iPad Mini Research Articles

Snellen iPad App versus Traditional Light-Box Snellen Chart in Distance Visual Acuity.

This study aimed to discover distance visual acuity (VA) assessments through the display of the Snellen chart on the iPad tablet. The findings are equivalent to those obtained using the conventional light-box Snellen chart. In this work, the Snellen iPad app and Eye Chart HD iOS app are utilized among the participants in the Ophthalmology Outpatient Department (OPD) for determining VA. A cross-sectional method was used for the examination, which included 100 new patients who were chosen by random selection. The age requirement for new patients was 8 years and up for both genders. Patients with a VA of less than 6/30 were disqualified from the experiment. Two testing modalities are used to measure VA, such as the iPad Mini 2 with the iOS software Eye Chart HD and the classic Snellen light-box chart. The observation revealed that the Snellen iPad app and the classic light-box Snellen chart produced equivalent findings. The classic Snellen chart may have been memorized by participants before their eye examination, undermining the accuracy of the conclusions of the initial testing modality used. Patient-related variables were also identified as confounders. Future studies should adjust the brightness of the iPad Mini 2 and the traditional light-box Snellen chart to make sure that neither experiment modality's brightness affects the accuracy of the findings. Future research should also investigate the use of premium apps, use both devices, and employ a bigger sample size.

Obsolete or Opportunity? Challenging Perceptions of Device Usefulness

Abstract: Obsolete devices add to the rising levels of electronic waste, a major environ- mental concern, and a contributing factor to climate change. In recent years, device manufacturers have established environmental commitments and launched initiatives such as supporting the recycling of obsolete devices by making more ways available for consum- ers to safely dispose of their old devices. However, little support is available for individuals who want to continue using legacy or ‘end-of-life’ devices and few studies have explored the usefulness of these older devices, the barriers to their continued use and the associated user experiences. With a human-computer interaction lens, this paper reflects on device usefulness as a function of utility and usability, and on the barriers to continued device use and app installation. Additionally, the paper contributes insights from a sequel study that extends on prior work evaluating app functionality of a ‘vintage’ Apple device with new empirical data on app downloadability and functionality for the same device when newly classified as ‘obsolete’. A total of 230 apps, comprising the top 10 free App Store apps for each of 23 categories, were assessed for downloadability and functionality on an Apple iPad Mini tablet. Although only 20 apps (8.7%) could be downloaded directly onto the newly obsolete device, 143 apps (62.2%) could be downloaded with the use of a different non-legacy device. Of these 163 downloadable apps, 131 apps (com- prising 57% of all 230 apps and 80.4% of the downloadable apps) successfully installed, opened, and functioned. This was a decrease of only 4.3% in functional apps (of the 230 total apps) compared to the performance of the device when previously classified as ‘vin- tage’.

EVALUATION OF AN OFF-THE-SHELF, WEARABLE ACTIGRAPH SYSTEM FOR USE BY OLDER COUPLES

Abstract There are many off-the-shelf wearable devices that provide the user with information regarding their physical activity and sleep patterns. Little is known about how easy it is for older individuals to use these devices. We tested a wrist-worn actigraph on couples both of whom were at least 70 years old. The aim was to evaluate the usability of the device, and to share data within the couples. Mixed methods were used to collect data. Over the three-week trial, 14 couples, nine of which had one member with mild cognitive impairment, used the system. Each person wore a Garmin Vivofit 4 continuously and used the Garmin application installed on an iPad mini to compare and review results over time. At the end of weeks one and three, participants completed the positively scored System Usability Scale (SUS), and each week met with the researcher to discuss the data and system usability. All couples were able to work together to use the system after being trained. Scores on the SUS indicated the system was moderately easy to use. Qualitative findings were that most participants (88%) liked being able to wear the device continuously, without breaks for charging. They compared information about their activity and sleep patterns within the dyad. There were several age-specific usability challenges, but use of off-the-shelf actigraphs by older individuals holds promise if age-related physical and cognitive changes are considered during selection of the device.

Exploring the Use of an Electronic Competency Assessment Document Using iPad Minis to Assess Clinical Practice Competency in a Preregistration Nursing Program: A Cross-sectional Feasibility Study.

The aim of this study was to explore the feasibility of using iPad minis as a method of completing competency assessment in clinical practice. Digital technology helps to revolutionize all aspects of our lives. The use of digital technologies in clinical practice can facilitate a move toward a more flexible learning environment and enable students to adapt in a rapidly changing, interconnected world. The introduction of electronic clinical booklets in practice placements could facilitate the sharing of clinical information through connected healthcare systems, thus improving the student experience. A cross-sectional design was used in this study. A sample of BSc nursing students (n = 53) and clinically based healthcare professionals (n = 27) (preceptors and clinical placement coordinators) participated in this study. Data were collected using a modified version of Garrett and colleagues' instrument, the System Usability Scale, a demographics questionnaire, and three open-ended questions. There was a significant difference between the students and preceptors/clinical placement coordinators across all items with higher proportions of students (ranging from 66% to 75.5%), indicating that they agreed or strongly agreed with the reliability, ease of use, and effectiveness of the device in assessing their clinical competency (ranging from 11.1% to 40.7%). In addition, the iPad minis were found to be smaller, lighter, and easier to carry than paper-based booklets and encouraged students to access timely online learning resources during placement to help augment their learning. The use of iPad mini to complete the electronic competency assessment document as a replacement for a paper-based system to assess clinical practice is feasible. The introduction of electronic assessment documents should incorporate a robust training plan and standard operating procedures.

Deep Learning-Based System for Preoperative Safety Management in Cataract Surgery

An artificial intelligence-based system was implemented for preoperative safety management in cataract surgery, including facial recognition, laterality (right and left eye) confirmation, and intraocular lens (IOL) parameter verification. A deep-learning model was constructed with a face identification development kit for facial recognition, the You Only Look Once Version 3 (YOLOv3) algorithm for laterality confirmation, and the Visual Geometry Group-16 (VGG-16) for IOL parameter verification. In 171 patients who were undergoing phacoemulsification and IOL implantation, a mobile device (iPad mini, Apple Inc.) camera was used to capture patients’ faces, location of surgical drape aperture, and IOL parameter descriptions on the packages, which were then checked with the information stored in the referral database. The authentication rates on the first attempt and after repeated attempts were 92.0% and 96.3% for facial recognition, 82.5% and 98.2% for laterality confirmation, and 67.4% and 88.9% for IOL parameter verification, respectively. After authentication, both the false rejection rate and the false acceptance rate were 0% for all three parameters. An artificial intelligence-based system for preoperative safety management was implemented in real cataract surgery with a passable authentication rate and very high accuracy.

Intentional Observational Clinical Research Design: Innovative Design for Complex Clinical Research Using Advanced Technology.

The growing use of robots in nursing and healthcare facilities has prompted increasing research on human–robot interactions. However, specific research designs that can guide researchers to conduct rigorous investigations on human–robot interactions are limited. This paper aims to discuss the development and application of a new research design—the Intentional Observational Clinical Research Design (IOCRD). Data sources to develop the IOCRD were derived from surveyed literature of the past decade, focusing on clinical nursing research and theories relating robotics to nursing and healthcare practice. The distinction between IOCRD and other research design is the simultaneous data generation collected using advanced technological devices, for example, the wireless Bonaly-light electrocardiogram (ECG) to track heart rate variability of research subjects, robot application programs on the iPad mini to control robot speech and gestures, and Natural Language Processing programs. Even though IOCRD was developed for human–robot research, there remain vast opportunities for its use in nursing practice and healthcare. With the unique feature of simultaneous data generation and analysis, an interdisciplinary collaborative research team is strongly suggested. The IOCRD is expected to contribute guidance for researchers in conducting clinical research related to robotics in nursing and healthcare.

Patient Interest in and Feasibility of a Mobile Health App to Support Patients Undergoing Hematopoietic Stem Cell Transplantation

Introduction: Mobile health applications (mHealth apps) have the potential to enhance patient-provider communication and assessment through active and passive evaluation and tracking. Early detection may lead to earlier interventions and better outcomes for complex medical conditions. Hematopoietic stem cell transplantation (HCT) is a prime example of a complex medical treatment that causes significant symptom burdens for patients. We developed a mHealth app for HCT patients to allow for daily evaluation of patient health and symptoms. We conducted a survey to evaluate interest and usability in a group of HCT survivors and piloted this app with allogeneic HCT patients in a phase 1 clinical trial.Methods: In collaboration with Sicklesoft Inc., we developed a mHealth app, Technology Recordings to better Understand BMT (TRU-BMT), to facilitate wellness tracking and symptom reporting. Patients can enter their food intake, exercise, sleep habits, general health, mood, and daily symptoms (Figure 1). The app provided automatic reports to patients with information about trends over time. To gain feedback and gauge interest, we surveyed transplant survivors at the 2017 BMT InfoNet Symposium in Raleigh, North Carolina. Participants explored the app on iPads and then answered a user experience survey developed with the Behavioral Health and Survey Research Core to evaluate both usability as well as perceived helpfulness. To test real-world usability and feasibility of daily data entry, we also enrolled patients actively undergoing allogeneic HCT in a phase 1 trial. Patients were given Apple devices (iPad Mini, iPad Air) containing the TRU-BMT app to use at the start of transplant. Patients were taught how to use the app and received follow up visits to ensure that they were not struggling to enter data and that no technical difficulties were occurring with the devices.Results: A total of 31 surveys were collected at the BMT InfoNet Symposium. The median age was 62 (range 26-76), 55% were male. 76% of respondents thought TRU-BMT was easy to use; 67% felt confident in its use after only a few minutes of testing; and 80% thought most people could learn to use the app quickly. 83% thought daily symptom input would be useful. 76% would use the app at least 4 times per week, with 44% would use it daily. While there was a correlation between how helpful a participant perceived TRU-BMT and the number of days per week they could see themselves using the app, there was no correlation between age and any of the above responses.Nine patients have been enrolled on the phase I study to determine feasibility (Table 1). Four patients used TRU-BMT nearly every day throughout their transplant, one used TRU-BMT 2-3 times per week throughout transplant, and two are ongoing. One patient enrolled but never started using the app due to multiple medical complications surrounding conditioning chemotherapy. One patient used TRU-BMT for three days but then developed a medical complication, felt overwhelmed, and stopped. Patients have self-reported that in addition to filling out the app themselves, their caregivers also assisted in this process.Discussion: To our knowledge, TRU-BMT is the first mobile health app that specifically addresses symptom reporting and general wellness in the HCT patient population. Patients think such an app is useful, and they will use it daily for up to 90 days during transplant. One of the main concerns in using mHealth apps is making it accessible to patients of all ages. However, according to feedback from survey participants as well as patients using the app, age does not seem to impact a patient's desire or ability to use the app or wearable device. The biggest barrier to consistent use appears to be the health of the patient, as those who had the lowest number of entries or shortest duration of use had complicated transplants, during which symptom management and rest took precedence over data entry. We aim to continue evaluating this app in the setting of long-term follow up and surveillance of symptoms and early detection of complications such as chronic graft-versus-host disease. Given that our most significant challenge in adherence was the medical status of the patient, we predict that patients who have been successfully discharged from transplant will have an easier time complying. Our goal is to facilitate communication between the patient and the healthcare team, permitting closer follow up leading to improved outcomes. [Display omitted] DisclosuresSung:Merck: Research Funding; Novartis: Research Funding; Cellective: Research Funding. Shah:Alexion: Other: Speaker; Novartis: Other: Speaker.

Themes of Stressors, Emotional Fatigue, and Communication Challenges Found in Mobile Care Discussion Sessions With Patients Requiring Lifelong Home Parenteral Nutrition Infusions.

The purpose of this article is to examine themes and topics that emerged from 35 discussion sessions with teens and young adults requiring long-term home parenteral nutrition (HPN) intravenous infusions. The goal was to gain a more detailed understanding of participants' challenges and successes of living with HPN. These patients were invited to attend 3 discussion group sessions facilitated by health professionals. A secure iPad Mini was selected as the mobile tablet device for hosting these encrypted audio-visual group discussions. Content analysis, a standard research data-sorting technique, was used to summarize the anonymous data. Words, phrases, and topics in patients' discussions were coded and grouped together with similar concepts and subsequently categorized into themes. Themes in these discussions were related to patients' daily, complex management of HPN. These "themes" included having multiple repetitive illness-related stressors and how those stressors were managed; managing emotions; communication challenges with professionals, family, friends, and using social media; and lastly, the least frequent but no less important theme discussed was how HPN effects their daily lives. Teens and young adults living with lifelong HPN face a variety of unique psychological, physical, and emotional stressors and may benefit from numerous methods for managing these challenges.

Student Perception on Integration of 3D Complete Anatomy Software Application in Medical Curriculum

BackgroundAnatomy is a discipline where spatial visualization is of importance. In medical school, anatomy is often taught to students via lectures with slides and cadavers. While slide images and cadavers can show the relationships between muscles to a limited extent, neither can show movement well or be manipulated by the student to isolate specific structure(s). The 3D Complete Anatomy application was utilized by students to study muscle movements, determine points of proximal and distal attachment, understand spatial relationships between structures, take self‐assessments, and more, at their convenience.Objectiveof this study is to examine student perceptions about learning anatomy using 3D Complete Anatomy application and to explore how these perceptions shape the learning experience.MethodAt Florida International University Herbert Wertheim College of Medicine, first year students were provided iPad Mini’s with the 3D Complete Anatomy software. Students were advised to review the Complete Anatomy app during the introduction of the period 1 Anatomy course. Students were also encouraged to use the Complete Anatomy app during their mandatory anatomy lab sessions. Students’ feedback will be assessed using approximately ten survey statements that they can indicate their level of agreement with. Their responses will be scored using a five‐point Likert scale. The statements will assess the app’s ability to enhance students’ learning, retention of knowledge, and overall ease of studying the material. We are in the processes of getting exempt from IRB.ResultsWe expect the results to support our hypothesis that the 3D Complete Anatomy Application would improve first year medical students’ learning, retention of concepts, and ease of studying the material. Additionally, we expect the students to recommend the app for future classes to be used along with to the plastinated and prosected models during anatomy lab sessions. Final data analysis of the variables will be done after obtaining IRB exempt.ConclusionsWe expect that the majority of students will believe that the 3D Complete Anatomy application assisted their understanding of the spatial relationships between anatomical structures and mastery of the material. Additionally, we believe this resource will be among the tools the students used on a regular basis to effectively learn the material. We hope to be able to apply this knowledge of using supplemental 3D applications to enhance students’ understanding of spatial relationships to future anatomy classes.

3DBunch: A Novel iOS-Smartphone Application to Evaluate the Number of Grape Berries per Bunch Using Image Analysis Techniques

Evaluating the number of berries per bunch is a vital step of grape yield estimation in viticulture but is a labour intensive task for traditional manual measurement. Therefore, this paper develops a novel smartphone application for counting berries automatically from a single image. The application, called 3DBunch, acquires images from the camera or the album on a smartphone, and then estimates the number of berries by a reconstructed 3D bunch model based on the proposed image analysis techniques that are embedded in the developed iOS app. It also presents features of visualising the statistics of the reconstructed bunch, which including of the distribution of detected berry size in pixels and the total number of berries. It also has the capability of presenting sampling related information, which includes the person who conducted the sampling, the location of samples, the dates of sampling, the variety, farm, vineyards etc. The application was evaluated both on a simulator on a commercial computer and an iPad mini 4. By analysing 291 bunch images from two varieties the app achieved an accuracy of 91% regarding berry counting per bunch. Additionally, the computational time consumed to process 100 images on iPad mini 4 was studied and returned an average of 7.51 seconds per image. Obtaining these results with only a smartphone and a small backing board for capturing a photo with a single bunch, 3DBunch provides an efficient way for farmers to count berries in-vivo and it is available in the iOS App Store.

NOT READY FOR PRIME TIME: A FAILED STUDY TESTING A TECHNOLOGICAL INTERVENTION IN NURSING HOME CARE

This pilot-study tested an adaptation of a successful family caregiver telehealth support intervention in nursing home settings. The goal was to support staff in managing challenging behaviors of residents with dementia. Nursing homes were provided with an iPad mini equipped with a special application to video record staff-resident challenging care situations. Videos were uploaded to a secure site for review by dementia care experts who provided feedback to improve care. Despite efforts to engage staff, only four videos were submitted. Factors including privacy, workload, and fear of documenting abuse contributed to implementation failure. The same intervention was successfully implemented in the home setting; differences in engagement and utilization will be discussed. Understanding the unique environments of nursing home dementia care is needed to successfully implement technology-based interventions to improve care. Evaluation of factors predicting the failure of this intervention may inform future research.

HOUSEHOLD DIGITAL MEDIA ECOLOGIES - METHODOLOGICAL INNOVATIONS FOR FOSTERING RESEARCHER-PARTICIPANT TRUST

In this paper, we describe a research methodology we have developed, based upon digital ethnography approaches, and which used mobile devices, digital ethnographic software and creative data collection activities. Our approach, refined over the course of a number of interconnected research projects, addressed these difficulties through a staged process – utilising traditional ethnographic techniques, but augmenting them with something more novel: the “domestic probe”. In essence, the domestic probe comprised a box of equipment given to the household to use in order to record and interpret their use of domestic technologies. In more recent work, we extended our participatory approach through the use of digital media, such as by using iPad minis pre-loaded with a data collection software tool, Ethnocorder. As we argue in this paper, these approaches carry three specific trust-related methodological benefits (and challenges): the foster trust in us as researchers; trust in our participants as co-researchers; and, as a result of this mutual researcher-participant trust, insight and a productive point of entry into discussing participant "domestication" of, and trust in, various household technologies.

The \u2018connectaholic\u2019 behind the curtain: medical student use of computer devices in the clinical setting and the influence of patients

BackgroundThe use of mobile devices such as tablets and laptops by students to support their learning is now ubiquitous. The clinical setting is an environment, which lends itself to the use of mobile devices as students are exposed to novel clinical scenarios that may require rapid location of information to address knowledge gaps. It is unknown what preferences students have for these devices and how they are used in the clinical environment.MethodsIn this study we explored medical students’ choices and their use of different devices in their first year of clinical attachments. We sought to evaluate learners’ experiences with these devices using a mixed methods approach. All students newly entered into the clinical years were given the option of a MacBook Air or iPad. We surveyed these students using an online survey tool followed by individual semi-structured interviews to explore survey findings in more depth.ResultsStudents owned a multitude of devices however their preferences were for the 11 in. MacBook Air Laptop over the iPad mini. Students made constant use of online information to support their clinical learning, however three major themes emerged from the interview data: connection and devices (diverse personal ownership of technology by students and how this is applied to source educational materials), influence and interaction with patients (use of any device in a clinical setting) and influence and interaction with staff. In general students preferred to use their device in the absence of patients however context had a significant influence.ConclusionsThese mobile devices were useful in the clinical setting by allowing access to online educational material. However, the presence of patients, and the behaviour of senior teaching staff significantly influenced their utilisation by students. Understanding the preferences of students for devices and how they use their preferred devices can help inform educational policy and maximise the learning from online educational content.

Assessing the utility of an IoS application in the perioperative care of spine surgery patients: the NeuroPath Pilot study.

In an attempt to improve care while decreasing costs and postoperative pain, we developed a novel IoS mobile health application, NeuroPath. The objective of this innovative app is to integrate enhanced recovery after surgery (ERAS) principles, patient education, and real-time pain and activity monitoring in a home setting with unencumbered two-way communication. The NeuroPath application was built over 18 months, with support from Apple, Medable, the Department of Information-Technology and the Department of Neurosurgery. Target areas addressed by NeuroPath include patient prep for surgery, perioperative risk mitigation, activity monitoring, wound care, and opioid use management. These target areas are monitored through a provider app, which is downloaded to the care providers IPad Mini. The provider app permits real time viewing of wound healing (patient incision photographs), activity levels, pain levels, and narcotic usage. Participants are given a daily To-Do list, via the Care Card section of the interface. The To-Do list presents the patient with specific tasks for exercise, instructions to wash incision area, pre-operative instructions, directions for discussing medication with care team, among other patient specific recommendations. Of the 30 patients enrolled in the pilot study, there was a range of activity on the app. Patients with high involvement in the app logged in nearly every day from a week pre-op to >45 days post-op. Data for patients that utilized the app and uploaded regularly show trends of appropriately healing wounds, decreasing levels of pain, increasing step counts, and discontinuation of narcotics. This pilot study of the NeuroPath app demonstrates its potential utility for improving quality of patient care without increased costs. Participants who regularly used the app showed consistent improvement throughout the post-operative recovery period (increasing ambulation, decreasing pain and guided reduction in narcotic usage).

Social Support Patterns of Middle-Aged and Older Adults Within a Physical Activity App: Secondary Mixed Method Analysis.

BackgroundPhysical activity (PA) is critical for maintaining independence and delaying mobility disability in aging adults. However, 27 to 44% of older adults in the United States are meeting the recommended PA level. Activity trackers are proving to be a promising tool to promote PA adherence through activity tracking and enhanced social interaction features. Although social support has been known to be an influential behavior change technique to promote PA, how middle-aged and older adults use the social interaction feature of mobile apps to provide virtual support to promote PA engagement remains mostly underexplored.ObjectiveThis study aimed to describe the social support patterns of middle-aged and older adults using a mobile app as part of a behavioral PA intervention.MethodsData from 35 participants (mean age 61.66 [SD 6] years) in a 12-week, home-based activity intervention were used for this secondary mixed method analysis. Participants were provided with a Jawbone Up24 activity monitor and an Apple iPad Mini installed with the UP app to facilitate self-monitoring and social interaction. All participants were given an anonymous account and encouraged to interact with other participants using the app. Social support features included comments and likes. Thematic coding was used to identify the type of social support provided within the UP app and characterize the levels of engagement from users. Participants were categorized as superusers or contributors, and passive participants were categorized as lurkers based on the literature.ResultsOver the 12-week intervention, participants provided a total of 3153 likes and 1759 comments. Most participants (n=25) were contributors, with 4 categorized as superusers and 6 categorized as lurkers. Comments were coded as emotional support, informational support, instrumental support, self-talk, and other, with emotional support being the most prevalent type.ConclusionsOur cohort of middle-aged and older adults was willing to use the social network feature in an activity app to communicate with anonymous peers. Most of our participants were contributors. In addition, the social support provided through the activity app followed social support constructs. In sum, PA apps are a promising tool for delivering virtual social support to enhance PA engagement and have the potential to make a widespread impact on PA promotion.Trial RegistrationClinicalTrials.gov NCT01869348; https://clinicaltrials.gov/ct2/show/NCT01869348

Technical Note: The use of iSperm technology for on-farm measurement of equine sperm motility and concentration

The iSperm is a newly released semen analysis tool from Aidmics Biotechnology Co. LTD, which allows an iPad Mini to be transformed into a handheld microscope with objective semen analysis software for equine available through the Apple Store (version 4.5.2). The aim of this study was to compare iSperm values for sperm motility and sperm concentration to current acceptable methods for semen analysis and to determine the agreement with these methods using statistical methods. Two ejaculates from each of five Standardbred stallions were used to compare sperm motility (computer-assisted semen analysis [CASA] vs. iSperm) and concentration (NucleoCounter SP-100 [NC] vs. hemocytometer vs. iSperm). Data were analyzed by first testing for the differences between the means of each method using a linear mixed-effects model. The agreement between the two continuous measurements for each method was then investigated by computing Lin’s concordance correlation coefficient (CCC), with a value of 1 indicating perfect agreement between methods. Results are reported as the CCC with the associated 95% confidence interval in parentheses. Means for both total motility (TM) and progressive motility (PM) were equal between CASA and iSperm values (P = 0.0741 and P = 0.725, respectively). However, means for all velocity measurements were significantly different between CASA and iSperm readings (P < 0.001). For concentration, means were equal between NC and iSperm values (P = 0.748) and for hemocytometer and iSperm values (P = 0.953). The CCC for TM was 0.871 (0.788, 0.923) and for PM was 0.916 (0.847, 0.955) indicating good agreement between methods. Low levels of agreement were observed for all velocity measurements. Finally, the CCC for concentration compared by iSperm and NC was 0.970 (0.949, 0.982) and for iSperm and hemocytometer it was 0.962 (0.934, 0.978), both close to the line of perfect concordance. Although more work is needed to improve the iSperm software for velocity measurements to be acceptable by research standards, in its present form the iSperm will introduce a low-cost and affordable method for on-farm semen analysis (TM, PM, concentration) for breeders and veterinarians. As a result, more farms will have access to accurate sperm analysis tools which will help to standardize semen processing procedures leading to better overall quality of semen used for artificial insemination.

A Video-Enhanced Activity Schedule Reduces Food Stuffing in Child with Pervasive Developmental Disability: a Single Subject Design Case Study

This study evaluated the effects of a video-enhanced activity schedule on the dangerous food stuffing (rapid eating) of a child with pervasive developmental disorder-not otherwise specified (PDD-NOS). An iPad Mini and the software application My Pictures Talk were used to deliver the video-enhanced activity schedule intervention. A multiple baseline across meals with an embedded ABAB design was used to evaluate changes in food stuffing behavior. A reduction in food stuffing across breakfast, lunch, and snack was demonstrated with experimental control. Generalization probes with the child’s mother suggested the improvement generalized to meals without the therapist but caution in conclusions regarding generalization is limited by the small number of generalization probes. The child’s mother provided anecdotal social validity data indicating the intervention approach was acceptable, treatment goals were meaningful, and outcomes were positive. This study replicates previous research demonstrating the potential benefit of video-enhanced activity schedules and extends previous research by reducing inappropriate mealtime behavior in a child with PDD-NOS.

A Randomized Crossover Pilot Study of Telemedicine Delivered via iPads in Parkinson's Disease.

Background We investigated the feasibility and safety of a video-based telemedicine system, delivered via a tablet, in Parkinson's disease (PD). Methods In a randomized, crossover, open-label pilot trial, we compared a telemedicine period (regular visits every two months with intermediate video calls via an iPad mini) with a control period (regular visits every two months), both lasting 6 months. We included 10 patients diagnosed with PD according to the British Brain Bank criteria, aged 20–75 years. The primary outcome was the PD questionnaire summary index (PDQ-39 SI). Secondary outcomes included the Hoehn and Yahr Stage and scores on the Unified PD Rating Scale (UPDRS) part I–IV, Beck Depression Inventory (BDI), and visual analog scale for satisfaction. Results Both study periods were completed by 10 patients with PD. Friedman's test revealed that there were no significant differences between the two periods in primary and secondary outcomes (p > 0.05). With respect to visual analog scale scores for satisfaction, participants indicated high satisfaction with the telemedicine system. The number of extra hospital visits and phone calls did not differ between the periods. There were no adverse events or side effects. Conclusions We observed that a telemedicine system delivered via a tablet could successfully be used by patients as a part of their care. Further studies investigating the use of telemedicine to replace in-person visits are warranted. This trial is registered with UMIN000015536.

Using Videoconferencing for Verbal Reports to Improve Clinical Nurse Specialist Student Performance.

Clear, concise verbal reports are essential to clinical nurse specialists' practice, yet current literature addressing the development of this skill is sparse. The purpose of this study is to determine the effectiveness of using videoconferencing for verbal reports as a learning strategy for improving clinical nurse specialist students' communication competencies and advanced practice decision making. Videoconferencing, using iPad minis issued to faculty and students, was used routinely for verbal reports on clinical cases to faculty, which included immediate faculty feedback. A verbal report template of patient chief complaint, applicable history, review of systems, physical examination/labs, differential diagnoses, and management was developed and provided to students. Initial student verbal reports were disorganized, lengthy, lacking content, or containing extraneous details. After students routinely gave verbal reports via videoconferencing, verbal report time for the class decreased from more than 20 minutes to 3 to 5 minutes and the accuracy of reports also increased. A concise, clinically relevant verbal report template, combined with videoconferencing that allowed for frequent and immediate feedback from faculty, improved student communication competencies. Current technology, such as tablets and smart phones, provide videoconferencing opportunities that can be used to enhance learning for students.

A library mobile device deployment to enhance the medical student experience in a rural longitudinal integrated clerkship.

ObjectiveInvestigators implemented the Rural Information Connection (RIC) project, a library-initiated deployment of iPad Mini 3s for third-year medical students who were enrolled in a seven-month rural longitudinal integrated clerkship (LIC) rotation. The research aims were to determine if devices preloaded with high-quality mobile health apps enhanced the experience and increased access to and awareness of mobile health information resources for the enrolled project participants.MethodsNine participants enrolled in this mixed methods research project. Pre- and post-survey and structured learning journals (SLJs) were used for data collection on device and app use. Descriptive statistics and thematic coding analysis included data from seven pre-surveys, nine post-surveys, and sixty-four SLJ prompts. The validated Technology Acceptance Model instrument was also incorporated to gauge the devices’ integration into the participants’ workflow.ResultsThe investigation indicated that the iPad Mini 3 and resources were utilized and integrated at varying levels in the participants’ workflow. Reported use of health information apps suggests a preference for broad-based information sources rather than specific or specialized information resources. Participants performed several tasks on the device, including seeking background information, educating patients, and managing rotation schedules. Participant reflections indicated positive experiences utilizing the device and health information resources, which enhanced their rural LIC rotations.ConclusionsThe research analysis demonstrates the information-seeking behavior of medical students immersed in a rural environment and indicates an acceptance of mobile technology into the workflow of participants in this project. Mobile device deployments offer great opportunities for librarians to design innovative programming in medical education.