TITULO: APP, atención terciaria, enfermedad renal crónica.

Transcription

1 TITULO: APP, atención terciaria, enfermedad renal crónica. DESCRIPCION CORTA: Este APP se diseña con la finalidad de aplicarlo como herramienta para la prevención terciaria en una condición especifica de enfermedad renal crónica. Para lograr dicho objetivo, se inicia con la identificación de las necesidades de los usuarios con esa patología. Luego, con estas informaciones recopiladas, se elabora una serie de actividades que debe realizar el usuario con la finalidad de alcanzar el propósito por el cual se concibe el APP, a saber enlentecer la progresión de esta patología, de por si irreversible. Como tal, estas actividades pueden ser consideradas como una manera de seguimiento a través de una serie de datos recopilados a partir de un monitoreo estricto del usuario, por lo que se le indica un conjunto de pautas a seguir tendentes al logro de nuestro objetivo. Así, es una APP diseñada tanto para el usuario y el personal de salud que les permite monitorear la evolución de dicha condición y facilita al primero tener un expediente ordenado de todos los procesos realizados para su bienestar de acuerdo a los parámetros establecidos en el marco de una patología irreversible. Introduce yourself I am Robens Molaire, medical oncologist and PhD in nutrition. I was born in Saint- Marc, Haiti. I studied in my natal city until 4 years before the end and then I went to Port-au- Prince to finish in the same school, Saint- Louis de Gonzague where I achieve my diploma in Two years later, I went to Dominican Republic in June 1993 to study medicine and I was matriculated at autonomic university of Saint- Domingue (UASD) on October I started the study in January 1994 and I finished on June 2000 with my graduation, achieving Cum Laude. Then I worked for two years. I started in 2003 my specialty in internal medicine and I finished in One year after, I began Oncology to complete the medical formation and I finished in June I worked like internist and Oncologist until In December 2014, I initiated the study for a master in Hospital management in Spain online and I finished in December Then I did a PhD online with the International Atlantic University in nutrition. I always like to investigate and I read books

2 related, like Alicia, the distributor of pan, ect. And I am always in CME wit MEDSCAPE or NCCN. Share my story I was motivated by for things: technology use for patients well- being, my experience with patients with chronic disease, motivation for the use of this stool like stool in patients following. Like oncologist, I am always worried for the way patients organize their health data and I always advice them to have copy of all medical documents. So, I consider APP is excellent for that purpose. Also kidney disease is one of the worst pathologies that Humanity has to fight against, so I can t ignore this reality. Finally, the APP can be used like diet instrument assessment and then controls the recall bias in studies, that is: remembering food eaten in the past. Effectively, participants in studies tend to substantially over report some nutrients consumption, which leads to bias. Describe your idea: My idea consists in create an APP to help users and healthcare by monitoring to achieve an effective tertiary prevention for patients with chronic kidney disease. For that, we labored a set of activities to be done by the users like exercise, self- measurement of blood pressure, dairy report nutrient consumption, weight, lab analysis and other studies to estimate kidney function through renal Labs APP, answering quiz to achieve points to participate freely in recreate activities or to use freely a gym, playing minigames related to products like words games of drugs used frequently in nephrology to facilitate memorize them, advices about healthy nutrition to stimulate appetite, provide pocket dietitian, facilitate a food coach, provide data about healthy out, restaurant nutrition, smart medical- labs, smart medical labs, drug calcium, medication APP, pill reminder APP, medicate Meds & pill reminder, etc. and advices for continuing to compile your personal health record that constitute the main concerns of users with chronic kidney disease and according to the purpose of this app, it is necessary to address them. Categories: Data tracking/ goal setting

3 How does your idea attempt to address the selected category? In the recording, there are sections to record all the components included in the monitoring. All the data collected in the application are automatically uploaded to a central repository that stores the data. These data are globally accessible through the web- service. My app provides a list of resources designed to make this information easier to track and organize. - Keeping a personal health record - Provide a place to record your day to day symptoms - Give new doctors the complete and accurate information they need to provide you with the best possible care - Provide important treatment details that you may not remember later on - Treatment results, including any complications or side effects - A schedule for follow- up care - Complete contact information for doctors - Contact information for others doctors - Dates and details of major illness - Your family history -Details of past physical examination - Availability of nutrients tools and other tools like labs references that contribute to their healthcare. Impact - The main impact of this APP is providing an effective tertiary prevention to slow down the progression of this disease, classified like irreversible.

4 - The secondary impacts are: a. Allow users to interact with their doctor from home. This is an important innovation for many patients, who have a difficult time getting to a doctor s office, whether they are living in a rural area, are elderly or disabled, or they are travelling, or they have some specific conditions that require constantly medical assistance. Due to the fact to have an active participation in the activities to achieve the fixed desired goal, the users have a commitment to take care themselves. Through monitoring vital parameters like the blood pressure, the weight, abdominal perimeter, the availability of some references labs, availability of a pocket dietitian and other tools help the user to be more independent and can take care of himself. b. Other impact, like mentioned above is the possibility to reduce the bias in study, one of methodological challenges due to recall bias through dairy recording of nutrients consumption according previously healthcare dietitian guidelines. User interface It is a user face, easy to use. The following requirements are set on the user- interface: - The APP shall be built as a system that can be reached from the Internet - The user- interface shall be easy to access - The data shall be easy to access - It shall be possible to create specific goals for each data type that exists in the system - Each patient shall be able to view the goals that the clinician has created for him/her. - Each patient will be able to add new data to the system like labs results, new symptoms, dairy measurements of weight, blood pressure, urine output, abdominal perimeter, dairy nutrients consumption, etc. Technology

5 Sencha Touch It is the framework to building multiplatform mobile apps. This MVC based JavaScript framework is famous for supporting over 50 built- in UI components. Developers are leveraging the power of this one of the latest mobile app development technologies to build apps for windows, ios, and android operating systems. Sencha Touch is used for creating native looking apps with best themes to match the look and feel of diverse platform that support it. Sencha Touch is popular among developers for smooth navigation, addition of animations and adaptive layouts it offers to the community. Sencha Touch is a user interface (UI) JavaScript library or new framework, specifically built for the mobile web. It is based on web standards such as HTML5, CSS3 and JavaScript. The goal of Sencha Touch is to facilitate quick and easy development of HTML5 based mobile apps which run on Android, ios, Windows, Tizen, and Blackberry devices, simultaneously allowing a native look and feel to the apps. MVC Architecture Sencha Touch follows the MVC patterns which separates the application data, the control code and view. This separation allows large scale applications to be flexible and easy to maintain. Widget components and customizable themes Sencha Touch has an inbuilt DOM manipulation interface which negates the dependency on other UI frameworks like j Query. It includes a set of graphical user interface GUI- based controls (or components) for use within mobile web applications. These components are optimized for touch input. The components are: - Buttons with device specific themes and effects - Form elements such as text fields for . - Date picker and address - Sliders, selectors, and combo- boxes - A list component with momentum- scrolling and index bar

6 - A minimal icon set - Toolbars and menus - Movable tabs, bottom toolbars - A map component with support for multi- touch gestures such as pinch and zoom - Carousels All the components can be themed according to the target device. This is done using Sass, a style sheet language built over CSS. Some of the native- lookalike themes are Cupertino Classic (for ios 6.x and below), Cupertino (for ios 7) and Mountain View (for Android). Since Sencha Touch is ATML5 based, the layouts it offers are extremely adaptive in nature. Charting Sense Touch also supports charting components including pie charts, bar graphs, line series, etc with explanation legends. These components support interactivity like pinch and zoom. Just like the Grid components in ExtJS, Sencha Touch offers TouchGrid component functionality. Developer tools and plugins Sencha Touch provides IDE plugins for ease of development. Benefits of these plugins include code generation auto- completion, code refactoring and ease of navigation to framework codebase and custom classes. Sencha Touch has plugins for popular IDEs like Jet Brains, Visual Studio and Eclipse. There is a visual app builder, Sencha Architect, for building cross platform HTML5 apps. It provides addiction features like theming and command line integration. Sample usage Sencha Touch makes it convenient to use a map in your application using the Ext. Map Component. The inclusion of Google Maps API is essential for the Google Maps API to work. Data

7 - Hours sleep per night - Steps taken per days - Hours walked per day - Hours run per day - Hours riding bike per day - Calories burned per day - Weight - Markers of kidney disease These include: 1. Albuminuria (ACR more than 3mg/mmol) 2. Urine sediment abnormalities 3. Electrolytes 4. Other abnormalities due to tubular disorders, abnormalities detected by imaging, abnormalities detected by histology, structural abnormalities detected by imaging, and a history of kidney transplantation. 5. Drugs: renin- angiotensin- aldosterone system including angiotensinconverting enzyme (ACE) inhibitors, angiotensin- receptor blockers (ARBs), direct renin inhibitors and aldosterone antagonists 6. Creatine- based estimate of GFR 7. Cystatin C- based estimated of GFR 8. Haematuria 9. Renal ultrasound 10. Frequency of monitoring 11. Lifestyle advice ( take exercise, achieve a healthy weight and stop smoking, Reduce alcohol consumption, no stress) 12. Dietary interventions ( advice about potassium, phosphate, calories and salt intake appropriate to the severity of chronic kidney disease 13. No low protein diet

8 14. Anemia (check Hemoglobin level in people with a GFR of less than 4ml/ min/1.73m 2. Visuals Animation There s basically 3 ways you can embed animations in your views:

9 1. Show (animationcfg) method: pass an individual configuration with show/hide methods 2. Show Animation & hide Animation configurations 3. Animations with card layout. 4. Te Types of animations for Sencha Touch are: a. Cube b. Fade c. Flip d. Pop, e. Slide f. Wipe Cube, Flip and wipe don t work with android. Research Patients with chronic kidney disease who used a mobile device had a very low error rate when imputing medication information, according to a small study checking usability. Researchers wanted to determine if mobile technology could help prevent improperly dosed or dangerous medication decisions; they tested twenty predialysis patients, gave them a mobile flip- phone or an ipod Touch and trained them how to use it, and sent them three randomized sample bottles of pills. The patients were asked to enter the medication information into a medication inquiring system app, which then told the patient if the medication was safe or unsafe in chronic kidney disease or if the patients should speak with their doctor before taking the medication. The patient then recorded the information in a journal of 60 inquiries, there were three (5%) errors recorded by the patients, according to Clarissa Diamantidis, MD, at Duke University of School of Medicine, and the co- authors of the study. They published their results on Wednesday in the Clinical Journal of the American Society of Nephrology. Descriptions The main part in an APP is data about the people for which the App is designed. So, it is important to describe the chronic kidney disease. Kidneys have the responsibility of filtering waste products from the blood in the body. Chronic kidney disease is a gradual loss of kidney function over time. There

10 are no specific symptoms of the disease but illness, tiredness and a reduced appetite are all common symptoms. As the kidney function is worsening, waste products build to high levels in the blood pressure, muscle and bone mass loss. The risk of getting other diseases such as cardiovascular disease, pericarditis and anemia is also growing. When the waste products in a patient s body become so high that the patient starts to get sick from it, the patient requires dialysis. People with severe chronic kidney disease are in need of a kidney transplant. Until a transplant can be performed, dialysis is required. Despite that chronic kidney disease is considered to be an irreversible condition, the progress of the disease can be slowdown. The National Kidney Disease Education Program NKDEP) listed 3 strategies that can be used to slow down the progress. One of those strategies is lifestyle interventions and addresses different health- promoting behavior. One of the health- promoting behaviors they discuss is physical activity as the general population. Eventually, a patient with chronic kidney disease must undergo a kidney transplant. The patient must be in good physical shape, as the risk of infections and other diseases are too high. It is essential that the patients have too much belly fat. Not only the fat induces a greater risk for the patient s life, it also makes it harder for surgeons to practically perform the transplant. So based on those data, the APP is created.

11 Sketch of Sencha Touch