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1.
BMC Public Health ; 19(1): 449, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31035968

RESUMO

BACKGROUND: Electronic clinical decision algorithms (eCDAs) that guide clinicians during patient management are being deployed in resource-limited settings to improve the quality of care and rational use of medicines (especially antimicrobials). Little is known on how local clinicians perceive the use and impact of these tools in their daily practice. This study investigates clinician insights on an eIMCI tool. Specifically, we report their views on its medical content, assess their knowledge on microbes, antimicrobials and the development of resistance. METHODS: This qualitative study was conducted in the frame of a large-scale implementation in Burkina Faso of an eIMCI tool developed by the Swiss NGO Terre des hommes. Twelve in-depth interviews and 2 focus-group discussions were conducted including 21 health workers from 10 primary care facilities. Emerging themes were identified using qualitative data analysis software. RESULTS: eIMCI users expressed a high level of satisfaction, slowness of the tablet was perceived as the major inconvenience limiting uptake. Several frequent illnesses were identified as missing in the algorithm along with guidance for fever without focus. When asked about existing types of microbes, 9 and 4 out of 21 participants could mention bacteria and virus respectively; only 5 correctly answered that antibiotics had no action on viral disease and 6 mentioned the risk of antibiotic resistance. Level of knowledge was higher in nurses than in less trained health workers. The tool was perceived as improving patient management and the rational use of antibiotics. Positive changes in health facility organisation were reported, such as task shifting and improved triage. eIMCI was also perceived as a learning tool, and users expressed a strong desire to expand the geographic and temporal scope of the intervention. CONCLUSION: The use of eICMI was widely accepted and perceived as a powerful tool guiding daily practice. Findings suggest that it has positive effects on the health care system beyond the quality of consultation. To support large uptake and sustainability, better training of health workers in infectiology is essential and the medical content of eIMCI should be optimized to include frequent diseases and, for each of them, the appropriate management plan.


Assuntos
Antibacterianos/uso terapêutico , Atitude do Pessoal de Saúde , Sistemas de Apoio a Decisões Clínicas/organização & administração , Atenção Primária à Saúde/organização & administração , Adulto , Algoritmos , Antibacterianos/administração & dosagem , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Burkina Faso/epidemiologia , Criança , Computadores de Mão/normas , Comportamento do Consumidor , Sistemas de Apoio a Decisões Clínicas/normas , Farmacorresistência Bacteriana , Uso de Medicamentos , Feminino , Febre/tratamento farmacológico , Febre/microbiologia , Instalações de Saúde , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde/normas , Pesquisa Qualitativa , Viroses/tratamento farmacológico , Viroses/microbiologia
2.
JMIR Mhealth Uhealth ; 7(1): e10342, 2019 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-30702438

RESUMO

BACKGROUND: Recent developments in technology are promising for providing home-based exercise programs. OBJECTIVE: The objective of this study was to evaluate the feasibility and patient experience of a home-based rehabilitation program after total hip arthroplasty (THA) delivered using videos on a tablet personal computer (PC) and a necklace-worn motion sensor to continuously monitor mobility-related activities. METHODS: We enrolled 30 independently living patients aged 18-75 years who had undergone THA as a treatment for primary or secondary osteoarthritis (OA) between December 2015 and February 2017. Patients followed a 12-week exercise program with video instructions on a tablet PC and daily physical activity registration through a motion sensor. Patients were asked to do strengthening and walking exercises at least 5 days a week. There was weekly phone contact with a physiotherapist. Adherence and technical problems were recorded during the intervention. User evaluation was done in week 4 (T1) and at the end of the program (T2). RESULTS: Overall, 26 patients completed the program. Average adherence for exercising 5 times a week was 92%. Reasons mentioned most often for nonadherence were vacation or a day or weekend off 25% (33/134) and work 15% (20/134). The total number of technical issues was 8. The average score on the user evaluation questionnaire (range 0-5) was 4.6 at T1 and 4.5 at T2. The highest score was for the subscale "coaching" and the lowest for the subscale "sensor." CONCLUSIONS: A home-based rehabilitation program driven by a tablet app and mobility monitoring seems feasible for THA patients. Adherence was good and patient experience was positive. The novel technology was well accepted. When the home-based rehabilitation program proves to be effective, it could be used as an alternative to formal physiotherapy. However, further research on its effectiveness is needed.


Assuntos
Artroplastia de Quadril/reabilitação , Exercício/psicologia , Satisfação do Paciente , Reabilitação/instrumentação , Idoso , Estudos de Coortes , Computadores de Mão/normas , Computadores de Mão/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Serviços de Assistência Domiciliar/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Osteoartrite do Quadril/complicações , Osteoartrite do Quadril/psicologia , Osteoartrite do Quadril/cirurgia , Pacientes/psicologia , Pacientes/estatística & dados numéricos , Estudos Prospectivos , Reabilitação/métodos , Reabilitação/psicologia , Cooperação e Adesão ao Tratamento/psicologia , Resultado do Tratamento
3.
JMIR Mhealth Uhealth ; 7(1): e12637, 2019 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-30664475

RESUMO

BACKGROUND: Zambia is faced with a severe shortage of health workers and challenges in national health financing. This burdens the medical licentiate practitioner (MLP) program for training nonphysician clinical students in Zambia because of the shortage of qualified medical lecturers and learning resources at training sites. To address this shortage and strengthen the MLP program, a self-directed electronic health (eHealth) platform was introduced, comprising technology-supported learning (e-learning) for medical education and support for health care practice. MLP students were provided with tablets that were preloaded with content for offline access. OBJECTIVE: This study aimed to explore MLP students' and medical lecturers' perceptions of the self-directed eHealth platform with an offline-based tablet as a training and health care practice support tool during the first year of full implementation. METHODS: We conducted in-depth qualitative interviews with 8 MLP students and 5 lecturers and 2 focus group discussions with 16 students to gain insights on perceptions of the usefulness, ease of use, and adequacy of self-directed e-learning and health care practice support accessible through the offline-based tablet. Participants were purposively sampled. Verbatim transcripts were analyzed following hypothesis coding. RESULTS: The eHealth platform (e-platform), comprising e-learning for medical education and health care practice support, was positively received by students and medical lecturers and was seen as a step toward modernizing the MLP program. Tablets enabled equal access to offline learning contents, thus bridging the gap of slow or no internet connections. The study results indicated that the e-platform appears adequate to strengthen medical education within this low-resource setting. However, student self-reported usage was low, and medical lecturer usage was even lower. One stated reason was the lack of training in tablet usage and another was the quality of the tablets. The mediocre quality and quantity of most e-learning contents were perceived as a primary concern as materials were reported to be outdated, missing multimedia features, and addressing only part of the curriculum. Medical lecturers were noted to have little commitment to updating or creating new learning materials. Suggestions for improving the e-platform were given. CONCLUSIONS: To address identified major challenges, we plan to (1) introduce half-day training sessions at the beginning of each study year to better prepare users for tablet usage, (2) further update and expand e-learning content by fostering collaborations with MLP program stakeholders and nominating an e-platform coordinator, (3) set up an e-platform steering committee including medical lecturers, (4) incorporate e-learning and e-based health care practice support across the curriculum, as well as (5) implement processes to promote user-generated content. With these measures, we aim to sustainably strengthen the MLP program by implementing the tablet-based e-platform as a serious learning technology for medical education and health care practice support.


Assuntos
Computadores de Mão/normas , Educação Médica/métodos , Pessoal de Saúde/psicologia , Percepção , Adulto , Computadores de Mão/estatística & dados numéricos , Educação Médica/normas , Feminino , Grupos Focais/métodos , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Ensino/psicologia , Ensino/normas , Zâmbia
4.
J Holist Nurs ; 37(2): 163-174, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30111233

RESUMO

PURPOSE: To evaluate the feasibility of Tai Chi (TC) and electronic tablet (ET) interventions on older adults' cognition and health and to explore participants' perceptions of intervention activities. DESIGN: An emergent embedded experimental mixed methods design was used in which the qualitative strand helped explain intervention results. METHOD: Older adults who participate in TC classes will have improved cognition and health compared with older adults who participate in ET classes. Twenty-six participants from two assisted living residences were recruited and randomized to receive nine TC or ET classes. The Modified Mini Mental State Exam was used to measure cognition and the SF-12v2 assessed perceived health before and after the intervention. Participants were invited to share perceptions of the two interventions. Institutional review board approval was obtained and participants provided signed consent for both quantitative and qualitative strands. FINDINGS: There was no significant difference within or between groups on cognition and health scores. CONCLUSIONS: TC and ET use are activities that can be delivered in the community and have the potential to promote compensatory scaffolding as described by the revised scaffolding theory of aging and cognition. Future research should involve larger samples and teaching methods that promote learning postures.


Assuntos
Cognição , Nível de Saúde , Tai Ji/normas , Interface Usuário-Computador , Idoso , Idoso de 80 Anos ou mais , Computadores de Mão/normas , Feminino , Grupos Focais/métodos , Humanos , Masculino , Projetos Piloto , Pesquisa Qualitativa , Tai Ji/métodos
5.
Int J Cardiol ; 278: 295-299, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30545621

RESUMO

BACKGROUND: Coronary Artery Disease (CAD) is the leading cause of death worldwide. Ultrasound-detected carotid plaque has been previously shown to predict significant CAD. Despite this evidence, carotid plaque assessment has not been implemented in cardiac risk screening, likely due to the cost associated with a formal carotid ultrasound examination. This study sought to determine whether a handheld vascular ultrasound device could be used as an accurate point-of-care imaging tool for the assessment of carotid artery plaque. METHODS: We performed a focused vascular ultrasound of the carotid arteries of 200 patients referred for coronary angiography using a handheld ultrasound device as well as a full-size conventional ultrasound system. For each participant, the maximum plaque height (MPH) and total plaque area (TPA) of the carotid artery bulbs were measured. RESULTS: Carotid plaque assessment using the handheld device was comparable to that of the conventional ultrasound system. We found a good correlation and no relevant bias between handheld and conventional ultrasound systems in measuring MPH (r = 0.84, p < 0.0001) and TPA (r = 0.94, p < 0.0001). Furthermore, there was good inter-rater reliability for online and offline measurements of MPH and offline measurements of TPA by handheld ultrasound (0.79, 0.76 and 0.85, respectively). CONCLUSIONS: This study demonstrates that a focused ultrasound of the carotid artery using a handheld device can be used to accurately measure MPH and TPA. This protocol has the potential to provide an expedited point-of-care assessment of carotid plaque.


Assuntos
Estenose das Carótidas/diagnóstico por imagem , Computadores de Mão/normas , Sistemas Automatizados de Assistência Junto ao Leito/normas , Ultrassonografia de Intervenção/instrumentação , Ultrassonografia de Intervenção/normas , Idoso , Estenose das Carótidas/terapia , Angiografia Coronária/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Ultrassonografia de Intervenção/métodos
6.
Int J Med Inform ; 119: 94-102, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30342692

RESUMO

BACKGROUND: Enabling personal mobile device use through a bring-your-own device (BYOD) policy can potentially save significant costs for medical schools and healthcare facilities, as they would not always have to acquire facility-owned devices. The BYOD policy is also perceived as a driver for balancing user needs for convenience with institutional needs for security. However, there seems to be a paucity in the literature on BYOD policy development, policy evaluation, and evaluation of mobile device implementation projects. OBJECTIVE: This review explored the literature to identify BYOD policy components (issues, interventions, and guidelines) that could potentially inform BYOD policy development and implementation in medical schools and healthcare facilities. METHODS: A literature search on PubMed, Web of Science, and Ebscohost (Academic Search Premier, ERIC, CINAHL, and MEDLINE) was conducted using the following search terms and their synonyms: healthcare facilities, mobile devices, BYOD, privacy and confidentiality, and health records. We developed a review matrix to capture the main aspects of each article and coded the matrix for emerging themes. The database and hand search yielded 1 594 articles, 14 of which were deemed as meeting the inclusion criteria. RESULTS: Several themes emerging from the analysis include: device management, data security, medical applications, information technology, education and/or curriculum, policy, and guidelines. The guidelines theme seems to provide a direction for BYOD policy development and implementation while the policy theme seems to be the comprehensive solution that synergizes BYOD implementation. CONCLUSION: Rather than an approach of 'chasing' issues with interventions, a more feasible approach towards achieving a safe mobile device use environment is through the development of comprehensive BYOD policies that would balance users' need for convenience with organizational security and patient privacy. The paucity in peer-reviewed literature calls for robust research that uses socio-technical approaches to development and evaluation of BYOD policies in medical schools and healthcare facilities.


Assuntos
Segurança Computacional/normas , Computadores de Mão/normas , Confidencialidade , Instalações de Saúde/normas , Publicações Periódicas como Assunto , Faculdades de Medicina , Humanos
7.
Perspect Med Educ ; 7(2): 110-119, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29488098

RESUMO

INTRODUCTION: Tablet-based assessments offer benefits over scannable-paper assessments; however, there is little known about the impact to the variability of assessment scores. METHODS: Two studies were conducted to evaluate changes in rating technology. Rating modality (paper vs tablets) was manipulated between candidates (Study 1) and within candidates (Study 2). Average scores were analyzed using repeated measures ANOVA, Cronbach's alpha and generalizability theory. Post-hoc analyses included a Rasch analysis and McDonald's omega. RESULTS: Study 1 revealed a main effect of modality (F (1,152) = 25.06, p < 0.01). Average tablet-based scores were higher, (3.39/5, 95% CI = 3.28 to 3.51), compared with average scan-sheet scores (3.00/5, 95% CI = 2.90 to 3.11). Study 2 also revealed a main effect of modality (F (1, 88) = 15.64, p < 0.01), however, the difference was reduced to 2% with higher scan-sheet scores (3.36, 95% CI = 3.30 to 3.42) compared with tablet scores (3.27, 95% CI = 3.21 to 3.33). Internal consistency (alpha and omega) remained high (>0.8) and inter-station reliability remained constant (0.3). Rasch analyses showed no relationship between station difficulty and rating modality. DISCUSSION: Analyses of average scores may be misleading without an understanding of internal consistency and overall reliability of scores. Although updating to tablet-based forms did not result in systematic variations in scores, routine analyses ensured accurate interpretation of the variability of assessment scores. CONCLUSION: This study demonstrates the importance of ongoing program evaluation and data analysis.


Assuntos
Computadores de Mão/normas , Habilidades para Realização de Testes/normas , Análise de Variância , Avaliação Educacional/métodos , Desenho de Equipamento/normas , Humanos , Psicometria/instrumentação , Psicometria/métodos , Pesquisa Qualitativa , Reprodutibilidade dos Testes , Habilidades para Realização de Testes/métodos
8.
Europace ; 20(2): 225-233, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29040548

RESUMO

We are in the midst of a digital revolution in health care, although the application of new and useful technology in routine clinical practice is variable. The Characterizing Atrial fibrillation by Translating its Causes into Health Modifiers in the Elderly (CATCH ME) Consortium, in collaboration with the European Society of Cardiology (ESC), has funded the creation of two applications (apps) in atrial fibrillation (AF) for use in smartphones and tablets. The patient app aims to enhance patient education, improve communication between patients and health care professionals, and encourage active patient involvement in the management of their condition. The health care professional app is designed as an interactive management tool incorporating the new ESC Practice Guidelines on AF and supported by the European Heart Rhythm Association (EHRA), with the aim of improving best practice approaches for the care of patients with AF. Both stand-alone apps are now freely available for Android and iOS devices though the Google Play, Amazon, and Apple stores. In this article, we outline the rationale for the design and implementation of these apps. Our objective is to demonstrate the value of integrating novel digital technology into clinical practice, with the potential for patient engagement, optimization of pharmacological and interventional therapy in AF, and ultimately to improve patient outcomes.


Assuntos
Fibrilação Atrial/terapia , Comunicação , Computadores de Mão , Prestação Integrada de Cuidados de Saúde , Aplicativos Móveis , Relações Médico-Paciente , Smartphone , Telemedicina/instrumentação , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/fisiopatologia , Atitude do Pessoal de Saúde , Atitude Frente aos Computadores , Computadores de Mão/normas , Prestação Integrada de Cuidados de Saúde/normas , Europa (Continente) , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Aplicativos Móveis/normas , Educação de Pacientes como Assunto , Guias de Prática Clínica como Assunto , Smartphone/normas , Sociedades Médicas , Telemedicina/normas
9.
Abdom Radiol (NY) ; 43(5): 1254-1261, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-28828512

RESUMO

PURPOSE: To ascertain the accuracy and reliability of tablet as an imaging console for detection of radiological signs of acute appendicitis [on focused appendiceal computed tomography (FACT)] using Picture Archiving and Communication System (PACS) workstation as reference standard. METHODS: From January, 2014 to June, 2015, 225 patients underwent FACT at our institution. These scans were blindly re-interpreted by an independent consultant radiologist, first on PACS workstation and, two weeks later, on tablet. Scans were interpreted for the presence of radiological signs of acute appendicitis. Accuracy of tablet was calculated using PACS as reference standard. Kappa (κ) statistics were calculated as a measure of reliability. RESULTS: Of 225 patients, 99 had radiological evidence of acute appendicitis on PACS workstation. Tablet was 100% accurate in detecting radiological signs of acute appendicitis. Appendicoliths, free fluid, lymphadenopathy, phlegmon/abscess, and perforation were identified on PACS in 90, 43, 39, 10, and 12 scans, respectively. There was excellent agreement between tablet and PACS for detection of appendicolith (к = 0.924), phlegmon/abscess (к = 0.904), free fluid (к = 0.863), lymphadenopathy (к = 0.879), and perforation (к = 0.904). CONCLUSIONS: Tablet computer, as an imaging console, was highly reliable and was as accurate as PACS workstation for the radiological diagnosis of acute appendicitis.


Assuntos
Apendicite/diagnóstico por imagem , Computadores de Mão/normas , Sistemas de Informação em Radiologia , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Apêndice/diagnóstico por imagem , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Adulto Jovem
10.
Glob Health Action ; 10(1): 1380360, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29027507

RESUMO

BACKGROUND: Trauma registries (TRs) play a vital role in the assessment of trauma care, but are often underutilized in countries with a high burden of injuries. OBJECTIVES: We investigated whether information and communications technology (ICT) such as mobile health (mHealth) could enable the design of a tablet-based application for healthcare professionals. This would be used to inform trauma care and acquire surveillance data for injury control and prevention in Oman. This paper focuses on documenting the implementation process in a healthcare setting. METHODS: The study was conducted using an ICT implementation framework consisting of multistep assessment, development and pilot testing of an electronic tablet-based TR. The pilot study was conducted at two large hospitals in Oman, followed by detailed evaluation of the process, system and impact of implementation. RESULTS: The registry was designed to provide comprehensive information on each trauma case from the location of injury until hospital discharge, with variables organized to cover 11 domains of demographic and clinical information. The pilot study demonstrated that the registry was user friendly and reliable, and the implementation framework was useful in planning for the Omani hospital setting. Data collection by trained and dedicated nurses proved to be more feasible, efficient and reliable than real-time data entry by care providers. CONCLUSIONS: The initial results show the promising potential of a user-friendly, comprehensive electronic TR through the use of mHealth tools. The pilot test in two hospitals indicates that the registry can be used to create a multicenter trauma database.


Assuntos
Computadores de Mão/normas , Coleta de Dados/normas , Bases de Dados Factuais/normas , Assistência à Saúde/organização & administração , Sistema de Registros/normas , Telemedicina/organização & administração , Ferimentos e Lesões/patologia , Humanos , Oriente Médio , Projetos Piloto
11.
Work ; 58(1): 45-50, 2017 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-28922175

RESUMO

BACKGROUND: Project Career is an interprofessional five-year development project designed to improve academic and employment success of undergraduate students with a traumatic brain injury (TBI) at two- and four-year colleges and universities. Students receive technology in the form of iPad applications ("apps") to support them in and out of the classroom. OBJECTIVE: To assess participants' perspectives on technology at baseline and perceived benefit of apps after 6 and 12 months of use. METHODS: This article address a component of a larger study. Participants included 50 college-aged students with traumatic brain injuries. Statistical analysis included data from two Matching Person and Technology (MPT) assessment forms, including the Survey of Technology Use at baseline and the Assistive Technology Use Follow-Up Survey: Apps Currently Using, administered at 6- and 12-months re-evaluation. Analyses included frequencies and descriptives. RESULTS: Average scores at baseline indicated positive perspectives on technology. At 6 months, quality of life (67%) and academics (76%) improved moderately or more from the use of iPad apps. At 12 months, quality of life (65%) and academics (82%) improved moderately or more from the use of iPad apps. CONCLUSION: Students with a TBI have positive perspectives on technology use. The results on perceived benefit of apps indicated that students with a TBI (including civilians and veterans) report that the apps help them perform in daily life and academic settings.


Assuntos
Computadores de Mão/normas , Aplicativos Móveis/normas , Percepção , Estudantes/psicologia , Interface Usuário-Computador , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/psicologia , Humanos , Psicometria/instrumentação , Psicometria/métodos , Qualidade de Vida/psicologia , Equipamentos de Autoajuda/normas , Inquéritos e Questionários
13.
Clin Neurophysiol ; 128(10): 1823-1834, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28822302

RESUMO

OBJECTIVE: Spiral drawing is one of the standard tests used to assess tremor severity for the clinical evaluation of medical treatments. Tremor severity is estimated through visual rating of the drawings by movement disorders experts. Different approaches based on the mathematical signal analysis of the recorded spiral drawings were proposed to replace this rater dependent estimate. The objective of the present study is to propose new numerical methods and to evaluate them in terms of agreement with visual rating and reproducibility. METHODS: Series of spiral drawings of patients with essential tremor were visually rated by a board of experts. In addition to the usual velocity analysis, three new numerical methods were tested and compared, namely static and dynamic unraveling, and empirical mode decomposition. The reproducibility of both visual and numerical ratings was estimated, and their agreement was evaluated. RESULTS: The statistical analysis demonstrated excellent agreement between visual and numerical ratings, and more reproducible results with numerical methods than with visual ratings. CONCLUSIONS: The velocity method and the new numerical methods are in good agreement. Among the latter, static and dynamic unravelling both display a smaller dispersion and are easier for automatic analysis. SIGNIFICANCE: The reliable scores obtained through the proposed numerical methods allow considering that their implementation on a digitized tablet, be it connected with a computer or independent, provides an efficient automatic tool for tremor severity assessment.


Assuntos
Computadores de Mão , Diagnóstico por Computador/métodos , Tremor Essencial/diagnóstico , Tremor Essencial/fisiopatologia , Destreza Motora/fisiologia , Adulto , Idoso , Computadores de Mão/normas , Diagnóstico por Computador/normas , Feminino , Escrita Manual , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
14.
Games Health J ; 6(4): 229-236, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28691854

RESUMO

OBJECTIVE: Gamification has been incorporated into vision tests and vision therapies in the expectation that it may increase the user experience and engagement with the task. The current study aimed to understand how gamification affects the user experience, specifically during the undertaking of psychophysical tasks designed to estimate vision thresholds (chromatic and achromatic contrast sensitivity). METHODS: Three tablet computer-based games were developed with three levels of gaming elements. Game 1 was designed to be a simple clinical test (no gaming elements), game 2 was similar to game 1 but with added gaming elements (i.e., feedback, scores, and sounds), and game 3 was a complete game. Participants (N = 144, age: 9.9-42 years) played three games in random order. The user experience for each game was assessed using a Short Feedback Questionnaire. RESULTS: The median (interquartile range) fun level for the three games was 2.5 (1.6), 3.9 (1.7), and 2.5 (2.8), respectively. Overall, participants reported greater fun level and higher preparedness to play the game again for game 2 than games 1 and 3 (P < 0.05). There were significant positive correlations observed between fun level and preparedness to play the game again for all the games (p < 0.05). Engagement (assessed as completion rates) did not differ between the games. CONCLUSION: Gamified version (game 2) was preferred to the other two versions. Over the short term, the careful application of gaming elements to vision tests was found to increase the fun level of users, without affecting engagement with the vision test.


Assuntos
Jogos de Vídeo/normas , Testes Visuais/métodos , Testes Visuais/normas , Adolescente , Adulto , Criança , Computadores de Mão/normas , Feminino , Humanos , Masculino , Inquéritos e Questionários , Interface Usuário-Computador
15.
Adv Physiol Educ ; 41(3): 415-424, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28679580

RESUMO

The purpose of this laboratory exercise is to model the changes in preload, afterload, and contractility on a simulated pressure-volume loop and to correlate those findings with common measurements of clinical cardiovascular physiology. Once students have modeled these changes on a healthy heart, the students are asked to look at a simulated case of cardiogenic shock. Effects on preload, contractility, and afterload are explored, as well as the hemodynamic effects of a number of student-suggested treatment strategies.


Assuntos
Sistema Cardiovascular , Computadores de Mão/normas , Fisiologia/educação , Ensino/normas , Coração/fisiologia , Hemodinâmica/fisiologia , Humanos , Contração Miocárdica
16.
BMC Musculoskelet Disord ; 18(1): 198, 2017 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-28521738

RESUMO

BACKGROUND: The Multidimensional Daily Diary of Fatigue-Fibromyalgia-17 instrument (MDF-Fibro-17) has been developed for use in fibromyalgia (FM) clinical studies and includes 5 domains: Global Fatigue Experience, Cognitive Fatigue, Physical Fatigue, Motivation, and Impact on Function. Psychometric properties of the MDF-Fibro-17 needed to demonstrate the appropriateness of using this instrument in clinical studies are presented. METHODS: Psychometric analyses were conducted to evaluate the factor structure, reliability, validity, and responsiveness of the MDF-Fibro-17 using data from a Phase 2 clinical study of FM patients (N = 381). Confirmatory factor analyses (CFA) were performed to ensure understanding of the multidimensional domain structure, and a secondary factor analysis of the domains examined the appropriateness of calculating a total score in addition to domain scores. Longitudinal psychometric analyses (test-retest reliability and responder analysis) were also conducted on the data from Baseline to Week 6. RESULTS: The CFA supported the 17-item, 5 domain structure of this instrument as the best fit of the data: comparative fit index (CFI) and non-normed fit index (NNFI) were 0.997 and 0.992 respectively, standardized root mean square residual (SRMR) was 0.010 and the root mean square error of approximation (RMSEA) was 0.06. In addition, total score (CFI and NNFI both 0.95) met required standards. For the total and 5 domain scores, reliability and validity data were acceptable: test-retest and internal consistency were above 0.9; correlations were as expected with the Global Fatigue Index (GFI) (0.62-0.75), Fibromyalgia Impact Questionnaire (FIQ) Total (0.59-0.71), and 36-Item Short Form Health Survey (SF-36) vitality (VT) (0.43-0.53); and discrimination was shown using quintile scores for the GFI, FIQ Total, and Pain Numeric Rating Scale (NRS) quartiles. In addition, sensitivity to change was demonstrated with an overall mean responder score of -2.59 using anchor-based methods. CONCLUSION: The MDF-Fibro-17 reliably measures 5 domains of FM-related fatigue and psychometric evaluation confirms that this measure meets or exceeds each of the predefined acceptable thresholds for evidence of reliability, validity, and responsiveness to changes in clinical status. This suggests that the MDF-Fibro-17 is an appropriate and responsive measure of FM-related fatigue in clinical studies.


Assuntos
Computadores de Mão/normas , Fadiga/diagnóstico , Fibromialgia/diagnóstico , Registros Médicos/normas , Autorrelato/normas , Adulto , Fadiga/epidemiologia , Feminino , Fibromialgia/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Psicometria
17.
NeuroRehabilitation ; 40(3): 411-420, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28222561

RESUMO

BACKGROUND: Portable electronic devices are increasingly being used for clinical assessment of individuals with cognitive deficits. Prior to implementation of tablet-based assessments, comparison with other standard measures is needed. OBJECTIVE: The study purpose was to compare an iPad administered cognitive assessment known as the Standardized Touchscreen Assessment of Cognition (STAC) to the Cognitive Linguistic Quick Test (CLQT) and the Cognitive Assessment of Minnesota (CAM). METHODS: Eighty-eight neurotypical participants completed the STAC, CAM, and CLQT in a randomized order. The researchers compared the participants' responses across similar subtests. Performance across iPad comfort levels was also explored. RESULTS: Findings revealed moderate correlations in some areas of assessment: generative naming and immediate visual memory. The correlations varied across age groups within each area of assessment with no consistent pattern. Additionally, people with comfort using an iPad performed significantly better on three areas of STAC assessment (generative naming category and first letter, and auditory working memory) compared to people who reported no iPad comfort. CONCLUSIONS: Initial testing of the STAC in a neurotypical population identified moderate correlations with standard measures in some subtests; however, additional testing of the STAC is needed to determine the clinical utility and validity of assessing populations with cognitive impairments.


Assuntos
Cognição/fisiologia , Computadores de Mão/estatística & dados numéricos , Computadores de Mão/normas , Testes Neuropsicológicos/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição Aleatória , Adulto Jovem
18.
Behav Res Methods ; 49(2): 548-558, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27004485

RESUMO

Recent advances in technology and the increased use of tablet computers for mobile health applications such as vision testing necessitate an understanding of the behavior of the displays of such devices, to facilitate the reproduction of existing or the development of new vision assessment tests. The purpose of this study was to investigate the physical characteristics of one model of tablet computer (iPad mini Retina display) with regard to display consistency across a set of devices (15) and their potential application as clinical vision assessment tools. Once the tablet computer was switched on, it required about 13 min to reach luminance stability, while chromaticity remained constant. The luminance output of the device remained stable until a battery level of 5%. Luminance varied from center to peripheral locations of the display and with viewing angle, whereas the chromaticity did not vary. A minimal (1%) variation in luminance was observed due to temperature, and once again chromaticity remained constant. Also, these devices showed good temporal stability of luminance and chromaticity. All 15 tablet computers showed gamma functions approximating the standard gamma (2.20) and showed similar color gamut sizes, except for the blue primary, which displayed minimal variations. The physical characteristics across the 15 devices were similar and are known, thereby facilitating the use of this model of tablet computer as visual stimulus displays.


Assuntos
Computadores de Mão/normas , Testes Visuais/instrumentação , Testes Visuais/métodos , Visão Ocular/fisiologia , Cor/normas , Humanos , Estimulação Luminosa
19.
Gig Sanit ; 95(4): 387-91, 2016.
Artigo em Russo | MEDLINE | ID: mdl-27430073

RESUMO

In the article there are presented the results ofphysiological and hygienic evaluation of studies in kindergarten with the use of educational games on an electronic PC tablet. The study involved 44 foster-children. In one of the groups children in the classroom used the interactive game software on electronic PC tablets "Samsung", the same time while working with the PC tablet did not exceed 10 minutes, in the other--the classes were held traditionally. There were investigated the state of health, psychosomatic and psycho-emotional state of children, determined their functional readiness for systematic training in school, mental performance, the functional state of the central nervous system (CNS) by simple visual-motor reaction (SVMR) and reactions to a moving object (RDO). Developing ofgame sessions with the use of electronic PC tablets for 10 minutes were established to contribute to the activation of the central nervous system and increase in children resistance to the development of fatigue.


Assuntos
Capacitação de Usuário de Computador , Computadores de Mão/normas , Criança , Capacitação de Usuário de Computador/métodos , Capacitação de Usuário de Computador/normas , Avaliação Educacional/métodos , Feminino , Humanos , Masculino , Técnicas Projetivas , Desempenho Psicomotor , Materiais de Ensino/normas
20.
AANA J ; 84(2): 114-9, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27311152

RESUMO

Certified Registered Nurse Anesthetists (CRNAs) provide high-quality patient care to ensure patient safety. Strict vigilance and prompt response is required of the CRNA to make critical decisions. Distractions during anesthesia delivery may threaten patient safety. Personal electronic devices (PEDs) have become an integral tool used by 90% of adults. Adaptation of PEDs has permitted their integration into current anesthesia practice. Although technologic advancements have improved accessibility to resources and communication, they also serve as a source of distraction. Inappropriate PED use while administering anesthesia remains grossly underreported and understudied related to its impact on patient safety. The purpose of this article is to illustrate the critical need for further research in order to analyze safety risk, appropriately guide CRNA education, and properly develop and enforce media policies within organizations. Currently, PED use by the CRNA exists in ethically blurred boundaries, with potentially major patient safety and legal consequences.


Assuntos
Comunicação , Computadores de Mão/normas , Enfermeiras Anestesistas/normas , Segurança do Paciente/normas , Guias de Prática Clínica como Assunto , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco
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