Mobile health (mHealth) apps are designed to support health behavior outcomes and improve well-being. The existing body of literature confirms mHealth's overall efficacy in promoting physical activity; however, more research on its utility in sustaining user engagement is needed. Understanding the determinants of an individual's willingness to continue using mHealth is vital to improving the intervention's success. This study developed a unified model and survey instrument adapted from extant literature while introducing new constructs to predict the sustained use of gamified mHealth. A pilot study was conducted to validate the survey instrument using 48 gamified fitness app users in Malaysia. The survey instrument was tested following rigorous guidelines for quantitative research in the information system context. According to the findings, the reliabilities of most measurement items met the criterion, and those items were retained. Overall, this paper contributes by integrating social comparison theory and the self-determination theory for sustaining user engagement with gamified mHealth through an extrinsic and intrinsic motivation perspective.
The proliferative responses of peripheral blood mononuclear cells (PBMC) to Mycobacterium leprae and BCG were studied in two groups of leprosy patients: a group of 8 lepromatous patients who had been on treatment for more than 20 years (TLL) and a group of 8 untreated lepromatous leprosy patients (ULL). The mean response to M. leprae of the TLL group was 6195 cpm with 5 of the 8 patients responding positively. The mean response to M. leprae of the ULL group was 617 cpm, with only 1 patient showing a positive response. The corresponding proliferative responses to BCG were 19,908 cpm in the TLL group and 7908 in the ULL group. Thirteen M. leprae reactive clones were established from 2 TLL patients and 5 M. leprae reactive clones were established from 2 tuberculoid leprosy patients. Seven of these clones, 4 from the TLL patients and 3 from the tuberculoid (TT) patients could be studied further. Three of the TLL clones responded specifically to M. leprae, while one of the clones exhibited a broad cross-reactivity to other mycobacteria. All of these clones were of the CD4+CD8- phenotype. Our findings suggest that responsiveness to M. leprae can be detected in vitro in a proportion of LL patients who have undergone prolonged chemotherapy, and that this response involves M. leprae reactive CD8+CD8- T cells, of which some appear to be specific to M. leprae.