Tablet App Research Articles

The Impact of a Tablet App on Adherence to American Heart Association Guidelines During Simulated Pediatric Cardiopulmonary Resuscitation: Randomized Controlled Trial.

BackgroundEvidence-based best practices are the cornerstone to guide optimal cardiopulmonary arrest resuscitation care. Adherence to the American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) optimizes the management of critically ill patients and increases their chances of survival after cardiac arrest. Despite advances in resuscitation science and survival improvement over the last decades, only approximately 38% of children survive to hospital discharge after in-hospital cardiac arrest and only 6%-20% after out-of-hospital cardiac arrest.ObjectiveWe investigated whether a mobile app developed as a guide to support and drive CPR providers in real time through interactive pediatric advanced life support (PALS) algorithms would increase adherence to AHA guidelines and reduce the time to initiation of critical life-saving maneuvers compared to the use of PALS pocket reference cards.MethodsThis study was a randomized controlled trial conducted during a simulation-based pediatric cardiac arrest scenario caused by pulseless ventricular tachycardia (pVT). A total of 26 pediatric residents were randomized into two groups. The primary outcome was the elapsed time in seconds in each allocation group from the onset of pVT to the first defibrillation attempt. Secondary outcomes were time elapsed to (1) initiation of chest compression, (2) subsequent defibrillation attempts, and (3) administration of drugs, including the time intervals between defibrillation attempts and drug doses, shock doses, and the number of shocks. All outcomes were assessed for deviation from AHA guidelines.ResultsMean time to the first defibrillation attempt (121.4 sec, 95% CI 105.3-137.5) was significantly reduced among residents using the app compared to those using PALS pocket cards (211.5 sec, 95% CI 162.5-260.6, P<.001). With the app, 11 out of 13 (85%) residents initiated chest compressions within 60 seconds from the onset of pVT and 12 out of 13 (92%) successfully defibrillated within 180 seconds. Time to all other defibrillation attempts was reduced with the app. Adherence to the 2018 AHA pVT algorithm improved by approximately 70% (P=.001) when using the app following all CPR sequences of action in a stepwise fashion until return of spontaneous circulation. The pVT rhythm was recognized correctly in 51 out of 52 (98%) opportunities among residents using the app compared to only 19 out of 52 (37%) among those using PALS cards (P<.001). Time to epinephrine injection was similar. Among a total of 78 opportunities, incorrect shock or drug doses occurred in 14% (11/78) of cases among those using the cards. These errors were reduced to 1% (1/78, P=.005) when using the app.ConclusionsUse of the mobile app was associated with a shorter time to first and subsequent defibrillation attempts, fewer medication and defibrillation dose errors, and improved adherence to AHA recommendations compared with the use of PALS pocket cards.

Evaluation of a new rapid assessment and treatment (RAT) tablet app for Emergency Department (ED) nurses: Is earlier identification of investigations and treatments feasible?

Although doctor-led RAT has advantages, serial processing (triage - investigation - treatment) still predominates in UK EDs. We have designed a RAT decision-support app to assist ED nurses to select investigations and treatments at initial patient assessment and aid acuity scoring. MethodsTest nurses accompanied triage (‘control’) nurses in an observational study of 529 adult patients. Investigations, treatments and procedures, selected using the app, were compared with those selected later by ED clinicians. Acuities set by both nurses were re-evaluated blind by a consultant panel. ResultsData capture and decision making using RAT-support took a median of 1.43 min (IQR 1.13–2.07). Odds ratios are reported for matching of test versus control investigation and treatment orders. The ability to predict, within minutes, control investigations which were ordered at median of 50 min (IQR 21–99) is encouraging. Median times to order treatments (analgesia 88 min, IV antibiotics 112 min) were also reduced. Acuity scores versus the consultant panel gave weighted kappa of 0.54 (CI 0.48–0.61) for study nurses and for controls 0.45 (CI 0.36–0.53). ConclusionsWe conclude that nurse-led RAT for use in initial assessment is feasible given decision support. We also identified improvements required for the app.

The Use of Mobile Applications for Managing Care Processes During Chemotherapy Treatments: A Systematic Review.

The recent mobile technology advancements, such as the development of applications (apps) for mobile phones and tablets, can assist in the development of low-cost platforms to monitor therapeutic adherence or complications, providing easily accessible information or guidelines in self-care focused on the care recipient. The aim of this study was to gather scientific evidence about the efficacy of the use of mobile apps during chemotherapy treatments. A systematic review of quantitative studies was performed. All articles published until May 31, 2019 were identified in databases MEDLINE, CINAHL Psychology and Behavioral Sciences Collection, and Cochrane Library. A total of 10 quantitative studies were included. A set of metrics was identified that essentially analyze issues related to the devices' functionalities. The metrics associated with engagement and related to behavioral dimensions, associated with the use of/adherence to the mobile app, are predominant. The clinical metrics represent 25 of a total of 53 identified metrics. Beneficial and statistically significant results were identified related to fatigue, self-efficacy, and improvements in reports of complications. Based on the available research, mobile apps are likely to be a useful and acceptable tool to monitor interventions and complications. In addition, mobile apps can help in the self-management of treatment-related complications. Importantly, these apps need to bridge the academic context and clinical practice, by evaluating the impact of the use of mobile apps in patients. The concept of prescribing apps is being addressed to ensure that apps work and have fair privacy and data security policies that address safety requirements.

Effectiveness of a Home-Based Rehabilitation Program After Total Hip Arthroplasty Driven by a Tablet App and Remote Coaching: Nonrandomized Controlled Trial Combining a Single-Arm Intervention Cohort With Historical Controls.

BackgroundRecent technological developments such as wearable sensors and tablets with a mobile internet connection hold promise for providing electronic health home-based programs with remote coaching for patients following total hip arthroplasty. It can be hypothesized that such a home-based rehabilitation program can offer an effective alternative to usual care.ObjectiveThe aim of this study was to determine the effectiveness of a home-based rehabilitation program driven by a tablet app and remote coaching for patients following total hip arthroplasty.MethodsExisting data of two studies were combined, in which patients of a single-arm intervention study were matched with historical controls of an observational study. Patients aged 18-65 years who had undergone total hip arthroplasty as a treatment for primary or secondary osteoarthritis were included. The intervention consisted of a 12-week home-based rehabilitation program with video instructions on a tablet and remote coaching (intervention group). Patients were asked to do strengthening and walking exercises at least 5 days a week. Data of the intervention group were compared with those of patients who received usual care (control group). Effectiveness was measured at four moments (preoperatively, and 4 weeks, 12 weeks, and 6 months postoperatively) by means of functional tests (Timed Up & Go test and the Five Times Sit-to Stand Test) and self-reported questionnaires (Hip disability and Osteoarthritis Outcome Score [HOOS] and Short Form 36 [SF-36]). Each patient of the intervention group was matched with two patients of the control group. Patient characteristics were summarized with descriptive statistics. The 1:2 matching situation was analyzed with a conditional logistic regression. Effect sizes were calculated by Cohen d.ResultsOverall, 15 patients of the intervention group were included in this study, and 15 and 12 subjects from the control group were matched to the intervention group, respectively. The intervention group performed functional tests significantly faster at 12 weeks and 6 months postoperatively. The intervention group also scored significantly higher on the subscales “function in sport and recreational activities” and “hip-related quality of life” of HOOS, and on the subscale “physical role limitations” of SF-36 at 12 weeks and 6 months postoperatively. Large effect sizes were found on functional tests at 12 weeks and at 6 months (Cohen d=0.5-1.2), endorsed by effect sizes on the self-reported outcomes.ConclusionsOur results clearly demonstrate larger effects in the intervention group compared to the historical controls. These results imply that a home-based rehabilitation program delivered by means of internet technology after total hip arthroplasty can be more effective than usual care.Trial RegistrationClinicalTrials.gov NCT03846063; https://clinicaltrials.gov/ct2/show/NCT03846063 and German Registry of Clinical Trials DRKS00011345; https://tinyurl.com/yd32gmdo

Behavioral Pain Assessment Implementation in Long-Term Care Using a Tablet App: Case Series and Quasi-Experimental Design.

BackgroundPain is often underassessed and undertreated among long-term care (LTC) residents living with dementia. When used regularly, the Pain Assessment Checklist for Seniors With Limited Ability to Communicate (PACSLAC) scales have been shown to have beneficial effects on pain assessment and management practices and stress and burnout levels in frontline staff in LTC facilities. Such scales, however, are not utilized as often as recommended, which is likely to be related to additional record-keeping and tracking over time involved with their paper-and-pencil administration.ObjectiveUsing implementation science principles, we assessed the introduction of the PACSLAC-II scale by comparing two methods of administration—a newly developed tablet app version and the original paper-and-pencil version—with respect to the frequency of pain assessment and facility staff feedback.MethodsUsing a case series approach, we tracked pain-related quality indicators at baseline, implementation, and follow-up periods. A quasi-experimental design was used to evaluate the effect of the method of administration (ie, paper-and-pencil only [n=18], tablet only [n=12], paper-and-pencil followed by tablet app [n=31], and tablet app followed by paper-and-pencil [n=31]) on pain assessment frequency and frontline staff stress and burnout levels. Finally, semistructured interviews were conducted with frontline staff to obtain perspectives on each method of administration.ResultsThe implementation effort resulted in a great increase in pain assessment frequency across 7 independent LTC units, although these increases were not maintained during the follow-up period. Frontline staff reported lower levels of workload in the paper-and-pencil followed by tablet app condition than those in the paper-and-pencil only (P<.001) and tablet app followed by paper-and-pencil (P<.001) conditions. Frontline staff also reported lower levels of workload in the tablet-only condition than those in the paper-and-pencil only condition (P=.05). Similarly, lower levels of emotional exhaustion were reported by frontline staff in the paper-and-pencil followed by tablet app condition than those in the paper-and-pencil only (P=.002) and tablet app followed by paper-and-pencil (P=.002) conditions. Finally, frontline staff reported higher levels of depersonalization in the paper-and-pencil only condition than those in the tablet app only (P=.008), paper-and-pencil followed by tablet app (P<.001), and tablet app followed by paper-and-pencil (P<.001) conditions. Furthermore, narrative data from individual interviews with frontline staff revealed a preference for the tablet app over the paper-and-pencil method of administration.ConclusionsThis study provides support for the use of either the tablet app or the paper-and-pencil version of the PACSLAC-II to improve pain-related quality indicators, but a reported preference for and lower levels of stress and burnout with the use of the tablet app method of administration suggests that the use of the tablet app may have more advantages compared with the paper-and-pencil method of administration.

Educating Patients by Providing Timely Information Using Smartphone and Tablet Apps: Systematic Review.

BackgroundPatient education is a crucial element within health care. It is a known predictor for increased engagement in shared decision making, improved medication and treatment adherence, higher levels of satisfaction, and even better treatment outcomes. Unfortunately, often patients only remember a very limited amount of medical information. An important reason is that most patients are simply not capable of processing large amounts of new medical information in a short time. Apps for smartphones and tablets have the potential to actively educate patients by providing them with timely information through the use of push notifications.ObjectiveThe objective of this systematic review is to provide an overview of the effects of using smartphone and tablet apps to educate patients with timely education. Within this review, we focused on patients that receive their care in a hospital setting. We assessed the effects of the interventions on outcomes, such as patients’ knowledge about their illness and treatment, adherence to treatment instructions and to medication usage, and satisfaction with the care they received.MethodsA comprehensive search of MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Web of Science was conducted. Randomized controlled trials (RCTs) published between January 2015 and November 2019 were eligible for inclusion. Two reviewers independently searched and screened articles, assessed study quality and risk of bias, and extracted the data. Due to the heterogeneity of populations, interventions, and outcomes, a meta-analysis was not deemed appropriate. Instead, a narrative synthesis is presented.ResultsA total of 21 RCTs with 4106 participants were included. Compared to usual care, overall effectiveness of the interventions was demonstrated in 69% of the outcomes. Effectiveness increased to 82% when the intervention had a duration shorter than one month and increased to 78% when the intervention provided at least one push notification per week. The interventions showed the highest effects on satisfaction with information, adherence to treatment instructions and to medication usage, clinical outcomes, and knowledge.ConclusionsThis review demonstrates that educating patients with timely medical information through their smartphones or tablets improves their levels of knowledge, medication or treatment adherence, satisfaction, and clinical outcomes, as well as having a positive effect on health care economics. These effects are most pronounced in interventions with a short duration (ie, less than a month) and with a high frequency of messages to patients (ie, once per week or more). With the knowledge that patient education is a predictor for improved outcomes and the fact that patients have obvious difficulties processing large amounts of new medical information, we suggest incorporating the delivery of timely information through smartphone and tablet apps within current medical practices.

Rapid and non-destructive assessment of nutritional status in apple trees using a new smartphone-based wireless crop scanner system

This study presents a novel, rapid, and non-destructive approach for assessing the nutritional status of apple trees using a newly developed crop scanner system. The system consists of a camera-based scanner and a dedicated app for tablets or smartphones. The scanner device is standalone and supported on a wireless platform, and it uses a dedicated app interface on tablets or smartphones to communicate, receive and analyze image data. Two experiments were designed and carried out in order to evaluate the system’s applicability for nitrogen and chlorophyll estimation in apple leaves. We measured apple leaf color parameters using the crop scanner system and determined leaf concentrations of nitrogen and chlorophyll by two different destructive methods. Data analyses showed that color parameters (R, G, B, and RS value) obtained by the system individually had a varying degree of correlation with both nitrogen (correlation coefficients (r) were −0.6366, −0.7856, 0.7497, and 0.7493 for R, G, B, and RS value, respectively) and chlorophyll (correlation coefficients (r) were −0.7970, −0.8311, −0.7962, and 0.8307 for R, G, B, and RS value, respectively) concentrations. To improve the system’s applicability, we developed an original leaf color index (LCI) based on RGB parameters. The results indicated that this new LCI could be used to estimate both nitrogen and chlorophyll concentrations with improved accuracy (coefficients of determination (R2) were 0.6624 and 0.7276, respectively). The new LCI could be incorporated into the smartphone-based app interface, making the system more suitable and accurate for nitrogen assessment of apple trees. Furthermore, an inexpensive and easy-to-use leaf color chart (LCC) was developed. A satisfactory agreement was observed between the measured nitrogen concentrations and the estimates obtained by visually comparing colors of sampled leaves with the LCC, showing the usefulness of this simple LCC in estimating nitrogen content in apple leaves. The performance of both the smartphone-based crop scanner system and the simple LCC tool demonstrated their potential applications in nutrient management of apple orchards that can be carried out in a rapid and non-destructive manner.

Can tablet apps support the learning of handwriting? An investigation of learning outcomes in kindergarten classroom

Digital technologies are increasingly being used to support school learning, but few studies have assessed the effectiveness of these new teaching methods for very young students. The aim of the present study was to assess the impact of implementing a digital notebook application designed for a stylus-oriented tablet in kindergarten classrooms. This digital notebook was dedicated to the acquisition of handwriting skills by beginning writers. Using artificial intelligence to finely analyze the spatiotemporal characteristics of handwriting (i.e., shape, order and direction of the segments), the exercises were personalized, and extrinsic feedback was delivered at the end of each trial to inform learners of their results. A total of 22 kindergarten classes participated in a 12-week teacher-implemented program, half working exclusively with paper and pencil, and half partially undertaking their handwriting training with the digital notebook. A paper-and-pen writing task was administered as a pre-test and post-test to assess the progress of all the children. Data analysis showed that learning outcomes with the digital notebook were contingent upon the students' initial handwriting level, as the benefits of training with the app were only demonstrated for children with a medium level at the start of the study. The results are discussed in the light of the literature on the impact of extrinsic feedback and learners' initial levels.

A Tablet App Supporting Self-Management for People With Dementia: Explorative Study of Adoption and Use Patterns.

BackgroundAssistive technology (AT) is rapidly emerging within dementia care and support. One area of AT application is support of people with dementia in compensating for cognitive symptoms and thereby promoting their self-management. There is, however, little evidence for the applicability, usability, and effectiveness of AT for people with dementia, and there is a need to identify factors that can promote adoption.ObjectiveThis study aimed to (1) evaluate the applicability and usability of an app, tailor-made for people with dementia; (2) explore factors affecting adoption; (3) explore the possible influence of caregiver involvement; and (4) contribute to process evaluation of the intervention.MethodsThe ReACT (Rehabilitation in Alzheimer's disease using Cognitive support Technology) app was designed as a holistic solution to support memory and structure in daily living. Persons with dementia had access to a personal user account, and family caregivers were given a parallel login. Written and Web-based materials were provided to support self-applied implementation. A mixed methods design was applied to explore adoption and use patterns, including background and disease-related data, qualitative data from a survey, and log data. Adoption was defined as the use of the app over a period of ≥90 days.ResultsData from 112 participants and 98 caregivers were included. Shorter time from diagnosis (U=595; P=.046; r=0.19) and caregiver activating the app (P=.02) had a significant impact on the participant adoption status. Logistic regression analysis showed that if caregivers had activated the app, the participant was five times more likely to become an adopter (odds ratio 5.1, 95% CI 1.29-19.99; P=.02). However, the overall predictive power was low, and there was a wide variation in background and disease-related characteristics among adopters. The level of experience and skills in tablet use were not significantly different between adopters and nonadopters. Adopters generally rated the app high on usefulness, satisfaction, and ease of use (rated on the USEdem questionnaire). Their scores were significantly higher compared with nonadopters (U=5.5; P=.02; r=0.64). Analysis of use patterns showed that all functionalities of the app were used among adopters.ConclusionsFor participants who became adopters, the ReACT app and the methods for self-applied implementation were applicable. However, the results were also in accordance with the well-known challenges of nonadoption and nonadherence to digital health interventions. The study provided insight into the importance of timely introduction and caregiver support for adoption of AT among people with dementia. It also underlined the high complexity of personal and contextual factors that influence adoption. These complex factors need to be considered when designing and implementing AT for people with dementia.

A New Prospective, Home-Based Monitoring of Motor Symptoms in Parkinson's Disease.

Background:Subjective symptoms, which are retrospectively assessed during clinical interviews in the office, may be influenced by patient recall in Parkinson’s disease (PD). Prospective collection of subjective data might be an effective tool to overcome this bias.Objective:We investigated the correspondence between prospectively and retrospectively assessed motor symptoms in PD.Methods:Forty-two consecutive patients (9 females, 67±9.8 years old) with mild to moderate PD reported their symptoms four times a day for two weeks, using the “SleepFit” application (app) for tablets. This app incorporates a new Visual Analogue Scale assessing global mobility (m-VAS), and the Scales for Outcome in Parkinson Assessment Diary Card (SCOPA-DC). At day 14, the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) parts II and IV questionnaires were completed at the hospital. Agreement (root mean square difference) and the tendency to under- or overestimate their symptoms by patients (relative difference after normalization) were calculated to compare prospectively vs. retrospectively collected information.Results:Although agreement was good for overall scores (m-VAS: 10.0%; SCOPA-DC: 18.3%), and for single motor symptoms (involuntary movements, hand dexterity, walking, changing position; each <20%), some individuals with more advanced disease, higher fatigue or worse sleep quality showed poor symptom recall in retrospect. Moreover, a subgroup of patients (16.7%) either over- or underestimated symptom severity.Conclusions:Regular, prospective monitoring of motor symptoms is suitable in PD patients. SleepFit might be a useful tool in routine practice to identify patients tending to under- or overestimate their symptoms, and for their follow-up.

Towards a Theoretical Foundation for Quality Tablet App-Enriched Learning Environments in Primary School Mathematics Education

There has been much research about tasks and learning environments but not yet sufficient regarding those involving mobile technologies for mathematics education. This paper discusses the quality of the expanding amount of tablet applications for primary school mathematics and their eloquent integration in student-centred learning environments (LE). It argues that students’ engagement in LE with tablet apps does not necessarily start with a particular a priori task designed within the LE and through a task-format, as by now reported in literature. An engaging design of touchpad apps may rather encourage explorative activities leading towards a single task formulation and its solution as a result of that process. The paper further aims at framing essential characteristics and potentials of environments enriched with tablet-apps in three main categories: mathematical and curricular meaning, didactical aspects and technical matters. Setting the focus on the didactical potentials of tablet-apps, the overarching categories are further specified finalizing with six categories: (1) mathematical contents and relation to curriculum, (2) communication, collaboration and cooperation, (3) differentiation, (4) feedback and assessment, (5) connections and networking and (6) logistics, obtained through the grounded methodological approach in a theoretical model. The suggested model should also adequately represent the development of task, task-format and LE in it. Additionally, a descriptive case study for illustrating the theoretical model for design and analysis of potentials of tablet apps for elementary geometry is also offered. The proposed model may be meaningful for teachers’ decision making when selecting and implementing touchpad-apps in their instructional practices but also for developmental surveying of existing apps, their re-designs and further novel designs involving identified potentials.

Not part of my routine: a qualitative study of use and understanding of UV forecast information and the SunSmart app

BackgroundThe Ultraviolet (UV) Index provides a reliable means of monitoring the strength of UV radiation at the Earth’s surface, which can be used to indicate the potential for skin damage. This qualitative study aims to examine public understanding of the UV Index among Australians who routinely use UV forecast information as well as those who do not.MethodsRecent use of the SunSmart app (a popular mobile and tablet app that provides UV forecast information) served as a proxy for use of UV forecast information. Six focus groups were conducted with ‘new users’, who trialled the SunSmart app for the first time in the two weeks preceding the group discussion. In addition, 15 in-depth interviews were conducted with ‘existing users’, who routinely used the SunSmart app. Thematic discourse analysis was undertaken to compare views and experiences.ResultsMisperceptions about UV radiation were common. Participants learnt new information about UV radiation, the UV Index, and the times of the day that sun protection is recommended. Among adults who were using UV forecast information for the first time, this learning rarely translated to new behaviours; for these participants, the UV Index forecast information and recommendations were inconsistent with their own observation of the weather and subsequent judgement about their propensity to burn. Thus new users considered the UV forecast information to be overly cautious. In contrast, existing users recognised their inability to judge the UV Index level; for these participants, UV forecast information provided by the SunSmart app was incorporated into their daily routines and used to inform their sun protection behaviours.Conclusions/implicationsNo matter how broadly UV forecast information is promoted, it is unlikely to improve sun protection behaviours across the Victorian population due to the low level of basic understanding of UV radiation. Public education strategies that correct the commonly held misperception that temperature and/or sunshine can reliably predict the potential for UV damage are required. Improved public awareness about UV radiation and how the UV Index can be used to prevent skin cancer may help Australians to develop more effective sun protection habits.

The Needs of Assistive Technology on Students’ EFL Writing

Nowadays generally, technology encompasses all aspects of modern life and particularly, the writing by using English language. The challenges of learning English writing in Indonesia are plenty as English is perceived as a Foreign Language. This paper aims to reveal tertiary level students’ perception and attitude towards their technology aptitude: usage models, noticed benefits of and challenges to employ technology in learning English as Foreign Language (EFL) writing. This is a qualitative research, a case study, and used a self-structured questionnaire and interview to collect the data. Two participant lecturer observers and one hundred and sixty-seven students in a private college in Tangerang were purposively selected thirty students for questionnaire and interview. The data were carried out to reveal the lecturers and students’ perspective of assistive technology in EFL writing. The results revealed that assistive technology such as Webbing/Blogs, Computer software, Social Mediaapps, YouTubechannel, smart phone and tablet apps are found to be used by EFL learners to learn EFL Writing. Yet, most of the students had constraint at bad Internet connection. The outcome of this study offers thinkable instructional suggestions for students’ EFL Writing and creates base for further studies in this area.Keywords: Students’ EFL Writing, Learning EFL Writing, Assistive Technology

An Evaluation of Digital Health Tools for Diabetes Self-Management in Hispanic Adults: Exploratory Study

BackgroundAlthough multiple self-monitoring technologies for type 2 diabetes mellitus (T2DM) show promise for improving T2DM self-care behaviors and clinical outcomes, they have been understudied in Hispanic adult populations who suffer disproportionately from T2DM.ObjectiveThe objective of this study was to evaluate the acceptability, feasibility, and potential integration of wearable sensors for diabetes self-monitoring among Hispanic adults with self-reported T2DM.MethodsWe conducted a pilot study of T2DM self-monitoring technologies among Hispanic adults with self-reported T2DM. Participants (n=21) received a real-time continuous glucose monitor (RT-CGM), a wrist-worn physical activity (PA) tracker, and a tablet-based digital food diary to self-monitor blood glucose, PA, and food intake, respectively, for 1 week. The RT-CGM captured viewable blood glucose concentration (mg/dL) and PA trackers collected accelerometer-based data, viewable on the device or an associated tablet app. After 1 week of use, we conducted a semistructured interview with each participant to understand experiences and thoughts on integration of the data from the devices into a technology-facilitated T2DM self-management intervention. We also conducted a brief written questionnaire to understand participants’ self-reported T2DM history and past experience using digital health tools for T2DM self-management. Feasibility was measured by device utilization and objective RT-CGM, PA tracker, and diet logging data. Acceptability and potential integration were evaluated through thematic analysis of verbatim interview transcripts.ResultsParticipants (n=21, 76% female, 50.4 [SD 11] years) had a mean self-reported hemoglobin A1c of 7.4 [SD 1.8] mg/dL and had been diagnosed with T2DM for 7.4 [SD 5.2] years (range: 1-16 years). Most (89%) were treated with oral medications, whereas the others self-managed through diet and exercise. Nearly all participants (n=20) used both the RT-CGM and PA tracker, and 52% (11/21) logged at least one meal, with 33% (7/21) logging meals for 4 or more days. Of the 8 possible days, PA data were recorded for 7.1 [SD 1.8] days (range: 2-8), and participants averaged 7822 [SD 3984] steps per day. Interview transcripts revealed that participants felt most positive about the RT-CGM as it unveiled previously unknown relationships between lifestyle and health and contributed to changes in T2DM-related thoughts and behaviors. Participants felt generally positive about incorporating the wearable sensors and mobile apps into a future intervention if support were provided by a health coach or health care provider, device training were provided, apps were tailored to their language and culture, and content were both actionable and delivered on a single platform.ConclusionsSensor-based tools for facilitating T2DM self-monitoring appear to be a feasible and acceptable technology among low-income Hispanic adults. We identified barriers to acceptability and highlighted preferences for wearable sensor integration in a community-based intervention. These findings have implications for the design of T2DM interventions targeting Hispanic adults.

A Peer-Led Electronic Mental Health Recovery App in a Community-Based Public Mental Health Service: Pilot Trial.

BackgroundThere is an increasing need for peer workers (people with lived experience of mental health problems who support others) to work alongside consumers to improve recovery and outcomes. In addition, new forms of technology (tablet or mobile apps) can deliver services in an engaging and innovative way. However, there is a need to evaluate interventions in real-world settings.ObjectiveThis exploratory proof-of-concept study aimed to determine if a peer worker–led electronic mental health (e-mental health) recovery program is a feasible, acceptable, and effective adjunct to usual care for people with moderate-to-severe mental illness.MethodsOverall, 6 consumers and 5 health service staff participated in the evaluation of a peer-led recovery app delivered at a community-based public mental health service. The peer worker and other health professional staff invited attendees at the drop-in medication clinics to participate in the trial during June to August 2017. Following the intervention period, participants were also invited by the peer worker to complete the evaluation in a separate room with the researcher. Consumers were explicitly informed that participation in the research evaluation was entirely voluntary. Consumer evaluation measures at postintervention included recovery and views on the acceptability of the program and its delivery. Interviews with staff focused on the acceptability and feasibility of the app itself and integrating a peer worker into the health care service.ResultsConsumer recruitment in the research component of the study (n=6) fell substantially short of the target number of participants (n=30). However, from those who participated, both staff and consumers were highly satisfied with the peer worker and somewhat satisfied with the app. Health care staff overall believed that the addition of the peer worker was highly beneficial to both the consumers and staff.ConclusionsThe preliminary findings from this proof-of-concept pilot study suggest that a peer-led program may be a feasible and acceptable method of working on recovery in this population. However, the e-mental health program did not appear feasible in this setting. In addition, recruitment was challenging in this particular group, and it is important to note that these study findings may not be generalizable. Despite this, ensuring familiarity of technology in the target population before implementing e-mental health interventions is likely to be of benefit.

Bee colony losses in Brazil: a 5-year online survey

In 2014, an online survey was launched to assess impacts of bee losses in Brazil (honeybees, stingless bees, and solitary bees). Events from January 2013 to December 2017 were collected on a website http://www.semabelhasemalimento.com.br/beealert as well as in apps for smartphones and tablets. In total, 322 post-confirmed qualified reports (287 for honeybee, 33 for stingless bee, 2 for solitary bee) were included in our analyses. Overall, 19,296 of 37,453 colonies and nests were lost (estimated > 1 billion bees). Losses were highest for Africanized honeybees (Apis mellifera), followed by stingless bee Tetragonisca angustula. Honeybee 95% confidence intervals (CI) for loss rates on the basis of year, 5-year interval, regions, and operation sizes were estimated using a generalized linear model (GLM) for total loss (TL) and a Wald method for average losses (AL). Other species losses were mentioned in the text. Based on information from respondents, pesticide exposures were suspected as the main cause of nest and colony losses. In Sao Paulo State, which accounted for 45.7% of total reports, neonicotinoids and fipronil led pesticide are listed in 55.9% of reports (fipronil, clothianidin, imidacloprid, and thiamethoxam are widely used in sugar cane plantations and orange groves in this state).

Priming, enabling and assessment of curiosity

In the information age, where all answers are just a click away, curiosity, the intrinsic drive to learn, becomes of paramount importance. How easy is it to prime for curiosity and what are its effects? What simple interventions can be used to enable curiosity-driven behaviors? We have conducted a large-scale study to address these questions, using a novel curiosity-based application (app) on university applicants. Using the same app, we addressed the issue of curiosity assessment, which in recent years has mainly been performed via self-reporting questionnaires. The curiosity assessment tool was developed in order to assess curiosity via an objective, quantitative and digital way. The tool measured several behavioral aspects during a free and task-less interaction with the tablet app. From the recorded activity logs we calculated quantitative behavioral measures related to their exploration patterns. We show that a single word can prime the participants and induce better learning of their self-explored knowledge. We also show that by simply enabling more time to explore, without the ability to stop at will, induces more exploration and more learning. Finally, we show that our behavioral measures, obtained with the digital quantitative assessment tool, are significant predictors of the participants’ self-reported curiosity and Psychometric Entrance Test scores. These results suggest that simple priming for curiosity and enabling enough time to explore improve self-paced learning, and that a relatively simple and short interaction with a digital app can greatly improve state-of-the-art curiosity assessment.

Teaching cursive handwriting: A contribution to the acceptability study of using digital tablets in French classrooms

The process of teaching and learning handwriting is complex and laborious. A digital learning environment in the form of a tablet app could enhance teachers' knowledge of writer characteristics and their management of classroom diversity. This study aims to identify the needs of cursive writing teachers from a survey of 164 kindergarten teachers in France teaching writing skills for children aged 5 to 6 years. The results provide insights into teacher needs and, therefore, can be used to identify the acceptability criteria of a tool designed to scaffold the teaching of writing gestures. The results of needs analyses have been interpreted in the light of new scientific findings on reading and writing skills, and there is a discussion on the potential of such a digital learning environment for the classroom, particularly during the training and skills assessment phases. Questionnaire answers show that the teachers interviewed rarely use digital tools in the classroom and this prompts reflection on the value and meaning that preschool children give to the digital trace.

An educational IoT lab kit and tools for energy awareness in European schools

Abstract The use of maker community tools and IoT technologies inside classrooms is spreading to an ever-increasing number of education and science fields. GAIA is a European research project focused on achieving behavior change for sustainability and energy awareness in schools. In this work, we report on how a large IoT deployment in a number of educational buildings and real-world data from this infrastructure, are utilized to support a “maker” lab kit activity inside the classroom. We also provide some insights to the integration of these activities in the school curriculum, along with a discussion on feedback produced through a series of workshop activities in a number of schools in Greece. Moreover, we discuss the application of the lab kit framework towards implementing an interactive installation. We also report on how the lab kit is paired with a serious game and an augmented reality app for smartphones and tablets, supporting the in-class activities. Our initial evaluation results show a very positive first reaction by the school community.

Patient Engagement as Measured by Inpatient Portal Use: Methodology for Log File Analysis.

BackgroundInpatient portals (IPPs) have the potential to increase patient engagement and satisfaction with their health care. An IPP provides a hospitalized patient with similar functions to those found in outpatient portals, including the ability to view vital signs, laboratory results, and medication information; schedule appointments; and communicate with their providers. However, IPPs may offer additional functions such as meal planning, real-time messaging with the inpatient care team, daily schedules, and access to educational materials relevant to their specific condition. In practice, IPPs have been developed as websites and tablet apps, with hospitals providing the required technology as a component of care during the patient’s stay.ObjectiveThis study aimed to describe how inpatients are using IPPs at the first academic medical center to implement a system-wide IPP and document the challenges and choices associated with this analytic process.MethodsWe analyzed the audit log files of IPP users hospitalized between January 2014 and January 2016. Data regarding the date/time and duration of interactions with each of the MyChart Bedside modules (eg, view lab results or medications and patient schedule) and activities (eg, messaging the provider and viewing educational videos) were captured as part of the system audit logs. The development of a construct to describe the length of time associated with a single coherent use of the tool—which we call a session—provides a foundational unit of analysis. We defined frequency as the number of sessions a patient has during a given provision day. We defined comprehensiveness in terms of the percentage of functions that an individual uses during a given provision day.ResultsThe analytic process presented data challenges such as length of stay and tablet-provisioning factors. This study presents data visualizations to illustrate a series of data-cleaning issues. In the presence of these robust approaches to data cleaning, we present the baseline usage patterns associated with our patient panel. In addition to frequency and comprehensiveness, we present considerations of median data to mitigate the effect of outliers.ConclusionsAlthough other studies have published usage data associated with IPPs, most have not explicated the challenges and choices associated with the analytic approach deployed within each study. Our intent in this study was to be somewhat exhaustive in this area, in part, because replicability requires common metrics. Our hope is that future researchers in this area will avail themselves of these perspectives to engage in critical assessment moving forward.