BACKGROUND Direct feedback on quality of care is one of the key features of a learning health care system (LHS), enabling health care professionals to improve upon the routine clinical care of their patients during practice. OBJECTIVE This study aimed to evaluate the potential of routine care data extracted from electronic health records (EHRs) in order to obtain reliable information on low-density lipoprotein cholesterol (LDL-c) management in cardiovascular disease (CVD) patients referred to a tertiary care center. METHODS We extracted all LDL-c measurements from the EHRs of patients with a history of CVD referred to the University Medical Center Utrecht. We assessed LDL-c target attainment at the time of referral and per year. In patients with multiple measurements, we analyzed LDL-c trajectories, truncated at 6 follow-up measurements. Lastly, we performed a logistic regression analysis to investigate factors associated with improvement of LDL-c at the next measurement. RESULTS Between February 2003 and Decluding primary and secondary care; and medication use need to be improved in order to enhance usability of the EHR system for adequate feedback. ©T Katrien J Groenhof, Daniel Kofink, Michiel L Bots, Hendrik M Nathoe, Imo E Hoefer, Wouter W Van Solinge, A Titia Lely, Folkert W Asselbergs, Saskia Haitjema. Originally published in JMIR Medical Informatics (http//medinform.jmir.org), 02.04.2020.BACKGROUND Smartphone apps are an increasingly popular means for delivering psychological interventions to patients suffering from a mental disorder. In line with this popularity, there is a need to analyze and summarize the state of the art, both from a psychological and technical perspective. OBJECTIVE This study aimed to systematically review the literature on the use of smartphones for psychological interventions. Our systematic review has the following objectives (1) analyze the coverage of mental disorders in research articles per year; (2) study the types of assessment in research articles per mental disorder per year; (3) map the use of advanced technical features, such as sensors, and novel software features, such as personalization and social media, per mental disorder; (4) provide an overview of smartphone apps per mental disorder; and (5) provide an overview of the key characteristics of empirical assessments with rigorous designs (ie, randomized controlled trials [RCTs]).  https://www.selleckchem.com/products/Erlotinib-Hydrochloride.html  METHODS The Preferred Reed to fully realize their potential for the treatment of mental health disorders. ©Ignacio Miralles, Carlos Granell, Laura Díaz-Sanahuja, William Van Woensel, Juana Bretón-López, Adriana Mira, Diana Castilla, Sven Casteleyn. Originally published in JMIR mHealth and uHealth (http//mhealth.jmir.org), 02.04.2020.BACKGROUND Variations in patient demand increase the challenge of balancing high-quality nursing skill mixes against budgetary constraints. Developing staffing guidelines that allow high-quality care at minimal cost requires first exploring the dynamic changes in nursing workload over the course of a day. OBJECTIVE Accordingly, this longitudinal study analyzed nursing care supply and demand in 30-minute increments over a period of 3 years. We assessed 5 care factors patient count (care demand), nurse count (care supply), the patient-to-nurse ratio for each nurse group, extreme supply-demand mismatches, and patient turnover (ie, number of admissions, discharges, and transfers). METHODS Our retrospective analysis of data from the Inselspital University Hospital Bern, Switzerland included all inpatients and nurses working in their units from January 1, 2015 to December 31, 2017. Two data sources were used. The nurse staffing system (tacs) provided information about nurses and all the care they provided to patienhroughout the day, is the key driver of changes in the patient-to-nurse ratio. This demand-side variability challenges the supply-side mandate to provide safe and reliable care. Detecting and describing patterns in variability such as these are key to appropriate staffing planning. This descriptive analysis was a first step towards identifying time-related variables to be considered for a predictive nurse staffing model. ©Sarah N N. Musy, Olga Endrich, Alexander B Leichtle, Peter Griffiths, Christos T Nakas, Michael Simon. Originally published in the Journal of Medical Internet Research (http//www.jmir.org), 02.04.2020.BACKGROUND Given the interactive media characteristics and intrinsically motivating appeal, virtual serious games are often praised for their potential for assessment and treatment. OBJECTIVE This study aims to validate and develop normative data for a virtual serious game (Deusto-e-motion1.0) for the evaluation of emotional facial expression recognition and social skills, both of which are components of the theory of mind. METHODS A total of 1236 children took part in the study. The children were classified by age (8-12 years old), gender (males=639, females=597), and educational level (between the third and sixth years of Primary Education). A total of 10 schools from the Basque Country and 20 trained evaluators participated in this study. RESULTS Differences were found in Deusto-e-motion1.0 scores between groups of children depending on age and gender. Moreover, there was a moderately significant correlation between the emotional recognition scores of Deusto-e-motion1.0 and those of the Feel facial recognition test. CONCLUSIONS Deusto-e-motion1.0 shows concurrent validity with instruments that assess emotional recognition. Results support the adequacy of Deusto-e-motion1.0 in assessing components of the theory of mind in children. ©Esther Lázaro, Imanol Amayra, Juan Francisco López-Paz, Oscar Martínez, Manuel Pérez Alvarez, Sarah Berrocoso, Mohammad Al-Rashaida, Maitane García, Paula Luna, Paula Pérez-Núñez, Alicia Aurora Rodriguez, Paula Fernández, Pamela Parada Fernández, Mireia Oliva-Macías. Originally published in JMIR Serious Games (http//games.jmir.org), 02.04.2020.INTRODUCTION Multiple sclerosis (MS) is a progressive, chronic inflammatory demyelinating disease of the central nervous system, whose symptoms include sexual disorders. Sexual dysfunctions can influence on quality of life (QOL) of patients with MS. AIM To evaluate the occurrence of sexual disorders among women with MS and correlations between QOL, prevalence of sexual disorders, and level of sexual satisfaction. METHODS Polish women (n = 101) aged 22-66 years with diagnosed MS were included in the study. MAIN OUTCOME MEASURES The Female Sexual Function Index, the Sexual Satisfaction Questionnaire, the Satisfaction with Life Scale, and the Multiple Sclerosis International Quality of Life Questionnaire were used. In addition, an Authors-Designed Questionnaire was used to collect sociodemographic data. RESULTS More than half of the patients surveyed were totally or somewhat unsatisfied with their sex life, and 44.55% of the patients were diagnosed with significant sexual disorders. It was shown that patients with diagnosed sexual disorders and a low level of sexual satisfaction rated their QOL the lowest among all the surveyed patients.