Evaluation of user satisfaction and usability of a mobile app for smoking cessation

Background Mobile apps have a great potential to support patients in healthcare, and to encourage healthy behavioral changes such as smoking cessation. Nevertheless, the user rejection levels are still high. A set of factors that has impact on the app effectiveness is related to the quality of those features that lead to positive user experiences when using the app. This work aims to evaluate the user experience, and more specifically the usability and the user satisfaction with a mobile application for smoking cessation. This will also provide a basis for future improvements. Methods We provided a smoking cessation mobile Android app to two different user cohorts, the smokers as valid users and the experts, for three weeks. The app featured usual functionalities to help quit smoking, including an achieved benefits section, mini-games to distract during cravings, and supportive motivational messages. We collected information about user experience, through game playability and message satisfaction questionnaires, and the experts’ opinions. We also considered usage of app sections, the duration of the mini-game sessions, and the user ratings for motivational messages. Results We included 45 valid users and 25 experts in this study. The questionnaire indicated 80% satisfaction rate for the motivational messages. According to game questionnaires, over 69% of the participants agreed that the games have good usability features, however, for questions related to mobility and gameplay heuristics, agreements were below 67%. The most accessed app sections were achieved benefits and the one with motivational messages. The experts described issues that could help to improve the application. Conclusions The combination of questionnaires with expert reports allowed to identify several problems and possible corrections. Our study showed that motivational messages have a good satisfaction rate, although it is necessary to consider technical features of some mobile devices that may hinder message reception. Games have good usability and it's expected that the addition of difficulty levels and a better accessibility to the game menu could make them more attractive and increase its usage. Future development of mHealth apps based on gamification and motivational messages need to consider these factors for better user satisfaction and usability.European Union's Horizon 2020 No 68112

Opening the Black Box: Explaining the Process of Basing a Health Recommender System on the I-Change Behavioral Change Model

Recommender systems are gaining traction in healthcare because they can tailor recommendations based on users' feedback concerning their appreciation of previous health-related messages. However, recommender systems are often not grounded in behavioral change theories, which may further increase the effectiveness of their recommendations. This paper's objective is to describe principles for designing and developing a health recommender system grounded in the I-Change behavioral change model that shall be implemented through a mobile app for a smoking cessation support clinical trial. We built upon an existing smoking cessation health recommender system that delivered motivational messages through a mobile app. A group of experts assessed how the system may be improved to address the behavioral change determinants of the I-Change behavioral change model. The resulting system features a hybrid recommender algorithm for computer tailoring smoking cessation messages. A total of 331 different motivational messages were designed using 10 health communication methods. The algorithm was designed to match 58 message characteristics to each user pro le by following the principles of the I-Change model and maintaining the bene ts of the recommender system algorithms. The mobile app resulted in a streamlined version that aimed to improve the user experience, and this system's design bridges the gap between health recommender systems and the use of behavioral change theories. This article presents a novel approach integrating recommender system technology, health behavior technology, and computer-tailored technology. Future researchers will be able to build upon the principles applied in this case study.European Union's Horizon 2020 Research and Innovation Programme under Grant 68112

Using the Social-Local-Mobile App for Smoking Cessation in the SmokeFreeBrain Project: Protocol for a Randomized Controlled Trial

Background: Smoking is considered the main cause of preventable illness and early deaths worldwide. The treatment usually prescribed to people who wish to quit smoking is a multidisciplinary intervention, combining both psychological advice and pharmacological therapy, since the application of both strategies significantly increases the chance of success in a quit attempt. Objective: We present a study protocol of a 12-month randomized open-label parallel-group trial whose primary objective is to analyze the efficacy and efficiency of usual psychopharmacological therapy plus the Social-Local-Mobile app (intervention group) applied to the smoking cessation process compared with usual psychopharmacological therapy alone (control group). Methods: The target population consists of adult smokers (both male and female) attending the Smoking Cessation Unit at Virgen del Rocío University Hospital, Seville, Spain. Social-Local-Mobile is an innovative intervention based on mobile technologies and their capacity to trigger behavioral changes. The app is a complement to pharmacological therapies to quit smoking by providing personalized motivational messages, physical activity monitoring, lifestyle advice, and distractions (minigames) to help overcome cravings. Usual pharmacological therapy consists of bupropion (Zyntabac 150 mg) or varenicline (Champix 0.5 mg or 1 mg). The main outcomes will be (1) the smoking abstinence rate at 1 year measured by means of exhaled carbon monoxide and urinary cotinine tests, and (2) the result of the cost-effectiveness analysis, which will be expressed in terms of an incremental cost-effectiveness ratio. Secondary outcome measures will be (1) analysis of the safety of pharmacological therapy, (2) analysis of the health-related quality of life of patients, and (3) monitoring of healthy lifestyle and physical exercise habits. Results: Of 548 patients identified using the hospital’s electronic records system, we excluded 308 patients: 188 declined to participate and 120 did not meet the inclusion criteria. A total of 240 patients were enrolled: the control group (n=120) will receive usual psychopharmacological therapy, while the intervention group (n=120) will receive usual psychopharmacological therapy plus the So-Lo-Mo app. The project was approved for funding in June 2015. Enrollment started in October 2016 and was completed in October 2017. Data gathering was completed in November 2018, and data analysis is under way. The first results are expected to be submitted for publication in early 2019. Conclusions: Social networks and mobile technologies influence our daily lives and, therefore, may influence our smoking habits as well. As part of the SmokeFreeBrain H2020 European Commission project, this study aims at elucidating the potential role of these technologies when used as an extra aid to quit smoking

Application of Robot Programming to the Teaching of Object-Oriented Computer Languages

Object-oriented programming (OOP) abstract concepts are often difficult to understand for students, since it is not easy to find the equivalence of such concepts in daily life. In this paper we will study if an interdisciplinary approach based on an introduction to robotics and robot programming helps the student in acquiring theOOPconcepts. For our experiments, we selected a sample of thirty individuals among students with an adequate knowledge of procedural programming. This sample was divided into two groups of fifteen students each: for the first one we used a standard introductory approach to C#, whereas for the second one we developed an experimental course that included a demonstration program that illustrated OOP basic concepts using the features of a specific type of commercial ball-shaped robot with sensing, wireless communication and output capabilities. After the courses, both groups were evaluated by completing a multiple-choice exam and aC#programming exercise. Our results show that the student group that attended the course including the robot demo showed a higher interest level (i.e. they felt more motivated) than those students that attended the standard introductory C# course. Furthermore, the students from the experimental group also achieved an overall better mark

Análisis energético e impactos de uso de agua de la producción de biomasa seca de microalgas en fotobiorreactores

Los problemas ambientales asociados al uso de combustibles fósiles sitúan a los biocombustibles como una importante fuente de energía alternativa. Las microalgas han sido señaladas como la fuente de biomasa óptima para la obtención de biodiesel. No obstante, en algunos estudios ambientales y energéticos, los resultados hallados no confirman su superioridad frente a otras fuentes de biomasa. Este trabajo tiene como objetivos realizar un análisis energético y evaluar los impactos por el uso del agua de la producción de biomasa seca de microalgas cultivadas en un fotobiorreactor piloto, construido en la Universidad Federal de Paraná (Brasil). Los resultados muestran que esta producción genera una pérdida neta de energía, mientras que su impacto por el uso del agua es menor que el asociado a otras fuentes. Por lo tanto, es necesario mejorar el proceso de producción para que el balance energético sea positivo, permitiendo considerar a las microalgas como una fuente real de energía.The environmental problems associated with the use of fossil fuels has wakened up great scientific and technological interest for the potential use of biofuels as an alternative energy source. Several studies have pointed to microalgae as the major biomass source for biodiesel production. However, in some environmental and energetic studies, the results do not confirm microalgae superiority over other biomass sources. The aims of this study are to perform an energetic analysis and to assess the impacts for water use in the production of microalgae dry biomass grown in a pilot photobioreactor, built in the Federal University of Paraná (Brazil). The results confirm that this production causes a net energy loss, while its impact for water use is lower than the impact reported for other sources. Therefore, it is necessary to enhance the production process to make the energetic balance positive, turning microalgae into a real source of energy.Tema 6: Energía eólica, geotermia, biomasa y otras energías no convencionales.Facultad de Arquitectura y Urbanism

Análisis energético e impactos de uso de agua de la producción de biomasa seca de microalgas en fotobiorreactores

Los problemas ambientales asociados al uso de combustibles fósiles sitúan a los biocombustibles como una importante fuente de energía alternativa. Las microalgas han sido señaladas como la fuente de biomasa óptima para la obtención de biodiesel. No obstante, en algunos estudios ambientales y energéticos, los resultados hallados no confirman su superioridad frente a otras fuentes de biomasa. Este trabajo tiene como objetivos realizar un análisis energético y evaluar los impactos por el uso del agua de la producción de biomasa seca de microalgas cultivadas en un fotobiorreactor piloto, construido en la Universidad Federal de Paraná (Brasil). Los resultados muestran que esta producción genera una pérdida neta de energía, mientras que su impacto por el uso del agua es menor que el asociado a otras fuentes. Por lo tanto, es necesario mejorar el proceso de producción para que el balance energético sea positivo, permitiendo considerar a las microalgas como una fuente real de energía.The environmental problems associated with the use of fossil fuels has wakened up great scientific and technological interest for the potential use of biofuels as an alternative energy source. Several studies have pointed to microalgae as the major biomass source for biodiesel production. However, in some environmental and energetic studies, the results do not confirm microalgae superiority over other biomass sources. The aims of this study are to perform an energetic analysis and to assess the impacts for water use in the production of microalgae dry biomass grown in a pilot photobioreactor, built in the Federal University of Paraná (Brazil). The results confirm that this production causes a net energy loss, while its impact for water use is lower than the impact reported for other sources. Therefore, it is necessary to enhance the production process to make the energetic balance positive, turning microalgae into a real source of energy.Tema 6: Energía eólica, geotermia, biomasa y otras energías no convencionales.Facultad de Arquitectura y Urbanism

A Mobile Health Solution Complementing Psychopharmacology-Supported Smoking Cessation: Randomized Controlled Trial

Background: Smoking cessation is a persistent leading public health challenge. Mobile health (mHealth) solutions are emerging to improve smoking cessation treatments. Previous approaches have proposed supporting cessation with tailored motivational messages. Some managed to provide short-term improvements in smoking cessation. Yet, these approaches were either static in terms of personalization or human-based nonscalable solutions. Additionally, long-term effects were neither presented nor assessed in combination with existing psychopharmacological therapies. Objective: This study aimed to analyze the long-term efficacy of a mobile app supporting psychopharmacological therapy for smoking cessation and complementarily assess the involved innovative technology. Methods: A 12-month, randomized, open-label, parallel-group trial comparing smoking cessation rates was performed at Virgen del Rocío University Hospital in Seville (Spain). Smokers were randomly allocated to a control group (CG) receiving usual care (psychopharmacological treatment, n=120) or an intervention group (IG) receiving psychopharmacological treatment and using a mobile app providing artificial intelligence–generated and tailored smoking cessation support messages (n=120). The secondary objectives were to analyze health-related quality of life and monitor healthy lifestyle and physical exercise habits. Safety was assessed according to the presence of adverse events related to the pharmacological therapy. Per-protocol and intention-to-treat analyses were performed. Incomplete data and multinomial regression analyses were performed to assess the variables influencing participant cessation probability. The technical solution was assessed according to the precision of the tailored motivational smoking cessation messages and user engagement. Cessation and no cessation subgroups were compared using t tests. A voluntary satisfaction questionnaire was administered at the end of the intervention to all participants who completed the trial. Results: In the IG, abstinence was 2.75 times higher (adjusted OR 3.45, P=.01) in the per-protocol analysis and 2.15 times higher (adjusted OR 3.13, P=.002) in the intention-to-treat analysis. Lost data analysis and multinomial logistic models showed different patterns in participants who dropped out. Regarding safety, 14 of 120 (11.7%) IG participants and 13 of 120 (10.8%) CG participants had 19 and 23 adverse events, respectively (P=.84). None of the clinical secondary objective measures showed relevant differences between the groups. The system was able to learn and tailor messages for improved effectiveness in supporting smoking cessation but was unable to reduce the time between a message being sent and opened. In either case, there was no relevant difference between the cessation and no cessation subgroups. However, a significant difference was found in system engagement at 6 months (P=.04) but not in all subsequent months. High system appreciation was reported at the end of the study. Conclusions: The proposed mHealth solution complementing psychopharmacological therapy showed greater efficacy for achieving 1-year tobacco abstinence as compared with psychopharmacological therapy alone. It provides a basis for artificial intelligence–based future approaches. Trial Registration: ClinicalTrials.gov NCT03553173; https://clinicaltrials.gov/ct2/show/NCT03553173 International Registered Report Identifier (IRRID): RR2-10.2196/12464H2020 European Commission research and innovation program grant agreement 68112

Venezuela, April 2002: Coup or Popular Rebellion? The Myth of a United Venezuela

This article assesses the merits of opposing National Assembly reports into the coup against President Chavez of Venezuela in April 2002. Looking at the historical context and the content of the reports, it argues that the two opposing accounts reflect a class division that has always existed in Venezuela but has been officially denied. It concludes that a possible exit from the stalemate could be that the opposition accept the reality of this class division and therefore the Chavez government as a legitimate representative of the popular classes. This, however, is unlikely in the present circumstances

Fragmentation of Contaminant and Endogenous DNA in Ancient Samples Determined by Shotgun Sequencing; Prospects for Human Palaeogenomics

Despite the successful retrieval of genomes from past remains, the prospects for human palaeogenomics remain unclear because of the difficulty of distinguishing contaminant from endogenous DNA sequences. Previous sequence data generated on high-throughput sequencing platforms indicate that fragmentation of ancient DNA sequences is a characteristic trait primarily arising due to depurination processes that create abasic sites leading to DNA breaks