Childhood obesity treatment: integrating mobile health technology into a paediatric obesity service

Background: The management of childhood obesity is challenging. Aims: Thesis, i) reviews the evidence for lifestyle treatment of obesity, ii) explores cardiometabolic burden in childhood obesity, iii) explores whether changes in body composition predicts change in insulin sensitivity (IS), iv) develops and evaluates a lifestyle obesity intervention; v) develops a mobile health application for obesity treatment and vi) tests the application in a clinical trial. Methods: In Study 1, systematic reviews and meta-analyses of the 12���month effects of lifestyle and mHealth interventions were conducted. In Study 2, the prevalence of cardiometabolic burden was estimated in a consecutive series of 267 children. In Study 3, body composition was estimated with bioelectrical impedance analysis (BIA) and dual x-ray absorptiometry (DXA) and linear regression analyses were used to estimate the extent to which each methods predicted change in IS. Study 4 describes the development of the Temple Street W82GO Healthy Lifestyle intervention for clinical obesity in children and a controlled study of treatment effect in 276 children is reported. Study 5 describes the development and testing of the Reactivate Mobile Obesity Application. Study 6 outlines the development and preliminary report from a clinical effectiveness trial of Reactivate. Results: In Study 1, meta--���analyses BMI SDS changed by -0.16 (-0.24,���0.07, p<0.01) and -0.03 (-0.13, 0.06, p=0.48). In study 2, cardiometabolic comorbidities were common (e.g. hypertension in 49%) and prevalence increased as obesity level increased. In Study 3, BC changes significantly predicted changes in IS. In Study 4, BMI SDS was significantly reduced in W82GO compared to controls (p<0.001). In Study 5, the Reactivate application had good usability indices and preliminary 6���month process report data from Study 6, revealed a promising effect for Reactivate. Conclusions: W82GO and Reactivate are promising forms of treatment.

Reviewing mHealth in developing countries: A stakeholder perspective

Infrastructural deficiencies, limited access to medicare, and shortage of health care workers are just a few of the barriers to health care in developing countries. As a consequence, the burden of disease and its impact on the livelihoods and the economic productivity of people are staggering. mHealth has been extolled as one possible solution to overcoming these challenges, yet discussion of mHealth systems is often limited to specific tasks and user groups. To address this, we adopt a stakeholder perspective and analyze existing research on the mHealth process in developing countries. Specifically, we focus on three key stakeholder groups, i.e. healthcare workers, patients, and system developers. We perform an in-depth analysis of 60 peer-reviewed studies to determine the extent to which different mHealth stakeholder interactions are researched, and to identify high-level themes emerging within these interactions. This analysis illustrates two key gaps in existing mHealth research. First, while interactions involving healthcare workers and/or patients have received significant attention, relatively little research has looked at the role of patient-to-patient interactions. Second, the interactions between system developers and the other stakeholder groups are strikingly under-represented. We conclude by calling for more mHealth research that explicitly addresses these stakeholder interactions.

A cycle route planner mobile-app for Dublin city

In a road network, cyclists are the group exposed to the maximum amount of risk. Route choice of a cyclist is often based on level of expertise, perceived or actual road risks, personal decisions, weather conditions and a number of other factors. Consequently, cycling tends to be the only significant travel mode where optimised route choice is not based on least-path or least-time. This paper presents an Android platform based mobile-app for personalised route planning of cyclists in Dublin. The mobile-app, apart from its immediate advantage to the cyclists, acts as the departure point for a number of research projects and aids in establishing some critical calibration values for the cycling network in Dublin.��

Investigation into a best practice model for providing an integrated user experience with mobile cloud applications

Mobile Cloud Computing promises to overcome the physical limitations of mobile devices by executing demanding mobile applications on cloud infrastructure. In practice, implementing this paradigm is difficult; network disconnection often occurs, bandwidth may be limited, and a large power draw is required from the battery, resulting in a poor user experience. This thesis presents a mobile cloud middleware solution, Context Aware Mobile Cloud Services (CAMCS), which provides cloudbased services to mobile devices, in a disconnected fashion. An integrated user experience is delivered by designing for anticipated network disconnection, and low data transfer requirements. CAMCS achieves this by means of the Cloud Personal Assistant (CPA); each user of CAMCS is assigned their own CPA, which can complete user-assigned tasks, received as descriptions from the mobile device, by using existing cloud services. Service execution is personalised to the user's situation with contextual data, and task execution results are stored with the CPA until the user can connect with his/her mobile device to obtain the results. Requirements for an integrated user experience are outlined, along with the design and implementation of CAMCS. The operation of CAMCS and CPAs with cloud-based services is presented, specifically in terms of service description, discovery, and task execution. The use of contextual awareness to personalise service discovery and service consumption to the user's situation is also presented. Resource management by CAMCS is also studied, and compared with existing solutions. Additional application models that can be provided by CAMCS are also presented. Evaluation is performed with CAMCS deployed on the Amazon EC2 cloud. The resource usage of the CAMCS Client, running on Android-based mobile devices, is also evaluated. A user study with volunteers using CAMCS on their own mobile devices is also presented. Results show that CAMCS meets the requirements outlined for an integrated user experience.