains a major obstacle, judged by 39% of patients to be too high, and could therefore be proposed in specific situations requiring precise data., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

The breathtaking technological progress in the field of mobile computing, smartphones and wearables offers new opportunities for psychiatric research and therapy. Wearables enable not only the objective assessment of psychiatric symptoms in real time and everyday life but using continuous monitoring and analysis of relevant parameters can also define important situations, contexts and timing during which extended assessment strategies and real-life interventions can be implemented. The momentary effect of inner city green space exposure on well-being, motivational behavior feedback and geofencing for the detection of drinking episodes are used as examples to illustrate the core benefits of real-time analyses and feedback from wearables for psychiatric research and therapy. [ABSTRACT FROM AUTHOR]

Popular descriptions of studying frequency show remarkable discrepancies: students complain about their workload, and alumni describe freedom and pleasure. Unfortunately, empirical evidence on student time use is sparse. To investigate time use and reveal contributing psychological factors, we conducted an e-diary study. One hundred fifty-four students reported their time use and valence hourly over 7 days, both at the start of the semester and during their examination period. Motivational problems, social support and self-control were assessed once via questionnaires. Whereas the mean academic time use was in the expected range, the between-subject differences were substantial. We used multilevel modeling to separately analyze the within- and between-subject associations of valence as within factor and time use and social support, self-control, and motivation as between factors and time use. The analyses revealed the importance of affective factors on a within-subject level. Before studying, valence was already low, and it deteriorated further during studying. As expected at the between-subject level, motivational problems were related to less time studying, whereas surprisingly, self-control had no effect. The findings at the start of the semester were replicated in the examination period. [ABSTRACT FROM AUTHOR]

Previous research associated smartphone use with worsened sleep among adolescents. However, the prior findings were mainly based on cross-sectional, self-reported data, and a between-person level of analysis. This study examined between- and within-person associations for adolescents' smartphone use and multiple sleep outcomes: sleep onset time, sleep onset latency, sleep duration, subjective sleep quality, and subjective daily sleepiness. The participants were 201 Czech adolescents (aged 13–17) who daily reported their sleep outcomes, daily stressors, and other media use for 14 consecutive days via a custom-made research app on their smartphones. The app also collected logs of the participants' smartphone use. We found that interindividual differences within the average volume of smartphone use before sleep were not associated with differences in sleep outcomes. At the within-person level, we found that, when adolescents used smartphones before sleep for longer than usual, they went to sleep earlier (β = −.12) and slept longer (β =.11). However, these two associations were weak. No other sleep outcomes were affected by the increased use of a smartphone before sleep on a given day. We found no interaction effects for age, gender, insomnia symptoms, media use, or daily stressors. However, the association between smartphone use and earlier sleep onset time was stronger on nights before a non-school day. Our findings suggest that the link between smartphone use and adolescent sleep is more complex, and not as detrimental, as claimed in some earlier studies. • We examined inter- and intraindividual associations between evening SU and adolescent sleep. • Typical level of logged SU before sleep was not associated to sleep outcomes. • At nights when SU was longer than usual, it was associated with improved sleep. • Unlike other media use, SU was not found to be detrimental to adolescent sleep. [ABSTRACT FROM AUTHOR]

The sudden appearance and devastating effects of the COVID-19 pandemic resulted in the need for multiple adaptive changes in societies, business operations and healthcare systems across the world. This review describes the development and increased use of digital technologies such as chat bots, electronic diaries, online questionnaires and even video gameplay to maintain effective treatment standards for individuals with mental health conditions such as depression, anxiety and post-traumatic stress syndrome. We describe how these approaches have been applied to help meet the challenges of the pandemic in delivering mental healthcare solutions. The main focus of this narrative review is on describing how these digital platforms have been used in diagnostics, patient monitoring and as a treatment option for the general public, as well as for frontline medical staff suffering with mental health issues., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Guest, Vasilevska, Al-Hamadi, Eder, Falkai and Steiner.)

Growing smartphone ownership creates unprecedented opportunities for using participants' own smartphones as diaries to record transient phenomena in daily life. In three studies, we assessed the hypothesis that participant-owned smartphone diaries would result in superior compliance and higher number of recorded entries than the traditional paper-diary method. Paper and smartphone diaries were compared for self-initiated recording of involuntary autobiographical memories (Studies 1 and 2) and everyday memory failures (Study 3). Diary-recording period (7-day, 1-day) was also examined by comparing results of Studies 1 and 2. Smartphone owners were highly compliant, carrying diaries and making entries sooner. Nevertheless, significantly fewer memory events were recorded in smartphones than paper diaries in all studies. Moreover, the number of memories recorded in Study 2 (1-day) was significantly higher than recorded on day 1 of Study 1 (7-day), suggesting that shorter diary-keeping periods may be preferable. Implications and opportunities for improving smartphone-diary functionality are discussed. [ABSTRACT FROM AUTHOR]

Summary: Objective: To analyze data from Seizure Tracker, a large electronic seizure diary, including comparison of seizure characteristics among different etiologies, temporal patterns in seizure fluctuations, and specific triggers. Methods: Zero‐inflated negative binomial mixed‐effects models were used to evaluate temporal patterns of seizure events (during the day or week), as well as group differences in monthly seizure frequency between children and adults and between etiologies. The association of long seizures with seizure triggers was evaluated using a mixed‐effects logistic model with subject as the random effect. Incidence rate ratios (IRRs) and odds ratios were reported for analyses involving zero‐inflated negative binomial and logistic mixed‐effects models, respectively. Results: A total of 1,037,909 seizures were logged by 10,186 subjects (56.7% children) from December 2007 to January 2016. Children had more frequent seizures than adults did (median monthly seizure frequency 3.5 vs. 2.7, IRR 1.26; p < 0.001). Seizures demonstrated a circadian pattern (higher frequency between 07:00 a.m. and 10:00 a.m. and lower overnight), and seizures were reported differentially across the week (seizure rates higher Monday through Friday than Saturday or Sunday). Longer seizures (>5 or >30 min) had a higher proportion of the following triggers when compared with shorter seizures: “Overtired or irregular sleep,” “Bright or flashing lights,” and “Emotional stress” (p < 0.004). Significance: This study explored a large cohort of patients with self‐reported seizures; strengths and limitations of large seizure diary databases are discussed. The findings in this study are consistent with those of prior work in smaller validated cohorts, suggesting that patient‐recorded databases are a valuable resource for epilepsy research, capable of both replication of results and generation of novel hypotheses. [ABSTRACT FROM AUTHOR]

Early detection of treatment response is important in the long-term treatment and management of patients with chronic obstructive pulmonary disease (COPD). This analysis evaluated whether early improvement in symptoms, recorded in the first 7 or 14 days via an electronic diary (eDiary) compared with baseline, can predict clinically meaningful treatment responders at 12 weeks. CRYSTAL was a 12-week, randomized, open-label study that demonstrated the increased effectiveness of indacaterol/glycopyrronium (IND/GLY) or glycopyrronium (GLY), after a direct switch from on-going baseline therapies, in patients with symptomatic COPD and moderate airflow obstruction. The co-primary endpoints were trough forced expiratory volume in 1 second (FEV1) and transition dyspnea index (TDI) at Week 12. Patients' symptom status was recorded daily in an eDiary. Of 4,389 patients randomized, 3,936 and 3,855 reported symptoms on Days 7 and 14, respectively. Patients who reported an early decrease in symptoms on Day 7 or 14 were more likely to achieve the minimal clinically important difference of ≥100 mL in trough FEV1 or ≥ 1 point in TDI at Week 12. Using stepwise multivariate regression models we identified as best predictors of FEV1 responders the decrease in wheeze on Day 7, and nighttime symptoms and wheeze on Day 14; best predictors of TDI responders were decrease in nighttime symptoms and wheeze on Day 7, and nighttime symptoms, sputum and wheeze on Day 14. Early symptom improvement at Day 7 or 14, especially wheeze and nighttime symptoms, may identify patients with clinically important improvement in lung function and dyspnea at Week 12. [ABSTRACT FROM AUTHOR]

Context: Understanding cancer patients' everyday pain experiences and their concomitant use of pain medication may help identify ways to improve pain management among outpatients.Objectives: This study examined the between-person and within-person associations between pain intensity and analgesic use in metastatic breast cancer patients.Methods: Fifty-three women who were initiating treatment for metastatic breast cancer completed electronic diary assessments six times per day for 14 days.Results: The likelihood of taking medication was found to depend on patients' average pain levels and on whether their pain was better or worse than usual at the time. Patients who typically experienced moderate-to-high pain were more likely to be prescribed and to take analgesics than were patients who typically experienced low pain. However, these patients tended not to vary their medication use based on within-person fluctuations in pain. In contrast, patients who typically experienced low pain tended to increase their medication use at times when their pain was higher than usual but were less likely to use medication than were patients who typically experienced higher levels of pain.Conclusion: Our findings provide some evidence that patients with advanced cancer tend to use their pain medications appropriately. Patients with lower pain appear to be taking medications in response to increases in pain, whereas patients whose pain is typically more intense may be relying on other cues to prompt them to take analgesic medication. Clinicians may need to be sensitive to individual differences in the factors associated with pain medication use in daily life. [ABSTRACT FROM AUTHOR]

Background/Aims: Patients with sickle cell anemia can experience recurrent pain episodes, which affect quality of life. The reported prevalence of pain is higher in studies using patient diaries than in healthcare facility utilization data. Determining Effects of Platelet Inhibition on Vaso-Occlusive Events was a multinational study that assessed the efficacy and safety of prasugrel in reducing the rate of vaso-occlusive events in children with sickle cell anemia (NCT01794000) and included an electronic patient-reported outcome diary to record pain occurrence. We aimed to capture diary completion rates and compliance in children who used the electronic patient-reported outcome diary during the Determining Effects of Platelet Inhibition on Vaso-Occlusive Events study and examine factors contributing to diary completion rates and compliance. Methods: Daily electronic patient-reported outcome diary data were collected for up to 9 months in Determining Effects of Platelet Inhibition on Vaso-Occlusive Events participants aged 4 to <18 years in Africa, the Americas, Europe, and the Middle East. The questionnaires were available in 11 languages/dialects for collecting subjective (pain intensity, activity interference) and objective (study drug use, analgesic use, school attendance) data. Pain intensity was measured using the Faces Pain Scale-Revised. Data were entered by participants or caregivers and transferred wirelessly each day to a central database. Diary completion rates were the number of daily diary entries divided by the total number of expected daily diary entries. Percentages of participants who were compliant with the diary (=80% diary completion) were calculated. Results: A total of 311 participants received a diary; 268 provided diary data through Month 9. Diary completion rates and compliance were high throughout the collection period and across all groups and regions, despite no games being included on the device. For subjective data, the overall completion rate was 94.4%, and 92.6% of participants were compliant. For objective data, the overall completion rate was 93.3%, and 89.7% of participants were compliant. Completion rates and compliance differed significantly by age and region and were higher for 4 to <12 year olds and very much higher for participants from Africa and the Middle East. Caregivers almost always entered data for participants <6 years and rarely entered data for participants =12 years. Comparing participant-entered and caregiver-entered data, pain intensity score data were more consistent for 4 to <12 year olds than older children, but pain intensity scores for older children were higher when entered by caregivers. Conclusion: With appropriate design, participant training, and sufficient monitoring, an electronic patient-reported outcome diary can capture daily sickle cell-related pain data in large multinational studies. Providing a mechanism for caregiver reporting is particularly valuable for participants <6 years and may also facilitate compliance in older children who experience high levels of pain. [ABSTRACT FROM AUTHOR]

Background Medication-overuse headache (MOH) is a chronic disabling condition associated with a high rate of relapse. Methods We evaluated whether the adoption of electronic-assisted monitoring, advice and communication would improve the outcome over a follow-up of 6 months in a controlled, multicentre, multinational study conducted in six headache centres located in Europe and Latin America. A total of 663 MOH subjects were enrolled and divided into two groups: the Comoestas group was monitored with an electronic diary associated with an alert system and a facilitated communication option, and the Classic group with a paper headache diary. Results We observed a significantly higher percentage of overuse-free subjects in the Comoestas group compared with the Classic group: 73.1 vs 64.1% (odds ratio 1.45, 95% confidence interval 1.07-2.09, p = 0.046). The Comoestas group performed better also regarding the number of days/month with intake of acute drugs and the level of disability [Migraine Disability Assessment Score: Comoestas group - 42.5 ± 53.6 (35.5-49.3) and Classic group - 27.5 ± 56.1 (20.6-34.3) ( p < 0.003)]. Conclusion The adoption of the electronic tool improved the outcome of patients suffering from MOH after withdrawal from overused drugs. Information and communication technology represents a valid aid for optimizing the management of chronic conditions at risk of worsening or of relapsing. Trial registration The trial was registered at ClinicalTrials.gov (no. NCT02435056). [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to evaluate the psychometric properties of the Dysmenorrhea Daily Diary (DysDD), an electronic patient-reported outcome, in a sample of 355 women with primary dysmenorrhea enrolled in a phase IIb, multicenter, randomized, partially blinded, placebo-controlled trial for treatment of dysmenorrhea.Methods: Subjects completed the DysDD over three menstrual cycles, one pre-treatment baseline cycle and two treatment cycles. The DysDD was administered alongside the Menstrual Distress Questionnaire (MDQ), the Short-Form 36 Version 2.0 (SF-36v2), and a Global Assessment of Change (GAC). Item response distributions, test-retest reliability, concurrent and known groups validity, responsiveness, and minimally important difference (MID) were evaluated for the DysDD.Results: As expected, item response distributions varied throughout the menstrual period for all items, with the response scales fully utilized. Within-cycle test-retest reliability was adequate (weighted kappa: 0.5-0.7), although between-cycle test-retest was poor (weighted kappa: 0.1-0.5), most likely due to the highly variable nature of dysmenorrhea between cycles rather than limitations of the measure. Correlations with the MDQ and SF-36v2 were low-moderate, but in the predicted direction, supporting concurrent validity. There were significant differences in DysDD scores across severity groups based on pain medication use. The DysDD was responsive to changes in patients' dysmenorrhea with significantly different changes in scores between change groups (p < 0.0001). MID analyses suggest changes on the DysDD 0-10 pelvic pain score of three points can be considered clinically meaningful.Conclusions: Overall, findings indicate that the DysDD has acceptable reliability and is a valid and responsive instrument for assessing dysmenorrhea. [ABSTRACT FROM AUTHOR]

Hospitalization in the intensive care unit can be a stressful time for patients and their family members. Patients' family members often have difficulty processing all of the information that is given to them. Therefore, an intensive care unit diary can serve as a conduit for synthesizing information, maintaining connection with patients, and maintaining a connection with family members outside the intensive care unit. Paper intensive care unit diaries have been used outside the United States for many years. This article explores the development of an electronic intensive care unit diary using a rapid prototyping model to accelerate the process Initial results of design testing demonstrate that it is feasible, useful, and desirable to consider the implementation of electronic intensive care unit diaries for patients at risk for post-intensive care syndrome. [ABSTRACT FROM AUTHOR]