Preliminary User Research Articles

Development and Preliminary Usability Evaluation of a Somatosensory Square Dance System for Older Chinese Persons: Mixed Methods Study.

BackgroundChinese square dancing, known as guangchang wu in Chinese, is a well-known public fitness activity that provides an entertaining way for older Chinese women to improve their flexibility, lower extremity strength, overall coordination, and balance. However, injuries, noise conflicts, and lack of space are challenging aspects of this activity. Somatosensory games (SG) are an increasingly popular physical fitness approach to enhance the selective attention of older persons with indoor engagement and exercises.ObjectiveThe objectives of this study were to develop a newly designed somatosensory square dance system for older Chinese people and to evaluate its usability.MethodsThis is a mixed methods study. The newly designed somatosensory square dance system is a somatic training tool that provides adequate Chinese square dance fitness training based on Laban Movement Analysis (LMA) and design guidelines established in a previous stage. The usability evaluation involved a questionnaire and interviews. Twelve participants were interviewed before and after experiencing the 15-minute dancing and learning process within the program. In addition, participants scored their experience satisfaction in psychological, physiological, and relaxation sections on a scale of 1 to 5 using a questionnaire. Qualitative content analysis and quantitative analysis of the satisfaction scores supported understanding of usability problems.ResultsBased on the interview results, 6/12 (50%) of the participants thought the system could help them correct their dancing movements indoors without being affected by poor outdoor weather. Among the participants, 3/12 (25%) indicated that this indoor system could enable them to enjoy fitness activities in a private space. Moreover, 3/12 participants (25%) stated that this system could promote family relationships by providing easy dancing movements. All participants were highly satisfied with the relaxation aspect of the system (4.45/5). The participants were all psychologically satisfied and interested in the novel features of the system, with an average score of 4.16/5. Physiologically, participants affirmed that the system could help them maintain good health (4.91/5).ConclusionsThe results of this study suggest that the somatosensory square dance system can be used as an indoor fitness tool to improve older Chinese square dancers’ health conditions with reasonable dance training. Noise and space conflicts can be addressed. The Laban Elated Square Dance system, which was modified by therapists based on LMA and square dance design guidelines, was highly approved by dancers because it decreased the possibility of injuries, falls, and joint damage by considering the physical and psychological difficulties of older persons. Different features will be considered in the next stage, such as greater selection of exercises and difficulty level settings. Users’ social needs will also be explored in subsequent stages.

Serenity: A Low-Cost and Patient-Guided Mobile Virtual Reality Intervention for Cancer Coping

Medical procedures often induce physical pain and psychological distress. Cancer patients are particularly vulnerable to fatigue, heightened emotional distress, social isolation, and increased risk of depression, severely reducing quality of life and potential treatment non-adherence and prolonged hospital stays. Leveraging emerging virtual reality (VR) technology, we prototyped Serenity: a mobile smartphone-based VR cancer coping intervention informed by distraction therapy to help alleviate the symptoms of coping and promote patient empowerment. It leverages emerging low-cost VR to improve accessibility and effectiveness of distraction therapy. We describe the results of a preliminary usability study and lessons learned that apply to future design and evaluation of virtual reality interventions for behavioral health.

Smart hospital emergency system

In recent years, the UK’s emergency call and response has shown elements of great strain as of today. The strain on emergency call systems estimated by a 9 million calls (including both landline and mobile) made in 2014 alone. Coupled with an increasing population and cuts in government funding, this has resulted in lower percentages of emergency response vehicles at hand and longer response times. In this paper, we highlight the main challenges of emergency services and overview of previous solutions. In addition, we propose a new system call Smart Hospital Emergency System (SHES). The main aim of SHES is to save lives through improving communications between patient and emergency services. Utilising the latest of technologies and algorithms within SHES is aiming to increase emergency communication throughput, while reducing emergency call systems issues and making the process of emergency response more efficient. Utilising health data held within a personal smartphone, and internal tracked data (GPU, Accelerometer, Gyroscope etc.), SHES aims to process the mentioned data efficiently, and securely, through automatic communications with emergency services, ultimately reducing communication bottlenecks. Live video-streaming through real-time video communication protocols is also a focus of SHES to improve initial communications between emergency services and patients. A prototype of this system has been developed. The system has been evaluated by a preliminary usability, reliability, and communication performance study.

A Tablet-Based Interactive Movement Tool for Pediatric Rehabilitation: Development and Preliminary Usability Evaluation.

BackgroundMotivating interactive tools may increase adherence to repetitive practice for children with disabilities, but many virtual reality and active video gaming systems are too challenging for children with significant needs.ObjectiveThe objective of this study was to develop and conduct a usability evaluation of the Fun, Interactive Therapy Board (FITBoard), a movement toy bridging digital and physical interactions for children with disabilities.MethodsThe FITBoard is a tablet app involving games controlled by hand, head, or foot touch of configurable, wired surfaces. Usability evaluation involved a cognitive walkthrough and think-aloud processes. Participants verbalized aloud while completing a series of 26 task actions involved in selecting a game and configuring the FITBoard to achieve the therapeutic goal. Therapists then responded to questions about usability perceptions. Unsuccessful actions were categorized as goal or action failures. Qualitative content analysis supported understanding of usability problems.ResultsParticipants included 5 pediatric physical therapists and 2 occupational therapists from 2 clinical sites. Goal failure was experienced by all participants in 2 tasks, and action failure was experienced by all participants in 2 tasks. For 14 additional tasks, 1 or more patients experienced goal or action failure, with an overall failure rate of 69% (18 of 26 tasks). Content analysis revealed 4 main categories: hardware usability, software usability, facilitators of therapy goals, and improvement suggestions.ConclusionsFITBoard hardware and software changes are needed to address goal and action failures to rectify identified usability issues. Results highlight potential FITBoard applications to address therapeutic goals and outline important practical considerations for product use by therapists. Subsequent research will evaluate therapist, parent, and child perspectives on FITBoard clinical utility when integrated within regular therapy interventions.

PUFPass: A password management mechanism based on software/hardware codesign

Secure passwords need high entropy, but are difficult for users to remember. Password managers minimize the memory burden by storing site passwords locally or generating secure site passwords from a master password through hashing or key stretching. Unfortunately, they are threatened by the single point of failure introduced by the master password which is vulnerable to various attacks such as offline attack and shoulder surfing attack. To handle these issues, this paper proposes the PUFPass, a secure password management mechanism based on software/hardware codesign. By introducing the hardware primitive, Physical Unclonable Function (PUF), into PUFPass, the random physical disorder is exploited to strengthen site passwords. An illustration of PUFPass in the Android operating system is given. PUFPass is evaluated from aspects of both security and preliminary usability. The security of the passwords is evaluated using a compound heuristic algorithm based PUF attack software and an open source password cracking software, respectively. Finally, PUFPass is compared with other password management mechanisms using the Usability-Deployability-Security (UDS) framework. The results show that PUFPass has great advantages in security while maintaining most benefits in usability.

The short-term influence of rear wheel axle position and training on manual wheelchair propulsion technique in novice able-bodied participants during steady-state treadmill propulsion, a pilot study

ABSTRACTPurpose: To examine if wheelchair fit influenced the effectiveness of video-based propulsion technique training.Method: Based on a cross sectional design, able-bodied participants (n = 21) received an optimally configured wheelchair (OCW; n = 11) or a nonoptimally configured wheelchair (NOCW; n = 10) to determine if propulsion technique was influenced by configuration before and after training. Outcome variables collected during steady-state treadmill propulsion at 1.1 m/s included peak resultant force (peak Fr; N), peak torque (N), contact angle (CA; degrees), stroke frequency (SF; strokes/s), power output (PO; W), and braking torque (BT; N m).Results: Significant group by time interactions were observed for PO (p = 0.05) and peak torque (p = 0.01), while CA, SF, and BT were significant by time (p < 0.05).Conclusion: Results suggest similar benefits from training regardless of rear axle position except for PO and peak torque where configuration was influential. Results suggest the combined effects of optimal configuration with training were most effective; however, those receiving training in a nonoptimal configuration can still improve. Although findings are preliminary, clinicians and end users should be alert to the interplay of configuration andtraining when attempting to modify technique.

Gradient-echo-based 3D submillisecond echo time pulmonary MR imaging: a preliminary usability study on clinical and preclinical MR scanners.

To preliminarily investigate a technical feasibility of a submillisecond echotime concurrent-dephasing-and-excitation (CODE) sequence for pulmonary MRI on clinical and preclinical MR scanners Methods: CODE imaging (echo time, 0.14 ~ 0.18 ms) was performed with American College of Radiology phantom at 3T, 7 healthy volunteers at 1.5 and 3T, 10 rabbits at 3T, and 2 rodents at 9.4T. Signal-to-noise ratio was compared in phantom. Image quality of human MRI was visually assessed on a 5-point scale for comparison between CODE and conventional lung MRI sequences. Visibility of bronchi, subcentimeter nodules, and MR air-bronchogram were assessed in animal studies. In phantom study, signal-to-noise ratio was higher with CODE than with original three-dimensional ultrashort-echotime sequence (106.71 ± 4.32 vs 91.66 ± 3.54; p < 0.001). Image quality of human MRI was better with CODE than with conventional MRI sequences (p ≤ 0.002). Bronchi remained traceable up to the fifth bronchial generation in CODE images in rabbits and rodents. 95.2% of metastatic nodules (diameter, 1.5 ±0.4mm) and 93.8% of MR air-bronchogram (diameter, 0.9 ±0.2 mm) in rabbits. Submillisecond echotime pulmonary MRI was technically feasible by using CODE on various MR scanners. Advances in knowledge: CODE can be a practical alternative for lung MRI on both clinical and pre-clinical scanners, without challenges of free-induction-decay-based ultrashort-echo time sequences.

Personal Computer-less (PC-less) Microcontroller Training Kit

The need of microcontroller training kit is necessary for practical work of students of electrical engineering education. However, to use available training kit not only costly but also does not meet the need of laboratory requirements. An affordable and portable microcontroller kit could answer such problem. This paper explains the design and development of Personal Computer Less (PC-Less) Microcontroller Training Kit. It was developed based on Lattepanda processor and Arduino microcontroller as target. The training kit equipped with advanced input-output interfaces that adopted the concept of low cost and low power system. The preliminary usability testing proved this device can be used as a tool for microcontroller programming and industrial automation training. By adopting the concept of portability, the device could be operated in the rural area which electricity and computer infrastructure are limited. Furthermore, the training kit is suitable for student of electrical engineering student from university and vocational high school.

Accessing Map Information Using NFC-Based User Interfaces for In-Situ Learning Environments

Maps have been used by teachers for centuries to manipulate information related to geographical locations. This paper presents a novel way to interact with maps through the combination of mobile devices and the Near Field Communication (NFC) technology. This proposal provides teachers and students with the ability to retrieve and store information related to geographical locations defined in a traditional paper map. Consequently, the information that is exchanged among teachers and learners is contextually enriched with a reference to a geographical location in a physical map. This interaction mechanism is an interesting way to encourage in-situ learning scenarios, such as teaching Geography lessons in museums, art galleries, historic buildings or outdoor scenarios, etc. Thus, this article describes an application that employs a NFC-based interaction mechanism to browse geographical information in physical maps. It also presents the hardware and software infrastructure required support this application. Finally, it analyzes the result of a preliminary usability evaluation of the application.

Development of a robotic device for post-stroke home tele-rehabilitation

This work deals with the complex mechanical design task of converting a large pneumatic rehabilitation robot into an electric and compact system for in-home post-stroke therapies without losing performance. It presents the new HomeRehab robot that supports rehabilitation therapies in three dimensions with an adaptive controller that optimizes patient recovery. A preliminary usability test is also conducted to show that its performance resembles that found in RoboTherapist 2D commercial system designed for hospitals. The mechanical design of a novel and smart two-dimensional force sensor at the end-effector is also described.

An experimental training support framework for eye fundus examination skill development

The eye fundus examination consists of viewing the back of the eye using specialised ophthalmoscopy equipment and techniques that allow a medical examiner to determine the condition of the eye. Recent technological advances in immersive and interactive technologies are providing tools that can be employed to complement traditional medical training methods and techniques. To overcome some of the issues associated with traditional eye examination approaches, our work is examining the application of consumer-level virtual reality technologies to eye fundus examination. Here, we present a cost-effective virtual-reality eye fundus examination virtual simulation tool. Results of a preliminary usability study indicate that the virtual simulation tool provides trainees the opportunity to obtain a greater understanding of the physiological changes within the eye in an interactive, immersive, and engaging manner.

CARMIE

The incidence of chronic diseases is increasing and monitoring patients in a home environment is recommended. Noncompliance with prescribed medication regimens is a concern, especially among older people. Heart failure is a chronic disease that requires patients to follow strict medication plans permanently. With the objective of helping these patients managing information about their medicines and increasing adherence, the personal medication advisor CARMIE was developed as a conversational agent capable of interacting, in Portuguese, with users through spoken natural language. The system architecture is based on a language parser, a dialog manager, and a language generator, integrated with already existing tools for speech recognition and synthesis. All modules work together and interact with the user through an Android application, supporting users to manage information about their prescribed medicines. The authors also present a preliminary usability study and further considerations on CARMIE.

CHEMOTION: A gesture based chemistry virtual laboratory with leap motion

AbstractChemistry laboratories are expensive to setup and operate as well as it entails safety issues. However, as technologies develop and new technologies are being produced every day, an advance solution for physical Chemistry laboratories limitation is the use of virtual laboratories. In this paper, we present the design and implementation of a virtual chemistry laboratory system that utilizes gesture computing technology to create an interactive and entertaining laboratory application for pupils. The system is software that works on PCs with the help of Leap motion controller, off‐the‐shelf gesture recognition hardware, to simulate a chemistry laboratory. The system provides number of experiments to perform along with tutorials and quizzes. A preliminary usability evaluation of the system shows the high level of interest from the pupils in using such a system and the positive feedback.

Empowering patients to self-identify financial assistance programs using an online application.

4 Background: Available financial resources are relatively unknown to many patients with cancer facing high treatment-related costs. PAPNavigator is a web-based app designed to reduce out-of-pocket treatment costs by connecting patients to financial assistance programs specific to them. Traditionally used by financial counselors, PAPNavigator was modified to be patient-facing for this study, testing preliminary usability and effectiveness. Methods: Eligible patients with cancer were receiving anti-cancer treatment and reported out-of-pocket treatment costs. Patients interacted with PAPNavigator, inputted personal and financial data, and reviewed personalized financial resource results. Usability was assessed via the validated System Usability Scale (SUS). Effectiveness was assessed by two measures: “PAPNavigator improved my knowledge about financial aspects of cancer care and what can be done about it” and “Using this website was helpful with my financial concerns.” For all items, patients responded using a 5-point Likert scale. Results: 19 of 20 patients completed pilot testing (95%, 1 withdrew due to illness). 53% of patients were male, 26% were non-white, 79% had greater than a high school education, and 21% were employed full- or part-time. Median annual household income was $77,500. The median SUS score was 75 out of 100 (with &gt;68 considered above average.) In response to statements, “I think that I would need assistance to be able to use this website,” and “I felt very confident using this website,” the median scores were 2 and 5 respectively. Additionally, in response to the statements, “PAPNavigator improved my knowledge about financial aspects of cancer care and what can be done about it,” and “Using this website was helpful with my financial concerns,” the median score for each was 4. Conclusions: The modified version of PAPNavigator demonstrated high usability and preliminary effectiveness in improving knowledge about financial aspects of cancer care and potential interventions to reduce cost. Further testing in larger samples is necessary.

Framework of sensor-based monitoring for pervasive patient care.

Sensor-based health systems can often become difficult to use, extend and sustain. The authors propose a framework for designing sensor-based health monitoring systems aiming to provide extensible and usable monitoring services in the scope of pervasive patient care. The authors' approach relies on a distributed system for monitoring the patient health status anytime-anywhere and detecting potential health complications, for which healthcare professionals and patients are notified accordingly. Portable or wearable sensing devices measure the patient's physiological parameters, a smart mobile device collects and analyses the sensor data, a Medical Center system receives notifications on the detected health condition, and a Health Professional Platform is used by formal caregivers in order to review the patient condition and configure monitoring schemas. A Service-oriented architecture is utilised to provide extensible functional components and interoperable interactions among the diversified system components. The framework was applied within the REMOTE ambient-assisted living project in which a prototype system was developed, utilising Bluetooth to communicate with the sensors and Web services for data exchange. A scenario of using the REMOTE system and preliminary usability results show the applicability, usefulness and virtue of our approach.

A Cervical Cancer Screening Trainer for Use in Low-Resource Settings

Each year, cervical cancer causes the death of over 275,000 women worldwide with eighty percent of these cases occurring in low or lower-middle income countries. Cervical cancer screening programs reduce cervical cancer occurrence by identifying and treating pre-cancerous cervical abnormalities before they develop to malignant stages. Standard methods of screening are inappropriate for use in low-resource settings and therefore screening is very limited. Based on a design ethnography studyperformed over a two-month period in Ghana, a need was identified for a low-fidelity model to assist in training healthcare providers to screen for cervical cancer using visual inspection with acetic acid. The design presented in this paper is a box trainer with a simulated vaginal cavity that allows a user to insert cervical images displayed on plastic tabs or cards from the Jhpiego Visual Inspection of the Cervix Flash Card Set©. A modular electronic feedback mechanism trains the user to properly complete the steps of the screening procedure and to track the successes of their diagnoses. This paper describes the need for a cervical cancer screening trainer, the process used to design a trainer to support visual inspection with acetic acid, and the results of prototyping and preliminary usability tests.

Design of a Tablet Computer App for Facilitation of a Molecular Blood Culture Test in Clinical Microbiology and Preliminary Usability Evaluation.

BackgroundUser mobility is an important aspect of the development of clinical information systems for health care professionals. Mobile phones and tablet computers have obtained widespread use by health care professionals, offering an opportunity for supporting the access to patient information through specialized applications (apps) while supporting the mobility of the users. The use of apps for mobile phones and tablet computers may support workflow of complex tasks, for example, molecular-based diagnostic tests in clinical microbiology. Multiplex Blood Culture Test (MuxBCT) is a molecular-based diagnostic test used for rapid identification of pathogens in positive blood cultures. To facilitate the workflow of the MuxBCT, a specialized tablet computer app was developed as an accessory to the diagnostic test. The app aims to reduce the complexity of the test by step-by-step guidance of microscopy and to assist users in reaching an exact bacterial or fungal diagnosis based on blood specimen observations and controls. Additionally, the app allows for entry of test results, and communication thereof to the laboratory information system (LIS).ObjectiveThe objective of the study was to describe the design considerations of the MuxBCT app and the results of a preliminary usability evaluation.MethodsThe MuxBCT tablet app was developed and set up for use in a clinical microbiology laboratory. A near-live simulation study was conducted in the clinical microbiology laboratory to evaluate the usability of the MuxBCT app. The study was designed to achieve a high degree of realism as participants carried out a scenario representing the context of use for the MuxBCT app. As the MuxBCT was under development, the scenario involved the use of molecular blood culture tests similar to the MuxBCT for identification of microorganisms from positive blood culture samples. The study participants were observed, and their interactions with the app were recorded. After the study, the participants were debriefed to clarify observations.ResultsFour medical laboratory technicians, for example, representative of end users of the app, participated in the clinical simulation study. Using the MuxBCT app, the study participants successfully identified and reported all microorganisms from the positive blood cultures examined. Three of the four participants reported that they found the app useful, while one study participant reported that she would prefer to make notes on paper and later enter them into the LIS.ConclusionsThe preliminary usability evaluation results indicate that use of the MuxBCT tablet app can facilitate the workflow of the MuxBCT diagnostic test.

Using Semantic Web technologies for the generation of domain-specific templates to support clinical study metadata standards.

BackgroundThe Biomedical Research Integrated Domain Group (BRIDG) model is a formal domain analysis model for protocol-driven biomedical research, and serves as a semantic foundation for application and message development in the standards developing organizations (SDOs). The increasing sophistication and complexity of the BRIDG model requires new approaches to the management and utilization of the underlying semantics to harmonize domain-specific standards. The objective of this study is to develop and evaluate a Semantic Web-based approach that integrates the BRIDG model with ISO 21090 data types to generate domain-specific templates to support clinical study metadata standards development.MethodsWe developed a template generation and visualization system based on an open source Resource Description Framework (RDF) store backend, a SmartGWT-based web user interface, and a “mind map” based tool for the visualization of generated domain-specific templates. We also developed a RESTful Web Service informed by the Clinical Information Modeling Initiative (CIMI) reference model for access to the generated domain-specific templates.ResultsA preliminary usability study is performed and all reviewers (n = 3) had very positive responses for the evaluation questions in terms of the usability and the capability of meeting the system requirements (with the average score of 4.6).ConclusionsSemantic Web technologies provide a scalable infrastructure and have great potential to enable computable semantic interoperability of models in the intersection of health care and clinical research.

Augmented Reality Cubes for Cognitive Gaming: Preliminary Usability and Game Experience Testing

Early detection is important in dementia care; however, cognitive impairment is still under-recognised and under-diagnosed. Cognitive screening and training are two important preventative treatments, which can lead to early detection of cognitive decline. In this work, the “Cognitive Augmented Reality Cubes” (CogARC) system is presented, i.e. a serious game for cognitive training and screening, utilising an interaction technique based on Augmented Reality and the manipulation of tangible, physical objects (cubes). The game is a collection of cognitive mini-games of preventative nature and is, primarily, targeting elderly players (≥60 years old). A preliminary testing was conducted focusing on the game experience that CogARC offers (utilising the In-Game Experience Questionnaire), the usability of the system (using the System Usability Scale), and the specific user observations and remarks, as documented by open, semi-structured interviews. Overall, CogARC demonstrated satisfying positive responses, however, the negative reactions indicated that there are specific problems with aspects of the interaction technique and a number of mini-games. The open interview shed more light on the specific issues of each mini-game and further interpretation of user interactions. The current study managed to provide interesting insights into the game design elements, integration of Augmented Reality, tangible interaction of the system, and on how elderly players perceive and use those interaction components.

Patient narratives representing patient voices to inform research: a pilot qualitative study.

We are investigating the feasibility and effectiveness of establishing a library of patient narratives to inform patient-centered research in the U.S. Veterans Affairs organization. Using qualitative methods, we conducted a needs assessment of 15 researchers and then interviewed and videotaped 11 veterans with traumatic brain injury or diabetes. We developed a method for displaying the narratives to researchers modeled after a UK initiative called DIPEx and then performed preliminary usability testing. We found that it is not only feasible to provide researchers with patient narratives that could help guide their research, but that similar narratives might be useful to practitioners, health system decision makers, and other patients as well.