Designing User Experience in eHealth Applications for Young-Age Epilepsy

Epilepsy is one of the most common neurological diseases in the world. One of the problems for families with children with epilepsy is nocturnal seizures: it’s important to prevent them or to promptly intervene, as they can be life-threatening. FightTheStroke foundation supports these families with MirrorHR, a mHealth application for epilepsy self-management. This thesis aimed to analyze the user needs and pain points of parents with children with epilepsy, assess the usability of MirrorHR, and evaluate a new remote monitoring scenario for the Real-Time Monitoring feature of the application. To achieve these objectives, extensive background research was conducted, starting with the more general scope of eHealth, and then exploring in more detail the various aspects surrounding epilepsy and the state of the art of digital solutions for epilepsy self-management and seizure detection. Based on this, a study was conducted on 9 users of the application, which consisted of two semi-structured qualitative interviews, each followed by a post-interview anonymous questionnaire. From the study, user needs and pain points were formulated and divided into 4 categories: Diagnostic journey, Epilepsy management, Educational support, and Parental support; more generic pain points on epilepsy self-management applications were also found and are considered as a separate additional category; good usability of the application was found, but some difficulties encountered by some users were also noted; ultimately, a new remote monitoring scenario was identified, in which MirrorHR monitoring functionality can also be used with the devices of different caregivers and at greater distances than before. A prototype was designed and developed for this scenario. The results of the study, along with the prototype, were positively evaluated by the participants. User needs and pain points provide useful insights for MirrorHR and other epilepsy self-management applications, as well as some more generic pain points may be of value for other mHealth applications. The analysis that led to the development of the identified scenario may be useful for other mHealth application scenarios that also consider children

Applications across Co-located Devices

We live surrounded by many computing devices. However, their presence has yet to be fully explored to create a richer ubiquitous computing environment. There is an opportunity to take better advantage of those devices by combining them into a unified user experience. To realize this vision, we studied and explored the use of a framework, which provides the tools and abstractions needed to develop applications that distribute UI components across co-located devices. The framework comprises the following components: authentication and authorization services; a broker to sync information across multiple application instances; background services that gather the capabilities of the devices; and a library to integrate web applications with the broker, determine which components to show based on UI requirements and device capabilities, and that provides custom elements to manage the distribution of the UI components and the multiple application states. Collaboration between users is supported by sharing application states. An indoor positioning solution had to be developed in order to determine when devices are close to each other to trigger the automatic redistribution of UI components. The research questions that we set out to respond are presented along with the contributions that have been produced. Those contributions include a framework for crossdevice applications, an indoor positioning solution for pervasive indoor environments, prototypes, end-user studies and developer focused evaluation. To contextualize our research, we studied previous research work about cross-device applications, proxemic interactions and indoor positioning systems. We presented four application prototypes. The first three were used to perform studies to evaluate the user experience. The last one was used to study the developer experience provided by the framework. The results were largely positive with users showing preference towards using multiple devices under some circumstances. Developers were also able to grasp the concepts provided by the framework relatively well.Vivemos rodeados de dispositivos computacionais. No entanto, ainda não tiramos partido da sua presença para criar ambientes de computação ubíqua mais ricos. Existe uma oportunidade de combiná-los para criar uma experiência de utilizador unificada. Para realizar esta visão, estudámos e explorámos a utilização de uma framework que forneça ferramentas e abstrações que permitam o desenvolvimento de aplicações que distribuem os componentes da interface do utilizador por dispositivos co-localizados. A framework é composta por: serviços de autenticação e autorização; broker que sincroniza informação entre várias instâncias da aplicação; serviços que reúnem as capacidades dos dispositivos; e uma biblioteca para integrar aplicações web com o broker, determinar as componentes a mostrar com base nos requisitos da interface e nas capacidades dos dispositivos, e que disponibiliza elementos para gerir a distribuição dos componentes da interface e dos estados de aplicação. A colaboração entre utilizadores é suportada através da partilha dos estados de aplicação. Foi necessário desenvolver um sistema de posicionamento em interiores para determinar quando é que os dispositivos estão perto uns dos outros para despoletar a redistribuição automática dos componentes da interface. As questões de investigação inicialmente colocadas são apresentadas juntamente com as contribuições que foram produzidas. Essas contribuições incluem uma framework para aplicações multi-dispositivo, uma solução de posicionamento em interiores para computação ubíqua, protótipos, estudos com utilizadores finais e avaliação com programadores. Para contextualizar a nossa investigação, estudámos trabalhos anteriores sobre aplicações multi-dispositivo, interação proxémica e sistemas de posicionamento em interiores. Apresentámos quatro aplicações protótipo. As primeiras três foram utilizadas para avaliar a experiência de utilização. A última foi utilizada para estudar a experiência de desenvolvimento com a framework. Os resultados foram geralmente positivos, com os utilizadores a preferirem utilizar múltiplos dispositivos em certas circunstâncias. Os programadores também foram capazes de compreender a framework relativamente bem

Simplifying, reading, and machine translating health content: an empirical investigation of usability

Text simplification, through plain language (PL) or controlled language (CL), is adopted to increase readability, comprehension and machine translatability of (health) content. Cochrane is a non-profit organisation where volunteer authors summarise and simplify health-related English texts on the impact of treatments and interventions into plain language summaries (PLS), which are then disseminated online to the lay audience and translated. Cochrane’s simplification approach is non-automated, and involves the manual checking and implementation of different sets of PL guidelines, which can be an unsatisfactory, challenging and time-consuming task. This thesis examined if using the Acrolinx CL checker to automatically and consistently check PLS for readability and translatability issues would increase the usability of Cochrane’s simplification approach and, more precisely: (i) authors’ satisfaction; and (ii) authors’ effectiveness in terms of readability, comprehensibility, and machine translatability into Spanish. Data on satisfaction were collected from twelve Cochrane authors by means of the System Usability Scale and follow-up preference questions. Readability was analysed through the computational tool Coh-Metrix. Evidence on comprehensibility was gathered through ratings and recall protocols produced by lay readers, both native and non-native speakers of English. Machine translatability was assessed in terms of adequacy and fluency with forty-one Cochrane contributors, all native speakers of Spanish. Authors seemed to welcome the introduction of Acrolinx, and the adoption of this CL checker reduced word length, sentence length, and syntactic complexity. No significant impact on comprehensibility and machine translatability was identified. We observed that reading skills and characteristics other than simplified language (e.g. formatting) might influence comprehension. Machine translation quality was relatively high, with mainly style issues. This thesis presented an environment that could boost volunteer authors’ satisfaction and foster their adoption of simple language. We also discussed strategies to increase the accessibility of online health content among lay readers with different skills and language backgrounds

SoK: Web3 Recovery Mechanisms

Account recovery enables users to regain access to their accounts when they lose their authentication credentials. While account recovery is well established and extensively studied in the Web2 (traditional web) context, Web3 account recovery presents unique challenges. In Web3, accounts rely on a (cryptographically secure) private-public key pair as their credential, which is not expected to be shared with a single entity like a server owing to security concerns. This makes account recovery in the Web3 world distinct from the Web2 landscape, often proving to be challenging or even impossible. As account recovery has proven crucial for Web2 authenticated systems, various solutions have emerged to address account recovery in the Web3 blockchain ecosystem in order to make it more friendly and accessible to everyday users, without punishing users if they make honest mistakes. This study systematically examines existing account recovery solutions within the blockchain realm, delving into their workflows, underlying cryptographic mechanisms, and distinct characteristics. After highlighting the trilemma between usability, security, and availability encountered in the Web3 recovery setting, we systematize the existing recovery mechanisms across several axes which showcase those tradeoffs. Based on our findings, we provide a number of insights and future research directions in this field

Développement d'une approche d'entrainement pour l'utilisation du fauteuil roulant motorisé pour les personnes ayant une déficience cognitive

Introduction : La mobilité détermine la possibilité de s'engager dans des activités de la vie quotidienne et contribue au maintien de la santé et du bien-être. De plus en plus de personnes présentent des limitations à la mobilité. Le fauteuil roulant motorisé est une aide à la mobilité qui peut devenir nécessaire. Les personnes qui ont besoin d'utiliser un fauteuil roulant motorisé peuvent présenter un ensemble complexe de déficiences physiques, cognitives ou sensorielles. Afin de favoriser une utilisation efficace et sécuritaire du fauteuil roulant motorisé, l'Organisation mondiale de la santé recommande d'entrainer tous les utilisateurs de fauteuil roulant motorisé à l'utilisation de leur aide à la mobilité. Cependant, les approches d'entrainements existantes ne répondent pas aux besoins de mobilité et aux besoins d'apprentissage des personnes ayant une déficience cognitive. De ce fait, ces personnes sont majoritairement exclues des processus d'attribution avant même qu'elles aient eu la possibilité de recevoir un entrainement adapté. L'objectif principal de cette thèse consiste à développer une approche d'entrainement à l'utilisation du fauteuil roulant motorisé pour les personnes ayant une déficience cognitive. Cet objectif repose sur l'hypothèse qu'un entrainement à l'utilisation du fauteuil roulant motorisé adapté aux besoins des utilisateurs ayant une déficience cognitive permettrait d'améliorer l'attribution du fauteuil roulant motorisé à cette population en lui permettant de développer des habiletés et d'améliorer sa sécurité. Méthodologies : Le modèle méthodologique New Medical Research Council Framework comprend quatre phases orientant le développement d'interventions complexes en santé. Ce modèle a été utilisé pour structurer les différentes étapes de cette thèse. Les quatre études réalisées complètent les deux premières phases du modèle (développement et faisabilité). Une étude de la portée a été réalisée afin d'explorer les relations entre le fonctionnement cognitif et l'utilisation du fauteuil roulant motorisé (Chapitre 2). Une étude transversale a exploré les relations entre l'utilisation du fauteuil roulant motorisé, le fonctionnement cognitif et la confiance chez des utilisateurs expérimentés de fauteuil roulant motorisé. Les variables étaient évaluées par des outils d'évaluation clinique reconnus (Chapitre 3). Une méthode mixte a été réalisée pour co-créer une approche d'entrainement pour la mobilité. Cette étude, incluant des utilisateurs de fauteuil roulant motorisé, des ergothérapeutes et des chercheurs, a utilisé des groupes de discussion focalisée (phase 1) et la méthode Delphi (phase 2) (Chapitre 4). La faisabilité et l'applicabilité clinique de l'approche d'entrainement ont été testées auprès de personnes qui venaient de se voir attribuer un fauteuil roulant motorisé ou qui avaient été évaluées comme nécessitant un entrainement supplémentaire avant de se voir attribuer le fauteuil roulant motorisé (Chapitre 5). Résultats : Une bonne efficience cognitive et la confiance perçue sont nécessaires pour utiliser un fauteuil roulant motorisé, les déficiences cognitives influençant négativement l'utilisation du fauteuil roulant motorisé et la confiance perçue par l'utilisateur. Cependant, malgré la présence de déficiences cognitives il peut être possible d'utiliser un fauteuil roulant motorisé de façon sécuritaire et d'améliorer les capacités à l'utilisation du fauteuil roulant motorisé si elles sont entrainées (Chapitres 2 et 3). Ces constats ont bâti le socle théorique de l'approche d'entrainement. Les parties prenantes au projet (phase 1 : n=16; phase 2 : n=207) ont convenu que l'approche d'entrainement à l'utilisation du fauteuil roulant motorisé en présence de déficience cognitive devrait être centrée sur les objectifs individuels de la personne, devrait être basée sur les occupations, devrait favoriser une relation de confiance entre la personne et l'entraineur, et devrait être réalisée dans un environnement réel, sécuritaire et adapté (Chapitre 4). Il a finalement été démontré que cette approche d'entrainement à l'utilisation du fauteuil roulant motorisé est faisable et applicable en pratique clinique (Chapitre 5). Conclusion : Une nouvelle approche d'entrainement à l'utilisation du fauteuil roulant motorisé pour les personnes ayant une déficience cognitive a été développée dans ce travail de recherche. Elle comble une lacune en matière d'entrainement à l'utilisation du fauteuil roulant motorisé. Pour les ergothérapeutes, elle élargit les approches d'entrainement disponibles. Pour les utilisateurs de fauteuil roulant motorisé, elle offre la possibilité d'accéder à l'utilisation du fauteuil roulant motorisé et de développer performance et confiance lors de l'utilisation du fauteuil roulant motorisé. De futures études évaluant à plus grande échelle l'efficacité de cette nouvelle approche d'entrainement et évaluant son implantation en pratique clinique devraient être investies pour compléter les deux dernières phases du modèle méthodologique New Medical Research Council framework.Introduction: Functional and independent mobility determines the ability to engage in activities of daily living and contributes to health and well-being. However, more and more people present mobility limitations. To over come these limitations, power wheelchair is a mobility aid that may become necessary. People who require using a power wheelchair to enable them to be mobile generally have a complex set of motor, cognitive and sensory impairments. In addition, these individuals do not represent a homogeneous group of people. To promote safe and effective use of power wheelchair, the World Health Organization recommends that all new power wheelchair users have to be trained to use their mobility aid. However, available training approaches do not meet the mobility and learning needs of individuals with cognitive impairments. As a result, these individuals are largely excluded from power wheelchair provision before they get a chance to try using a power wheelchair or receiving appropriate training. This thesis assumes that power wheelchair training tailored to the needs of cognitively impaired users would allow future users would have a more independent and safer mobility. The overall objective of this thesis was to develop a power wheelchair training approach for individuals with cognitive impairments. Methodologies: The New Medical Research Council Framework methodological model includes four phases guiding the development of complex health interventions. This model was used to structure the realization of this thesis. The four studies correspond to the first two phases of this methodological model (development and clinical applicability). A scoping review was conducted to explore the relationships between cognitive functioning and power wheelchair use (Chapter 2). A cross-sectional study explored the relationships between power wheelchair use, cognitive functioning, and confidence among experienced power wheelchair users. The variables were assessed by recognized clinical assessment tools (Chapter 3). A mixed-methods approach was realized to co-create an innovative approach to power wheelchaur training for individuals with mobility and cognitive impairments. This study including power wheelchair users, occupational therapists, and researchers used focus groups (Phase 1) and the Delphi method (Phase 2) (Chapter 4). The feasibility and the clinical applicability of the training approach was tested with individuals who had recently been provided a power wheelchair or who had been assessed as requiring additional training prior to being provided a power wheelchair (Chapter 5). Results: Cognitive functioning and perceived confidence are necessary to use a power wheelchair, with cognitive impairments negatively influencing power wheelchair use and user perceived confidence. However, individuals with diverse cognitive impairments can safely use a power wheelchair and can improve their power wheelchair skills if trained is provided (Chapters 2 and 3). These findings formed the theoretical basis for the training approach. The stakeholders of the research project (Phase 1: n=16; Phase 2: n=207) agreed that the power wheelchair training approach should focus on the individual's goals, should be occupation-based, should foster a trusting relationship between the person and the trainer, and should be carried out in a safe, adapted, and real-world environment (Chapter 4). Finally, with few modifications the developed training approach may be applicable in clinical practice(Chapter 5). Conclusion: An innovative power wheelchair training approach adapted for people with cognitive impairment is available. It fills a gap in power wheelchair training. For occupational therapists it expands the training approaches available. For power wheelchair users, this innovative training approach has the potential to improve their performance and confidence when using a power wheelchair. Future studies evaluating the effectiveness of this new training approach on a larger scale and assessing its implementation in clinical practice should be investigated to complete the last two phases of the New Medical Research Council framework

Game-Based Learning, Gamification in Education and Serious Games

The aim of this book is to present and discuss new advances in serious games to show how they could enhance the effectiveness and outreach of education, advertising, social awareness, health, policies, etc. We present their use in structured learning activities, not only with a focus on game-based learning, but also on the use of game elements and game design techniques to gamify the learning process. The published contributions really demonstrate the wide scope of application of game-based approaches in terms of purpose, target groups, technologies and domains and one aspect they have in common is that they provide evidence of how effective serious games, game-based learning and gamification can be

Don’t forget to save! User experience principles for video game narrative authoring tools.

Interactive Digital Narratives (IDNs) are a natural evolution of traditional storytelling melded with technological improvements brought about by the rapidly increasing digital revolution. This has and continues to enhance the complexities and functionality of the stories that we can tell. Video game narratives, both old and new, are considered close relatives of IDN, and due to their enhanced interactivity and presentational methods, further complicate the creation process. Authoring tool software aims to alleviate the complexities of this by abstracting underlying data models into accessible user interfaces that creatives, even those with limited technical experience, can use to author their stories. Unfortunately, despite the vast array of authoring tools in this space, user experience is often overlooked even though it is arguably one of the most vital components. This has resulted in a focus on the audience within IDN research rather than the authors, and consequently our knowledge and understanding of the impacts of user experience design decisions in authoring tools are limited. This thesis tackles the modeling of complex video game narrative structures and investigates how user experience design decisions within IDN authoring tools may impact the authoring process. I first introduce my concept of Discoverable Narrative which establishes a vocabulary for the analysis, categorization, and comparison of aspects of video game narrative that are discovered, observed, or experienced by players — something that existing models struggle to detail. I also develop and present my Novella Narrative Model which provides support for video game narrative elements and makes several novel innovations that set it apart from existing narrative models. This thesis then builds upon these models by presenting two bespoke user studies that examine the user experience of the state-of-the-art in IDN authoring tool design, together building a listing of seven general Themes and five principles (Metaphor Testing, Fast Track Testing, Structure, Experimentation, Branching) that highlight evidenced behavioral trends of authors based on different user experience design factors within IDN authoring tools. This represents some of the first work in this space that investigates the relationships between the user experience design of IDN authoring tools and the impacts that they can have on authors. Additionally, a generalized multi-stage pipeline for the design and development of IDN authoring tools is introduced, informed by professional industry- standard design techniques, in an effort to both ensure quality user experience within my own work and to raise awareness of the importance of following proper design processes when creating authoring tools, also serving as a template for doing so