Obsessive-compulsive disorder (OCD) is a psychiatric disorder affecting 2% to 3% of world population. Patients having this disorder engage in repetitive and discomforting behaviors usually linked to controlling or cleaning. The potential of technical solutions trying to support both patients and therapists has been to a limited extent explored with some encouraging results. However, the use of a mobile phone application has not yet been explored. We present a study of a distributed application, partly running on mobile phone and partly on a website, with four patients suffering from OCD and their therapist. Our qualitative evaluation yields encouraging conclusions for practitioners and developers of such applications.
Background: Patients with chronic obstructive pulmonary disease (COPD) demonstrate reduced levels of daily physical activity (DPA) compared to healthy controls. This results in a higher risk of hospital admission and shorter survival. Performing regular DPA reduces these risks. Objective: To develop an eHealth intervention that will support patients with COPD to improve or maintain their DPA after pulmonary rehabilitation. Methods: The design process consisted of literature research and the iterative developing and piloting phases of the Medical Research Council (MRC) model for complex clinical interventions and the involvement of end users. Participants were healthy adults and persons with COPD. Results: The mobile phone interface met all the set requirements. Participants found that the app was stimulating and that reaching their DPA goals was rewarding. The mean (SD) scores on a 7-point scale for usability, ease of use, ease of learning, and contentment were 3.8 (1.8), 5.1 (1.1), 6.0 (1.6), and 4.8 (1.3), respectively. The mean (SD) correlation between the mobile phone and a validated accelerometer was 0.88 (0.12) in the final test. The idea of providing their health care professional with their DPA data caused no privacy issues in the participants. Battery life lasted for an entire day with the final version, and readability and comprehensibility of text and colors were favorable. Conclusions: By employing a user-centered design approach, a mobile phone was found to be an adequate and feasible interface for an eHealth intervention. The mobile phone and app are easy to learn and use by patients with COPD. In the final test, the accuracy of the DPA measurement was good. The final version of the eHealth intervention is presently being tested by our group for efficacy in a randomized controlled trial in COPD patients.
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Background: In the past years, a mobile health (mHealth) app called the Dutch Talking Touch Screen Questionnaire (DTTSQ) was developed in The Netherlands. The aim of development was to enable Dutch physical therapy patients to autonomously complete a health-related questionnaire regardless of their level of literacy and digital skills. Objective: The aim of this study was to evaluate the usability (defined as the effectiveness, efficiency, and satisfaction) of the prototype of the DTTSQ for Dutch physical therapy patients with diverse levels of experience in using mobile technology. Methods: The qualitative Three-Step Test-Interview method, including both think-aloud and retrospective probing techniques, was used to gain insight into the usability of the DTTSQ. A total of 24 physical therapy patients were included. The interview data were analyzed using a thematic content analysis approach aimed at analyzing the accuracy and completeness with which participants completed the questionnaire (effectiveness), the time it took the participants to complete the questionnaire (efficiency), and the extent to which the participants were satisfied with the ease of use of the questionnaire (satisfaction). The problems encountered by the participants in this study were given a severity rating that was used to provide a rough estimate of the need for additional usability efforts. Results: All participants within this study were very satisfied with the ease of use of the DTTSQ. Overall, 9 participants stated that the usability of the app exceeded their expectations. The group of 4 average-/high-experienced participants encountered only 1 problem in total, whereas the 11 little-experienced participants encountered an average of 2 problems per person and the 9 inexperienced participants an average of 3 problems per person. A total of 13 different kind of problems were found during this study. Of these problems, 4 need to be addressed before the DTTSQ will be released because they have the potential to negatively influence future usage of the tool. The other 9 problems were less likely to influence future usage of the tool substantially. Conclusions: The usability of the DTTSQ needs to be improved before it can be released. No problems were found with satisfaction or efficiency during the usability test. The effectiveness needs to be improved by (1) making it easier to navigate through screens without the possibility of accidentally skipping one, (2) enabling the possibility to insert an answer by tapping on the text underneath a photograph instead of just touching the photograph itself, and (3) making it easier to correct wrong answers. This study shows the importance of including less skilled participants in a usability study when striving for inclusive design and the importance of measuring not just satisfaction but also efficiency and effectiveness during such studies.
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The demand for mobile agents in industrial environments to perform various tasks is growing tremendously in recent years. However, changing environments, security considerations and robustness against failure are major persistent challenges autonomous agents have to face when operating alongside other mobile agents. Currently, such problems remain largely unsolved. Collaborative multi-platform Cyber- Physical-Systems (CPSs) in which different agents flexibly contribute with their relative equipment and capabilities forming a symbiotic network solving multiple objectives simultaneously are highly desirable. Our proposed SMART-AGENTS platform will enable flexibility and modularity providing multi-objective solutions, demonstrated in two industrial domains: logistics (cycle-counting in warehouses) and agriculture (pest and disease identification in greenhouses). Aerial vehicles are limited in their computational power due to weight limitations but offer large mobility to provide access to otherwise unreachable places and an “eagle eye” to inform about terrain, obstacles by taking pictures and videos. Specialized autonomous agents carrying optical sensors will enable disease classification and product recognition improving green- and warehouse productivity. Newly developed micro-electromechanical systems (MEMS) sensor arrays will create 3D flow-based images of surroundings even in dark and hazy conditions contributing to the multi-sensor system, including cameras, wireless signatures and magnetic field information shared among the symbiotic fleet. Integration of mobile systems, such as smart phones, which are not explicitly controlled, will provide valuable information about human as well as equipment movement in the environment by generating data from relative positioning sensors, such as wireless and magnetic signatures. Newly developed algorithms will enable robust autonomous navigation and control of the fleet in dynamic environments incorporating the multi-sensor data generated by the variety of mobile actors. The proposed SMART-AGENTS platform will use real-time 5G communication and edge computing providing new organizational structures to cope with scalability and integration of multiple devices/agents. It will enable a symbiosis of the complementary CPSs using a combination of equipment yielding efficiency and versatility of operation.
