Proof of concept of a smartphone app to support delivery of an intervention to facilitate mothers' mind-mindedness.
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ABSTRACT:
SUBMITTER: Larkin F
PROVIDER: S-EPMC6705768 | biostudies-literature | 2019
REPOSITORIES: biostudies-literature
Publications
Proof of concept of a smartphone app to support delivery of an intervention to facilitate mothers' mind-mindedness.
Larkin Fionnuala F Oostenbroek Janine J Lee Yujin Y Hayward Emily E Meins Elizabeth E
PloS one 20190822 8
The present study reports on the first evaluation of a parenting intervention utilizing a smartphone app, BabyMind. The intervention aimed to facilitate mothers' mind-mindedness-attunement to their infants' internal states. Mothers in the intervention group (n = 90) used the BabyMind app from their infants' births and were followed up at age 6 months (n = 66). Mothers in the control group (n = 151) were recruited when their infants were age 6 months and had never used the BabyMind app. Mind-mind ...[more]
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Project description:BackgroundNovel wearable biosensors, ubiquitous smartphone ownership, and telemedicine are converging to enable new paradigms of clinical research. A new generation of continuous glucose monitoring (CGM) devices provides access to clinical-grade measurement of interstitial glucose levels. Adoption of these sensors has become widespread for the management of type 1 diabetes and is accelerating in type 2 diabetes. In parallel, individuals are adopting health-related smartphone-based apps to monitor and manage care.ObjectiveWe conducted a proof-of-concept study to investigate the potential of collecting robust, annotated, real-time clinical study measures of glucose levels without clinic visits.MethodsSelf-administered meal-tolerance tests were conducted to assess the impact of a proprietary synbiotic medical food on glucose control in a 6-week, double-blind, placebo-controlled, 2×2 cross-over pilot study (n=6). The primary endpoint was incremental glucose measured using Abbott Freestyle Libre CGM devices associated with a smartphone app that provided a visual diet log.ResultsAll subjects completed the study and mastered CGM device usage. Over 40 days, 3000 data points on average per subject were collected across three sensors. No adverse events were recorded, and subjects reported general satisfaction with sensor management, the study product, and the smartphone app, with an average self-reported satisfaction score of 8.25/10. Despite a lack of sufficient power to achieve statistical significance, we demonstrated that we can detect meaningful changes in the postprandial glucose response in real-world settings, pointing to the merits of larger studies in the future.ConclusionsWe have shown that CGM devices can provide a comprehensive picture of glucose control without clinic visits. CGM device usage in conjunction with our custom smartphone app can lower the participation burden for subjects while reducing study costs, and allows for robust integration of multiple valuable data types with glucose levels remotely.Trial registrationClinicalTrials.gov NCT04424888; http://clinicaltrials.gov/ct2/show/NCT04424888.
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Project description:Parental mind-mindedness (MM), defined as the propensity to view one's child as an agent with thoughts, feelings, and desires, is associated with positive child outcomes (McMahon & Bernier, 2017) and can be assessed in expectant parents by using five-minute speech samples (Magaña et al., 1986). Individual differences in MM appear stable across the transition to parenthood (Foley et al., in press), offering an exciting intervention opportunity, as expectant mothers' thoughts and feelings about their unborn infants are associated with the quality of mother-infant interactions. To assess prenatal MM as a predictor of parent-infant conversation at 7 months, we followed 93 low-risk British heterosexual couples across the transition to parenthood. Mothers' and fathers' MM was measured both in the third trimester of pregnancy and at 4 months. Wearable LENA devices were used to gather detailed measures of mother-, father-, and infant-initiated conversations at 7 months. Prenatal MM in both parents was associated with more frequent infant-initiated conversations at 7 months, while prenatal maternal (not paternal) MM was also associated with more mother- and father-initiated conversations. While longitudinal research with more diverse samples is needed, these findings highlight the importance of parental mentalizing in the prenatal period for early family interactions.
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Project description:BackgroundGenetic testing allows patients and clinicians to understand the risk of hereditary diseases. By testing early, individuals can make informed medical decisions about management which may minimize the risk of developing certain diseases. Importantly, genetic test results may also be applicable to patients' biological relatives; thus, these results could also lead to minimizing their risk of disease. However, sharing genetic test results between patients and their relatives is scarce. The most frequently reported problems are that patients cannot clearly explain this information and relatives misinterpret the results. Smartphone apps in the healthcare field are a possible solution as they allow patients to accurately share sensitive information to others, while providing educational material to support understanding the information. However, these apps may not provide security to protect patients' identifiable information. We developed ShareDNA, a smartphone app that (1) allows patients to securely share their genetic test results with others, (2) provides information on how to interpret these results, and (3) minimizes the amount of patient information needed to use the service.ResultsWe recruited thirteen participants to test the usability of our app and provide feedback. We found overall that participants were comfortable with using this app and could easily learn each app function when filling out our questionnaire. Additionally, based on vocalized impressions of the usefulness of the app, participants indicated that the user-interface could be more intuitive and that we needed to add more text within the app to explain why ShareDNA is a secure service.ConclusionsShareDNA is a free smartphone app that allows patients to share their genetic test results with others, including their biological relatives. Sharing these results along with educational material will enable relatives to share accurate information and discuss their possible risk for disease with their clinical providers. As a result, appropriate testing in relatives could be improved.
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Project description:MAIN OUTCOME:Thirty patients (60%) found it satisfying or very satisfying to communicate their pain with the app. Pain experienced after surgery was scored by patients as 'no': 3 (6%), 'little': 5 (10%), 'bearable': 25 (50%), 'considerable': 13 (26%) and 'severe': 1 (2%). Forty-five patients (90%) were positive about the ease of recording. Forty-five patients (90%) could correctly record their pain with the app. Thirty-eight patients (76%) agreed that in-app notifications to record pain were useful. Two patients (4%) were too ill to use the application. Based on usability feedback, we will redesign the pain intensity wheel and the in-app pain chart to improve clarity for patients to understand the course of their pain. SECONDARY OUTCOMES:The median patient recorded pain app score 4.0 (range 0 to 10) and nurse recorded numerical rating scale (NRS) for pain NRS 4.0 (range 0 to 9) were not statistically different (p = 0.06). Forty-two percent from a total of 307 patient pain app scores were ? 5 (on a scale from 0 no pain at all to 10 worst imaginable pain). Of these, 83% were recorded as 'bearable' while only in 18% of the recordings patients asked for additional analgesia. The results suggest that self-recording the severity of postoperative pain by patients with a smartphone application could be useful for postoperative pain management. The application was perceived as user-friendly and had high satisfaction rates from both patients and stakeholders. Further research is needed to validate the 11-point numeric and faces pain scale with the current gold standards visual analogue scale (VAS) and NRS for pain.
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Project description:BackgroundPrevious studies have suggested that resident physicians are the most meaningful teachers during the clinical clerkships of third-year medical students (MS3s). Unfortunately, residents often feel unprepared for this crucial role. The pediatrics clerkship at our institution identified a paucity in the frequency of resident-led teaching with MS3s. Lack of confidence, suboptimal teaching space, and insufficient time were cited as the most significant barriers. To enhance resident-led teaching of MS3s, we created teaching scripts of general pediatrics topics accessible via a smartphone application (app).MethodsPrior to the implementation of the app, MS3s and pediatric residents were surveyed on clerkship teaching practices. From May 2017 through July 2018, pediatric residents working with MS3s were introduced to the app, with both groups queried on resident teaching habits afterward. We compared pre-intervention and post-intervention data of time spent teaching, teaching frequency, and a ranking of pediatric resident teaching performance compared to residents of other MS3 core clerkships.Results44 out of 90 residents (49%) responded to a pre-intervention survey on baseline teaching habits. 49 out of 61 residents (80%) completed our post-intervention survey. Pre-intervention, 75% (33/44) of residents reported spending less than 5 min per teaching session on average. Post-intervention, 67% (33/49) reported spending more than 5 min (p < 0.01). 25% (11/44) of residents reported teaching at least once per day pre-intervention, versus 55% (27/49, p = 0.12) post-intervention. Post-intervention data demonstrated a statistically significant correlation between app use and increased frequency of teaching (p < 0.01). The MS3 average ranking of pediatric resident teaching increased from 2.4 to 3.4 out of 6 (p < 0.05) after this intervention.ConclusionsResidency programs looking to reform resident-led teaching, particularly of residents early in their training, should consider our novel approach. In addition to addressing barriers to teaching and creating a platform for near-peer teaching, it is adaptable to any specialty or learner level. Future direction includes developing objective measures for teaching performance and content proficiency to better assess our intervention as an educational curriculum, as well as further investigation of the intervention as a controlled trial.
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Project description:The objective of this proof-of-concept study was to demonstrate the targeted delivery of erythropoietin (EPO) using magnetically guided magnetic nanoparticles (MNPs).MNPs consisting of a ferric-ferrous mixture (FeCl3·6H2O and FeCl2·4H2O) were prepared using a co-precipitation method. The drug delivery system (DDS) was manufactured via the spray-drying technique using a nanospray-dryer. The DDS comprised 7.5 mg sodium alginate, 150 mg MNPs, and 1000 IU EPO.Scanning electron microscopy revealed DDS particles no more than 500 nm in size. Tiny particles on the rough surfaces of the DDS particles were composed of MNPs and/or EPO, unlike the smooth surfaces of the only alginate particles. Transmission electron microscopy showed the tiny particles from 5 to 20 nm in diameter. Fourier-transform infrared spectroscopy revealed DDS peaks characteristic of MNPs as well as of alginate. Thermal gravimetric analysis presented that 50% of DDS weight was lost in a single step around 500°C. The mode size of the DDS particles was approximately 850 nm under in vivo conditions. Standard soft lithography was applied to DDS particles prepared with fluorescent beads using a microchannel fabricated to have one inlet and two outlets in a Y-shape. The fluorescent DDS particles reached only one outlet reservoir in the presence of a neodymium magnet. The neurotoxicity was evaluated by treating SH-SY5Y cells in 48-well plates (1 × 10 cells/well) with 2 μL of a solution containing sodium alginate (0.075 mg/mL), MNPs (1.5 mg/mL), or sodium alginate + MNPs. A cell viability assay kit was used to identify a 93% cell viability after MNP treatment and a 94% viability after sodium alginate + MNP treatment, compared with the control. As for the DDS particle neurotoxicity, a 95% cell viability was noticed after alginate-encapsulated MNPs treatment and a 93% cell viability after DDS treatment, compared with the control.The DDS-EPO construct developed here can be small under in vivo conditions enough to pass through the lung capillaries with showing the high coating efficiency. It can be guided using magnetic control without displaying significant neurotoxicity in the form of solution or particles.
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Project description:BACKGROUND:Falls have implications for older adults' health and well-being. Strength and balance interventions significantly reduce the risk of falls. However, patients do not always perform the unsupervised home exercise needed for fall reduction. OBJECTIVE:This study aims to develop motivational smartphone apps co-designed with health professionals and older adults to support patients to perform exercise proven to aid fall reduction and to explore the apps' usability and acceptability with both health professionals and patients. METHODS:There were 3 phases of app development that included analysis, design, and implementation. For analysis, we examined the literature to establish key app components and had a consultation with 12 older adults attending a strength and balance class, exercise instructors, and 3 fall services. For design, we created prototype apps and conducted 2 patient and public involvement workshops, one with 5 health professionals and the second with 8 older adults from an exercise group. The apps were revised based on the feedback. For implementation, we tested them with one fall service and their patients for 3 weeks. Participatory evaluation was used through testing, semistructured interviews, and focus groups to explore acceptability and usability. Focus groups were conducted with the service that tested the apps and two other services. Qualitative data were analyzed using the framework approach. RESULTS:On the basis of findings from the literature and consultations in the analysis phase, we selected Behavior Change Techniques, such as goal setting, action planning, and feedback on behavior, to be key parts of the app. We developed goals using familiar icons for patients to select and add while self-reporting exercise and decided to develop 2 apps, one for patients (My Activity Programme) and one for health professionals (Motivate Me). This enabled health professionals to guide patients through the goal-setting process, making it more accessible to nontechnology users. Storyboards were created during the design phase, leading to prototypes of "Motivate Me" and "My Activity Programme." Key changes from the workshops included being able to add more details about the patients' exercise program and a wider selection of goals within "Motivate Me." The overall app design was acceptable to health professionals and older adults. In total, 7 patients and 3 health professionals participated in testing in the implementation phase, with interviews conducted with 6 patients and focus groups, with 3 teams (11 health professionals). Barriers, facilitators, and further functionality were identified for both apps, with 2 cross-cutting themes around phone usability and confidence. CONCLUSIONS:The motivational apps were found to be acceptable for older adults taking part in the design stage and patients and health professionals testing the apps in a clinical setting. User-led design is important to ensure that the apps are usable and acceptable.
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Project description:PurposeTo develop a deep learning (DL) algorithm for predicting anterior chamber depth (ACD) from smartphone-acquired anterior segment photographs.MethodsFor algorithm development, we included 4,157 eyes from 2,084 Chinese primary school students (aged 11-15 years) from Mojiang Myopia Progression Study (MMPS). All participants had with ACD measurement measured with Lenstar (LS 900) and anterior segment photographs acquired from a smartphone (iPhone Xs), which was mounted on slit lamp and under diffuses lighting. The anterior segment photographs were randomly selected by person into training (80%, no. of eyes = 3,326) and testing (20%, no. of eyes = 831) dataset. We excluded participants with intraocular surgery history or pronounced corneal haze. A convolutional neural network was developed to predict ACD based on these anterior segment photographs. To determine the accuracy of our algorithm, we measured the mean absolute error (MAE) and coefficient of determination (R 2) were evaluated. Bland Altman plot was used to illustrate the agreement between DL-predicted and measured ACD values.ResultsIn the test set of 831 eyes, the mean measured ACD was 3.06 ± 0.25 mm, and the mean DL-predicted ACD was 3.10 ± 0.20 mm. The MAE was 0.16 ± 0.13 mm, and R 2 was 0.40 between the predicted and measured ACD. The overall mean difference was -0.04 ± 0.20 mm, with 95% limits of agreement ranging between -0.43 and 0.34 mm. The generated saliency maps showed that the algorithm mainly utilized central corneal region (i.e., the site where ACD is clinically measured typically) in making its prediction, providing further plausibility to the algorithm's prediction.ConclusionsWe developed a DL algorithm to estimate ACD based on smartphone-acquired anterior segment photographs. Upon further validation, our algorithm may be further refined for use as a ACD screening tool in rural localities where means of assessing ocular biometry is not readily available. This is particularly important in China where the risk of primary angle closure disease is high and often undetected.
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