Consensus on the Terms and Procedures for Planning and Reporting a Usability Evaluation of Health-Related Digital Solutions: Delphi Study and a Resulting Checklist.

BACKGROUND: Usability evaluation both by experts and target users is an integral part of the process of developing and assessing digital solutions. Usability evaluation improves the probability of having digital solutions that are easier, safer, more efficient, and more pleasant to use. However, despite the widespread recognition of the importance of usability evaluation, there is a lack of research and consensus on related concepts and reporting standards. OBJECTIVE: The aim of the study is to generate consensus on terms and procedures that should be considered when planning and reporting a study on a usability evaluation of health-related digital solutions both by users and experts and provide a checklist that can easily be used by researchers when conducting their usability studies. METHODS: A Delphi study with 2 rounds was conducted with a panel of international participants experienced in usability evaluation. In the first round, they were asked to comment on definitions, rate the importance of preidentified methodological procedures using a 9-item Likert scale, and suggest additional procedures. In the second round, experienced participants were asked to reappraise the relevance of each procedure informed by round 1 results. Consensus on the relevance of each item was defined a priori when at least 70% or more experienced participants scored an item 7 to 9 and less than 15% of participants scored the same item 1 to 3. RESULTS: A total of 30 participants (n=20 females) from 11 different countries entered the Delphi study with a mean age of 37.2 (SD 7.7) years. Agreement was achieved on the definitions for all usability evaluation-related terms proposed (usability assessment moderator, participant, usability evaluation method, usability evaluation technique, tasks, usability evaluation environment, usability evaluator, and domain evaluator). A total of 38 procedures related to usability evaluation planning and reporting were identified across rounds (28 were related to usability evaluation involving users and 10 related to usability evaluation involving experts). Consensus on the relevance was achieved for 23 (82%) of the procedures related to usability evaluation involving users and for 7 (70%) of the usability evaluation procedures involving experts. A checklist was proposed that can guide authors when designing and reporting usability studies. CONCLUSIONS: This study proposes a set of terms and respective definitions as well as a checklist to guide the planning and reporting of usability evaluation studies, constituting an important step toward a more standardized approach in the field of usability evaluation that may contribute to enhancing the quality of planning and reporting usability studies. Future studies can contribute to further validating this study work by refining the definitions, assessing the practical applicability of the checklist, or assessing whether using this checklist results in higher-quality digital solutions.

Perceptions on Extending the Use of Technology after the COVID-19 Pandemic Resolves: A Qualitative Study with Older Adults.

The COVID-19 pandemic of the last two years has affected the lives of many individuals, especially the most vulnerable and at-risk population groups, e.g., older adults. While social distancing and isolation are shown to be effective at decreasing the transmission of the virus, these actions have also increased loneliness and social isolation. To combat social distancing from family and friends, older adults have turned to technology for help. In the health sector, these individuals also had a variety of options that strengthened eHealth care services. This study analyzed the technologies used during the COVID-19 pandemic by a group of older people, as well as explored their expectations of use after the pandemic period. Qualitative and ethnographic interviews were conducted with 10 Portuguese older adults, and data were collected over a period of seven months between 2020 and 2021. The research demonstrated that the use of current and new technologies in the post-pandemic future is likely to be related to overcoming: (i) insecurity regarding privacy issues; (ii) difficulties in using technologies due to the level of use of digital technology; and (iii) the human distancing and impersonal consequences of using these technologies.

Extending the Stochastic Titration CpHMD to CHARMM36m.

The impact of pH on proteins is significant but often neglected in molecular dynamics simulations. Constant-pH Molecular Dynamics (CpHMD) is the state-of-the-art methodology to deal with these effects. However, it still lacks widespread adoption by the scientific community. The stochastic titration CpHMD is one of such methods that, until now, only supported the GROMOS force field family. Here, we extend this method's implementation to include the CHARMM36m force field available in the GROMACS software package. We test this new implementation with a diverse group of proteins, namely, lysozyme, Staphylococcal nuclease, and human and E. coli thioredoxins. All proteins were conformationally stable in the simulations, even at extreme pH values. The RMSE values (pKa prediction vs experimental) obtained were very encouraging, in particular for lysozyme and human thioredoxin. We have also identified a few residues that challenged the CpHMD simulations, highlighting scenarios where the method still needs improvement independently of the force field. The CHARMM36m all-atom implementation was more computationally efficient when compared with the GROMOS 54A7, taking advantage of a shorter nonbonded interaction cutoff and a less frequent neighboring list update. The new extension will allow the study of pH effects in many systems for which this force field is particularly suited, i.e., proteins, membrane proteins, lipid bilayers, and nucleic acids.

Defining Recommendations to Guide User Interface Design: Multimethod Approach.

BACKGROUND: For the development of digital solutions, different aspects of user interface design must be taken into consideration. Different technologies, interaction paradigms, user characteristics and needs, and interface design components are some of the aspects that designers and developers should pay attention to when designing a solution. Many user interface design recommendations for different digital solutions and user profiles are found in the literature, but these recommendations have numerous similarities, contradictions, and different levels of detail. A detailed critical analysis is needed that compares, evaluates, and validates existing recommendations and allows the definition of a practical set of recommendations. OBJECTIVE: This study aimed to analyze and synthesize existing user interface design recommendations and propose a practical set of recommendations that guide the development of different technologies. METHODS: Based on previous studies, a set of recommendations on user interface design was generated following 4 steps: (1) interview with user interface design experts; (2) analysis of the experts' feedback and drafting of a set of recommendations; (3) reanalysis of the shorter list of recommendations by a group of experts; and (4) refining and finalizing the list. RESULTS: The findings allowed us to define a set of 174 recommendations divided into 12 categories, according to usability principles, and organized into 2 levels of hierarchy: generic (69 recommendations) and specific (105 recommendations). CONCLUSIONS: This study shows that user interface design recommendations can be divided according to usability principles and organized into levels of detail. Moreover, this study reveals that some recommendations, as they address different technologies and interaction paradigms, need further work.

Procedures of User-Centered Usability Assessment for Digital Solutions: Scoping Review of Reviews Reporting on Digital Solutions Relevant for Older Adults.

BACKGROUND: The assessment of usability is a complex process that involves several steps and procedures. It is important to standardize the evaluation and reporting of usability procedures across studies to guide researchers, facilitate comparisons across studies, and promote high-quality usability studies. The first step to standardizing is to have an overview of how usability study procedures are reported across the literature. OBJECTIVE: This scoping review of reviews aims to synthesize the procedures reported for the different steps of the process of conducting a user-centered usability assessment of digital solutions relevant for older adults and to identify potential gaps in the present reporting of procedures. The secondary aim is to identify any principles or frameworks guiding this assessment in view of a standardized approach. METHODS: This is a scoping review of reviews. A 5-stage scoping review methodology was used to identify and describe relevant literature published between 2009 and 2020 as follows: identify the research question, identify relevant studies, select studies for review, chart data from selected literature, and summarize and report results. The research was conducted on 5 electronic databases: PubMed, ACM Digital Library, IEEE, Scopus, and Web of Science. Reviews that met the inclusion criteria (reporting on user-centered usability evaluation procedures for any digital solution that could be relevant for older adults and were published in English) were identified, and data were extracted for further analysis regarding study evaluators, study participants, methods and techniques, tasks, and test environment. RESULTS: A total of 3958 articles were identified. After a detailed screening, 20 reviews matched the eligibility criteria. The characteristics of the study evaluators and participants and task procedures were only briefly and differently reported. The methods and techniques used for the assessment of usability are the topics that were most commonly and comprehensively reported in the reviews, whereas the test environment was seldom and poorly characterized. CONCLUSIONS: A lack of a detailed description of several steps of the process of assessing usability and no evidence on good practices of performing it suggests that there is a need for a consensus framework on the assessment of user-centered usability evaluation. Such a consensus would inform researchers and allow standardization of procedures, which are likely to result in improved study quality and reporting, increased sensitivity of the usability assessment, and improved comparability across studies and digital solutions. Our findings also highlight the need to investigate whether different ways of assessing usability are more sensitive than others. These findings need to be considered in light of review limitations.

Mortalidade dos adultos por doenças cardiovasculares e fatores associados no semiárido brasileiro / Adult mortality from cardiovascular disease and associated factors in the Brazilian semiarid region

As doenças do aparelho circulatório representam o principal grupo de causa de óbito no mundo eno Brasil, cujas principais causas de mortalidade são as doenças isquêmicas do coração e infarto agudo do miocárdio. No Brasil, mesmo tendo ocorrido declínio da mortalidade por doenças do aparelho circulatório, vários estudos encontraram desníveis sociais nas áreas geográficas. No semiárido brasileiro são encontrados níveis de mortalidade mais elevados e diferenciados em relação ao restante do País. Os dados de mortalidade foram obtidos do Sistema de Informações sobre Mortalidade do Ministérioda Saúde. Os dados populacionais têm como fonte a Fundação Instituto Brasileiro de Geografia e Estatística. As informações demográficas socioeconômicas foram obtidas do Programa para as Nações Unidas para o Desenvolvimento. Percentuais, taxas de mortalidade e um índice regional demortalidade foram calculados para traçar o perfil da mortalidade por doenças do aparelho circulatório e suas principais causas de morte das microrregiões do semiárido. A regressão beta foi usada para se verificar as relações entre a morte por doenças do aparelho circulatório e fatores socioeconômicos e demográficos para ambos os sexos. Foi encontrada associação na mortalidade dos homens com os indicadores Probabilidade de sobrevivência até 60 anos, esperança de vida ao nascer, percentual de domicílio com eletricidade e taxa de envelhecimento. Para as mulheres: IDHM Renda, Percentual de domicílios com banheiro e água encanada e probabilidade de sobrevivência até 60 anos. Espera-se que o entendimento desses achados contribua para o planejamento de ações preventivas de uma região com poucos estudos sobre esta abordagem.

Diseases of the circulatory system represent the main group of causes of death in the world and inBrazil, whose main causes of death are ischemic heart disease and acute myocardial infarction. In Brazil, even with a decrease in mortality from diseases of the circulatory system, several studies have found social inequality in the geographical areas. The mortality rate in the Brazilian semiarid region is higher and different from the other regions of the country. Mortality data were obtained from the Mortality Information System of the Ministry of Health. Population data are from the Brazilian Institute of Geography and Statistics. The socioeconomic demographic information was obtained from the United Nations Development Programme. Percentage, mortality rates and the regional mortality rate werecalculated to outline the profile of mortality from diseases of the circulatory system and the maincauses of death of micro-regions of semiarid region. Beta regression was used to examine relationshipsbetween death from diseases of the circulatory system and socioeconomic and demographic factors forboth sexes. Association was found in mortality of men with the following indicators:probability of survivalup to 60 years of age, life expectancy at birth, percentage of homes with electricity, and aging rate. Forwomen: the Municipal Human Development Index – Income (IDHMRenda), percentage of households with toilets and piped water, and the probability of survival up to 60 years. It is expected that theunderstanding of these findings will contribute to the development of preventive actions in a region withfew studies with this approach.

Fatores explicativos da mortalidade por tuberculose em adultos no nordeste / Explanatory factors of tuberculosis mortality in adults in the northeast

Um dos componentes fundamentais da demografia é a mortalidade. Os índices de mortalidade subsidiam gestores públicos em saúde a identificar como e onde investir na saúde de uma população. A mortalidade por Tuberculose permanece como uma das preocupações em regiões de menor desenvolvimento econômico, como o Nordeste brasileiro. Sendo, assim, o presente estudo teve-se como objetivo verificar a relação da mortalidade por Tuberculose com fatores explicativos na citada região. O estudo foi de tipo transversal no ano 2008. As fontes dos dados foram o Ministério do Trabalho e Emprego, Ministério da Saúde e Sistema FIRJAN. Os passos metodológicos foram: estudar a qualidade das estatísticas de óbitos; aplicar o método estatístico de análise de regressão linear para verificar o grau de relação que os fatores explicativos escolhidos para o estudo tinham com a mortalidade por Tuberculose. Concluiu-se que alguns fatores socioeconômicos, ocupação e doenças como HIV e Pneumonia evidenciaram uma relação significativa com a mortalidade por Tuberculose no Nordeste brasileiro.

One of the fundamental components of demography is mortality. Mortality rates subsidize public health managers to identify how and where to invest in the health of a population. Tuberculosis mortality remains a concern in regions with less economic development, such as the Brazilian Northeast. Thus, the present study aimed to verify the relationship between tuberculosis mortality and explanatory factors in the aforementioned region. The study was cross-sectional in 2008. The data sources were the Ministry of Labor and Employment, Ministry of Health and Sistema FIRJAN. The methodological steps were: to study the quality of death statistics; apply the statistical method of linear regression analysis to verify the degree of relationship that the explanatory factors chosen for the study had with tuberculosis mortality. It was concluded that some socioeconomic factors, occupation and diseases such as HIV and Pneumonia showed a significant relationship with mortality from Tuberculosis in Northeastern Brazil.