Mobile Emergency, an Emergency Support System for Hospitals in Mobile Devices: Pilot Study

BACKGROUND: Hospitals are vulnerable to natural disasters, man-made disasters, and mass causalities events. Within a short time, hospitals must provide care to large numbers of casualties in any damaged infrastructure, despite great personnel risk, inadequate communications, and limited resources. Communications are one of the most common challenges and drawbacks during in-hospital emergencies. Emergency difficulties in communicating with personnel and other agencies are mentioned in literature. At the moment of emergency inception and in the earliest emergency phases, the data regarding the true nature of the incidents are often inaccurate. The real needs and conditions are not yet clear, hospital personnel are neither efficiently coordinated nor informed on the real available resources. Information and communication technology solutions in health care turned out to have a great positive impact both on daily working practice and situations. OBJECTIVE: The objective of this paper was to find a solution that addresses the aspects of communicating among medical personnel, formalizing the modalities and protocols and the information to guide the medical personnel during emergency conditions with a support of a Central Station (command center) to cope with emergency management and best practice network to produce and distribute intelligent content made available in the mobile devices of the medical personnel. The aim was to reduce the time needed to react and to cope with emergency organization, while facilitating communications. METHODS: The solution has been realized by formalizing the scenarios, extracting, and identifying the requirements by using formal methods based on unified modeling language (UML). The system and was developed using mobile programming under iOS Apple and PHP: Hypertext Preprocessor My Structured Query Language (PHP MySQL). Formal questionnaires and time sheets were used for testing and validation, and a control group was used in order to estimate the reduction of time needed to cope with emergency cases. First, we have tested the usability and the functionalities of the solution proposed, then a real trial was performed to assess the reduction in communication time and the efficiency of the solution with respect to a case without Mobile Emergency tools. RESULTS: The solution was based on the development of a mobile emergency application and corresponding server device to cope with emergencies and facilitate all the related activities and communications, such as marking the position, contacting people, and recovering the exits information. The solution has been successfully tested within the Careggi Hospital, the largest medical infrastructure in Florence and Tuscany area in Italy, thus demonstrating the validity of the identified modalities, procedures, and the reduction in the time needed to cope with the emergency conditions. The trial was not registered as the test was conducted in realistic but simulated emergency conditions. CONCLUSIONS: By analyzing the requirements for developing a mobile app, and specifically the functionalities, codes, and design of the Mobile Emergency app, we have revealed the real advantages of using mobile emergency solutions compared to other more traditional solutions to effectively handle emergency situations in hospital settings

A pilot study to assess the usability of a novel psychotherapeutic interactive gaming application as a tool to measure facial emotion recognition in patients with schizophrenia

This work presents the development and the assessment of Feeling Master, a novel psychotherapeutic interactive gaming application that uses cartoon stimuli to measure facial emotion recognition in schizophrenic patients. A pilot study among 24 patients with schizophrenia (PS) and 17 healthy control (HC) subjects was conducted to assess the usability of Feeling Master as a tool to measure facial emotion recognition ability in schizophrenic patients. The usability assessment of the application was based on three criteria: adaptability, effectiveness, and efficiency of the tool (Nielsen, 1994; Schwebel, McClure, & Severson, 2014). The study also attempted to determine whether people with schizophrenia would show emotion recognition deficits and if such deficits would vary among the basic emotions described by Ekman and Friesen (1971). Moreover, our team aimed to relate the results of facial emotion recognition within the schizophrenia group to clinical variables such as the Personal and Situational Attribution Questionnaire (IPSAQ). Descriptive data reveal that Feeling Master is a useful tool for measuring facial emotion recognition in patients with schizophrenia. Schizophrenia patients showed impairments in the emotions recognition. PS subjects remained slower than HC (Average time: F(1.38) = 15.1, p = 0.000). On the other hand, we did not find significant values for the overall emotion discrimination (average accuracy: F(1.38) = 0.733, p>0.05), but we found significant error rates for discrimination in fear: F=(1.38)=8.2, p < 0.007) ) using Fisher¿s exact test to compare errors between PS and HC groups. Using the Feeling Master tool, the performances of patients with schizophrenia were compared to those of healthy control volunteers on computerized tasks of emotion recognition, and the Personal and Situational Attribution Questionnaire (IPSAQ) was administered to determine whether emotion processing deficits were correlated with the attributional style. The correlations between correct response on the Feeling Master and Personal and Situational Attribution Questionnaire (IPSAQ) were not significant, but they showed interesting relations: Sad vs. External Situational Negative, Rho= 0.346, p=0.106; Sad vs. External Situational Positive, Rho=0.320, p=0.136. Finally, the Technology Acceptance Model (TAM) was used to study the acceptance among professionals of the Feeling Master as a tool to measure facial emotion recognition in rehabilitation psychiatric units. The TAM study was conducted among 66 experienced mental health professionals. Except for Perceived Ease of Use (PEOU), which has a high value, the other TAM construct values (i.e., Perceived usefulness (PU), Attitude Toward Using (ATU), Enjoyment (E), and Behavioral Intention (BI)) should be improved. In conclusion, the study puts forward the usability of a novel, psychotherapeutic interactive gaming tool used in Facial Emotion Recognition for people with schizophrenia. These findings lend support to the notion that difficulties in emotion recognition are associated with key cognitive deficits among individuals with schizophrenia. These findings were consistent with previous studies.Este trabajo presenta el desarrollo y la evaluación de Feeling Master, un novedoso videojuego psicoterapéutico que utiliza ilustraciones faciales como estímulos para medir el reconocimiento de emociones en pacientes esquizofrénicos. Se realizó un estudio piloto a 24 pacientes con diagnostico de esquizofrenia (PS) y 17 controles voluntarios (HC) para evaluar la usabilidad de Feeling Master como herramienta para la medición del reconocimiento de emociones faciales en pacientes esquizofrénicos. La evaluación de la usabilidad de Feeling Master se baso en tres criterios: la adaptabilidad, la eficacia y la eficiencia de la herramienta (Nielsen, 1994; Schwebel et al., 2014). Conjuntamente, se intentó determinar si las personas enfermas de esquizofrenia muestran déficits en el reconocimiento de las emociones faciales y si tales déficits varían entre las distintas emociones básicas descritas por Ekman y Friesen (1971). Además, se relacionaron los resultados del reconocimiento de emociones faciales del grupo de personas enfermas de esquizofrenia con variables clínicas como el cuestionario de atribuciones internas, personales y situacionales (IPSAQ). Los resultados obtenidos en este estudio revelan que Feeling Master es una herramienta efectiva para la medición del reconocimiento de emociones faciales en personas enfermas de esquizofrenia. Los pacientes con diagnostico de esquizofrenia mostraron un déficit de reconocimiento de las emociones faciales. El grupo PS necesitó mas tiempo que el grupo HC para el reconocimiento de las emociones (tiempo medio: F (1,38) = 15,1, p = 0,000). El estudio no evidenció valores significativos para la discriminación en general de emociones faciales (precisión media: F (1,38) = 0.733, p> 0,05). Por otra parte, se encontró una tasa de error significativo para la discriminación en el miedo: F = (1 , 38) = 8,2, p <0.007)) con la prueba exacta de Fisher para comparar errores entre los grupos PS y HC. Los resultados del reconocimiento de emociones faciales del grupo PS obtenidos con el Feeling Master, se relacionaron con el IPSAQ para determinar si existen correlaciones entre el déficit de reconocimiento de las emociones y el estilo atribucional. Las correlaciones entre los resultados obtenidos por el Feeling Master y el IPSAQ no fueron significativas, pero se encontraron las siguientes relaciones interesantes: tristeza vs. externa situacional negativa, Rho = 0,346, p = 0,106; tristeza vs. externa situacional positiva, Rho = 0,320, p = 0,136. Por último, se utilizo el modelo de aceptación de la tecnología (TAM) para estudiar la adopción de Feeling Master como herramienta para el reconocimiento de emociones faciales en unidades psiquiátricas de rehabilitación. El estudio TAM se realizó a 66 profesionales experimentados de la salud mental. Excepto por la facilidad de uso percibida, que ha obtenido un alto valor, el resto de los constructos del TAM (utilidad percibida , actitud hacia el uso, placer de uso y la intención hacia el uso) deben mejorar sus valores. hacia el uso) deben mejorar sus valores. Como conclusión podemos afirmar que, este trabajo demuestra la correcta usabilidad de Feeling Master como herramienta para la medición del reconocimiento de emociones faciales en personas enfermas de esquizofrenia. Conjuntamente, los resultados de nuestra investigación confirman la existencia de un déficit de reconocimiento de las emociones faciales en las personas enfermas de esquizofrenia. Estos resultados son consistentes con el resto de la literatura científica. de la salud mental. Excepto por la facilidad de uso percibida, que ha obtenido un alto valor, el resto de los constructos del TAM (utilidad percibida , actitud hacia el uso, placer de uso y la intención hacia el uso) deben mejorar sus valores.Postprint (published version