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d (K range 0.7-1.0), except for the color of the tongue body (K=0.22) and slippery tongue fur (K=0.1). Inter-rater reliability was moderate for tongue coating (Gwet AC2 range 0.49-0.55), and fair for color and other features of the tongue body (Gwet AC2=0.34). Conclusions Taken together, our study has shown that tongue images collected via smartphone contain some reliable features, including tongue coating, that can be used in mHealth analysis. Our findings thus support the use of smartphones in telemedicine for detecting changes in tongue coating.Background Information technology and video gaming have potential advantages in the treatment of schizophrenia. However, the amount of information regarding the habits and attitudes related to internet use and video gaming among the population has been limited. Objective This study aims to explore the habits and attitudes regarding video gaming and information technology, and their associated factors, among people with schizophrenia in Hong Kong. Methods In this cross-sectional survey, service users with schizophrenia were recruited from six halfway hostels and seven integrated centers for mental wellness in Hong Kong. A 79-item self-report questionnaire was utilized to explore the habits on internet use and video gaming. The attitudes towards video gaming was assessed by the Gaming Attitudes, Motivations, and Experiences Scales (GAMES). A total of 110 participants were recruited using a convenience sample (a response rate of 74%). The data were analyzed using descriptive statistics, an independent t-test, Peand "evasive playing," were formed to describe the characteristics of video game playing. Conclusions In our data, there was a high internet utilization rate among people with schizophrenia in Hong Kong. Only a few of them had used the internet to search for health-related information. Our study also exemplified the unique habits of gaming among the participants. Healthcare professionals might utilize video games to engage and promote coping with stress and to provide social skills training. The identification of gaming attitudes can contribute to the development of serious games for the population. Further investigation is vital for the promotion of mental health through online platforms.Background Population size estimates (PSEs) for hidden populations at increased risk of HIV, including female sex workers (FSWs), are important to inform public health policy and resource allocation. The service multiplier method (SMM) is commonly used to estimate the sizes of hidden populations. We used this method to obtain PSEs for FSWs at 9 sites in Zimbabwe and explored methods for assessing potential biases that could arise in using this approach. Objective This study aimed to guide the assessment of biases that arise when estimating the population sizes of hidden populations using the SMM combined with respondent-driven sampling (RDS) surveys. AMPK inhibitor Methods We conducted RDS surveys at 9 sites in late 2013, where the Sisters with a Voice program (the program), which collects program visit data of FSWs, was also present. Using the SMM, we obtained PSEs for FSWs at each site by dividing the number of FSWs who attended the program, based on program records, by the RDS-II weighted proportion of FSWs who reported of program existence, and in the majority of sites, there was no evidence that the characteristics of the populations differed between RDS and program data. Conclusions We used a series of rigorous methods to explore potential biases in our PSEs. We were able to identify the biases and their potential direction, but we could not determine the ultimate direction of these biases in our PSEs. We have evidence that the PSEs in most sites may be biased and a suggestion that the bias is toward underestimation, and this should be considered if the PSEs are to be used. These tests for bias should be included when undertaking population size estimation using the SMM combined with RDS surveys.Background Timely and comprehensive diagnostic image sharing across institutional and regional boundaries can produce multiple benefits while supporting integrated models of care. In Ontario, Canada, the Diagnostic Imaging Common Service (DICS) was created as a centralized imaging repository to enable the sharing and viewing of diagnostic images and associated reports across hospital and community-based clinicians throughout the province. Objective (1) To explore real-world utilization and perceived clinical value of the DICS following the provision of system-wide access, and (2) identify strategies to optimize the technology platform functionality and encourage adoption. Methods This multi-methods study included semi-structured interviews with physicians and administrative stakeholders, and descriptive analysis of current DICS usage data. Results Forty-one participants were interviewed including 34 physicians and seven administrative stakeholders. Four key themes emerged (i) utilization of the DICS depended on awareness of the technology and preferred channels of accessing images, which varied widely; (ii) clinical responsibilities and available institutional resources were drivers of utilization (or lack thereof); (iii) centralized image repositories were perceived to offer value at the patient, provider and health system levels; and (iv) enabling factors to realize value included aspects of technology infrastructure (i.e., available functionality) alongside policy supports. High-volume DICS usage was not evenly distributed throughout the province. Conclusions Suboptimal adoption of the DICS was driven by poor awareness and variations in clinical workflow. Alignment with physician workflow, policy supports and investment in key technological features and infrastructure would improve functionality and data comprehensiveness, thereby optimizing health system performance of patient and provider experience, population health and health system costs.Background Blended face-to-face and web-based treatment is a promising way to deliver smoking cessation treatment. Since adherence has been shown to be an indicator for treatment acceptability and a determinant for effectiveness, we explored and compared adherence and predictors of adherence to a blended and a face-to-face smoking cessation treatment, both similar in content and intensity. Objective The objectives of this study were (1) to compare adherence to a blended smoking cessation treatment (BSCT) with adherence to a face-to-face treatment (F2F); (2) to compare adherence within the blended treatment to its F2F-mode and Web-mode; and (3) to determine baseline predictors of adherence to both treatments as well as (4) the predictors to both modes of the blended treatment. Methods We calculated the total duration of treatment exposure for patients (N=292) of a Dutch outpatient smoking cessation clinic, who were randomly assigned either to the blended smoking cessation treatment (BSCT, N=162) or to a face-to-face treatment with identical ingredients (F2F, N=130).