Exploring the use of mobile phones by children with intellectual disabilities: experiences from Haryana, India

PURPOSE

Covid-induced lockdowns have increased the importance of technology in education. Though access to technology as well as availability of the internet remain a major concern for a lot of children in the global south, children with intellectual disabilities are disadvantaged even more as most of the e-content is developed keeping in mind the average learner.

MATERIALS AND METHODS

Unstructured interviews were conducted with children with intellectual disabilities studying in government schools in Haryana as well as their teachers and parents. Thematic analysis of the interviews was conducted to understand the use-patterns of mobile phones by children with intellectual disabilities.

RESULTS

Findings suggest that these children are learning to use mobile phones on their own or with some support and are able to navigate the complexities of these smartphones quite well. They use these devices mostly for their entertainment. This paper then reflects on the need and strategies to develop these technologies in ways that they can be used as effective tools for teaching children with intellectual disabilities, especially in the inclusive education system in developing countries.

CONCLUSION

The paper reflects on the need to develop technology and tools using flexible and exploratory designs to enhance the learning processes for children with intellectual disabilities from the lower income strata.IMPLICATIONS FOR REHABILITATIONThis study highlights the importance of being able to use mobile phones by children with intellectual disabilities belonging to low income families.Following this, the article argues for designing of mobile phones suitable for use by children with intellectual disabilities using playfulness and explorations, andBuilding e-content keeping the elements of playfulness and exploration which can enhance the learnings of this group of students which is often ignored.

Mobile and wearable technologies for the analysis of Ten Meter Walk Test: A concise systematic review

Physical issues started to receive more attention due to the sedentary lifestyle prevalent in modern culture. The Ten Meter Walk Test allows measuring the person's capacity to walk along 10 m and analyzing the advancement of various medical procedures for ailments, including stroke. This systematic review is related to the use of mobile or wearable devices to measure physical parameters while administering the Ten Meter Walk Test for the analysis of the performance of the test. We applied the PRISMA methodology for searching the papers related to the Ten Meter Walk Test. Natural Language Processing (NLP) algorithms were used to automate the screening process. Various papers published in two decades from multiple scientific databases, including IEEE Xplore, Elsevier, Springer, EMBASE, SCOPUS, Multidisciplinary Digital Publishing Institute (MDPI), and PubMed Central were analyzed, focusing on various diseases, devices, features, and methods. The study reveals that chronometer and accelerometer sensors measuring spatiotemporal features are the most pertinent in the Gait characterization of most diseases. Likewise, all studies emphasized the close relation between the quality of the sensor's data obtained and the system's ultimate accuracy. In other words, calibration procedures are needed because of the body part where the sensor is worn and the type of sensor. In addition, using ambient sensors providing kinematic and kinetic features in conjunction with wearable sensors and consistently acquiring walking signals can enhance the system's performance. The most common weaknesses in the analyzed studies are the sample size and the unavailability of continuous monitoring devices for measuring the Ten Meter Walk Test.

The role of the California tier system in controlling population mobility during the COVID-19 pandemic

BACKGROUND

Policies to restrict population mobility are a commonly used strategy to limit the transmission of contagious diseases. Among measures implemented during the COVID-19 pandemic were dynamic stay-at-home orders informed by real-time, regional-level data. California was the first state in the U.S. to implement this novel approach; however, the effectiveness of California's four-tier system on population mobility has not been quantified.

METHODS

Utilizing data from mobile devices and county-level demographic data, we evaluated the impact of policy changes on population mobility and explored whether demographic characteristics explained variability in responsiveness to policy changes. For each California county, we calculated the proportion of people staying home and the average number of daily trips taken per 100 persons, across different trip distances and compared this to pre-COVID-19 levels.

RESULTS

We found that overall mobility decreased when counties moved to a more restrictive tier and increased when moving to a less restrictive tier, as the policy intended. When placed in a more restrictive tier, the greatest decrease in mobility was observed for shorter and medium-range trips, while there was an unexpected increase in the longer trips. The mobility response varied by geographic region, as well as county-level median income, gross domestic product, economic, social, and educational contexts, the prevalence of farms, and recent election results.

CONCLUSIONS

This analysis provides evidence of the effectiveness of the tier-based system in decreasing overall population mobility to ultimately reduce COVID-19 transmission. Results demonstrate that socio-political demographic indicators drive important variability in such patterns across counties.

Self-management system for postpartum women with hypertension disorders: an eHealth application intervention study

BACKGROUND

Hypertension disorders are relatively common in pregnant women and often persist in the postpartum period. Few studies are available regarding the self-management of postpartum hypertension via the eHealth system. This study aimed to develop a self-management eHealth system for women with postpartum hypertension during the postpartum period.

METHODS

We adopted a multi-platform system for this research, not only for use on the web interface but also on smartphones. The proposed system possessed three features: (1) the population was limited to postnatal women with hypertension; (2) a self-care record, which allowed postnatal women to keep track of their blood pressure, pulse, weight, medication record, exercise record, and risk factor assessment; and (3) through this system, nurse-midwives could keep track of postnatal women's health status maintaining the complete record and could communicate directly with the users if their health monitor values reach beyond normal range.

RESULTS

Thirty-nine postnatal women with postpartum hypertension were recruited to the study. A survey to evaluate the usability and satisfaction of the proposed e-health application system was completed by these women. The usability rate of the system reached 92.4% (46.2% satisfied and 46.2% strongly satisfied), which suggested that the system was helpful to the users. The satisfaction rate of the system reached 94.9% (43.6% satisfied and 51.3% strongly satisfied), which suggested that the system was acceptable to the users.

CONCLUSION

This proposed system has been developed completely with user experience and professional advice from experts. Postnatal women could gain important postpartum-related knowledge and access their related health records and other information easily via their smartphones or computers. During the postpartum period, an eHealth application system can effectively assist women with hypertension to manage their blood pressure and related postnatal healthcare issues.

Effects of mobile-based cognitive interventions for the cognitive function in the community-dwelling older adults: A systematic review and meta-analysis

Cognitive interventions that can be operated using mobile gadgets could facilitate the maintenance and improvement in the cognitive function of the community-dwelling elderly. The aims of this study was to estimate influences for mobile-based cognitive interventions in the community-dwelling elderly. A systematic literature search were conducted using various databases such as the Cochrane Library, PubMed, the Excerpta Medica Database, and Cumulative Index to Nursing and Allied Health Literature. Published articles up to August 2021 were searched without period limit. Integrated and analyzed RCTs' results that identified the effects of mobile-based cognitive interventions on the cognitive function of community-dwelling older adults with normal cognitive function. A meta-analysis was performed by RevMan 5.3 version. The methodological quality was assessed by the Cochrane Collaboration risk of bias tool. Registered with PROSPERO, the registration number is CRD42021268788. Overall, 6 randomized controlled trials identified from 400 articles were included in meta-analysis. The mobile-based cognitive interventions were found to have a significant effect on the short-term memory [standardized mean difference(SMD)= 0.22; 95% confidence interval (CI)=0.13,0.32; p<.001; I²=0%], working memory (SMD=0.70; 95% CI=0.02,1.37; p=.040; I²=81%), reasoning (SMD=0.27; 95% CI=0.11,0.42; p<.001; I²=25%), and executive function (SMD=0.62; 95% CI=0.09,1.16; p=.020; I²=0%). Finally, Egger's regression test and a funnel plot were conducted to examine publication bias; however, there was no significant bias. The mobile-based cognitive interventions had significantly affirmative effect on the older adults' executive function, reasoning, short-term memory, and working memory. Such programs may be employed as a supportive or an alternative method for improving their cognitive functions.

Cross-sectional associations between early mobile device usage and problematic behaviors among school-aged children in the Hokkaido Study on Environment and Children's Health

BACKGROUND

Concerns have been raised about the adverse health impacts of mobile device usage. The objective of this cross-sectional study was to examine the association between a child's age at the first use of a mobile device and the duration of use as well as associated behavioral problems among school-aged children.

METHODS

This study focused on children aged 7-17 years participating in the Hokkaido Study on Environment and Children's Health. Between October 2020 and October 2021, the participants (n = 3,021) completed a mobile device use-related questionnaire and the strengths and difficulties questionnaire (SDQ). According to the SDQ score (normal or borderline/high), the outcome variable was behavioral problems. The independent variable was child's age at first use of a mobile device and the duration of use. Covariates included the child's age at the time of survey, sex, sleep problems, internet addiction, health-related quality of life, and history of developmental concerns assessed at health checkups. Logistic regression analysis was performed for all children; the analysis was stratified based on the elementary, junior high, and senior high school levels.

RESULTS

According to the SDQ, children who were younger at their first use of a mobile device and used a mobile device for a longer duration represented more problematic behaviors. This association was more pronounced among elementary school children. Moreover, subscale SDQ analysis showed that hyperactivity, and peer and emotional problems among elementary school children, emotional problems among junior high school children, and conduct problems among senior high school children were related to early and long usage of mobile devices.

CONCLUSIONS

Elementary school children are more sensitive to mobile device usage than older children, and early use of mobile devices may exacerbate emotional instability and oppositional behaviors in teenagers. Longitudinal follow-up studies are needed to clarify whether these problems disappear with age.

Comparison of Acoustic Voice Features Derived From Mobile Devices and Studio Microphone Recordings

OBJECTIVES/HYPOTHESIS

Improvements in mobile device technology offer new opportunities for remote monitoring of voice for home and clinical assessment. However, there is a need to establish equivalence between features derived from signals recorded from mobile devices and gold standard microphone-preamplifiers. In this study acoustic voice features from android smartphone, tablet, and microphone-preamplifier recordings were compared.

METHODS

Data were recorded from 37 volunteers (20 female) with no history of speech disorder and six volunteers with Huntington's disease (HD) during sustained vowel (SV) phonation, reading passage (RP), and five syllable repetition (SR) tasks. The following features were estimated: fundamental frequency median and standard deviation (F0 and SD F0), harmonics-to-noise ratio (HNR), local jitter, relative average perturbation of jitter (RAP), five-point period perturbation quotient (PPQ5), difference of differences of amplitude and periods (DDA and DDP), shimmer, and amplitude perturbation quotients (APQ3, APQ5, and APQ11).

RESULTS

Bland-Altman analysis revealed good agreement between microphone and mobile devices for fundamental frequency, jitter, RAP, PPQ5, and DDP during all tasks and a bias for HNR, shimmer and its variants (APQ3, APQ5, APQ11, and DDA). Significant differences were observed between devices for HNR, shimmer, and its variants for all tasks. High correlation was observed between devices for all features, except SD F0 for RP. Similar results were observed in the HD group for SV and SR task. Biological sex had a significant effect on F0 and HNR during all tests, and for jitter, RAP, PPQ5, DDP, and shimmer for RP and SR. No significant effect of age was observed.

CONCLUSIONS

Mobile devices provided good agreement with state of the art, high-quality microphones during structured speech tasks for features derived from frequency components of the audio recordings. Caution should be taken when estimating HNR, shimmer and its variants from recordings made with mobile devices.

More or less? Improving monocular head mounted display assisted visual search by reducing guidance precision

OBJECTIVE

To test six different methods of directing a user's attention in a peripheral head mounted display assisted visual search task.

BACKGROUND

Each time a user needs to shift their attention between virtual information and their environment has a cost. The faster a user can process a guiding cue and the fewer times they need to return to it, the more efficient that cue will be at directing a user's attention. The most effective method, creating a visual effect at the location of the target, is not suitable for peripheral head mounted displays. This study tests alternative guiding cues better suited to these devices.

METHOD

Participants searched for a singleton target hidden among 299 distractors while directed with one of six device-delivered guiding cues. Search times were recorded.

RESULTS

A static region map was the most efficient and most preferred cue. Static and dynamic directional cues were also effective in comparison to non-guided search. Cues designed to work solely within the participants' peripheral vision were relatively ineffective CONCLUSION: Guidance cues that direct a user's attention to targets within the real environment do not need to precisely lead to the target. It is instead more efficient to lead a user to the general vicinity of the target quickly and then have the user revert to their natural visual search behaviour.

APPLICATION

This finding is broadly useful when assisting visual search tasks with handheld or worn devices which do not cover the user's full field of view. PRéCIS: This study tested six different methods of guiding attention in a peripheral head-mounted display assisted visual search task. This study compared static, dynamic and peripheral-vision endogenous cues to targets and found a static simple map cue both fastest and most preferred by users.

Prevalence and dynamics of distracted pedestrian behaviour at railway level crossings: Emerging issues

Recent increases in pedestrian collisions have led to several studies investigating the effects of distraction on pedestrian behaviour at road intersections. Although distraction has been identified as a contributing factor to pedestrian crashes at railway crossings, only limited research is available regarding the prevalence of this behaviour occurring at railway level crossings. It is, therefore, essential to better understand distraction prevalence at railway crossings to support the use of countermeasures to improve safety outcomes. We conducted field observations at a railway crossing in Brisbane, Australia and its adjacent road intersection to gauge the prevalence of distracted pedestrians. Overall, 585 pedestrians were observed and video recorded during the daytime. The video recordings were coded to estimate the prevalence of distraction behaviour that road users engaged in, factors that affected these proportions, and dynamic changes in behaviour. Compliance with signals was also analysed. We found distraction behaviours such as talking and looking at the mobile screen (41.9%) while walking to be prevalent and affected by age. Highly distractive tasks were found to be less commonplace at the railway crossing, accounting for 3% of the observations. Still, pedestrians at the railway crossing engaged in these highly distractive tasks on their phones for a much longer period of time. While most non-compliances (with traffic lights) occurred among attentive pedestrians and are likely to be intentional, non-compliances by distracted pedestrians were also observed, highlighting that distraction can lead to unsafe decisions or lack of decisions that result in unsafe behaviours. Finally, distraction was found to be a dynamic phenomenon as a few pedestrians stopped engaging in distractive tasks once they reached the crossing, while others engaged in more distractive tasks once they were on the road or crossing. Our study shows that pedestrian distraction is a prevalent issue at railway crossings and future research is required to further understand and mitigate this changing behaviour.

Can we dream of an integrated pain management app for cancer patients?

The cancer burden continues to grow globally, exerting tremendous physical, emotional, and financial strain on individuals, families, communities, and health systems. The number of health-related mobile applications (apps) is increasing rapidly. We searched for pain apps specific for cancer patients on App Store for iOS devices and Google Play for Android devices. An integrated pain management app (IPMA) is the need of the hour, which will not only provide a platform to users to assess their pain scores but also assess other associated symptoms and can provide a step-wise assessment to their symptomatology. This can offset the patient burden in the outpatient pain clinic and reduce the number of follow-up visits by addressing common concerns that can be tackled easily at home.

Barriers and facilitators of using mobile devices as an educational tool by nursing students: a qualitative research

Background

Although the use of mobile devices can facilitate the learning process, there may be barriers to using them for learning purposes. This study aimed to identify and investigate the barriers and facilitators of using mobile devices as an educational device from the perspective of nursing students.

Methods

This qualitative descriptive study was conducted in 2020 on undergraduate nursing students of the Nursing and Midwifery Faculty, Tehran University of Medical Sciences. A total of 22 undergraduate nursing students were selected by purposive sampling with maximum variability. Inclusion criteria were Undergraduate nursing education, having mobile devices, and willingness to participate in research. Data were collected through semi-structured individual interviews for 45–75 min in the proposed environment of students until the data were saturated. Data analysis was performed manually using the framework analysis method with the steps: familiarization, identifying a thematic framework, indexing, Charting and Synthesis, Mapping, and Interpretation. Trustworthiness was determined by methods of Credibility, Dependability, Conformability, and Transferability.

Results

The majority of participants (45.45%) were 21 years old, 63.63% were women, and 36.36% studied in the 8th semester. Findings from the analysis of interviews showed that barriers to the use of mobile devices were classified into 4 main categories (barriers related to mobile devices, barriers related to Internet access, barriers related to information literacy, cultural-environmental barriers) and 15 subcategories, and facilitating the use of mobile devices was divided into 2 main categories (easy to use mobile devices and easy access to information) and 6 subcategories.

Conclusion

The results of this study help educational managers and curriculum planners to adapt to technological change, to focus on the many benefits of mobile devices as an educational tool, and to plan to overcome barriers to mobile device use, and use mobile devices to teach theoretical topics and clinical nursing skills effectively.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00750-9.

The PostStroke-Manager - combining mobile, digital and sensor-based technology with personal assistance: protocol of the feasibility study

INTRODUCTION

Post stroke management has moved into the focus as it represents the only way to secure acute treatment effects in the long term. Due to individual courses, post stroke management appears rather challenging and is hindered by existing barriers between treatment sectors. As a novel concept, the PostStroke-Manager combines digital and sensor-based technology with personal assistance to enable intersectoral cooperation, best possible reduction of stroke-related disability, optimal secondary prevention, and detection of physical and psychological comorbidities.

METHODS

This prospective single-center observational study aims to investigate the feasibility of the PostStroke-Manager concept in an outpatient setting. Ninety patients who have suffered an ischemic or hemorrhagic stroke or transient ischemic attack will be equipped with a tablet and mobile devices recording physical activity, blood pressure, and electrocardiographic signals. Through a server-based platform, patients will be connected with the primary care physician, a stroke pilot and, if necessary, other specialists who will use web-based platforms. Via the tablet, patients will have access to an application with 10 newly designed components including, for instance, a communication tool, medication schedule, medical records platform, and psychometric screenings (e.g., depression, anxiety symptoms, quality of life, adherence, cognitive impairment). During the 1-year follow-up period, clinical visits are scheduled at three-month intervals. In the interim, communication will be secured by an appropriate tool that includes text messenger, audio, and video telephony. As the primary endpoint, feasibility will be measured by a 14-item questionnaire that addresses digital components, technical support, and personal assistance. The PostStroke-Manager will be judged feasible if at least 50% of these aspects are rated positively by at least 75% of patients. Secondary endpoints include feedback from professionals and longitudinal analyses on clinical and psychometric parameters.

PERSPECTIVE

This study will answer the question of whether combined digital and personal support is a feasible approach to post stroke management. Furthermore, the patient perspective gained regarding digital support may help to specify future applications. This study will also provide information regarding the potential use of remote therapies and mobile devices in situations with limited face-to-face contacts.

TRIAL REGISTRATION

German Register for Clinical Trials ( DRKS00023213 .), registered 27 April 2021.

Exploring Caregiver Perceptions of a One-to-One Tablet Program for Kindergartners

The adoption of one-to-one device programs in early childhood classrooms is a relatively new phenomenon that is quickly becoming widespread. While these devices carry potential as educational learning tools, there is still much to learn about how to successfully integrate them into classrooms and into children's lives. One important area to consider is the interplay of home and school contexts around children's device use for early learning. This focus group study sought to investigate caregivers' thoughts and perceptions of their kindergarteners' classroom-based tablet use. Participant responses revealed the complexities and nuanced challenges of navigating their children's device use both at home and in school. Caregivers conveyed a variety of perceived benefits, but also concerns and fears related to their children's device use. They expressed sentiments of trust in their children's teachers and schools, and they were eager to be shared partners who supported their children's technology use for early learning. However, they also expressed frustration at a lack of communication around school technology use, which they perceived as an obstacle to this partnership. Findings are discussed in terms of theory advancement as well as practical implications for caregivers, teachers, and school administrators.

Image and video processing on mobile devices: a survey

Image processing and computer vision on mobile devices have a wide range of applications such as digital image enhancement and augmented reality. While images acquired by cameras on mobile devices can be processed with generic image processing algorithms, there are numerous constraints and external issues that call for customized algorithms for such devices. In this paper, we survey mobile image processing and computer vision applications while highlighting these constraints and explaining how the algorithms have been modified/adapted to meet accuracy and performance demands. We hope that this paper will be a useful resource for researchers who intend to apply image processing and computer vision algorithms to real-world scenarios and applications that involve mobile devices.

Exploring the technological acceptance of a mobile learning tool used in the teaching of an indigenous language

Language is the primordial element for cultural transfer in indigenous communities; if it is not practiced, there is a risk of losing it and with it, a large part of the history of a community. Ecuador is a multicultural and multiethnic country with 18 indigenous peoples. Currently, in this country, some native languages are at risk of disappearing due to factors such as racial discrimination, underestimation of the language, and, above all, the lack of interest and motivation of the new generations to learn this language. Information technologies have made it possible to create mobile applications such as games, dictionaries, and translators that promote the learning of the Kichwa language. However, the acceptance of technology has not been evaluated, nor the intention to involve mobile devices in the process of teaching this language. Subsequently the objective of this work is to explore the acceptance of technology and the use of mobile devices to motivate the learning of the Kichwa language. For this purpose, the mobile application "Otavalo Rimay" was used with several students of a Kichwa language learning center. The methodology used to verify the hypothesis of this work was Design Sciences Research (DSR) together with the theory of acceptance and use of technology (UTAUT). The instrument used for this evaluation was a survey carried out after the use of the mobile application. The statistical analysis of the results obtained indicates characteristics such as the utility and perceived ease of use, positively influence students to motivate the use of mobile devices in learning a language. The results also show the great technological acceptance by students for learning and confirm that currently, mobile learning is accepted for use in education.

Towards a new era of mass data collection: Assessing pandemic surveillance technologies to preserve user privacy

Controlling the coronavirus pandemic is triggering a cross-border strategy by which national governments attempt to control the spread of the COVID-19 pandemic. A response based on sharing facts about millions of private movements and a call to study information behavior during the global health crisis has been advised worldwide. The present study aims to identify the technologies to control the COVID-19 and future pandemics with massive data collection from users' mobile devices. This research undertakes a Systematic Literature Review (SLR) of the studies about the currently available methods, strategies, and actions to collect and analyze data from users' mobile devices. In a total of 76 relevant studies, 13 technologies that are classified based on the following aspect of data and data management have been identified: (1) security; (2) destruction; (3) voluntary access; (4) time span; and (5) storage. In addition, in order to understand how these technologies can affect user privacy, 25 data points that these technologies could have access to if installed through mobile applications have been detected. The paper concludes with a discussion of important theoretical and practical implications of preserving user privacy and curbing COVID-19 infections in the global public health emergency situation.

Kardia Mobile and ISTEL HR applicability in clinical practice: a comparison of Kardia Mobile, ISTEL HR, and standard 12-lead electrocardiogram records in 98 consecutive patients of a tertiary cardiovascular care centre

Aims

Mobile, portable ECG-recorders allow the assessment of heart rhythm in out-of-hospital conditions and may prove useful for monitoring patients with cardiovascular diseases. However, the effectiveness of these portable devices has not been tested in everyday practice.

Methods and results

A group of 98 consecutive cardiology patients [62 males (63%), mean age 69 ± 12.9 years] were included in an academic care centre. For each patient, a standard 12-lead electrocardiogram (SE), as well as a Kardia Mobile 6L (KM) and Istel (IS) HR-2000 ECG were performed. Two groups of experienced physicians analysed obtained recordings. After analysing ECG tracings from SE, KM, and IS, quality was marked as good in 82%, 80%, and 72% of patients, respectively (P < 0.001). There were no significant differences between devices in terms of detecting sinus rhythm [SE (60%, n = 59), KM (58%, n = 56), and IS (61%, n = 60); SE vs. KM P = 0.53; SE vs. IS P = 0.76) and atrial fibrillation [SE (22%, n = 22), KM (22%, n = 21), and IS (18%, n = 18); (SE vs. KM P = 0.65; SE vs. IS = 0.1)]. KM had a sensitivity of 88.1% and a specificity of 89.7% for diagnosing sinus rhythm. IS showed 91.5% and 84.6% sensitivity and specificity, respectively. The sensitivity of KM in detecting atrial fibrillation was higher than IS (86.4% vs. 77.3%), but their specificity was comparable (97.4% vs. 98.7%).

Conclusion

Novel, portable devices are useful in showing sinus rhythm and detecting atrial fibrillation in clinical practice. However, ECG measurements concerning conduction and repolarization should be clarified with a standard 12-lead electrocardiogram.

Indoor and outdoor environmental data: A dataset with acoustic data acquired by the microphone embedded on mobile devices

All mobile devices include a microphone that can be used for acoustic data acquisition. This article presents a dataset of acoustic signals related to nine environments, captured with a microphone embedded on off-the-shelf mobile devices. The mobile phone can be placed in the pants pockets, in a wristband, over the bedside table, on a table, or on other furniture. Data collection environments are bar, classroom, gym, kitchen, library, street, hall, living room, and bedroom. The data was collected by 25 individuals (15 men and 10 women) in different environments around Covilhã and Fundão municipalities (Portugal). The microphone data was sampled with 44,100 Hz into an array with 16-bit unsigned integer values in the range [0, 255] with a 128 offset for zero. The dataset presented in this paper presents at least 2000 samples of 5 s of data for each environment, corresponding to around 2.8 h for each environment into text files. In total, it includes at least 25.2 h of acoustic data for the implementation of data processing techniques, e.g., Fast Fourier Transform (FFT), and other machine learning methods for the different analysis.

Structured Digital Self-Assessment of Patient Anamnesis Prior to Computed Tomography: Performance Evaluation and Added Value

The aim of this study was to evaluate the performance of a tablet-based, digitized structured self-assessment (DSSA) of patient anamnesis (PA) prior to computed tomography (CT). Of the 317 patients consecutively referred for CT, the majority (n = 294) was able to complete the tablet-based questionnaire, which consisted of 67 items covering social anamnesis, lifestyle factors (e.g., tobacco abuse), medical history (e.g., kidney diseases), current symptoms, and the usability of the system. Patients were able to mark unclear questions for a subsequent discussion with the radiologist. Critical issues for the CT examination were structured and automatically highlighted as “red flags” (RFs) in order to improve patient interaction. RFs and marked questions were highly prevalent (69.5% and 26%). Missing creatinine values (33.3%), kidney diseases (14.4%), thyroid diseases (10.6%), metformin (5.5%), claustrophobia (4.1%), allergic reactions to contrast agents (2.4%), and pathological TSH values (2.0%) were highlighted most frequently as RFs. Patient feedback regarding the comprehensibility of the questionnaire and the tablet usability was mainly positive (90.9%; 86.2%). With advanced age, however, patients provided more negative feedback for both (p = 0.007; p = 0.039). The time effort was less than 20 min for 85.1% of patients, and faster patients were significantly younger (p = 0.046). Overall, the DSSA of PA prior to CT shows a high success rate and is well accepted by most patients. RFs and marked questions were common and helped to focus patients’ interactions and reporting towards decisive aspects.

Accessing Passersby Proxemic Signals through a Head-Worn Camera: Opportunities and Limitations for the Blind

The spatial behavior of passersby can be critical to blind individuals to initiate interactions, preserve personal space, or practice social distancing during a pandemic. Among other use cases, wearable cameras employing computer vision can be used to extract proxemic signals of others and thus increase access to the spatial behavior of passersby for blind people. Analyzing data collected in a study with blind (N=10) and sighted (N=40) participants, we explore: (i) visual information on approaching passersby captured by a head-worn camera; (ii) pedestrian detection algorithms for extracting proxemic signals such as passerby presence, relative position, distance, and head pose; and (iii) opportunities and limitations of using wearable cameras for helping blind people access proxemics related to nearby people. Our observations and findings provide insights into dyadic behaviors for assistive pedestrian detection and lead to implications for the design of future head-worn cameras and interactions.

Molecular Data Visualization with Augmented Reality (AR) on Mobile Devices

Augmented reality (AR) allows a computer-generated 3D model to be superimposed onto a real-world environment in real time. The model can then be manipulated or probed interactively as if it is part of the real world. The application of AR in visualizing macromolecular structures is growing, primarily in showing preset collections of scenes for education purpose. Here, our emphasis is, however, on exploiting AR as a tool to facilitate scientific communication on the go. We have searched for freely available mobile software and custom-built tools which allow the display of user-specified protein structures. We provide step-by-step guides on a standalone app Ollomol (iOS and Android), as well as an in-browser web app, WebAR-PDB. Both of them allow users to specify entries from the Protein Data Bank (PDB) for an elementary AR experience. The application of AR enhances interactivity and imaginativity in macromolecular visualization.

Activities of daily living with motion: A dataset with accelerometer, magnetometer and gyroscope data from mobile devices

The dataset presented in this paper is related to the performance of five Activities of Daily Living (ADL) with motion, such as walking, running, standing, walking upstairs, and walking downstairs. These activities were performed with a mobile device in a waistband, containing the data acquired from accelerometer, magnetometer, and gyroscope sensors. These data include the motion data, which allow the characterization of the different types of movement. The data acquisition was performed in open environments by 25 individuals (15 man, and 10 woman) in the Covilhã, and Fundão municipalities (Portugal). The data related to the different sensors was acquired with a sampling rate of 100 Hz by the accelerometer, 50 Hz by the magnetometer, and 100 Hz by the gyroscope sensors. It includes the captures related to a minimum of 2000 captures for each ADL, which corresponds to 2.8 h (approximately) for each ADL. In total, this dataset includes 13.9 h (approximately) of captures. These data can be reused for the implementation of data processing techniques, and artificial intelligence methods.

Molecular Data Visualization on Mobile Devices: A Quick Starter's Guide

With the rise of tablets, truly portable molecular graphics are now available for wide use by scientists to share structural information in real time. We have surveyed the existing software available on Apple iPads and on Android tablets in order to make a recommendation to potential users, primarily based on the product features. Among the three apps for high-quality 3-D display, iMolview (available on both platforms) stands out to be our choice, with PyMOL app (iOS) a close alternative and NDKmol (Android) offering some uniquely useful functions. Hence we include a tutorial on how to get started using iMolview to do some simple visualization in 10 min.

Sensors are Capable to Help in the Measurement of the Results of the Timed-Up and Go Test? A Systematic Review

The analysis of movements used in physiotherapy areas related to the elderly is becoming increasingly important due to factors such as the increase in the average life expectancy and the rate of elderly people over the whole population. In this systematic review, we try to determine how the inertial sensors embedded in mobile devices are exploited for the measurement of the different parameters involved in the Timed-Up and Go test. The results show the mobile devices equipped with onboard motion sensors can be exploited for these types of studies: the most commonly used sensors are the magnetometer, accelerometer and gyroscope available in consumer off-the-shelf smartphones. Other features typically used to evaluate the Timed-Up and Go test are the time duration, the angular velocity and the number of steps, allowing for the recognition of some diseases as well as the measurement of the subject's performance during the test execution.

Data acquisition of timed-up and go test with older adults: accelerometer, magnetometer, electrocardiography and electroencephalography sensors' data

We present a dataset related to the acquisition of different sensors data during the performance of the Timed-Up and Go test with the mobile device positioned in a waistband for the acquisition of accelerometer and magnetometer data, and a BITalino device positioned in a chest band for the acquisition of Electrocardiography and Electroencephalography for further processing. The data acquired from the BITalino device is acquired simultaneously by a Bluetooth connection with the same mobile application. The data was acquired in five institutions, including Centro Comunitário das Lameiras, Lar Nossa Senhora de Fátima, Centro Comunitário das Minas da Panasqueira, Lar da Misericórdia da Santa Casa da Misericórdia do Fundão, and Lar da Aldeia de Joanes da Santa Casa da Misericórdia do Fundão from Fundão and Covilhã municipalities (Portugal). This article describes the data acquired from a several subjects from the different institutions for the acquisition of accelerometer and magnetometer data, where each person performed the Timed-Up and Go test three times, where each output from the sensors was acquired with a sampling rate of 100 Hz. Related to the data acquired by the sensors connected to the BITalino device, 31 persons performed the different experiments related to the Timed-Up and Go Test. Following the data acquired from Electroencephalography and Electrocardiography sensors, only the data acquired from 14 individuals was considered valid. The data acquired by a BITalino device has a sampling rate of 100 Hz. These data can be reused for testing machine learning methods for the evaluation of the performance of the Timed-Up and Go test with older adults.

Accelerometer data from the performance of sit-to-stand test by elderly people

The sit-to-stand test is commonly used by clinicians and researchers to analyze the functional capacity of older adults. The test consists to stand up and sit down from a chair and can be applied either in function of a predetermined number of repetitions to be completed or according to a specific time. The most common tool used by the evaluators is the chronometer, due to its low cost and ease of use. However, this tool may miss some important data throughout the test, such as the stand-up time and the total time of each repetition, as well as other kinematic and kinetic variables. Therefore, it is necessary to develop new cheap and affordable tools to capture these data with reliability. In this perspective, the development of mobile applications can be a valid and reliable alternative for the automatic calculation of different variables with sensors’ data, including acceleration, velocity, force, power, and others. Thus, in this paper, we present a dataset related to the acquisition of the accelerometer data from a commodity smartphone for the measurement of different variables during the sit-to-stand test with institutionalized older adults. Forty participants (20 men and 20 women, 78.9 ± 8.6 years old, 71.7 ± 15.0 kg, 1.57 ± 0.1 m) from five community-dwelling centers (Centro de Dia e Apoio Domiciliário de Alcongosta, Lar Nossa Senhora de Fátima, Centro Comunitário das Minas da Panasqueira, Lar da Misericórdia, and Lar da Aldeia de Joanes) from Fundão, in Portugal, volunteered to participate in the data acquisition. A mobile phone was attached to the waist of the participants to capture the data during the sit-to-stand test. Then, seated in an armless chair with the arms crossed over the chest, the participants stood up and sat down in a chair six times. The stand-up action was ordered by an acoustic signal emitted by the mobile application. All data were acquired with the mobile application, and the outcome measures were the reaction time, total time, stand-up time and movement time. This paper describes the procedures to acquire the data. These data can be reused for testing machine learning or other methods for the evaluation of neuromuscular function in older adults during the sit-to-stand test.

Learning from patient and site perspectives to develop better digital health trials: Recommendations from the Clinical Trials Transformation Initiative

In order to harness the potential of digital health technologies to enhance the quality of clinical research, it is critical to first understand how to engage patients and research sites when planning and conducting digital health trials. To pave the way for the more effective use of digital health technologies in trials, the Clinical Trials Transformation Initiative has developed the first comprehensive, evidence-based set of recommendations for incorporating patient and site perspectives in digital health trials. While directed primarily at sponsors, these recommendations are expected to be valuable for all stakeholders including investigators.

Social inequalities in traditional and emerging screen devices among Portuguese children: a cross-sectional study

BACKGROUND

Children are often exposed to too much screen time but few studies have explored the use of old and new digital media among young children. This study assesses screen time, including traditional and mobile devices, in pre-school and elementary school-aged children, according to their gender, age, and socioeconomic position (SEP).

METHODS

A total of 8430 children (3 to 10 years; 50.8% boys) from the north, center and south-central Portugal were included in the present study. Data was collected by a parental questionnaire during 2016/2017. Children's screen time (by media device, weekdays and at the weekend; calculated by mean minutes per day) were reported by parents. Analysis were carried to compare screen time by children's age, gender and family SEP (classified using father's educational degree).

RESULTS

Daily screen time was high both in children aged 3 to 5 and 6 to 10 years - 154 min/day (95% CI: 149.51-158.91) and 200.79 min/day (95% CI: 197.08-204.50), respectively - and the majority of children, independently of their gender, exceed the recommended 2 h/day of screen viewing. Children are still primarily engaging in screen time through television but the use of mobile devices, particularly tablets, were already high among 3 year-old children and increased with age. SEP was a negative predictor of screen time in the linear regression analysis, including after adjustment.

CONCLUSIONS

Considering the negative health impacts of excessive screen time, recognizing subgroups at risk of excessive screen time and identifying how each device is used according to age is fundamental to enable appropriate future interventions. The screen time in children aged 3-10 years is longer than the recommended, particularly among boys and in those children from lower SEP. Parents and policymakers should have in mind that children spend most of their screen time watching television but mobile devices are becoming extremely popular starting at a young age.

An Interim Report on the Provision of Prenatal Care for Pregnant Mothers Experiencing Homelessness in Hawai'i

The State of Hawai'i ranks third in the nation for homelessness. Homelessness disproportionately affects the health care of pregnant mothers and their children. These homeless persons are at risk for malnutrition, physical and psychological trauma, injuries and chronic illnesses, and have difficulty accessing healthcare and social services. With the generous support of a Waiwai Ola grant from AlohaCare, a non-profit health plan in Hawai'i, the Maternal-Fetal Medicine physicians at the University Health Partners of Hawai'i created a pilot program with a midwife and medical assistant to provide prenatal health care and social services for homeless mothers on the island of O'ahu. This innovative project has given the midwife and medical assistant opportunities to perform needs assessments for homeless mothers and pilot new mobile health devices out in the field that can be optimized for delivering prenatal and postpartum health care for the most vulnerable populations of homeless mothers and their newborns.

A quasi-experiment on using guided mobile learning interventions in ESL classrooms: Time use and academic performance

This quasi-experimental study examined a guided learning approach towards the use of mobile devices and investigated the performance of language learners who were guided in the usage. A total of 419 students from two faculties were invited to participate in this 8-week intervention, 155 participants in the control group and 264 in the experimental group. In the experimental group, the researchers incorporated guided activities Module Intervention Model (MIM) using mobile devices into the ESL lessons whereas the control group lessons were without guided activities. Participants from both groups were asked to record their daily mobile device use for activities related to English language learning using an online form. These data were compared to the results of the tests conducted pre- and post-treatment. At the end of the study, students who received guided language activities utilizing the mobile devices had significantly higher levels of language performance than control group students. However, treatment group students who spent more time using mobile devices to learn the language did not display better performance compared to those who spent minimal time. This finding re-established the importance of guided activities as intervention to facilitate students' learning and points to the need for curricular modernization and faculty development in the instructional use of technology. Due to the increased need for online instruction precipitated by "social distancing and isolation' required to overcome the coronavirus pandemic, the need for faculty to acquire skills in guided use of mobile devices for school-related learning is anticipated to be greater than ever.

Facilitating the development of cross-platform mHealth applications for chronic supportive care and a case study

Mobile health (mHealth) apps have received increasing attention, due to their abilities to support patients who suffer from various conditions. mHealth apps may be especially helpful for patients with chronic diseases, by providing pertinent information, tracking symptoms, and inspiring adherence to medication regimens. To achieve these objectives, researchers need to prototype mHealth apps with dedicated software architectures. In this paper, a cloud-based mHealth application development concept is presented for chronic patient supportive care apps. The concept integrates existing software platforms and services for simplified app development that can be reused for other target applications. This developmental method also facilitates app portability, through the use of common components found across multiple mobile platforms, and scalability, through the loose coupling of services. The results are demonstrated by the development of native Android and cross-platform web apps, in a case study that presents an mHealth solution for endocrine hormone therapy (EHT). A performance analysis methodology, an app usability evaluation, based on focus group responses, and alpha and pre-beta testing results are provided.

mHealth technology for ecological momentary assessment in physical activity research: a systematic review

OBJECTIVE

To systematically review the publications on ecological momentary assessment (EMA) relating to physical activity (PA) behavior in order to classify the methodologies, and to identify the main mHealth technology-based tools and procedures that have been applied during the first 10 years since the emergence of smartphones. As a result of this review, we want to ask if there is enough evidence to propose the use of the term "mEMA" (mobile-based EMA).

DESIGN

A systematic review according to PRISMA Statement (PROSPERO registration: CRD42018088136).

METHOD

Four databases (PsycINFO, CINALH, Medline and Web of Science Core Collection) were searched electronically from 2008 to February 2018.

RESULTS

A total of 76 studies from 297 potential articles on the use of EMA and PA were included in this review. It was found that 71% of studies specifically used "EMA" for assessing PA behaviors but the rest used other terminology that also adjusted to the inclusion criteria. Just over half (51.3%) of studies (39) used mHealth technology, mainly smartphones, for collecting EMA data. The majority (79.5%) of these studies (31 out of 39) were published during the last 4 years. On the other hand, 58.8% of studies that only used paper-and-pencil were published during the first 3 years of the 10-year period analyzed. An accelerometer was the main built-in sensor used for collecting PA behavior by means of mHealth (69%). Most of the studies were carried out on young-adult samples, with only three studies in older adults. Women were included in 60% of studies, and healthy people in 82%. The studies lasted between 1 and 7 days in 57.9%, and between three and seven assessments per day were carried out in 37%. The most popular topics evaluated together with PA were psychological state and social and environmental context.

CONCLUSIONS

We have classified the EMA methodologies used for assessing PA behaviors. A total of 71% of studies used the term "EMA" and 51.3% used mHealth technology. Accelerometers have been the main built-in sensor used for collecting PA. The change of trend in the use of tools for EMA in PA coincides with the technological advances of the last decade due to the emergence of smartphones and mHealth technology. There is enough evidence to use the term mEMA when mHealth technology is being used for monitoring real-time lifestyle behaviors in natural situations. We define mEMA as the use of mobile computing and communication technologies for the EMA of health and lifestyle behaviors. It is clear that the use of mHealth is increasing, but there is still a lot to be gained from taking advantage of all the capabilities of this technology in order to apply EMA to PA behavior. Thus, mEMA methodology can help in the monitoring of healthy lifestyles under both subjective and objective perspectives. The tendency for future research should be the automatic recognition of the PA of the user without interrupting their behavior. The ecological information could be completed with voice messages, image captures or brief text selections on the touch screen made in real time, all managed through smartphone apps. This methodology could be extended when EMA combined with mHealth are used to evaluate other lifestyle behaviors.

Information and Communication Technology, Mobile Devices, and Medical Education

Information and communication technologies (ICT) are practical and highly available tools. In medical education, ICTs allow physicians to update their knowledge and remember the necessary information within reach of current mobile devices. ICTs as preparation tools for medical education have not been reported for medical students in Mexico. To assess the use of mobile devices as ICTs with medical education purposes, we distributed a questionnaire through an online survey management system to all the medical students (n = 180) from a private university in Mexico City, 100% agreed to participate. We developed a questionnaire based on previous surveys and adapted it to our university. All participants reported possession of an electronic mobile device, and 95% used it regularly for learning purposes. Regardless of the school year, the most frequent usage given to these devices was the search and reading of medical articles, the use of medical calculators, and taking notes. As the levels in career advances, there was a reduction in the use of electronic devices. According to the students, the main barriers towards using mobile devices for learning purposes were both the lack of access to the Internet and permission from the professor to use them. Most medical students use mobile devices for learning purposes, but usage changes during their education. It is convenient to encourage the use of mobile devices and the development of ICT skills as tools for educational purposes rather than banning their use in schools and hospitals.

Designing a mHealth clinical decision support system for Parkinson's disease: a theoretically grounded user needs approach

Background

Despite the established evidence and theoretical advances explaining human judgments under uncertainty, developments of mobile health (mHealth) Clinical Decision Support Systems (CDSS) have not explicitly applied the psychology of decision making to the study of user needs. We report on a user needs approach to develop a prototype of a mHealth CDSS for Parkinson’s disease (PD), which is theoretically grounded in the psychological literature about expert decision making and judgement under uncertainty.

Methods

A suite of user needs studies was conducted in 4 European countries (Greece, Italy, Slovenia, the UK) prior to the development of PD_Manager, a mHealth-based CDSS designed for Parkinson’s disease, using wireless technology. Study 1 undertook Hierarchical Task Analysis (HTA) including elicitation of user needs, cognitive demands and perceived risks/benefits (ethical considerations) associated with the proposed CDSS, through structured interviews of prescribing clinicians (N = 47). Study 2 carried out computational modelling of prescribing clinicians’ (N = 12) decision strategies based on social judgment theory. Study 3 was a vignette study of prescribing clinicians’ (N = 18) willingness to change treatment based on either self-reported symptoms data, devices-generated symptoms data or combinations of both.

Results

Study 1 indicated that system development should move away from the traditional silos of ‘motor’ and ‘non-motor’ symptom evaluations and suggest that presenting data on symptoms according to goal-based domains would be the most beneficial approach, the most important being patients’ overall Quality of Life (QoL). The computational modelling in Study 2 extrapolated different factor combinations when making judgements about different questions. Study 3 indicated that the clinicians were equally likely to change the care plan based on information about the change in the patient’s condition from the patient’s self-report and the wearable devices.

Conclusions

Based on our approach, we could formulate the following principles of mHealth design: 1) enabling shared decision making between the clinician, patient and the carer; 2) flexibility that accounts for diagnostic and treatment variation among clinicians; 3) monitoring of information integration from multiple sources. Our approach highlighted the central importance of the patient-clinician relationship in clinical decision making and the relevance of theoretical as opposed to algorithm (technology)-based modelling of human judgment.

Heads Up, Phones Down: A Pedestrian Safety Intervention on Distracted Crosswalk Behavior

Cell phone use has been implicated in driver distraction and motor vehicle crashes, and more recently has been associated with distracted pedestrians. There are limited data on interventions aimed at this important public health issue. We hypothesized that the use of a visual intervention near street crossings would decrease the frequency of distracted behaviors of pedestrians. We performed a prospective observational cohort study examining painted sidewalk stencils reading, "Heads Up, Phones Down" as an intervention to decrease cell phone distractions amongst pedestrians. These stenciled messages were placed at a children's hospital, middle school, and high school in Los Angeles County. Anonymous observations of pedestrian distractions (texting, talking on a phone, headphone use, and other) were conducted before, 1 week after, and 4 months after the intervention. Distractions were compared before and after intervention using Chi square tests. A total of 11,533 pedestrians were observed, with 71% children and 29% adults. Total distractions decreased from 23% pre-intervention to 17% 1 week after stencil placement (p < 0.01), but this was not sustained at 4 months (23%, p = 0.4). A sustained decrease was observed only for texting at 4 months post-intervention (8.5% vs. 6.8%, p < 0.01). A simple visual intervention reduced distracted cell phone usage in pedestrians crossing the street, but this was most effective early after the intervention. Future studies are warranted to determine how to sustain this effect over time and how to minimize other types of distractions.

Mobile applications for pain management: an app analysis for clinical usage

BACKGROUND

Pain is the most common and distressing symptom for patients in all clinical settings. The dearth of health informatics tools to support acute and chronic pain management may be contributing to the chronic pain and opioid abuse crises. The purpose of this study is to qualitatively evaluate the content and functionality of mobile pain management apps.

METHODS

The Apple App Store and the Google Play Store were searched to identify pain management apps. The inclusion criteria were as follows: (1) that apps include a pain diary function allowing users to record pain episodes, (2) are available in either Apple App Store or Google Play Store, and (3) are available in the English language. We excluded apps if they were limited to only specific forms of pain or specific diseases.

RESULTS

A total of 36 apps met the inclusion criteria. Most of the apps served as pain diary tools to record the key characteristics of pain. The pain diary features of the apps were grouped into nine categories: the recordings of pain intensity, pain location, pain quality, pain's impacts on daily life, other features of pain, other related symptoms, medication, patients' habits and basic information, and other miscellaneous functions. The apps displayed various problems in use. The problem of not involving healthcare professionals in app development has not been resolved. Approximately 31% of apps including a pain diary function engaged clinicians in app development. Only 19% involved end-users in development and then only in an ad-hoc way. Only one third of the apps supported the cross-platforms, none of the apps supported clinician access to graphical pain data visualization, none secured HIPAA compliance, and none endorsed the PEG tool for primary care physicians' chronic pain management.

CONCLUSIONS

Most of the 36 pain management apps demonstrated various problems including user interface and security. Many apps lacked clinician and end-user involvement in app development impacting the clinical utility of these apps. We could not find any pain apps suitable for clinical usage despite high demand from clinicians due to the US opioid crisis.

What is the role of smartphones on physical activity promotion? A systematic review and meta-analysis

OBJECTIVES

To identify and evaluate the effect of interventions that used cell phones as a means to promote physical activity (PA).

METHODS

The databases searched were MedLine/PubMed, Scopus, SPORTDiscus, PsycINFO, Science Direct, Lilacs, and SciELO. After removing duplicates, applying exclusion criteria, and checking the reference lists, 45 studies were reviewed. The Downs and Black (D&B) scale measured methodological quality, and a random effect model was used to compute the meta-analysis of PA by the reported unit (minutes per day or steps per day), delivery agent (application (APP), SMS, or other), and PA measurement (questionnaire, accelerometer, pedometer).

RESULTS

Mobile phone-based PA interventions were efficient in increasing both minutes [10.49; CI (3.37-17.60); p = 0.004] and steps per day [735.17; CI (227.72-1242.61); p = 0.005] in adults when compared to baseline. Furthermore, APP-based interventions were able to increase the number of steps (p = 0.04) and minutes per day of PA (p = 0.04) in adults. Also, 85% of included manuscripts were classified as moderate- to high-quality articles.

CONCLUSIONS

Mobile phone-based PA interventions, inclusive those delivery by APP, were effective to increase minutes and steps per day in adults.

Acceptability and feasibility of recruitment and data collection in a field study of hospital nurses' handoffs using mobile devices

Background

The portability and multiple functionalities of mobile devices make them well suited for collecting field data for naturalistic research, which is often beset with complexities in recruitment and logistics. This paper describes the implementation of a research protocol using mobile devices to study nurses’ exchanges of patient information at change of shift.

Methods

Nurses from three medical and surgical units of an acute care teaching hospital in Montreal, Canada, were invited to participate. On 10 selected days, participants were asked to record their handoffs using mobile devices and to complete paper questionnaires regarding these exchanges. Nurse acceptance of mobile devices was assessed using a 30-item technology acceptance questionnaire and focus group interviews. The principal feasibility indicator was whether or not 80 complete handoffs could be collected on each unit.

Results

From October to December 2017, 63 of 108 eligible nurses completed the study. Results suggest that the use of mobile devices was acceptable to nurses, who felt that the devices were easy to use but did not improve their job performance. The principal feasibility criterion was met, with complete data collected for 176, 84, and 170 of the eligible handoffs on each unit (81% of eligible handoffs). The research protocol was acceptable to nurses, who felt the study’s demands did not interfere with their clinical work.

Conclusions

The research protocol involving mobile devices was feasible and acceptable to nurses. Nurses felt the research protocol, including the use of mobile devices, required minimal investment of time and effort. This suggests that their decision to participate in research involving mobile devices was based on their perception that the study protocol and the use of the device would not be demanding. Further work is needed to determine if studies involving more sophisticated and possibly more demanding technology would be equally feasible and acceptable to nurses.

Electronic supplementary material

The online version of this article (10.1186/s40814-018-0353-x) contains supplementary material, which is available to authorized users.

A Low-Profile Digital Eye-Tracking Oculometer for Smart Eyeglasses

Wearable eye tracking devices have broad uses in medicine, psychology, augmented & virtual reality and consumer market research. Most mobile eye trackers available today utilize infrared imaging of the pupil and corneal reflections with video cameras. This tracking method requires sophisticated real-time processing of video signals consuming substantial electrical power. This method is thus unsuitable for light weight wearables such as adaptive smart eyeglasses for correction of presbyopia. In this paper we present a low-profile, low-power (7.7 mJ/sample) digital eye tracker oculometer based on infrared sclera tracking. The system is implemented using eight, 24-bit infrared proximity sensors and synchronous infrared LEDs. The pupil location is determined from 32 reflected pulsed light measurements independent of ambient illumination. The digital oculometer is 3.1 mm thick and weighs ~3 g. The tracker mounts adjacent to the tunable lenses in the smart eyeglasses frame. The eye tracker showed a pointing error of 1.3 degrees rms over a vertical and horizontal range of 30 degrees when tested by an observer.

Maternal body weight and diet management system

Background

Body weight control is a significant issue to pregnant women. Overweight or underweight not only affects the normal growth of the fetus but also results in health impacts for pregnant women. Currently, some mobile applications which have released to stress how to achieve the purpose of weight control are not suitable for pregnant women. To design an appropriate mobile application of body weight control for pregnant women, a multidiscipline team collaborated.

Objective

This study proposed a mobile application approach to assist women to maintain an ideal weight control during their pregnancy. In addition, the usefulness of the application was evaluated among pregnancy women.

Methods

Firstly, the guidance of weight and diet management for pregnant women were obtained from textbooks and professional healthcare providers including nurses and nutritionists. Secondly, the researcher considered aspects of Human-Computer Interaction and theories of information technology behavior to design the mobile application. Finally, 52 pregnant women were recruited to test the prototype, which is a mobile application available on different devices with browsers.

Conclusions

Compared with other similar types of body weight and diet management mobile applications, the proposed application offers several characteristics to increase pregnant women's willingness to use it.

Digital health: a new dimension in rheumatology patient care

The new digital health innovations have opened up several opportunities to help the clinicians, patients and other caregivers of rheumatology healthcare system in maximizing efficiencies resulting in better patient outcomes. In the global context, digital health technology has the potential to bridge the distance gap between all the key stakeholders involved in rheumatology health care. In this review, we update on the recent advances in the field of digital health and highlight unique features of these technologies which would help in routine care. Application of technology in any form to enable, facilitate or enhance the quality of care is the foundation of digitised care. The components could be smartphone apps, sensors, video, social media platforms or messenger platforms, wearables or a combination of these enabling healthcare delivery and overcoming the constraints of distance, location and time. Digital therapeutics have started evolving and an important step in this direction is the involvement of FDA in the approval process. Speciality specific apps, personalised patient education as per disease status, remote specialist consultations or virtual health coach to guide on lifestyle modifications are some of the developments which have been facilitated by increased digitization in all walks of life. Assisted care with the help of robots rendering care in the hospitals or an intelligent robot guiding a patient by voice and visual sense at home are already at the threshold of entering the mainstream of patient care. Wearable devices equipped with powerful sensors are coming handy in keeping a watch on patient symptoms all the time and providing useful insights on disease progression, clinical response or complications. In chronic care such as rheumatology the implications, possibilities and benefits seem unprecedented. Real time data analytics and artificial intelligence are helping the clinicians, healthcare systems and policy makers optimise the resources and improve patient outcomes. Digitization of healthcare has gained momentum in the recent years and it is envisaged that it could be a catalyst to change, bridge the quality of care and most important democratise the healthcare access across the globe. However, more data, efficacy and objective results are needed which would be fulfilled by ongoing observational studies, clinical trials, systematic review and meta-analysis to further establish the role of digital health in the realms of patient care.

The Use of Smartphones in Different Phases of Medical School and its Relationship to Internet Addiction and Learning Approaches

The use of smartphones is revolutionizing the way information is acquired, leading to profound modifications in teaching medicine. Nevertheless, inadvertent use can negatively affect student learning. The present study aims to evaluate smartphone use in the educational context as well as Internet addiction and its repercussions on surface and deep learning and to compare them during the different phases of medical students' education. This is a cross-sectional study involving medical students in all phases of education. Sociodemographic data, type and frequency of smartphone use, degree of digital addiction (Internet Addiction Test - IAT), and surface and deep approaches to learning (Biggs) were analyzed. A total of 710 students were included. Almost all students had a smartphone and a total of 96.8% used it during lectures, classes, and meetings. Less than half of the students (47.3%) reported using a smartphone for more than 10 min for educational purposes, a usage that is higher among clerkship students. At least 95% reported using a smartphone in the classroom for activities not related to medicine (social media and searching for general information) and 68.2% were considered problematic Internet users according to the IAT. The most common reasons for noneducational use were that the class was uninteresting, students needed to receive or make an important call, and the educational strategy was not stimulating. The "frequency of smartphone use" and higher "internet addiction" were correlated to both higher levels of surface learning and lower levels of deep learning. Educators should advise and educate their students about conscientious use of this tool to avoid detrimental impact on the learning process.

Medical apps used during advanced pharmacy practice experiences

BACKGROUND AND PURPOSE

The purpose of this study was to determine what type of medical applications (apps) are being used by fourth-year students during advanced pharmacy practice experiences (APPEs).

EDUCATIONAL ACTIVITY AND SETTING

Recent doctor of pharmacy school graduates were surveyed pertaining to their use of medical apps on APPEs, frequency of use for select apps, willingness to buy apps and at what cost, and their perceived importance on using medical apps in their pharmacy practice. The survey concluded by inquiring if medical apps should be taught in the pharmacy curriculum.

FINDINGS

Ninety of 132 recent graduates responded to the survey and over 97% of the students used medical apps on their APPEs. Lexicomp^®, UpToDate^® and the Atherosclerotic Cardiovascular Disease (ASCVD) Risk calculator were the most frequently used applications during APPEs. Of those surveyed, 83% believe that medical apps should be taught in pharmacy school.

DISCUSSION AND SUMMARY

Medical apps are frequently used on APPEs. It may be prudent to teach students how to use and evaluate medical apps before going on experiences so that students and patients can get the most benefit from these tools.

Use of Mobile Devices to Measure Outcomes in Clinical Research, 2010-2016: A Systematic Literature Review

Background

The use of mobile devices in clinical research has advanced substantially in recent years due to the rapid pace of technology development. With an overall aim of informing the future use of mobile devices in interventional clinical research to measure primary outcomes, we conducted a systematic review of the use of and clinical outcomes measured by mobile devices (mobile outcomes) in observational and interventional clinical research.

Method

We conducted a PubMed search using a range of search terms to retrieve peer-reviewed articles on clinical research published between January 2010 and May 2016 in which mobile devices were used to measure study outcomes. We screened each publication for specific inclusion and exclusion criteria. We then identified and qualitatively summarized the use of mobile outcome assessments in clinical research, including the type and design of the study, therapeutic focus, type of mobile device(s) used, and specific mobile outcomes reported.

Results

The search retrieved 2,530 potential articles of interest. After screening, 88 publications remained. Twenty-five percent of the publications (n = 22) described mobile outcomes used in interventional research, and the rest (n = 66) described observational clinical research. Thirteen therapeutic areas were represented. Five categories of mobile devices were identified: (1) inertial sensors, (2) biosensors, (3) pressure sensors and walkways, (4) medication adherence monitors, and (5) location monitors; inertial sensors/accelerometers were most common (reported in 86% of the publications). Among the variety of mobile outcomes, various assessments of physical activity were most common (reported in 74% of the publications). Other mobile outcomes included assessments of sleep, mobility, and pill adherence, as well as biomarkers assessed using a mobile device, including cardiac measures, glucose, gastric reflux, respiratory measures, and intensity of head-related injury.

Conclusion

Mobile devices are being widely used in clinical research to assess outcomes, although their use in interventional research to assess therapeutic effectiveness is limited. For mobile devices to be used more frequently in pivotal interventional research – such as trials informing regulatory decision-making – more focus should be placed on: (1) consolidating the evidence supporting the clinical meaningfulness of specific mobile outcomes, and (2) standardizing the use of mobile devices in clinical research to measure specific mobile outcomes (e.g., data capture frequencies, placement of device). To that aim, this manuscript offers a broad overview of the various mobile outcome assessments currently used in observational and interventional research, and categorizes and consolidates this information for researchers interested in using mobile devices to assess outcomes in interventional research.

Feeling validated yet? A scoping review of the use of consumer-targeted wearable and mobile technology to measure and improve sleep

The objectives of this review were to evaluate the use of consumer-targeted wearable and mobile sleep monitoring technology, identify gaps in the literature and determine the potential for use in behavioral interventions. We undertook a scoping review of studies conducted in adult populations using consumer-targeted wearable technology or mobile devices designed to measure and/or improve sleep. After screening for inclusion/exclusion criteria, data were extracted from the articles by two co-authors. Articles included in the search were using wearable or mobile technology to estimate or evaluate sleep, published in English and conducted in adult populations. Our search returned 3897 articles and 43 met our inclusion criteria. Results indicated that the majority of studies focused on validating technology to measure sleep (n = 23) or were observational studies (n = 10). Few studies were used to identify sleep disorders (n = 2), evaluate response to interventions (n = 3) or deliver interventions (n = 5). In conclusion, the use of consumer-targeted wearable and mobile sleep monitoring technology has largely focused on validation of devices and applications compared with polysomnography (PSG) but opportunities exist for observational research and for delivery of behavioral interventions. Multidisciplinary research is needed to determine the uses of these technologies in interventions as well as the use in more diverse populations including sleep disorders and other patient populations.

Electronic health record on the go: Device form factor and Fitts' law

PURPOSE

With electronic health records (EHRs) becoming ubiquitous, computer use in exam rooms during patient-provider interactions is commonplace. Although computer use brings many benefits to providers, and patients generally rate computer-use as having a positive impact, the use of mobile devices could eliminate existing issues, for example allowing providers to enter or review records while face-to-face with patients. Using mobile devices increases flexibility of providers, but also creates challenges associated with the mobile device itself. For example, the form factor (i.e., display size) of the mobile device may affect provider performance, satisfaction and usability of the EHR. This study assessed the impact of the device form factor on usability of the EHR by measuring the most commonly used devices. This question relates to the applicability of Fitts' law, which does not predict differences in usability of devices varying in their form factor, assuming a linear scaling of the user interface.

PROCEDURES

Health care providers participated in this study by performing common EHR related tasks using devices differing in their form factor. Each participant performed these tasks on each of the devices. Interaction with a desktop computer served as baseline.

RESULTS

Usability and task load ratings for all mobile devices were significantly lower than for the desktop. Among the mobile devices, the iPad with its largest form factors performed best, where the iPhone performed the worst. The time to complete the tasks revealed that the mobile devices took more time to complete the tasks with the iPad requiring the least time among the mobile devices. Finally, in terms of error rates, all mobile devices had a significantly higher error rate than the desktop control. Again, the lowest error rate was observed with the devices that had the largest form factor.

CONCLUSIONS

The results of this study suggest that the form factor of mobile devices is of critical importance for usability and task performance with none of the mobile devices performing as well as the desktop. In addition, it appears that Fitt's law requires some additional examination in the context of touch screen devices. Given these results, challenges associated with mobile access to the EHR exist that need to be addressed in the future.

Improving the Accessibility of Mobile OCR Apps Via Interactive Modalities

Mobile optical character recognition (OCR) apps have come of age. Many blind individuals use them on a daily basis. The usability of such tools, however, is limited by the requirement that a good picture of the text to be read must be taken, something that is difficult to do without sight. Some mobile OCR apps already implement auto-shot and guidance mechanisms to facilitate this task. In this paper, we describe two experiments with blind participants, who tested these two interactive mechanisms on a customized iPhone implementation. These experiments bring to light a number of interesting aspects of accessing a printed document without sight, and enable a comparative analysis of the available interaction modalities.

Nursing students' perceptions of using smartphones in the community practicum: A qualitative study

BACKGROUND

Smartphones have the potential to revolutionize the way in which nurses practice by facilitating access to evidence-based resources, however their integration in nursing practice remain variable. Millennials tend to be more comfortable with technology, yet find themselves limited in their ability to use smartphones within the context of clinical practice.

METHODS/DATA SOURCES

Using a qualitative descriptive design, we explored nursing students' perceptions of using smartphones in the community practicum. Individual semi-structured interviews were conducted and verbatim transcripts were subjected to data analysis.

PARTICIPANTS

The sample consisted of 8 undergraduate and graduate nursing students. Participants were recruited using a purposive sampling strategy.

RESULTS

Students' narratives describe unclear expectations regarding the use of smartphones that force them to adopt individualized strategies to maintain their professional image and avoid negative consequences.

CONCLUSION

A cultural shift will be required at the academic and organizational levels if we are to foster acceptance of smartphones in community practice going forward.