INTRODUCTION Smartphone-based smoking cessation interventions are increasingly used around the world. However, the effects of smartphone applications on applicability and efficacy on cessation rate and prevention of relapses are not often evaluated. Therefore, this review aims to assess the evidence on effectiveness of smartphone applications as an intervention tool for smoking cessation support. METHODS We conducted the search using Ovid Medline/PubMed, CENTRAL and Scopus databases dated (January 2007-June 2016. Inclusion criteria include randomized control trials or intervention studies with mobile applications that offer smoking cessation support. Two assessors independently extracted and evaluated the data from each included study. RESULTS The review of eight selected studies illustrate the use of smartphone applications in increasing quit rates among smokers, however adherence to app features influences quit rates. Audiovisual features followed by a quit plan, tracking progress and sharing features are most accepted and utilised app features. However, inconsistency was observed in their association with abstinence or quit rate. App engagement features increase the statistical significance in the quit rate. Development of smartphone applications was supported by behavior change theories in all studies nevertheless; heterogeneous forms of intervention were adopted within studies. Similarly, reduction in relapse attributed to enhanced discussion among quitters using social media applications was observed. CONCLUSIONS Quality evidence is warranted with large sample size to measure effect size of the intervention. Future research on effectiveness and efficacy of smartphone alone and comparisons with other mHealth interventions, such as text messaging would be useful.

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Objectives:To determine the average health-related quality of life (HRQOL) score levels and their determinants in patients with predialysis chronic kidney disease (CKD).Methods:A systematic literature search was conducted for relevant observational studies published between April 2007 and April 2017 in MEDLINE, EBSCOhost, and CINAHL databases.Results:Thirteen observational studies with a total sample of 8635 subjects comprising 53.3% male with an aggregate mean age of 59.5 (SD 14.9) years were included in this review. Of the 8 generic HRQOL domains of the Short-Form Health Surveys, Social Functioning had the highest mean score whereas General Health had the lowest mean score in patients with predialysis CKD. Physical component summary (PCS) was more impaired than mental component summary (MCS). The determinants of poor HRQOL in predialysis CKD patients included both modifiable risk factors such as comorbidities (namely anxiety and depression), low serum hemoglobin level, sedentary lifestyle, unemployment and non-modifiable risk factors such as poor glomerular filtration rate, female gender, and older age. The risk factors impeded PCS more than MCS.Conclusion:Several risk factors influence HRQOL impairment in patients with predialysis CKD, with PCS being more impacted than MCS. The risk factors for poor HRQOL are important for future research and for improving renal care in patients with predialysis CKD.PROSPERO registration number: CRD42018093385

INTRODUCTION Smoking cessation support with smartphone applications is widely practised, however, quality and novel content is yet to be established. This study examined content, quality and compliance of the STaR (Sihat Tanpa Rokok-Healthy Without Smoking) smartphone application to smoking cessation clinical practice guidelines. METHODS Mobile Application Rating Scale (MARS) was applied to assess the quality of the mobile application. A total of 33 compliance assessment criteria were developed, based on the smoking cessation clinical practice guidelines adopted by the Brunei Ministry of Health and used to rate the compliance. RESULTS The STaR app has an average quality and compliance score. The mean MARS score of 3.31 and a subjective quality score of 2.50 was measured on a 5-point scale (from 1=inadequate to 5=excellent). The application contents that adhere to smoking cessation clinical practice guidelines suggest adequate adherence to the 5A (Ask, Advice, Assess, Assist, Arrange) and 5R motivational interventions (Relevance, Risks, Rewards, Roadblocks, Repetition) approach for smoking cessation. CONCLUSIONS The STaR mobile app with the integration of all components of smoking cessation clinical practice guidelines (such as 5A approach and pharmacotherapy intervention) may improve quality scores.

Background Childhood obesity has become a global public health crisis. Many studies have been conducted to explore the knowledge, attitude and practices towards eating and physical activity amongst parents and healthcare workers. However, very little is known amongst children. It is imperative to understand these factors as they have been associated with obesity among children. Objective This study aimed to assess the knowledge, attitude and practices of Bruneian children towards eating and physical activity, in order to identify the factors that influence the development of obesity. Methods The study involved 353 children from four primary schools in Brunei. The data collection tool used was modified validated questionnaires with sections on demographic characteristic, knowledge about obesity, eating habits and physical activity. Results The majority of children (>60%) had good knowledge of obesity and intake of healthy food, but, 84.2% lacked knowledge on the required daily servings of fruits and vegetables. 68.8% purchased food and beverages from their school canteen. 93.8% were aware about the health benefits of physical activity and 70.2% spent only 1-2 h of screen time per day, however, 46.9% did not meet the recommended amount of physical activity although they reported to have performed enough. This suggested that a comprehensive education on food intake requirements and physical activity are necessary in order to better educate children. Conclusion Health educators and public health professionals may find our findings useful in order to plan and develop tailored interventions for children, as well as better promotion of a healthy lifestyle to children and their families.

Background Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality globally. This review aimed to summarise evidence on the key features, usability and benefits of CVD risk calculators using digital platforms for CVDs prevention and management in populations. Methods We used search engines and thematic analyses to conduct a scoping review. As the reporting guideline for this review, we used Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Results A total of 17 studies meeting eligibility criteria were included in the analysis, from which about 70% of the studies have prognostic level I (n = 8) and level II (n = 4) evidence. The review found that various guidelines are recommending different algorithms for CVD risk prediction. The QRISK® was the most accurate CVD risk calculator for several study populations, whereas World Health Organization/International Society of Hypertension (WHO/ISH) risk scores were the least accurate. The key features of CVD risk calculators are variables, predictive accuracy, discrimination index, applicability, understandability, and cost-effectiveness. Conclusion For the selected risk prediction tool, development and validation research must be done, which considers a mix of stroke-specific risk and CVD risk to establish its usability in the local community and advantages to the particular health-care environment. To get healthcare professionals more involved in preventing and treating CVDs, each healthcare setting should use an online CVD risk assessment tool that is more useful, accurate, and easy to use, based on the population and health system.