Objectives: Conventional face-to-face nutrition counseling has played a crucial role in promoting healthy habits. However, the emergence of digital health technologies has introduced mobile app-based nutrition counseling as an effective alternative. This research aims to develop and evaluate the usability and effectiveness of the FIT4PEDON mobile nutrition counseling application in promoting healthy dietary behaviors and lifestyle modifications among childhood cancer survivors (CCS). Methods: This study employed a mixed-methods approach, incorporating both survey and qualitative and quantitative analyses. A total of 33 health care professional experts participated. The reliability of the questionnaire was assessed using the Kuder-Richardson method, and its content validity was confirmed through expert evaluation. Usability testing was conducted with a validated questionnaire. Results: The development process resulted in two applications: an Android mobile application and an admin web application. The findings indicated that a significant proportion of experts endorsed the app for dietary management. Statistical analysis showed significant differences between “yes” and “no” responses. However, no significant differences were found when comparing responses across different sex or age groups. Conclusions The FIT4PEDON application shows promise in supporting CCS to adopt healthier lifestyles. Nevertheless, the study underscores the necessity for further research, particularly focusing on specific age groups of experts with relevant experience, to achieve more conclusive results. Leveraging technology through mobile apps has the potential to improve the quality of survivorship care and foster sustained engagement in long-term care for pediatric cancer survivors.

Objectives: Conventional face-to-face nutrition counseling has played a crucial role in promoting healthy habits. However, the emergence of digital health technologies has introduced mobile app-based nutrition counseling as an effective alternative. This research aims to develop and evaluate the usability and effectiveness of the FIT4PEDON mobile nutrition counseling application in promoting healthy dietary behaviors and lifestyle modifications among childhood cancer survivors (CCS). Methods: This study employed a mixed-methods approach, incorporating both survey and qualitative and quantitative analyses. A total of 33 health care professional experts participated. The reliability of the questionnaire was assessed using the Kuder-Richardson method, and its content validity was confirmed through expert evaluation. Usability testing was conducted with a validated questionnaire. Results: The development process resulted in two applications: an Android mobile application and an admin web application. The findings indicated that a significant proportion of experts endorsed the app for dietary management. Statistical analysis showed significant differences between “yes” and “no” responses. However, no significant differences were found when comparing responses across different sex or age groups. Conclusions The FIT4PEDON application shows promise in supporting CCS to adopt healthier lifestyles. Nevertheless, the study underscores the necessity for further research, particularly focusing on specific age groups of experts with relevant experience, to achieve more conclusive results. Leveraging technology through mobile apps has the potential to improve the quality of survivorship care and foster sustained engagement in long-term care for pediatric cancer survivors.

Objectives: Conventional face-to-face nutrition counseling has played a crucial role in promoting healthy habits. However, the emergence of digital health technologies has introduced mobile app-based nutrition counseling as an effective alternative. This research aims to develop and evaluate the usability and effectiveness of the FIT4PEDON mobile nutrition counseling application in promoting healthy dietary behaviors and lifestyle modifications among childhood cancer survivors (CCS). Methods: This study employed a mixed-methods approach, incorporating both survey and qualitative and quantitative analyses. A total of 33 health care professional experts participated. The reliability of the questionnaire was assessed using the Kuder-Richardson method, and its content validity was confirmed through expert evaluation. Usability testing was conducted with a validated questionnaire. Results: The development process resulted in two applications: an Android mobile application and an admin web application. The findings indicated that a significant proportion of experts endorsed the app for dietary management. Statistical analysis showed significant differences between “yes” and “no” responses. However, no significant differences were found when comparing responses across different sex or age groups. Conclusions The FIT4PEDON application shows promise in supporting CCS to adopt healthier lifestyles. Nevertheless, the study underscores the necessity for further research, particularly focusing on specific age groups of experts with relevant experience, to achieve more conclusive results. Leveraging technology through mobile apps has the potential to improve the quality of survivorship care and foster sustained engagement in long-term care for pediatric cancer survivors.

Background/Aims: Per oral endoscopic myotomy (POEM) has been increasingly used for achalasia in Latin America, where Chagas disease is prevalent, and this makes POEM more challenging. The aim of this study was to determine the learning curve for POEM in Latin America. Methods: Patients undergoing POEM in Latin America with a single operator were included from a prospective registry over 4 years. Non-linear regression and cumulative sum control chart (CUSUM) analyses were conducted for the learning curve. Results: A total of 125 patients were included (52% male; mean age, 59 years), of which 80 had type II achalasia (64%), and 38 had Chagas disease (30%). The average pre-procedure and post-procedure Eckardt scores were 6.79 and 1.87, respectively. Technical success was achieved in 93.5% of patients, and clinical success was achieved in 88.8%. Adverse events occurred in 27 patients (22%) and included bleeding (4 patients), pneumothorax (4 patients), mucosal perforation (13 patients), mediastinitis (2 patients), and leakage (4 patients).
The CUSUM chart showed a median procedure time of 97 min (range, 45-196 min), which was achieved at the 61st procedure. Procedure duration progressively decreased, with the last 10 procedures under 50 min approaching a plateau (p-value <0.01). Conclusions Mastering POEM in Latin America requires approximately 61 procedures for both POEM efficiency and to accomplish the procedure within 97 minutes.

Background/Aims: Per oral endoscopic myotomy (POEM) has been increasingly used for achalasia in Latin America, where Chagas disease is prevalent, and this makes POEM more challenging. The aim of this study was to determine the learning curve for POEM in Latin America. Methods: Patients undergoing POEM in Latin America with a single operator were included from a prospective registry over 4 years. Non-linear regression and cumulative sum control chart (CUSUM) analyses were conducted for the learning curve. Results: A total of 125 patients were included (52% male; mean age, 59 years), of which 80 had type II achalasia (64%), and 38 had Chagas disease (30%). The average pre-procedure and post-procedure Eckardt scores were 6.79 and 1.87, respectively. Technical success was achieved in 93.5% of patients, and clinical success was achieved in 88.8%. Adverse events occurred in 27 patients (22%) and included bleeding (4 patients), pneumothorax (4 patients), mucosal perforation (13 patients), mediastinitis (2 patients), and leakage (4 patients).
The CUSUM chart showed a median procedure time of 97 min (range, 45-196 min), which was achieved at the 61st procedure. Procedure duration progressively decreased, with the last 10 procedures under 50 min approaching a plateau (p-value <0.01). Conclusions Mastering POEM in Latin America requires approximately 61 procedures for both POEM efficiency and to accomplish the procedure within 97 minutes.