Innovative App Research Articles

Smartphone-based nystagmus diagnostics: development of an innovative app for the targeted detection of vertigo

BackgroundIn medicine, the symptom of dizziness is one of the most common multidisciplinary causes of emergency medical presentation. Attending physicians are often faced with difficult decisions when evaluating patients with dizziness. A rapid differential diagnostic decision must be made during the initial examination. The goal of this study, was to develop a smartphone-based app that can diagnose and qualify nystagmus. The app should enable differentiation between acute emergencies such as strokes ("central vertigo") and vestibular disorders ("peripheral vertigo") using and recognizing or analyzing the accompanying symptom "nystagmus".Materials and methodsThis prospective study was conducted at the Department of Otolaryngology, Head and Neck Surgery "Otto Körner", Rostock (Germany). The experimental study design consisted of two test runs and two control runs. In the two test runs, nystagmus was tracked and evaluated by caloric and optokinetic stimulation, respectively, through a custom-developed app. Sensitivity and correlation were calculated for the app's application performance and compared under different experimental conditions.ResultsThe patient sample included twenty healthy participants with a mean age of 25.6 years (± 2.2 SD) who participated in the study. The overall sensitivity of detection of nystagmus averaged 82.14% in the optokinetic stimulation test trials. There is no correlation regarding specific subject data and sensitivity.ConclusionsThe results of our experimental validation study show that a smartphone-based nystagmus app is a useful tool for vertigo diagnosis. The results of our analyses show that it is possible to diagnose nystagmus and determine shape or direction with the app.

Abstract 55: Improved Efficiency, Analysis And Reporting Of Stroke Data By Automating Manual Data Extraction With Stroke Specific Data Fields Built In The Electronic Health Record

Data collection and analysis is essential for stroke center certification, registries and as a public responsibility. When large amounts of data need to be extracted, manual data collection is extremely time consuming. The existing challenge for stroke centers is leveraging technology for efficient data collection and analysis. The purpose of this project was to improve efficiency, analysis and reporting of stroke data by automating manual data extraction with stroke specific data fields built in the electronic health record. The data collected would create individual patient summaries, data reports and a stroke dashboard. The method chosen to accomplish this was by using data moved through an EPIC Clarity Database, our Enterprise Data Warehouse Suite of products, Subject Area Mart (SAM) and Instant Data Entry Application (IDEA app) and 5 SSRS Reports. Use of the innovative IDEA app allows for updating data behind the scenes. This 8-month collaborative project included IT support from a project manager, quality analyst, Power BI developer and SAM/data layer developer. This project resulted in over 250 discrete data points and 25 separate dashboard tabs, including volume, demographics, stroke metrics and outcomes. System-wide stroke data over a 10-month period included an overall volume of 2,814 patients, with 280 receiving tPA or thrombectomy. The option to run individual patient summaries and 5 different auditing reports was included. Estimated staff time savings is over 50 hours per month. In conclusion we have demonstrated it is possible to pull discrete data points from the electronic health record to be used in a dashboard, patient summaries and stroke data reports. The biggest challenge was dividing the large scope of work into manageable stages. A next step is to pull in EMS data through health data exchange. Streamlining data collection and analysis efficiency is essential for the future of a stroke center of excellence.

Gdpr and the Lost Generation of Innovative Apps

Gdpr and the Lost Generation of Innovative Apps

An Innovative App (ExoDont) for Postoperative Care of Patients After Tooth Extraction: Prototype Development and Testing Study.

BackgroundThe postoperative period is crucial for the initiation of healing and prevention of complications after any surgical procedure. Due to factors such as poor compliance, comprehension, and retention of instructions, and other unaccounted factors, the objectives of postoperative care are not always achieved. Therefore, an Android-based mobile health app (ExoDont) was developed to ensure a smooth postoperative period for patients after a dental extraction. The ExoDont app delivers reminders for postoperative instructions and drug intake at defined intervals, thus fostering self-reliance among patients in taking their prescribed dose of medication.ObjectiveThe aim of this study is to design, develop, and validate ExoDont, an innovative app for improved adherence to postoperative instructions after tooth extraction.MethodsA postoperative treatment protocol was developed by a team of oral and maxillofacial surgeons and general dentists, following which the clinical and technological requirements of the app were determined along with the software engineers, graphic designers, and applications architect in the team. ExoDont was developed to provide timely reminders for medication and postoperative care. The app was field tested and validated using the User Version of the Mobile Application Rating Scale.ResultsThe ExoDont software design was divided into a 3-level architecture comprising a user interface application, logical layer, and database layer. The software architecture consists of an Android-based ExoDont app for patients and a web version of the admin panel. The testing and validation of the ExoDont app revealed that Perceived Impact received the highest mean score of all rated components (mean 4.6, SD 0.5), while Engagement received the lowest mean score (mean 3.5, SD 0.8).ConclusionsThe testing and validation of the app support its usability and functionality, as well as its impact on users. The ExoDont app has been designed, keeping the welfare of patients in view, in a user-friendly manner that will help patients adhere to the prescribed drug regimen and ensure easy and efficient dissemination of postoperative instructions. It could play an instrumental role in fostering compliance among patients and significantly decrease the complication rate following dental extractions.

The forgotten agriculture-nutrition link: farm technologies and human energy requirements

In the quest to reduce global under- and malnutrition, which are particularly high among smallholder farmers, agriculture-nutrition linkages are receiving increasing attention. Researchers have analyzed the link between the quantity and diversity of food that farmers produce and nutritional outcomes but paid limited attention to a third agriculture-nutrition link: the link between how food is produced and nutritional outcomes. This neglect persists despite the majority of smallholder farmers relying on hand tools for farming, which implies heavy physical work and, thus, high energy requirements. To address this research gap, this study compares the energy requirements of farm households in rural Zambia that are characterized by three different levels of mechanization: hand tools, animal drought power, and tractors. 1638 days of detailed time-use and nutrition data were collected from 186 male and female adults and boys and girls during different seasons (land preparation, weeding, and harvesting/processing) using an innovative picture-based smartphone app called “Timetracker”. This data served to calculate different proxies for physical activity and energy requirements using “Ainsworth’s Compendium of Physical Activities”. The results suggest that detailed time-use data offers great potentials to study physical activity and energy requirements. The findings show strong linkages between farm technologies, physical activity levels, and energy requirements, suggesting that this agriculture-nutrition link deserves more scientific and political attention to reduce under- and malnutrition among smallholder farmers.

Launching a pilot for a self-monitoring app for people living with heart failure: a nurse's experience

As nurses worldwide grapple with changes to their roles and practice as a result of the COVID-19 pandemic, Mandie Welch shares her team's involvement with a 3-month pilot for an innovative app for people with heart failure

DAHAGA: An Islamic spiritual mindfulness-based application to reduce depression among nursing students during the COVID-19 pandemic.

The COVID-19 pandemic significantly impacts students' mental health. Most of them may experience depression. Due to restrictions and social distancing during the pandemic, counseling may not be applicable in detecting the problems. Therefore, an Islamic spiritual mindfulness-based application called DAHAGA is created in order to detect and reduce depression. It is believed that this innovative app could reduce mental health problems among students. This study aimed to determine the effect of DAHAGA on reducing depression among nursing students during the COVID-19 pandemic in Indonesia. This was a quasi-experimental study with a comparison group pretest/posttest design conducted from May to June 2020. Seventy students were selected using convenience sampling, of which 35 were assigned in an experimental group and a comparison group. The validated Indonesian Version-Beck Depression Inventory-II (BDI-II) was used for data collection. Paired t-test and independent t-test were used for data analysis. There was a significant effect of DAHAGA on depression (p < 0.001). The level of depression after intervention (mean 11.49, SD 4.49) was lower than it before the intervention (mean 17.20, SD 4.94). Additionally, there was a significant difference in depression level between the experimental and comparison groups after the intervention with a p-value of < 0.001. The DAHAGA is proven effective in reducing depression. Therefore, this study offers a new and innovative app that fits with the COVID-19 pandemic to help Muslim students maintain their health status. The findings also support Islamic spiritual mindfulness as a part of nursing interventions among psychiatric nurses to deal with mental health problems, especially depression.

Reducing distracted pedestrian behavior using Bluetooth beacon technology: A crossover trial

BackgroundThe number of fatal pedestrian injuries in the United States has steadily increased over the past decade. Multiple factors likely contribute to this trend, but the growth of pedestrians distracted by mobile devices is widely hypothesized to play a major role. Existing strategies to reduce distracted pedestrian behavior are few and mostly ineffective. The present study evaluated StreetBit, a mostly-passive primary prevention program to reduce distracted pedestrian behavior by alerting distracted pedestrians directly on their smartphone when they approach an intersection, reminding them to attend to traffic as they crossed. Methods385 individuals who regularly crossed a target street corner at an urban university downloaded StreetBit on their phones and participated in a crossover design study whereby the app was inactive for 3 weeks (baseline behavior phase), actively provided alerts for 3 weeks (intervention phase), and then was inactive again for 4 weeks (post-intervention phase). User distraction while crossing the intersection was collected electronically for a total of 34,923 street-crossing events throughout the 10-week study. ResultsIn crude (unadjusted) models, participant distraction was similar across all phases of the research; this result was maintained after adjusting for potential covariates as well as after conducting a sensitivity analysis limited to data from only week 3 of each study intervention phase. In a model stratified by phone/warning type and baseline distraction rates, Android phone users who received a warning that blocked the full screen and had a high baseline distraction rate (≥75% distracted crossings) had a 64% decreased odds of distraction during the alert phase (OR 0.36, 95% CI 0.25–0.51) and a 52% decreased odds of distraction during the post-intervention phase (OR 0.48, 95% CI 0.25–0.94). Users reported positive impressions about the StreetBit app in a post-intervention survey. DiscussionStreetBit, an innovative app designed to prevent distracted pedestrian behavior through a mostly-passive primary prevention strategy relying on intrusive reminders, proved effective among smartphone users who received a warning blocking the full screen and who were frequently distracted at baseline, but not among other users. The results appear to reflect the confluence of two influencing factors. First, due to software development limitations, visually-distracted Android users received a highly intrusive app warning that blocked their smartphone screen whereas iOS users received a less intrusive banner notification blocking a small upper portion of the screen. Second, most users were curious to see if the app was functioning properly, creating artificially-inflated estimates of distraction as users purposefully watched their phones when crossing. Thus, our results indicate promise for StreetBit as an effective intervention and warrant continued software development and empirical testing.

Smart Online Grocery Shopping App Development

Shopping is one of the activities that some people consider part of their life, while others do not even think of it. This comparison makes us discover people's problems with shopping. People have shopping problems such as limited time, expats in foreign countries without cars, a transportation issue, people consider physical shopping as a waste of time, health issues, long-distance to market. And the difficulty in obtaining some items. As the problems mentioned above, we have explored our idea, which is related to personal shopping. Therefore, we have built an application that combines different market shops, i.e. (Malls, supermarkets, and pharmacies). This personal grocery shopping is an innovative app that allows the customers to get all their needs and suggest items based on previous history. Then deliver items to their doorstep and can facilitate online shopping procedure where customers can browse unlimited products all at one time. This work supports people in exploiting their time to be safer and more accessible than wasting it physically. Moreover, people can order the product from home instead of going around for long distances for shopping. In addition, this app could help people who are facing health problems and unable to buy something physically to avoid future problems. Finally, some people do not have transportation methods for shopping, and they should keep pace with the evolution.

Processing Analysis of Swift Playgrounds in a Children’s Computational Thinking Course to Learn Programming

Computational thinking courses can cultivate students’ ability to apply logic in the fields of mathematics and information science. The new 12-year Basic Education Curriculum Guidelines were implemented in Fall 2019 in Taiwan. Courses on computational thinking, problem solving, and programming are contained in the technology education field in junior and senior high schools. Swift Playgrounds is an innovative app for the iPad and Mac that makes learning Swift interactive and fun. No programming knowledge is required to use Swift Playgrounds, making it very suitable for beginners. This study was carried out by letting elementary school teachers and students participate in Swift Playgrounds computational thinking courses. By trying this app, teachers of different disciplines attempted to realize more learning situations. Students learned how to cope with functions and loop skills by playing with “Byte”, which is a character in Swift Playgrounds. There were three purposes for this study: first, designing a computational thinking course for the most basic part, “Hello! Byte”, in Swift Playgrounds; second, assigning elementary school teachers to assess the qualitative analysis of tasks in Swift Playgrounds; and third, assigning elementary school students to do the tasks and assign a difficulty index in Swift Playgrounds after learning with this app. The results show that most teachers considered this approach to be able to improve logical thinking and inferential capability after assessing, and most students considered functions and loops quite difficult after using the app. According to the students’ indices, about 86 percent of students considered that adding commands is easy, and about 37 percent of students considered that functions are easy. On the other hand, about 24 percent of students considered that applying the Slotted Stairways is difficult, and about 34 percent of students considered that using loops is hard. It is suggested that more instructions for the course or extendibility for classes is required.

Screening for delirium in the intensive care unit using eDIS-ICU – A purpose-designed app: A pilot study

IntroductionDelirium, a common complication of an intensive care unit (ICU) admission, is inconsistently diagnosed by clinicians. Current screening tools require specialist expertise and/or training. Some are time-consuming to administer, and reliability in routine clinical practice is questionable. An innovative app designed to enable efficient and sensitive screening for delirium without specialist training (eDIS-ICU) has recently been described. This pilot study compared the eDIS-ICU against the reference standard expert assessment using DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) criteria and the Confusion Assessment Method for the ICU (CAM-ICU). MethodsIn this prospective, single-centre pilot study, a convenience sample of 29 ICU patients were recruited at a tertiary referral hospital between November 2018 and August 2019. After obtaining written consent, demographic and clinical data were collected, and the patients were screened for delirium using eDIS-ICU and CAM-ICU by two clinician researchers in random order. The patients were also assessed for presence of delirium independently by an expert clinician using a structured interview to diagnose as per DSM-V criteria. The results of screening and diagnosis were tabulated to allow comparison of screening tools against diagnosis; sensitivity and specificity of the tools were calculated. ResultsSeven participants were diagnosed with delirium as per DSM-V criteria. The eDIS-ICU tool correctly identified six of these participants compared with two identified by CAM-ICU. The sensitivity of the eDIS-ICU tool was 86% (95% confidence interval [CI] = 81.5–100.0) compared with 29% (95% CI = 5.1–69.7) for CAM-ICU (p < 0.05), and the specificity was 73% (95% CI = 81.5–100.0) versus 96% (95% CI = 75.1–99.8), respectively. ConclusionThe simple and novel eDIS-ICU delirium screening tool was noninferior to the CAM-ICU in detecting delirium as per DSM-V criteria. A definitive validation study is warranted.

A Digital Revolution in Pharmaceutical Industry: Mobile Health Applications

Today Meteoric advancement has spread to the field of medicine also. Most importantly the smartphone technology which has played an accountable role in this direction and has made the medical provisioning via mobile a reality which one could never have thought of earlier. We have developed and evaluated mobile apps for smartphones working on different platforms (Android, iOS, Window’s) to regulate and facilitate interactions between patients and doctors where patient capable to seek advice, diagnosis and treatment from the doctor from remote places around the globe. Numerous innovations and development in mobile software applications also provide potential benefits to the public health since the mobile platforms are becoming more user-friendly, computationally powerful and affordable with each successive day. It is because of these innovative apps that have significantly contributed in clinical consultation complementing face to face interactions with doctors, healthrecord maintenance, patient management and monitoring, clinical decision- making, medical education and training and the list goes on. The GUI displays screens of the smartphones are incorporated with medical data that is required by the clinician to interpret and respond in most efficient manner possible.

An efficient D2D quaternion encryption system for IoT using IEEE 754 standards

The Internet of Things (IoT) was recognized as one of the emerging IT innovation. Sensors, actuators and integrated communications equipment form an IoT device. The IoT device interconnection provides the capacity to share data across platforms through a unified structure, creating a common working scene to enable innovative apps. Information security in IoT is a challenging job due to the network’s vulnerability. An efficient encryption enhances the overall performance of the IoT. Cryptography plays an important role in the design of secure IoT systems. Among the two types of cryptographic systems, namely symmetric and asymmetric key encryption, the computation complexity of the symmetric key cryptography is low and provides desirable security. Symmetric key encryption is also favorable in device-to-device (D2D) communication. IoT devices are portable and featured with limited computing capacity. Therefore, a lightweight security system is an obvious need. In this paper, we have proposed a peer-to-peer encryption algorithm using quaternion applicable for IoT. The design of the algorithm is discussed and results are presented.

MoLaBSS: Server-Specific Add-On Biometric Security Layer Model to Enhance the Usage of Biometrics

With high-paced growth in biometrics, and its easy availability to capture various biometric features, it is emerging as one of the most valuable technologies for multifactor authentication to verify a user’s identity, for data security. Organizations encourage their members to use biometrics, but they are hesitant to use them due to perceived security risks. Because of its low usage rate, many medium and small segment organizations find it unfeasible to deploy robust biometric systems. We propose a server-specific add-on biometric security layer model (MoLaBSS) to enhance confidence in the usage of biometrics. We tested this model via a biometric mobile app, and the survey showed a favorable response of 80%. The innovative mobile app was tested for its usability and got a score of more than 71%. For test tool reliability, we examined the equal error rate (EER) of the app and got a reasonably low score of 6%. The results show good potential of this framework to enhance users’ confidence level in the usage of biometrics. Higher usage rates may make deployment of biometrics more cost-effective for many organizations to decrease their information security risk.

SafeSpot: an innovative app and mental health support package for Scottish schools - a qualitative analysis as part of a mixed methods study.

The aim of the study was to investigate teachers' and pupils' perceptions about the effect of the SafeSpot mental health curriculum on the well-being of young people and on their knowledge of mental health conditions. This trial intends to determine the acceptability and benefits of web and mobile technology in delivering emotional well-being in schools, through use of the SafeSpot programme. With 10% of young people aged 5 to 16 diagnosed with a mental disorder, there is pressure for schools to address their pupils' emotional well-being. However, many educators report that their schools have insufficient provisions and feel inadequately equipped to support pupils' mental health. This qualitative analysis was embedded within a randomly allocated stepped-wedge design, conducted in six West of Scotland secondary schools. A total of 2320 pupils (aged 11 to 14years) and 90 teachers were included. Young people's understanding of health-seeking, and teacher's confidence in delivering and accessing well-being information was assessed qualitatively. Qualitative analysis revealed themes highlighting the beneficial nature of SafeSpot, including pupil engagement, content of tutorials, perceived impact of SafeSpot and level of training provided for teachers. Web technology could potentially offer a more structured way for staff to support their pupils' mental health, whilst reducing stigma. SafeSpot was perceived, by pupils and teachers, to be engaging.

Engaging patients and triggering self-care: using Intelligent Augmented Reality apps.

A doable way of screening for atrial fibrillation (AF) is by the person knowing how to check their pulse and to recognise what a normal regular rhythm or an abnormal irregular rhythm feels like, which should prompt a clinic appointment with a GP or other health professional for further investigation. To this end, two novel innovative apps using augmented reality (AR) have recently been created to engage and help inform members of the general public. The first app focuses on how a person without any healthcare experience can learn to check their pulse and detect possible AF, and the second aims to educate patients who have been diagnosed with AF to help understand their condition and its potential consequences better, and thus seek and adhere to prescribed medication. AR is a technology where a phone camera is used to add to (or augment) real world capture with virtual 3D objects. Know My Heart and Know My Beat apps have been designed specifically to use this technology. The aim is to engage members of the public and individual patients …

International ResearchKit App for Women with Menstrual Pain: Development, Access, and Engagement.

BackgroundPrimary dysmenorrhea is a common condition in women of reproductive age. A previous app-based study undertaken by our group demonstrated that a smartphone app supporting self-acupressure introduced by a health care professional can reduce menstrual pain.ObjectiveThis study aims to evaluate whether a specific smartphone app is effective in reducing menstrual pain in 18- to 34-year-old women with primary dysmenorrhea in a self-care setting. One group of women has access to the full-featured study app and will be compared with 2 control groups who have access to fewer app features. Here, we report the trial design, app development, user access, and engagement.MethodsOn the basis of the practical implications of the previous app-based study, we revised and reengineered the study app and included the ResearchKit (Apple Inc) framework. Behavior change techniques (BCTs) were implemented in the app and validated by expert ratings. User access was estimated by assessing recruitment progress over time. User evolution and baseline survey respondent rate were assessed to evaluate user engagement.ResultsThe development of the study app for a 3-armed randomized controlled trial required a multidisciplinary team. The app is accessible for the target population free of charge via the Apple App Store. In Germany, within 9 months, the app was downloaded 1458 times and 328 study participants were recruited using it without external advertising. A total of 98.27% (5157/5248) of the app-based baseline questions were answered. The correct classification of BCTs used in the app required psychological expertise.ConclusionsConducting an innovative app study requires multidisciplinary effort. Easy access and engagement with such an app can be achieved by recruitment via the App Store. Future research is needed to investigate the determinants of user engagement, optimal BCT application, and potential clinical and self-care scenarios for app use.Trial RegistrationClinicalTrials.gov NCT03432611; https://clinicaltrials.gov/ct2/show/NCT03432611 (Archived by WebCite at http://www.webcitation.org/75LLAcnCQ).

The DOZE App: A Unique Approach to Overcoming Sleep Problems in Young Adults

Poor sleep is a common difficulty issue for teenagers and young adults worldwide. Unfortunately, the impact of poor sleep is substantial with clear links to mental health difficulties. Dr Colleen Carney, an Associate Professor and the Director of the Sleep and Depression Laboratory at Ryerson University, Canada, is committed to helping people sleep better. Dr Carney has recently turned her expertise to the development of an innovative app to alleviate sleep problems in teenagers and young adults.

ACCURACY AND USABILITY OF A MOBILE ALERT SYSTEM FOR COMMUNITY CITIZENS TO LOCATE PERSONS WITH DEMENTIA WHO GET LOST

Three out of five persons with dementia wander. While the literature supports community engagement in the location of lost older adults, publically funded Silver Alert programs are associated with jurisdictional issues and alert fatigue. In collaboration and consultation with key stakeholders (older adults living with dementia, care partners, service providers, advocates, police organizations), we developed Community ASAP, an alert system (mobile website and app) that mobilizes community citizens who volunteer to keep watch for persons with dementia reported to be lost. The purpose of this study was to evaluate usability and functionality of the Community ASAP app. Thirteen participants from six regions in Canada received a total of 130 missing person notifications. They recorded the time and content of these notifications, completed the Website Usability Questionnaire, and provided written feedback or participated in a group interview about their experiences using the app and suggestions for improvements. The Community ASAP app delivered notifications with 100% accuracy and received messages from participants with 98% accuracy. Overall, participants thought the interface was easy to navigate, graphics were pleasing, easy to use, and was clearly organized. Suggestions for improvements to increase usability included: 1) Multi-sensory alerts to make them more noticeable and increase readability; 2) Clearer navigation within the home screen and preferences; 3) User support (instructions, demo video, technical support). Evaluation results for this innovative app were favourable; suggestions will be used to further improve usability, particularly for end users who are novices at using mobile applications.

Applying Online Educational Technology to Foster Financial Literacy: Financial-Institution Leaders’ Insights

Financial literacy deficiency is a prevailing problem in United States raising the need for effective financial education. Financial-institution leaders can play a crucial role in promoting financial literacy with their practical experience and expertise. This article sheds new light on the application of online technology to promote financial literacy by exploring the perceptions of financial-institution leaders. Supported by Dewey’s pragmatic constructivist paradigm and the PEST conceptual framework, a qualitative inquiry research through in-depth telephone interviews with 20 leaders from banks and credit unions in Texas was conducted. The findings revealed some common ways to provide online financial literacy education, including website information posting, online financial calculators, external links, social media communication, and partnering with appropriate third parties. The financial leaders perceived that applying online technology would be an enlightening future direction especially for the millennial generation but face-to-face education would remain important. The opportunities included social responsibility fulfillment, corporate image strengthening, marketing, and favorable regulatory consideration. The challenges involved the human and financial resources constraints, IT support, lack of effective evaluation, and how to motivate online learning. Some leaders suggested the use of games, financial incentives, and innovative apps. The policy implications included increase in government support, partnership with schools, embracing financial literacy in the state test, and collaboration among financial leaders, regulators, educators, and policy makers to foster financial literacy for the benefits of the society.