Smartphones and tablets: Reshaping radiation oncologists’ lives

BackgroundSmartphones and tablets are new handheld devices always connected to an information source and capable of providing instant updates, they allow doctors to access the most updated information and provide decision support at the point of care.AimThe practice of radiation oncology has always been a discipline that relies on advanced technology. Smartphones provide substantial processing power, incorporating innovative user interfaces and applications.Materials and methodsThe most popular smartphone and tablet app stores were searched for “radiation oncology” and “oncology” related apps. A web search was also performed searching for smartphones, tablets, oncology, radiology and radiation oncology.ResultsSmartphones and tablets allow rapid access to information in the form of podcasts, apps, protocols, reference texts, recent research and more.ConclusionWith the rapidly changing advances in radiation oncology, the trend toward accessing resources via smartphones and tablets will only increase, future will show if this technology will improve clinical care.     

How smartphones are changing the face of mobile and participatory healthcare: an overview,with example from eCAALYX

The latest generation of smartphones are increasingly viewed as handheld computers rather than as phones, due to their powerful on-board computing capability, capacious memories, large screens and open operating systems that encourage application development. This paper provides a brief state-of-the-art overview of health and healthcare smartphone apps (applications) on the market today, including emerging trends and market uptake. Platforms available today include Android, Apple iOS, RIM BlackBerry, Symbian, and Windows (Windows Mobile 6.x and the emerging Windows Phone 7 platform). The paper covers apps targeting both laypersons/patients and healthcare professionals in various scenarios, e.g., health, fitness and lifestyle education and management apps; ambient assisted living apps; continuing professional education tools; and apps for public health surveillance. Among the surveyed apps are those assisting in chronic disease management, whether as standalone apps or part of a BAN (Body Area Network) and remote server configuration. We describe in detail the development of a smartphone app within eCAALYX (Enhanced Complete Ambient Assisted Living Experiment, 2009-2012), an EU-funded project for older people with multiple chronic conditions. The eCAALYX Android smartphone app receives input from a BAN (a patient-wearable smart garment with wireless health sensors) and the GPS (Global Positioning System) location sensor in the smartphone, and communicates over the Internet with a remote server accessible by healthcare professionals who are in charge of the remote monitoring and management of the older patient with multiple chronic conditions. Finally, we briefly discuss barriers to adoption of health and healthcare smartphone apps (e.g., cost, network bandwidth and battery power efficiency, usability, privacy issues, etc.), as well as some workarounds to mitigate those barriers.     

Smartphones in ecology and evolution: a guide for the app‐rehensive

Smartphones and their apps (application software) are now used by millions of people worldwide and represent a powerful combination of sensors, information transfer, and computing power that deserves better exploitation by ecological and evolutionary researchers. We outline the development process for research apps, provide contrasting case studies for two new research apps, and scan the research horizon to suggest how apps can contribute to the rapid collection, interpretation, and dissemination of data in ecology and evolutionary biology. We emphasize that the usefulness of an app relies heavily on the development process, recommend that app developers are engaged with the process at the earliest possible stage, and commend efforts to create open‐source software scaffolds on which customized apps can be built by nonexperts. We conclude that smartphones and their apps could replace many traditional handheld sensors, calculators, and data storage devices in ecological and evolutionary research. We identify their potential use in the high‐throughput collection, analysis, and storage of complex ecological information.     

Physiological responses during interval training with different intensities and duration of exercise

The purpose of this study was to compare 4 interval training (IT) sessions with different intensities and durations of exercise to determine the effect on mean VO?, total VO?, and duration of exertion ≥95% maximum power output (MPO), and the effects on biomarkers of fatigue such as blood-lactate concentration (BLC) and rating of perceived exertion. The subjects were 12 recreationally competitive male (n = 7, mean ± SD age = 26.2 ± 3.9 years) and female (n = 5, mean ± SD age = 27.6 ± 4.3 years) triathletes. These subjects performed 4 IT sessions on a cycle ergometer varying in intensity (90 and 100% MPO) and duration of exercise (30 seconds and 3 minutes). This study revealed that IT using 30-second duration intervals (30-30 seconds) allows the athlete to perform a longer session, with a higher total and mean VO? HR and lower BLC than 3-minute durations. Similarly, submaximal exertion at 90% of MPO also allows performing longer sessions with a higher total VO? than 100% intensity. Thus, the results of the present study suggested that to increase the total time at high intensity of exercise and total VO? of a single exercise session performed by the athlete, IT protocols of short durations (i.e., 30 seconds) and submaximal intensities (i.e., 90% MPO) should be selected. Furthermore, performing short-duration intervals may allow the athlete to complete a longer IT session with greater metabolic demands (VO?) and lower BLC than longer (i.e., 3 minutes) intervals.     

Social Networking Smartphone Applications and Sexual Health Outcomes among Men Who Have Sex with Men

Several smartphone applications (apps) designed to help men who have sex with men (MSM) find casual sexual partners have appeared on the market recently. Apps of this nature have the potential to impact sexual health and behavior by providing constant access to a large supply of available partners. In this study, the sexual health history, behavior, and personality of MSM who use these apps was compared to MSM who meet partners in other ways. A sample of 110 adult MSM was recruited online to complete a cross-sectional survey. All participants were either single or involved in a non-exclusive romantic relationship. There were no statistically significant differences between app users and non-users in frequency of insertive or receptive anal sex without a condom. However, app users reported significantly more sexual partners and had a higher prevalence of ever being diagnosed with an STI than did non-users. App users did not differ from non-users on any demographic or personality variables (including erotophilia, sensation seeking, and self-control); however, when adjusting lifetime total sex partners for those met specifically through apps, app users still had significantly more partners. This pattern of results suggests that app users may be more sexually active in general. More work is needed to fully understand the association between this emerging technology and potential sexual health risks.     

Comparative life cycle assessment of smartphone reuse: repurposing vs. refurbishment

Purpose

Waste management for end-of-life (EoL) smartphones is a growing problem due to their high turnover rate and concentration of toxic chemicals. The versatility of modern smartphones presents an interesting alternative waste management strategy: repurposing. This paper investigates the environmental impact of smartphone repurposing as compared to traditional refurbishing using Life Cycle Assessment (LCA).

Methods

A case study of repurposing was conducted by creating a smartphone “app” that replicates the functionality of an in-car parking meter. The environmental impacts of this prototype were quantified using waste management LCA methodology. Studied systems included three waste management options: traditional refurbishment, repurposing using battery power, and repurposing using a portable solar charger. The functional unit was defined as the EoL management of a used smartphone. Consequential system expansion was employed to account for secondary functions provided; avoided impacts from displaced primary products were included. Impacts were calculated in five impact categories. Break-even displacement rates were calculated and sensitivity to standby power consumption were assessed.

Results and discussion

LCA results showed that refurbishing creates the highest environmental impacts of the three reuse routes in every impact category except ODP. High break-even displacement rates suggest that this finding is robust within a reasonable range of primary cell phone displacement. The repurposed smartphone in-car parking meter had lower impacts than the primary production parking meter. Impacts for battery-powered devices were dominated by use-phase charging electricity, whereas solar-power impacts were concentrated in manufacturing. Repurposed phones using battery power had lower impacts than those using solar power, however, standby power sensitivity analysis revealed that solar power is preferred if the battery charger is left plugged-in more than 20 % of the use period.

Conclusions

Our analysis concludes that repurposing represents an environmentally preferable EoL option to refurbishing for used smartphones. The results suggest two generalizable findings. First, primary product displacement is a major factor affecting whether any EoL strategy is environmentally beneficial. The benefit depends not only on what is displaced, but also on how much displacement occurs; in general, repurposing allows freedom to target reuse opportunities with high “displacement potential.” Second, the notion that solar power is preferable to batteries is not always correct; here, the rank-order is sensitive to assumptions about user behavior.     

The efficacy of smartphone‐based mental health interventions for depressive symptoms: a meta‐analysis of randomized controlled trials

The rapid advances and adoption of smartphone technology presents a novel opportunity for delivering mental health interventions on a population scale. Despite multi‐sector investment along with wide‐scale advertising and availability to the general population, the evidence supporting the use of smartphone apps in the treatment of depression has not been empirically evaluated. Thus, we conducted the first meta‐analysis of smartphone apps for depressive symptoms. An electronic database search in May 2017 identified 18 eligible randomized controlled trials of 22 smartphone apps, with outcome data from 3,414 participants. Depressive symptoms were reduced significantly more from smartphone apps than control conditions (g=0.38, 95% CI: 0.24‐0.52, p<0.001), with no evidence of publication bias. Smartphone interventions had a moderate positive effect in comparison to inactive controls (g=0.56, 95% CI: 0.38‐0.74), but only a small effect in comparison to active control conditions (g=0.22, 95% CI: 0.10‐0.33). Effects from smartphone‐only interventions were greater than from interventions which incorporated other human/computerized aspects along the smartphone component, although the difference was not statistically significant. The studies of cognitive training apps had a significantly smaller effect size on depression outcomes (p=0.004) than those of apps focusing on mental health. The use of mood monitoring softwares, or interventions based on cognitive behavioral therapy, or apps incorporating aspects of mindfulness training, did not affect significantly study effect sizes. Overall, these results indicate that smartphone devices are a promising self‐management tool for depression. Future research should aim to distil which aspects of these technologies produce beneficial effects, and for which populations.     

The efficacy of app‐supported smartphone interventions for mental health problems: a meta‐analysis of randomized controlled trials

Although impressive progress has been made toward developing empirically‐supported psychological treatments, the reality remains that a significant proportion of people with mental health problems do not receive these treatments. Finding ways to reduce this treatment gap is crucial. Since app‐supported smartphone interventions are touted as a possible solution, access to up‐to‐date guidance around the evidence base and clinical utility of these interventions is needed. We conducted a meta‐analysis of 66 randomized controlled trials of app‐supported smartphone interventions for mental health problems. Smartphone interventions significantly outperformed control conditions in improving depressive (g=0.28, n=54) and generalized anxiety (g=0.30, n=39) symptoms, stress levels (g=0.35, n=27), quality of life (g=0.35, n=43), general psychiatric distress (g=0.40, n=12), social anxiety symptoms (g=0.58, n=6), and positive affect (g=0.44, n=6), with most effects being robust even after adjusting for various possible biasing factors (type of control condition, risk of bias rating). Smartphone interventions conferred no significant benefit over control conditions on panic symptoms (g=–0.05, n=3), post‐traumatic stress symptoms (g=0.18, n=4), and negative affect (g=–0.08, n=5). Studies that delivered a cognitive behavior therapy (CBT)‐based app and offered professional guidance and reminders to engage produced larger effects on multiple outcomes. Smartphone interventions did not differ significantly from active interventions (face‐to‐face, computerized treatment), although the number of studies was low (n≤13). The efficacy of app‐supported smartphone interventions for common mental health problems was thus confirmed. Although mental health apps are not intended to replace professional clinical services, the present findings highlight the potential of apps to serve as a cost‐effective, easily accessible, and low intensity intervention for those who cannot receive standard psychological treatment.     

Effectiveness of mobile apps in teaching field-based identification skills

It has been suggested that few students graduate with the skills required for many ecological careers, as field-based learning is said to be in decline in academic institutions. Here, we asked if mobile technology could improve field-based learning, using ability to identify birds as the study metric. We divided a class of ninety-one undergraduate students into two groups for field-based sessions where they were taught bird identification skills. The first group has access to a traditional identification book and the second group were provided with an identification app. We found no difference between the groups in the ability of students to identify birds after three field sessions. Furthermore, we found that students using the traditional book were significantly more likely to identify novel species. Therefore, we find no evidence that mobile technology improved students’ ability to retain what they experienced in the field; indeed, there is evidence that traditional field guides were more useful to students as they attempted to identify new species. Nevertheless, students felt positively about using their own smartphone devices for learning, highlighting that while apps did not lead to an improvement in bird identification ability, they gave greater accessibility to relevant information outside allocated teaching times.     

Rapid acquisition in concurrent chains: effects of initial-link duration

Pigeons were trained in a concurrent chains procedure in which the terminal-link schedules in each session were either fixed-interval (FI) 10s FI 20s or FI 20s FI 10s, as determined by a pseudorandom binary series. The initial-link was a variable-interval (VI) 10-s schedule. Training continued until initial-link response allocation stabilized about midway through each session and was sensitive to the terminal-link immediacy ratio in that session. The initial-link schedule was then varied across sessions between VI 0.01 s and VI 30s according to an ascending and descending sequence. Initial-link response allocation was a bitonic function over the full range of durations. Preference for the FI 10-s terminal-link at first increased as programmed initial-link duration varied from 0.01 to 7.5s, and then decreased as initial-link duration increased to 30s. The bitonic function poses a potential challenge for existing models for steady-state choice, such as delay-reduction theory (DRT) [Fantino, E., 1969. Choice and rate of reinforcement. J. Exp. Anal. Behav. 12, 723-730], which predict a monotonic function. However, an extension of Grace and McLean's [Grace, R.C., McLean, A.P., 2006. Rapid acquisition in concurrent chains: evidence for a decision model. J. Exp. Anal. Behav. 85, 181-202] decision model predicted the bitonic function, and may ultimately provide an integrated account of choice in concurrent chains under both steady-state and dynamic conditions.     

Self-regulation strategies support children with ADHD to overcome symptom-related behavior in the classroom

Children with attention deficit hyperactivity disorder (ADHD) suffer from self-regulation deficits that cause inattention, impulsivity, and hyperactivity. Self-regulation interventions may address these deficits, but to date, only few empirical studies have examined their benefits for children with ADHD in everyday life. The present study investigated three classroom interventions to promote self-regulation and tested their benefit on self-regulatory competencies (assessed with an ADHD questionnaire) in children with ADHD. Students of a special education school for children with ADHD participated in the intervention study that included three sessions (Session 1: Goal Intention or Goal Intention + If–Then Plan; Session 2: Goal Intention + If–Then Plan; Session 3: Goal Intention + If–Then Plan + Self-Monitoring). Teacher-rated self-regulatory competencies were assessed both before and after the intervention sessions. Children with ADHD had better self-regulatory competencies after their first Goal Intention + If–Then Plan Session, but lasting intervention effects were found only when children started with a mere goal intention session.     

Beyond Self-Report: Tools to Compare Estimated and Real-World Smartphone Use

Psychologists typically rely on self-report data when quantifying mobile phone usage, despite little evidence of its validity. In this paper we explore the accuracy of using self-reported estimates when compared with actual smartphone use. We also include source code to process and visualise these data. We compared 23 participants’ actual smartphone use over a two-week period with self-reported estimates and the Mobile Phone Problem Use Scale. Our results indicate that estimated time spent using a smartphone may be an adequate measure of use, unless a greater resolution of data are required. Estimates concerning the number of times an individual used their phone across a typical day did not correlate with actual smartphone use. Neither estimated duration nor number of uses correlated with the Mobile Phone Problem Use Scale. We conclude that estimated smartphone use should be interpreted with caution in psychological research.     

Crowdsourcing Language Change with Smartphone Applications

Crowdsourcing linguistic phenomena with smartphone applications is relatively new. In linguistics, apps have predominantly been developed to create pronunciation dictionaries, to train acoustic models, and to archive endangered languages. This paper presents the first account of how apps can be used to collect data suitable for documenting language change: we created an app, Dialäkt Äpp (DÄ), which predicts users’ dialects. For 16 linguistic variables, users select a dialectal variant from a drop-down menu. DÄ then geographically locates the user’s dialect by suggesting a list of communes where dialect variants most similar to their choices are used. Underlying this prediction are 16 maps from the historical Linguistic Atlas of German-speaking Switzerland, which documents the linguistic situation around 1950. Where users disagree with the prediction, they can indicate what they consider to be their dialect’s location. With this information, the 16 variables can be assessed for language change. Thanks to the playfulness of its functionality, DÄ has reached many users; our linguistic analyses are based on data from nearly 60,000 speakers. Results reveal a relative stability for phonetic variables, while lexical and morphological variables seem more prone to change. Crowdsourcing large amounts of dialect data with smartphone apps has the potential to complement existing data collection techniques and to provide evidence that traditional methods cannot, with normal resources, hope to gather. Nonetheless, it is important to emphasize a range of methodological caveats, including sparse knowledge of users’ linguistic backgrounds (users only indicate age, sex) and users’ self-declaration of their dialect. These are discussed and evaluated in detail here. Findings remain intriguing nevertheless: as a means of quality control, we report that traditional dialectological methods have revealed trends similar to those found by the app. This underlines the validity of the crowdsourcing method. We are presently extending DÄ architecture to other languages.     

Effects of unpredictable changes in initial-link duration on choice and timing

Four pigeons responded in a concurrent-chains procedure in which terminal-link schedules were fixed-interval (FI) 10 s and FI 20 s. Across sessions, the location of the shorter terminal-link changed according to a pseudorandom binary sequence. Each session, the variable-interval initial-link schedule value was sampled from a uniform distribution that ranged from 0.01 to 30 s. On some terminal links, food was withheld to obtain measures of temporal control. Terminal-link delays determined choice (log initial-link response ratios) and timing (start and stop times on no-food trials) measures, which stabilized within the 1st half of each session. Preference for the shorter terminal-link delay was a monotonically decreasing function of initial-link duration. There was no evidence of control by initial-link durations from previous sessions.     

Excess postexercise oxygen consumption following acute aerobic and resistance exercise in women who are lean or obese

Seventeen women were divided into lean (19.5 +/- 0.5 years; 22.2 +/- 0.6 kg.m(-2)) and obese (20.4 +/- 0.5 years; 34.9 +/- 2.1 kg.m(-2)) groups. On completion of a submax cycle ergometer test and 10-repetition maximum (10RM) of 5 exercises on a Smith machine, subjects returned for 2 exercise sessions during menses. Session 1 consisted of performing 3 sets of 10 repetitions at 70% of the predetermined 10RM for the following exercises: squat, calf raises, bench press, upright row, and shoulder press. Session 2 consisted of cycling at 60-65% VO2max for a duration that would expend the same number of calories as the resistance session. Postexercise respiratory exchange ratio and EPOC magnitude/duration were similar for both groups. These findings indicate that women who are lean or obese will respond similarly to exercise at similar relative intensities and that aerobic and resistance exercise of equal caloric expenditure will elicit similar EPOC responses.     

Crowdsourcing for Cognitive Science – The Utility of Smartphones

By 2015, there will be an estimated two billion smartphone users worldwide. This technology presents exciting opportunities for cognitive science as a medium for rapid, large-scale experimentation and data collection. At present, cost and logistics limit most study populations to small samples, restricting the experimental questions that can be addressed. In this study we investigated whether the mass collection of experimental data using smartphone technology is valid, given the variability of data collection outside of a laboratory setting. We presented four classic experimental paradigms as short games, available as a free app and over the first month 20,800 users submitted data. We found that the large sample size vastly outweighed the noise inherent in collecting data outside a controlled laboratory setting, and show that for all four games canonical results were reproduced. For the first time, we provide experimental validation for the use of smartphones for data collection in cognitive science, which can lead to the collection of richer data sets and a significant cost reduction as well as provide an opportunity for efficient phenotypic screening of large populations.     

The Impacts of Using Smartphone Dating Applications on Sexual Risk Behaviours in College Students in Hong Kong

Dating applications (apps) on smartphones have become increasingly popular. The aim of this study was to explore the association between the use of dating apps and risky sexual behaviours. Data were collected in four university campuses in Hong Kong. Subjects completed a structured questionnaire asking about the use of dating apps, sexual behaviours, and sociodemographics. Multiple linear and logistics regressions were used to explore factors associated with sexual risk behaviours. Six hundred sixty-six subjects were included in the data analysis. Factors associated with having unprotected sexual intercourse with more lifetime sexual partners included use of dating apps (β = 0.93, p<0.01), having one’s first sexual intercourse before 16 years of age (β = 1.74, p<0.01), being older (β = 0.4, p<0.01), currently being in a relationship (= 0.69, p<0.05), having a monthly income at least HKD$5,000 (β = 1.34, p<0.01), being a current smoker (β = 1.52, p<0.01), and being a current drinker (β = 0.7, p<0.01). The results of a multiple logistic regression analysis found that users of dating apps (adjust odds ratio: 0.52, p<0.05) and current drinkers (adjust odds ratio: 0.40, p<0.01) were less likely to have consistent condom use. Users of dating apps (adjust odds ratio: 1.93, p<0.05), bisexual/homosexual subjects (adjust odds ratio: 2.57, p<0.01) and female subjects (adjust odds ratio: 2.00, p<0.05) were more likely not to have used condoms the last time they had sexual intercourse. The present study found a robust association between using dating apps and sexual risk behaviours, suggesting that app users had greater sexual risks. Interventions that can target app users so that they can stay safe when seeking sexual partners through dating apps should be developed.     

A Smartphone App and Cloud-Based Consultation System for Burn Injury Emergency Care

Background

Each year more than 10 million people worldwide are burned severely enough to require medical attention, with clinical outcomes noticeably worse in resource poor settings. Expert clinical advice on acute injuries can play a determinant role and there is a need for novel approaches that allow for timely access to advice. We developed an interactive mobile phone application that enables transfer of both patient data and pictures of a wound from the point-of-care to a remote burns expert who, in turn, provides advice back.

Methods and Results

The application is an integrated clinical decision support system that includes a mobile phone application and server software running in a cloud environment. The client application is installed on a smartphone and structured patient data and photographs can be captured in a protocol driven manner. The user can indicate the specific injured body surface(s) through a touchscreen interface and an integrated calculator estimates the total body surface area that the burn injury affects. Predefined standardised care advice including total fluid requirement is provided immediately by the software and the case data are relayed to a cloud server. A text message is automatically sent to a burn expert on call who then can access the cloud server with the smartphone app or a web browser, review the case and pictures, and respond with both structured and personalized advice to the health care professional at the point-of-care.

Conclusions

In this article, we present the design of the smartphone and the server application alongside the type of structured patient data collected together with the pictures taken at point-of-care. We report on how the application will be introduced at point-of-care and how its clinical impact will be evaluated prior to roll out. Challenges, strengths and limitations of the system are identified that may help materialising or hinder the expected outcome to provide a solution for remote consultation on burns that can be integrated into routine acute clinical care and thereby promote equity in injury emergency care, a growing public health burden.