Background: Mobile-health applications are revolutionising the way healthcare is being delivered. However, current research focusses on apps aimed at monitoring of conditions rather than the prevention of disease. Healthcare apps that prevent disease can be classified as lifestyle apps (LAs) and encompass mindfulness, exercise, and diet apps. In order for widespread implementation of these apps, perspectives of the user must be taken into consideration. Therefore, this systematic literature review identifies the barriers and facilitators to the use of LAs from a user’s perspective. Objective: To both identify the facilitators to the use of LAs from a user perspective as well as identify the barriers to the use of LAs from a user perspective. Methods: A systematic literature review was conducted following PRISMA guidelines. Qualitative articles focussed on a healthy non-diseased population were obtained. Two independent researchers coded the articles, and themes were identified. Results: Our results found that there were five barriers and five facilitators to app use. The facilitators included (1) motivational aspects to the user, (2) effective marketing and communication, (3) user-centred design and content, (4) humanising technology, and (5) accessibility. The five barriers identified were (1) a non-conducive, (2) poor marketing and branding, (3) controlling and invasive, (4) disengaging content, and (5) inaccessibility. Conclusions: By overcoming the barriers of LAs and encouraging the facilitators found, users are more likely to engage with this method of health promotion. Future research must be conducted on the barriers and facilitators to development and distribution of apps in order for LAs to be implemented in widespread healthcare practice.

Background: The UK National Health Service (NHS) propose the use of oxybutynin prior to onabotulinumtoxinA (Botox) in the management of overactive bladder syndrome (OAB). Oxybutynin is costly and associated with poor adherence, which may not occur with Botox. We conducted a cost-utility analysis (CUA) to compare the medications. Methods: we compared the two treatments in quality-adjusted life years (QALYS), through the NHS’s perspective. Costs were obtained from UK-based sources and were discounted. Total costs were determined by adding the treatment cost and management cost for complications on each branch. A 12-month time frame was used to model the data into a decision tree. Results: Our results found that using Botox first-line had greater cost utility than oxybutynin. The health net benefit calculation showed an increase in 0.22 QALYs when Botox was used first-line. Botox also had greater cost-effectiveness, with the exception of pediatric patients with an ICER of £42,272.14, which is above the NICE threshold of £30,000. Conclusion: Botox was found to be more cost-effective than antimuscarinics in the management of OAB in adults, however less cost-effective in younger patients. This predicates the need for further research to ascertain the age at which Botox becomes cost-effective in the management of OAB.

BACKGROUND Mobile Health applications are revolutionising the way healthcare is being delivered. However, current research focusses on apps aimed at monitoring of conditions rather than the prevention of disease. Healthcare apps that prevent disease can be classified as Lifestyle apps (LAs) and encompass mindfulness, exercise and diet apps. In order for widespread implementation of these apps, perspectives of the user must be taken into consideration. Therefore, this systematic literature review identifies the barriers and facilitators to the use of LAs from a user's perspective. OBJECTIVE To both identify the facilitators to the use of LAs from a user perspective as well as identify the barriers to the use of LAs from a user perspective. METHODS A systematic literature review was conducted following PRISMA guidelines. Qualitative articles focussed on a healthy non-diseased population were obtained. Two independent researchers coded the articles and themes were identified. RESULTS Our results found that there were 5 barriers and 5 facilitators to app use. The Facilitators included (1) Motivational Aspects to the User, (2) Effective Marketing and Communication (3) User-Centred Design and Content (4) Humanising Technology (5) Accessibility. The 5 barriers identified were (1) A Non-Conducive, (2) Poor Marketing and Branding (3) Controlling and Invasive, (4) Disengaging Content (5) Inaccessibility CONCLUSIONS By overcoming the barriers of LAs and encouraging the facilitators found, users are more likely to engage with this method of health promotion. Future research must be conducted on the barriers and facilitators to development and distribution of apps in order for LAs to be implemented in widespread healthcare practice. CLINICALTRIAL N/A

Aim: To find the consequences of trunk exercises in addition to the traditional physiotherapy practices for trunk control, mobility, and balance in hemiparetic cerebral palsy children. Methods: Forty children withhemiparetic cerebral palsy of 10-14 years (without gender discrimination), were included in this randomized controlled trial. Both groups received a conventional physical therapy program, whilethe study group additionally received trunk exercises. Participants were re-evaluated after three months of treatment by using the Trunk Impairment Scale (TIS) for assessment of trunk control, Pediatric Berg Balance Scale (PBS) for balance assessments, and the dynamic gait index scale (DGI) for walking mobility function. Results:The Mann Whitney ‘U’ test was used to measure the difference between the 2 groups while Wilcoxon test was used to measure the difference within the group.Results were demonstrated as mean and standard deviations for pre and post-treatmentscores of variables TIS, PBS, and DGI.Comparison of outcome measures of each group before treatment specified no substantial differences. While, comparison of outcome measures after the treatmentwith traditional physiotherapy along with trunk exercises revealed noteworthy increase in the aptitude to maintain trunk stability, balance, and walking mobility function in study group A (p<0.05). Conclusion: The trunk exercise has a beneficial role and can be used in amalgamation with a traditional physiotherapy practiceto increase control of the trunk, and improvement of balance, and walking mobility functions in hemiparetic cerebral palsy individuals. Keywords: Hemiparetic Cerebral palsy, trunk control, balance, Pediatric Berg Balance Scale, Dynamic Gait Index