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Knowledge of the quantity and quality of apps related to coronavirus disease (COVID-19) is lacking. In addition, no directory has been established listing all the apps developed to address the COVID-19 pandemic. The aim of this study was to identify smartphone apps designed to address the COVID-19 pandemic and to analyze their characteristics. We performed an observational, cross-sectional, descriptive study of all smartphone apps associated with COVID-19. Between April 27 and May 2, 2020, we searched the App Store (iOS) and Google Play Store (Android) for COVID-19 apps. The search terms used were coronavirus, COVID-19, and SARS-COV-2. The apps were downloaded and evaluated. The variables analyzed were name, platform, country, language, category, cost, update date, size, version, number of downloads, developer, and purpose. Purpose was further classified into the following categories: news, general information, self-diagnosis, contact tracing, notices to contacts, notification of close cases, awareness, helplines, monitoring of clinical parameters, recording of symptoms and treatment, and messaging with health care professionals. We identified 114 apps on the investigated platforms. Of these, 62/114 (54.4%) were on Android and 52/114 (45.6%) were on iOS. Of the 114 apps, 37 (32.5%) were developed in Europe, 32 (28.1%) in Asia, and 30 (26.3%) in North America. The most frequent languages were English (65/114, 57.0%), Spanish (34/114, 29.8%), and Chinese (14/114, 12.3%). The most common categories were health and well-being/fitness apps (41/114, 41.2%) and medicine apps (43/114, 37.7%). Of the 114 apps, 113 (99.1%) were free. The mean time between the date of the analysis and the date of the last update was 11.1 days (SD 11.0). Overall, 95 of the 114 apps (83.3%) were intended for the general population, 99 apps (7.9%) were intended for health professionals, and 3 apps (2.6%) were intended for both. Regarding the type of developer, 64/114 apps (56.1%) were developed by governments; 42/114 (64.1%) were developed by national governments, and 23/114 (35.9%) were developed by regional governments. The apps with the highest number of downloads (100,000+) were developed by governments (P=.13), except for the World Health Organization app (500,000+). The purposes of the apps available in Western languages (107/114, 93.9%) were determined; the most common purposes were general information about COVID-19 (66, 64.0%), COVID-19 news (53, 51.0%), recording of symptoms (53, 51.0%), and contact tracing (51, 47.7%). More than one purpose was identified for 99/107 apps (92.5%). This paper offers a comprehensive and unique review of all available COVID-19 apps. Governments have adopted these tools during the pandemic, and more than half of the apps were developed by government agencies. The most common purposes of the apps are providing information on the numbers of infected, recovered, and deceased patients, recording of symptoms, and contact tracing.

Concerned significant others (CSOs) play a significant role in supporting individuals with substance use disorders. There is a lack of tailored support services for these CSOs, despite their substantial contributions to the well-being of their loved ones (LOs). The emergence of helplines as a potential avenue for CSO support is outlined, culminating in the focus on the Partnership to End Addiction's helpline service, an innovative public health intervention aimed at aiding CSOs concerned about an LO's substance use. The article analyzes the demographics and use patterns of the Partnership to End Addiction's helpline service, highlighting the critical role of such services, and advocating for expanded, tailored support models. This observational study draws data from 8 data platforms spanning April 2011 to December 2021, encompassing 24,096 client records. Surveys were completed by helpline specialists during synchronous telephone calls or self-reported by CSOs before helpline engagement. Collected information encompasses demographics, interaction language, substance of concern, CSO-LO relationship, and the LO's \"use state,\" that is, their location on the continuum of substance use. CSOs primarily comprised women (13,980/18,373, 76.1%) seeking support for their children (1062/1542, 68.9%). LOs were mostly male (1090/1738, 62.7%), aged 18-25 years (2380/7208, 33%), with primary substance concerns being cannabis (5266/12,817, 40.9%), opioids (2445/12,817, 19%), and stimulants (1563/12,817, 12.1%). CSOs primarily sought aid for LOs struggling with substances who were not in treatment (1102/1753, 62.9%). The majority of CSOs were looking for support in English (14,738/17,920, 82.2%), while the rest (3182/17,920, 17.8%) preferred to communicate in Spanish. Spanish-speaking CSOs were significantly more likely to call about cannabis (n=963, 53.7% vs n=4026, 38.6%) and stimulants (n=304, 16.9% vs n=1185, 11.3%) than English-speaking CSOs (P<.001). On the other hand, English-speaking CSOs were more likely to be concerned about opioids than Spanish-speaking CSOs (n=2215, 21.3% vs n=94, 5.2%; P<.001). The study illuminates the helpline's pioneering role in aiding CSOs grappling with an LO's substance use. It highlights helplines as crucial resources for CSOs, revealing key demographic, substance-related, and use-state trends. The dominant presence of women among users aligns with other helpline patterns and reflects traditional caregiving roles. While parents form a significant percentage of those reaching out, support is also sought by siblings, friends, and other family members, emphasizing the need for assistance for other members of an LO's social network. Spanish-speaking individuals' significant outreach underscores the necessity for bilingual support services. Substance concerns revolve around cannabis, opioids, and stimulants, influenced by age and language preferences. The helpline serves as an essential intermediary for CSOs, filling a gap between acute crisis intervention services and formalized health care and treatment services. Overall, the study highlights this helpline's crucial role in aiding CSOs with tailored, accessible support services.

Health care providers are increasingly screening low-income patients for social needs and making referrals to social services agencies to assist in resolving them. A major assumption of this approach is that local social services providers have the capacity and resources to help. To explore this assumption, we examined 711,613 requests related to fifty different social needs received from callers to 211 helplines in seven states during 2018. Our analyses focused on the proportion of requests for which referrals could not be made because of low capacity in the social services system. We examined the extent to which the capacity of this system varied by type of social need, ZIP code, and time of year, and we classified social needs in a new typology based on prevalence and system capacity. It is clear that health care's current screening and referral approach is appropriate for some social needs but not others.

Background Gambling products differ in terms of their harm potential. Products are also constantly developing and changing. However, little research has addressed changes and trends in the types of gambling that are associated with harms. The current study explores trends in the gambling product categories identified as harmful in longitudinal helpline data from three Nordic countries. Methods We use data collected by national helplines in Denmark (StopSpillet), Finland (Peluuri) and Sweden (Stödlinjen) in their daily operations (N = 46 646). The data consist of information collected on gamblers and concerned significant others who have contacted these helplines between January 2019 and December 2022. We analyse which gambling products are mentioned as harmful by clients. The analysis uses linear regression with the interaction term (country) times time regressed over the outcome variable (proportion per month). Results The results show that an increased share of contacts concern online gambling. Online casino products have become the most harmful category across contexts. The share of reported harms from online betting and new emerging online forms is also increasing. The share of land-based products as a reported source of harms has decreased across 2019–22. Conclusions The results suggest that online gamlbing environments, and particularly online casino products, are associated with increasing harms to help-seekers. The harmfulness of different gambling products may not be stable, but change over time. Further harm prevention efforts are needed to address the online gambling field, including emerging formats.

Background Information on rheumatic diseases is often complex to understand or scary, and additional support is often necessary. Rheuma Directly (RD) is a helpline with specially trained nurses on rheumatic diseases, funded by the Swedish Rheumatism Association and Spenshult Research and Development Centre. Little is known of how people calling a helpline perceive the contact. Objectives To describe the variation in how people perceive the contact with the helpline RD. Methods The study had a descriptive, qualitative design with a phenomenographic approach and was carried out by means of 27 semi-structured telephone interviews. The informants were 22 female and 5 men, and their ages ranged from 22 to 89 years (mean 54 years). Results The informants called RD when they had problems getting answers to their questions through the Internet or from healthcare professionals. Three different description categories emerged: Specific competence, Constructive dialogue, and Applicability. The informants' perceived Specific competence when the nurses were knowledgeable, the call was complementary to previously received information and when the informants had greater knowledge after the contact with RD. They perceived that it was a Constructive dialogue when they got someone to discuss with, a “sounding board”, and perceived emotional support, felt reassured and were satisfied with the answer. The informants perceived Applicability because RD was available and they could make different choices according to their own desire; before (how and when they would contact RD), during (what to tell and what question they would ask) and after (how and what they would do after the contact with RD). Conclusions People calling RD perceived that the telephone call with the nurses meant meeting specific competence, gaining constructive dialogue and that the helpline was applicable. This knowledge ad to a fuller understanding of factors that from a caller's perspective, are important when calling a helpline with specially trained nurses on rheumatic diseases. © 2017, Published by the BMJ Publishing Group Limited.

Background StrokeLine is a stroke‐specific helpline used by stroke survivors and their families in Australia to access professional support. There has been little research exploring stroke survivors' experiences of using helplines and their perceived impact on their stroke recovery. Aim The aim of this study is to explore the reasons prompting stroke survivors to call StrokeLine and their experiences and to describe the perceived impact of calling StrokeLine on their recovery. Methods An exploratory descriptive qualitative study was undertaken using thematic analysis of data collected through semi‐structured interviews of stroke survivors between December 2020 and May 2022. Participants were recruited using purposive sampling. Interviews were conducted via audio‐recorded Zoom conference calling and transcribed verbatim for thematic analysis. Results A total of eight callers (four men and women women) participated, with the time since stroke ranging from 3.5 months to 5 years. Four major themes were identified, including 17 sub‐themes. Key themes included (1) factors prompting use of StrokeLine; (2) experience of using StrokeLine; (3) perceived impact of using StrokeLine; and (4) conceptualising StrokeLine service provision. Conclusions Participants perceived their experience of contacting StrokeLine as having a positive impact on their stroke recovery, leaving them feeling empowered and motivated to self‐manage their condition. Patient or Public Contribution Stroke survivors with lived experience influenced the conceptualisation of this study through conversations with consumers and the Stroke Foundation. Eight stroke survivors were involved as participants in the research study.

PurposeThe aims of this systematic review were to summarize the profile of caregivers accessing cancer helplines, to evaluate caregiver satisfaction with the helpline service, and to review the evidence base of intervention studies testing the efficacy of community-based cancer helplines in improving caregiver health and well-being.MethodsFour electronic databases (Medline, CINAHL, PsychINFO, and EMBASE) were systematically searched to identify relevant literature, including all articles published in English until May 2018. Reference lists of accepted papers were reviewed for the inclusion of additional potentially relevant articles, gray literature was excluded.ResultsForty-five publications met the inclusion criteria for this review. Forty-one papers reported on the proportion of caregivers accessing cancer helplines. Twenty-six studies described demographic and clinical characteristics of caregivers and eight reported on call characteristics. Reasons for contacting the service were stated in 21 studies and caregiver satisfaction with the helpline service was assessed in 12 articles. Fourteen studies investigated specific topics of interest (e.g., prevalence of sleep problems, distress screening, or clinical trial participation). Two randomized controlled trials examined the efficacy of cancer helplines in improving caregiver outcomes, with findings showing interventions to be effective in reducing distress and unmet needs, and in increasing positive adjustment.ConclusionsThere is limited scientific evidence regarding the efficacy of cancer helplines to improve caregivers’ health and well-being. More intervention studies are needed to examine the benefits of cancer helplines to this study population to ensure structured referral pathways can be established.

The number of adults aged 65 years and older is expected to more than double worldwide over the next several decades, and for the first time in recorded history, older adults will outnumber children (https://bit.ly/ 3D4p0im). Despite these unprecedented population shifts, older adults are significantly underrepresented in biomedical research, especially in the field of nicotine and tobacco science (https://bit.ly/3shUSuI). This focus on younger cohorts has obscured the reality that combustible tobacco use (i.e., smoking) has remained virtually unchanged for older adults for nearly two decades in the United States (Figure 1).Meanwhile, smoking prevalences among youths and young adults in the United States are at the lowest levels ever recorded. One explanation for these differences in prevalence trajectories could be that, since at least 2005, quit rates among older smokers have remained stagnant (https://bit.ly/3Nax XeF).1 Aligning with this observation is evidence suggesting that traditional tobacco control policies (i.e., pricing, smoke-free policies, information campaigns, bans on advertising, health warning labels, cessation treatments) are not affecting older smokers the same as younger cohorts, as represented in an analysis of smoking behavior in Europe between 2004 and 2013 (https://bit.ly/3VVs2y2). Additionally, older smokers may have less knowledge of quitlines or other local smoking cessation services2,3 and more misconceptions about the relative harms of nicotine and combustible tobacco.2 Older adults are also less likely to use noncombustible nicotine products (https://bit.ly/3z3iZAY).The lack of attention paid to older smokers does not match the incredible burden of disease and death that this population carries. Tobacco-related disease is age-related disease as evidenced by older smokers incurring 12 times greater health care expenses than middle-aged smokers (https://bit. ly/3eXhLR8).4 As noted by the American Cancer Society, cancers associated with smoking are most often diagnosed after the age of 65 years and include lung, kidney, bladder, and stomach cancer (https://bit.ly/3F7gtxB). Although most people start smoking in the early part of their life, most suffering and deaths associated with tobacco use occur far later. Unfortunately, older adult smokers are not represented in the most basic methodological details of nicotine and tobacco research. For example, in other fields of study, \"older adults\" are often defined as those who are 65 years and older and may be further delineated as the young old (65-74 years), middle old (75-84 years), and old old (> 85 years).5 However, research on tobacco use does not adhere to this definition, with studies defining \"older adults\" across a wide range of ages (e.g., 25 years or older; https://bit.ly/3TIjwAr). Beyond this, many studies explicitly exclude anyone older than 65 years from participation (https://bit.ly/3VP032T). These inconsistencies in definitions and study inclusion criteria can confound what we know about tobacco use among older adults.

At a time of increased demand for specialist mental health services, a more nuanced understanding of how adolescents navigate systems of care and support is essential. We mapped 'networks of care' to explore patterns of mental health help-seeking alongside the perceived helpfulness of support accessed. We examined data from 23 927 adolescents aged 11-18 years who participated in the 2023 OxWell Student Survey, an English school-based, repeated cross-sectional survey of mental health and wellbeing. Students self-reported past-year access to 18 types of support across informal (e.g. friends and family), semi-formal (e.g. school and charities), and formal (e.g. health and social care) domains, alongside how helpful they found the support. We used a network approach to explore interconnections between sources of support accessed and perceived helpfulness. One in four (27.0%, 6449/23927) adolescents reported past-year access to mental health support, of which 56.7% (3658/6449) reported accessing multiple types. Informal networks were the most commonly accessed (23.1%, 5523/23927), followed by semi-formal (9.7%, 2317/23927) and formal (6.8%, 1623/23927) supports. Informal sources had high acceptability, with around 80-90% reporting them as helpful, whereas child and adolescent mental health services (CAMHS), helplines, and online supports were perceived to be the least helpful. The networks also identified groups who might not be optimally served by current systems, including gender diverse adolescents and adolescents who found mental health support from their parents unhelpful. Adolescents are accessing mental health support across informal, semi-formal, and formal sources of care. Services can no longer be developed, delivered, or evaluated in isolation from these networks.

Simulation study results suggest that COVID-19 contact tracing apps have the potential to achieve pandemic control. Concordantly, high app adoption rates were a stipulated prerequisite for success. Early studies on potential adoption were encouraging. Several factors predicting adoption rates were investigated, especially pertaining to user characteristics. Since then, several countries have released COVID-19 contact tracing apps. This study's primary aim is to investigate the quality characteristics of national European COVID-19 contact tracing apps, thereby shifting attention from user to app characteristics. The secondary aim is to investigate associations between app quality and adoption. Finally, app features contributing to higher app quality were identified. Eligible COVID-19 contact tracing apps were those released by national health authorities of European Union member states, former member states, and countries of the European Free Trade Association, all countries with comparable legal standards concerning personal data protection and app use voluntariness. The Mobile App Rating Scale was used to assess app quality. An interdisciplinary team, consisting of two health and two human-computer interaction scientists, independently conducted Mobile App Rating Scale ratings. To investigate associations between app quality and adoption rates and infection rates, Bayesian linear regression analyses were conducted. We discovered 21 national COVID-19 contact tracing apps, all demonstrating high quality overall and high-level functionality, aesthetics, and information quality. However, the average app adoption rate of 22.9% (SD 12.5%) was below the level recommended by simulation studies. Lower levels of engagement-oriented app design were detected, with substantial variations between apps. By regression analyses, the best-case adoption rate was calculated by assuming apps achieve the highest ratings. The mean best-case adoption rates for engagement and overall app quality were 39.5% and 43.6%, respectively. Higher adoption rates were associated with lower cumulative infection rates. Overall, we identified 5 feature categories (symptom assessment and monitoring, regularly updated information, individualization, tracing, and communication) and 14 individual features that contributed to higher app quality. These 14 features were a symptom checker, a symptom diary, statistics on COVID-19, app use, public health instructions and restrictions, information of burden on health care system, assigning personal data, regional updates, control over tracing activity, contact diary, venue check-in, chats, helplines, and app-sharing capacity. European national health authorities have generally released high quality COVID-19 contact tracing apps, with regard to functionality, aesthetics, and information quality. However, the app's engagement-oriented design generally was of lower quality, even though regression analyses results identify engagement as a promising optimization target to increase adoption rates. Associations between higher app adoption and lower infection rates are consistent with simulation study results, albeit acknowledging that app use might be part of a broader set of protective attitudes and behaviors for self and others. Various features were identified that could guide further engagement-enhancing app development.